More Arthroplasty for Hip Osteoarthritis With Dairy

July 10, 2017

Consumption increases risk in men. Understanding the mechanisms may help identify prevention strategies.

Increased consumption of dairy products is associated with increased risk of total hip arthroplasty for osteoarthritis in men, a new study found. No significant association was observed for women.

Researchers in Australia evaluated data in the Melbourne Collaborative Cohort Study in an analysis published online May 15 in The Journal of Rheumatology.

Led by Sultana Monira Hussain, PhD, of Monash University in Australia, the investigators had the primary goals of assessing the impact of dairy consumption on total hip arthroplasty for osteoarthritis in general and exploring potential differences between men and women.

An estimated 1 in 4 persons will have symptomatic hip osteoarthritis in their lifetime. Given the burden of hip osteoarthritis for both patients and society, identifying modifiable risk factors like diet may help reduce the incidence and prevalence of hip osteoarthritis in the population.

Prior research suggested that small changes in bone geometry are involved in the development of hip osteoarthritis. Although dairy products are an important source of dietary calcium and are needed to maintain bone health, dairy consumption may have adverse effects. For example, higher milk consumption is hypothesized to affect hip bone geometry by reducing bone turnover and resorption.

To date, no known study has evaluated the relationship between dairy product consumption and risk of total hip arthroplasty for osteoarthritis.

The study

This was a prospective cohort study of 41,514 participants, aged 27 to 75 years, recruited as part of the Melbourne Collaborative Cohort Study between 1990 and 1994. Dietary data were collected at baseline with a 121-item food frequency questionnaire. The 12 dairy-related foods items were cottage cheese, ricotta cheese, feta cheese, low fat cheese, low cholesterol cheese, hard grating cheese, cream cheese, cheddar or similar cheese, ice cream, custard, cream or sour cream, yogurt, and milk. Other data included demographic, lifestyle, and anthropometric factors and circulating 25-hydroxy vitamin D.

Incidence of total hip arthroplasty for osteoarthritis was assessed between 2001 and 2013 by linking participants in the cohort to the Australian Orthopaedic Association National Joint Replacement Registry. An incident case was defined as the first recorded primary total joint arthroplasty being a total hip arthroplasty for osteoarthritis.

A total of 1505 total hip arthroplasties for osteoarthritis were identified over the 11.8-year follow-up period, representing 524 men and 981 women.

For men and women alike who underwent total hip arthroplasty, participants were older with a greater BMI, more likely to be a nonsmoker, and less physically active.

Findings

Men who had hip arthroplasty had consumed more dairy products and calcium than women. Specifically for men, a 1 SD increase in dairy product consumption was associated with a 21% increased risk of total hip arthroplasty for osteoarthritis (HR 1.21, 95% CI, 1.10–1.33). There was also a dose-response relationship between increasing quartiles of dairy product consumption and the risk of hip arthroplasty for osteoarthritis (p for the trend = 0.001). 

In women, there was no significant relationship between dairy consumption and risk of total hip arthroplasty for osteoarthritis.

“We found a sex difference in the association between dairy product consumption and the incidence of hip OA,” wrote Hussain and study team. “It may be that other factors, such as hormones, have a greater effect on bone metabolism in women of this age group than in men.”

Understanding the mechanisms may help identify hip osteoarthritis prevention strategies, particularly for men, the authors concluded.

Disclosures:

The recruitment of the Melbourne Collaborative Cohort Study was funded by VicHealth and Cancer Council Victoria. This research was further supported by Australian National Health and Medical Research Council, as well as infrastructure provided by Cancer Council Victoria.

References:

Sultana Monira Hussain, Flavia M. Cicuttini, Graham G. Giles, et al. “Association between Dairy Product Consumption and Incidence of Total Hip Arthroplasty for Osteoarthritis.” J Rheumatol. 2017;44:1066-1070. doi: 10.3899/jrheum.161395. Epub 2017 May 15.