Background Chronic diseases are prevalent among African Americans (AA) with the likelihood increasing with aging and in postmenopausal women. Diabetes, hypertension, and dyslipidemia are the major risks for cardiovascular disease (CVD) but they also influence bone health among postmenopausal women. It has been suggested that there is a possible common link between CVD and bone health, as studies showed that unfavorable bone health may be higher in people with diabetes, hypertension and dyslipidemia— all major CVD risks. Another factor that may influence both CVD and bone health is the diet and a consumption of dairy foods, particularly the fermented dairy foods like yogurt. It is well established that low dairy consumption might lead to the deficiency of essential nutrients like calcium, magnesium, vitamin D, some B vitamins, protein and omega-3 fatty acids, all crucial in both CVD and bone health. Historically, AA are known to consume low amounts of dairy foods, in comparison to Caucasian Americans (CA), due to either true or perceived lactose intolerance or to some cultural preferences. The purpose of our study was to examine the consumption of fermented dairy foods (emphasis on yogurts) and their association with major CVD risk factors (diabetes, hypertension, and dyslipidemia), as well as the connection with osteopenia/osteoporosis in mid-life and older AA women. Methods African American women (n=70) were recruited from the community centers and events such as health fairs in North Florida. Sample size for some variables varied due to missing data and to have normality. Blood pressure and anthropometrics including weight, height, abdomen, hip and waist circumferences were measured in the standard fashion. Dual-energy x-ray absorptiometry (DXA) was used to assess body composition (fast and lean tissue) and bone mineral density (BMD) at different skeletal sites — (total body, spine, femur, forearm). Fasting blood samples were collected to analyze serum glucose, insulin, triglycerides, cholesterol, HDL, LDL, VLDL, and cholesterol/HDL ratio. The risk for CVD was estimated using the American Heart Association and Framingham Assessments, taking into consideration confounders and clinical variables. Food frequency questionnaire and three-day dietary records were used to assess overall dietary intake from which dairy and yogurt intake was calculated. Habitual physical activity was assessed with a self-reported questionnaire. In addition, the questionnaires to collect information about demographics, medication use and gastrointestinal symptoms were used as well. Nutrition knowledge about dairy foods before and after the educational sessions was assessed using pre- and post-tests. SPSS (version 24) was used to analyze data, including descriptive statistics, t-tests, Pearson correlations, and multiple regression. P<0.05 was deemed significant. Results Study included n=70 AA women who were 63.0±7.7 years old (mean±SD) with a BMI of 32.0±5.0 kg/m2. Approximately 70% of the participants had at least one chronic disease (diabetes, hypertension, and/or dyslipidemia) but only n=4 participants had osteopenia or osteoporosis (T-score for hip and/or spine <-1.0). Approximately 17.1% reported perceived lactose intolerance and over 70% of the participants had gastrointestinal symptoms with varying severity. Calcium intake was 788.3±520.6 mg/day, and yogurt intake amounted to 0.12±0.20 servings/day. Higher yogurt intake was associated with lower blood pressure and LDL. Participants with diabetes, hypertension, and/or dyslipidemia consumed more calcium than those without these diseases (752.1±517.6 mg/day versus 805.0±527.9 mg/day) but less servings of yogurt (0.11±0.20 versus 0.14±0.21). Multiple regression showed that CVD risk was significantly predicted by left femur BMD, age, and systolic blood pressure. Physical activity was positively associated with calcium intake. Also, the most physically active participants consumed significantly (p<0.05) higher amounts of yogurt (servings/day). The nutrition knowledge, based on true/false and multiple-choice questions that participants answered correctly, increased significantly (p<0.05) from pre- to post-test (66.6±14.5% versus 82.1±12.9%). Conclusion Overall, low calcium and yogurt consumption, perceived lactose intolerance, and dairyrelated gastrointestinal symptoms tended to be associated with a higher CVD risk. In addition, decreased yogurt consumption was associated with decreased BMD of the total body. Nutrition knowledge significantly increased after educational session. Based on our results, yogurt consumption benefited CVD risk and related risk factors in addition to bone health (depending on the skeletal site). Nutrition awareness and exposure to information about dairy is likely to help improve the cardiovascular and bone health of the target population. Future research should investigate the influence of blood pressure, diabetes and dyslipidemia on bone health as they seem to be common risk factors for CVD and osteopenia/osteoporosis.
