Is it time to rethink dairy? Here’s what 25 years of research reveals for women

By Priyanjana Pramanik, MSc.Reviewed by Susha Cheriyedath, M.Sc.Jun 10 2025

Could your daily glass of milk really help prevent fractures as you age? This landmark Finnish study uncovers how different dairy choices impact bone strength and hip fracture risk in older women.

​​​​​​​Study: Long-term consumption of liquid dairy products predicts lower fracture risk in aging women: a 25-year follow-up. Image Credit: Pixel-Shot / Shutterstock

In a recent article published in the European Journal of Nutrition, researchers investigated whether consuming dairy products is associated with a lower long-term risk of fractures among older Finnish women. Their findings indicate that consuming more dairy in liquid form reduces the risk of osteoporotic and other fractures, while cheese is specifically linked to a reduced risk of hip fractures.

Background

Fractures represent a major global public health concern, especially among older adults, due to their association with pain, disability, and early death. Over the last 30 years, fracture rates have risen globally by over 33%, primarily due to population aging.

In Finland alone, osteoporotic fractures are expected to increase by 33% between 2019 and 2034. Osteoporotic fractures, commonly affecting the wrist, hip, and spine, are the most frequent complication of osteoporosis, with about nine million cases annually worldwide. Preventive strategies have therefore focused on modifiable risk factors, including diet.

Dairy products are widely consumed and contain key bone-supporting nutrients such as bioactive compounds, protein, and calcium. However, existing research on their role in preventing fractures has produced mixed results.

While some cohort studies report a protective effect of dairy, particularly milk, on fracture risk, others have found no association or even an increased risk with high milk consumption. A Swedish cohort study notably linked high milk intake to higher fracture risk, further deepening the uncertainty.

One reason for this inconsistency may be the lack of long-term studies with repeated assessments of dairy intake and verified fracture data.

About the study

This study investigated whether the consumption of liquid dairy products and cheese was associated with a reduced risk of fractures over a 25-year period in a large cohort of aging Finnish women. Started in 1989, the study included 14,220 participants who were born between 1932 and 1941.

Respondents reported their dairy intake based on the daily amounts they consumed of liquid dairy items such as yogurt, sour milk, and milk in deciliters, and cheese in slices per day. They reported any fractures they experienced, including the location and timing; these were then validated through medical records.

To focus on the protective role of dairy, the researchers excluded pathological and high-energy fractures, including those resulting from traffic accidents and falls from heights above one meter. Fractures in the shoulder, wrist, spine, or hip were considered osteoporotic injuries.

Researchers also considered other explanatory factors that could influence fracture risk, including physical activity, vitamin D and calcium supplementation, alcohol consumption, medication use affecting the bones, and body mass index (BMI).

The statistical model calculated the time to survival until the end of the study, the last response, death, or the first fracture. Hazard ratios (HRs) were estimated for hip, osteoporotic, and any fractures through proportional hazard models that included time-dependent covariates.

Key findings

This long-term cohort study followed older Finnish women for an average of 17.6 years, resulting in data from 245,005 person-years to investigate the link between dairy consumption and fracture risk.

During the follow-up, 4,358 women reported experiencing any fracture, while 2,326 had osteoporotic fractures and 427 suffered hip fractures.

At baseline, women with higher liquid dairy intake tended to have a higher BMI and lower supplement use. Inversely, higher cheese consumption was associated with lower liquid dairy intake and a lower BMI.

Women who consumed moderate or high amounts of liquid dairy had a significantly reduced risk of any fracture by 23% and 26%, respectively, and osteoporotic fracture by 31% and 36%, respectively, compared to non-consumers.

This protective effect remained significant in time-dependent models and when dairy intake was treated as a continuous variable. However, liquid dairy intake was not associated with an increased risk of hip fractures.

Cheese consumption did not impact the risk of osteoporotic fractures; however, high intake was associated with a significantly reduced risk of hip fractures by 47% in adjusted models. The authors note, however, that the relatively low number of hip fracture events may have limited the statistical power for this analysis. These findings suggest that liquid dairy may protect against general and osteoporotic fractures, while cheese may offer specific protection against hip fractures.

Conclusions

This study showed that a higher intake of liquid dairy products was associated with a reduced risk of osteoporotic and other fractures, but not hip fractures. In contrast, cheese intake showed no association with overall fracture risk but was linked to a reduced risk of hip fractures.

These results align with some cohort and trial data, though previous meta-analyses have yielded inconsistent findings. Biological differences in bone types may partly explain the site-specific effects, as dairy's impact can vary between the trabecular bone, which is common in the spine, and the cortical bone that makes up most of the hip. Factors such as the protein-to-calcium ratio and sodium content in various dairy products may also play a role.

A major strength of the study is its long follow-up and the use of repeated dietary measurements, which allow for time-dependent analyses. However, limitations include a lack of detailed dietary data to distinguish between different types of cheese, potential recall bias from self-reported intake, and the use of binary categorization for supplement use. Additionally, the homogenous population may limit generalizability.

In conclusion, promoting the consumption of liquid dairy products may help lower the risk of fractures in aging populations. The study also suggests a potential threshold effect, where the most significant benefit is achieved when moving from no intake to moderate consumption, with diminishing returns thereafter. However, further research is needed, especially regarding specific cheese types and their impact on bone health.