POSITION STATEMENTS
New Study Suggests Association Between Intake of Dairy Milk with Greater Risk of Breast Cancer
A recent study from the US suggests women who drink as little as one cup /250 ml of cow’s milk per day could be increasing their risk of developing breast cancer by up to 50%. This study from Knutsen and colleagues is part of the Adventist Health Study-2, a large population-based study of Adventists from the US and Canada. The study assessed the relationship between risk of breast cancer and the intake of soy milk, other soy products, dairy milk, and other dairy foods.
This study followed nearly 53,000 women who were members of the Seventh Day Adventist Church for almost 8 years. The authors concluded that as dairy milk intake increased (regardless of fat content) so did the risk of breast cancer. No clear association was found between consumption of soy products and breast cancer.
It should be noted that this was an observational study. In this type of study, researchers observe what effect a risk factor (e.g., soy and dairy) has on health outcomes (e.g., breast cancer) over time. While this type of study can suggest a link (correlation or association) between a risk factor and an outcome, it cannot establish that the risk factor CAUSED the health outcome. In this study, dietary intake of soy and dairy was self-reported, leaving room for errors and omissions. In addition, diet was only assessed once, at the beginning of the study, meaning that possible changes in diet over the 8 years were not taken into account. The study also does not take into account other potential risk factors that could affect the outcome, such as quality of diet (fruit and vegetable intake was not measured); amount or intensity of physical activity; quantity of alcohol consumed; or amount smoked. Furthermore, Adventists diet may differ considerably from the general population as many follow a plant-based diet and exclude processed foods, alcohol, and caffeine, so it is difficult to know if these results can be applied to the general population.
The authors note that dairy milk has many positive nutritional qualities and suggest more research is needed to understand if there is a causal link between dairy intake or other closely related unidentified factors and breast cancer risk. Until then, a balanced and a varied diet including sources of calcium, regular physical activity, and avoiding smoking and excess alcohol make for a healthy lifestyle.
Osteoporosis Canada recommends that men and women over the age of 50 get 1000-1200 mg of calcium through all sources (diet and supplements). Information on non-dairy sources of calcium is available from the Calcium Calculator on the OC website.
https://osteoporosis.ca/bone-health-osteoporosis/calcium-calculator/#page-1
1. Dairy, soy, and risk of breast cancer: those confounded milks. Fraser GE, Jaceldo-Siegl K, Orlich M, Mashchak A, Sirirat R, Knutsen S. Int J Epidemiol. 2020 Feb 25. pii: dyaa007. doi: 10.1093/ije/dyaa007.
New Study Associates Intake of Dairy Milk with Greater Risk of Breast Cancer
Dairy, soy, and risk of breast cancer: those confounded milks
https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyaa007/5743492#199259276
Dairy, soy, and risk of breast cancer: those confounded milks Gary E Fraser, Karen Jaceldo-Siegl, Michael Orlich, Andrew Mashchak, Rawiwan Sirirat, Synnove Knutsen International Journal of Epidemiology, 25 February 2020
Recent media headlines point to a study suggesting that women who drink as little as one cup /250 ml of cow’s milk per day could be increasing their risk of developing breast cancer by up to 50%. This study is part of the Adventist Health Study, by Synnove Knutsen et al, from Loma Linda University and published in the International Journal of Epidemiology. https://doi.org/10.1093/ije/dyaa007 . The study evaluated associations between intakes of soy milk, other soy products, dairy milk and other dairy foods with risk of breast cancer.
This study followed nearly 53,000 Adventist women for 7.9 years focusing on the relative risk of a rare outcome. The authors concluded that as cow’s milk intake increased, regardless of fat level, so did the risk of breast cancer. No clear associations were found between consumption of soy products and breast cancer.
Weaknesses of this study are its observational design (cause and effect cannot be established) and possible residual confounding between dairy and unmeasured factors, despite extensive covariate adjustment. (1) Diet was measured only once at study baseline leaving room for error and omissions. Whether these results can be applied to other populations is unknown and therefore difficult to draw conclusions. Adventists lifestyle differ considerably from the general population as many follow a plant based diet and exclude processed foods, alcohol and caffeine.
The authors do note that cow’s milk has many positive nutritional qualities and suggest more research is needed to understand if there is a link between dairy intake or other closely-related unidentified factors and breast cancer risk. Until then, a balanced and a varied diet including sources of calcium, regular physical activity and avoiding smoking and excess alcohol make for a healthy lifestyle.
