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Comment & Response |

Early-Life Milk and Late-Life Fracture—Reply

Diane Feskanich, ScD1; Walter C. Willett, MD, DrPH1,2
[+] Author Affiliations
1Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
2Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
JAMA Pediatr. 2014;168(7):683-684. doi:10.1001/jamapediatrics.2014.178.
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In Reply Dr Heaney questioned our adjustment for calcium intake during adult years, which was done because our primary question was the independent contribution of milk intake during adolescence to future risk of hip fracture. However, repeating the analysis without adjustment for adult milk consumption and supplemental calcium intake made little difference. In men, the relative risk associated with each additional glass per day of adolescent milk intake changed from 1.09 (95% CI, 1.01-1.17) to 1.08 (95% CI, 1.00-1.16) and results for women remained null. The lack of confounding by adult intake was not surprising, given that adult milk and calcium intakes are not strongly associated with risk of hip fracture in our cohorts, meta-analyses of prospective studies, or randomized trials of calcium supplements without vitamin D.1,2

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July 1, 2014
Robert P. Heaney, MD
1Creighton University, Omaha, Nebraska
JAMA Pediatr. 2014;168(7):682-683. doi:10.1001/jamapediatrics.2014.172.
July 1, 2014
Robert H. Howland, MD
1University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
JAMA Pediatr. 2014;168(7):683. doi:10.1001/jamapediatrics.2014.175.
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