1. Dairy, soy, and risk of breast cancer: those confounded milks Gary E Fraser, Karen Jaceldo-Siegl, Michael Orlich, Andrew Mashchak, Rawiwan Sirirat, Synnove Knutsen International Journal of Epidemiology, 25 February 2020
BÜBL X DAVID DIXON LAUNCHES TO A PACKED HOUSE AT TORONTO FASHION WEEK® X RE\SET™
Introducing a fashion line inspired by the two million Canadians affected by osteoporosis
TORONTO, Feb. 6, 2019 – Models clad in stylish bubble wrap strutted down the Toronto Fashion Week® x RE\SET™ runway at last night’s Bübl x DAVID DIXON world-debut at the Royal Ontario Museum. More than 400 guests viewed the collection, but it was only the beginning for Bübl.
A partnership between Osteoporosis Canada and acclaimed fashion designer, David Dixon, Bübl x DAVID DIXON incorporates bubble wrap – a universal symbol for protection – into runway pieces inspired by the two million Canadians affected by osteoporosis.
“I am thrilled to be partnering with Osteoporosis Canada to bring awareness to bone health,” says Dixon. “A big part of my job as a designer is to take the invisible and make it visible; that’s exactly what Bübl will do for this largely unseen disease.”
For those who missed the Toronto Fashion Week® x RE\SET™ premier, photos can be found here and the Bübl collection is viewable online at BüblFashion.ca. For Torontonians, Yorkville Village, on the top floor of 55 Avenue Road, will host select pieces for the next two weeks.
Alongside Bübl, Osteoporosis Canada has many resources aimed at raising awareness around bone health. Since 1982, the organization has supported those living with the disease, helping drive awareness, research, and advances in treatment.
“We are on a mission to make Canadians unbreakable,” says Dr. Famida Jiwa, President and CEO, Osteoporosis Canada. “Osteoporosis affects two million Canadians, including many young people that do not realize the risks they face; so, it is imperative that we reach a new generation and younger audience; David Dixon and Toronto Fashion Week® x RE\SET™ will help us do just that.”
Because many Canadians don’t realize the risks they face, Osteoporosis Canada launched the Know Your Risk quiz. A simple quiz, it identifies personal risk factors and helps Canadians work with their doctors to protect themselves.
Visit bublfashion.ca to find out more and take the Know Your Risk quiz (it’s the stylish thing to do).
About Osteoporosis Canada
Osteoporosis Canada is the only national organization serving people affected by osteoporosis. The organization works to educate, empower and support individuals and communities on bone health and in the risk-reduction and treatment of osteoporosis.
Commonly referred to as the “silent thief,” osteoporosis is an incurable disease that can cause bones to weaken over time, without any signs or symptoms leading to increased risk of breaking a bone.
Osteoporosis Canada provides medically accurate information to patients, health care professionals and the public. The organization has established clinical practice guidelines and long-term care and exercise recommendations. The Scientific Advisory Council (SAC) is made up of experts in osteoporosis and bone metabolism and is a volunteer membership. Comprised of clinicians, researchers and educators, the SAC advises Osteoporosis Canada’s board and staff on scientific and medical issues.
Two million Canadians are affected by osteoporosis and many do not even know they are at risk of the disease and the fractures it causes. Understanding the risk factors associated with osteoporosis can lead to early detection and improved management of the condition.
Website: osteoporosis.ca
About David Dixon
David Dixon goes where no one else does. After graduating from Ryerson University in 1995, he recognized a gap in the Canadian Fashion Industry: women’s contemporary evening wear and event dressing. With that, his eponymous label was born. Today, his designs are sold across Canada and in select boutiques around the globe. David’s latest collection, Bübl x DAVID DIXON, continues his history of breaking new ground in fashion. Throughout his career, David’s innovative designs have won him a following with many in film and fashion, including Meg Ryan, Meagan Follows, Jeanne Beker, Noot Seear, Linda Evangelista, Coco Rocha and more.
Website: daviddixon.ca
About Toronto Fashion Week® x RE\SET™
Toronto Fashion Week® x RE\SET™, an event showcasing fashion, art, music and culture takes place in Yorkville, Toronto’s revitalized and most prestigious luxury retail neighborhood. The bi-annual event hosts national and international designers, entertainers and the fashion community to create a touchpoint where fashion is embraced and celebrated. As the leading fashion event in Canada, Toronto Fashion Week® x RE\SET™ creates a catalyst for media engagement, retail activity and global connectivity.
The founding partners are Yorkville Village, The Hazelton Hotel, Freed Developments and Hill & Gertner – an ownership group comprised of several of the country’s top companies in real estate, development and luxury hospitality.
Website: TFW.to
About RE\SET™
In February 2017, THE COLLECTIONS™ launched RE\SET™ a platform offering designers an opportunity to present their collections direct to consumer and the industry. RE\SET™ currently takes place bi-annually in September and February (prior to New York Fashion Week) and is in partnership with the official Toronto Fashion Week® x RE\SET™ located in Yorkville. RE\SET™ provides designers with a variety of presentation formats including: traditional runway, static presentations, a designer showroom model and has cumulatively featured over 100 participating designers.
Website: reset.fashion
SOURCE Osteoporosis Canada
For further information: Nora.Hickey@edelman.com, 416.850.0679 Ext. 5232 or Maryann.Nasello@Edelman.com, 647.252.2874
RELATED LINKS
Eating for Bone Health with the New Canada’s Food Guide
The new Canada’s Food Guide was released on Tuesday Jan 22nd. It is a modern approach to promoting healthy eating, making healthier eating choices easier for all Canadians. This new food guide focuses on what to eat and how to eat. It also includes updated recommendations on saturated fat, sodium, and sugars.
The food guide focuses on vegetables, fruits, proteins and whole grains. The new food guide encourages Canadians to choose plant-based proteins more often. According to the food guide, protein foods include legumes, nuts, seeds, tofu, fortified soy beverage, fish, shellfish, eggs, poultry, lean red meat including wild game, lower fat milk, lower fat yogurts, lower fat kefir, and cheeses lower in fat and sodium.
Canadians need adequate amounts of calcium, vitamin D and protein for optimal bone health. Milk products contain a high proportion of calcium per serving and are a great source of protein. Calcium can also be found in other foods such as calcium-fortified food and drink, some vegetables and fruits, nuts and seeds, and legumes. For suggestions regarding calcium containing foods, please click here.
Osteoporosis Canada continues to encourage adults who have osteoporosis or have risk factors for osteoporotic fractures, to get adequate vitamin D supplementation as it is difficult to obtain recommended levels through foods alone. Click here for more information on vitamin D.
Increased Risk of Vertebral Fracture After Stopping Denosumab
Denosumab (Prolia) has been shown to reduce the risk of fracture in postmenopausal women and men ≥50 years old with osteoporosis. It has also been approved for steroid induced bone loss.
Individuals who were in the FREEDOM study, which evaluated denosumab in comparison to placebo, were followed, and those who stopped denosumab had a subsequent reduction in bone mineral density (BMD) and an increase in the risk of fracture (Bone JCEM 2011).
Analysis of the data from the FREEDOM study as well as the Extension trial of denosumab up to a total of 10 years, confirmed that stopping denosumab was associated with an increase in rate of bone loss as measured by bone turnover markers, which rose 3 months after missing a scheduled dose. BMD decreased back to the baseline level 12 months after missing a scheduled dose of denosumab (Cummings JBMR 2017).
Individuals who had received ≥2 doses of denosumab or placebo, and stopped treatment but remained in the study for ≥ 7 months after the last dose, were reviewed. In the 1001 patients who stopped denosumab, the rate of spine fractures increased from 1.2/100 patient-years (while on treatment) to 7.1/100 patient-years, a similar rate to the placebo group. Multiple (>1) vertebral fractures appeared to be more common in the group stopping denosumab than the group stopping placebo (3.4% vs 2.2%). The risk of having multiple (>1) vertebral fractures after stopping denosumab was higher in those people who had already experienced a prior spine fracture, and also in those who had rapid rates of bone loss. The rates of non-spine fractures were similar in those stopping denosumab and those stopping placebo (2.8% denosumab, 3.8% placebo) (Cummings et al JBMR 2017).
Due to the increased risk of vertebral fractures associated with denosumab discontinuation, it is important not to miss scheduled doses of denosumab once treatment has started. Patients need to be advised of the increased risk of bone loss and vertebral fracture when therapy is stopped. If denosumab needs to be stopped, it should be replaced by an alternative osteoporosis medication to help prevent rapid bone loss and risk of fractures (Symonds CMAJ April 2018).
Osteoporosis Canada advises individuals on denosumab therapy to discuss their treatment with their physician prior to stopping therapy or missing a scheduled dose.
1. Bone HG et al JCEM 2011:96:972-980
2. Cummings et al JBMR vol 33, No2, Feb 2018 pp 190-198
3. Symonds C, Kline G CMAJ 2018 April 23 :190 pp E485- 486
Prepared by Aliya Khan, Sandra Kim, Rowena Ridout and Lianne Tile, on behalf of the Scientific Advisory Council of Osteoporosis Canada, Rapid Response Committee.
Scientific Advisory Council
Osteoporosis Canada’s rapid response team, made up of members of the Scientific Advisory Council, creates position statements as news breaks regarding osteoporosis. The position statements are used to inform both the healthcare professional and the patient. The Scientific Advisory Council (SAC) is made up of experts in Osteoporosis and bone metabolism and is a volunteer membership.