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American Journal of Epidemiology Advance Access originally published online on November 21, 2007
American Journal of Epidemiology 2008 167(4):406-411; doi:10.1093/aje/kwm320
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Childhood Cod Liver Oil Consumption and Bone Mineral Density in a Population-based Cohort of Peri- and Postmenopausal Women

The Nord-Trøndelag Health Study

Siri Forsmo1, Sigurd Kjørstad Fjeldbo2 and Arnulf Langhammer1

1 Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
2 Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

Correspondence to Dr. Siri Forsmo, Department of Public Health and General Practice, Medisinsk-teknisk senter, N-7489 Trondheim, Norway (e-mail: siri.forsmo{at}ntnu.no).

Received for publication April 27, 2007. Accepted for publication October 1, 2007.

Use of cod liver oil, which is rich in vitamins A and D, is traditionally recommended during the fall and winter months as a protective measure against vitamin D deficiency in several countries. It is not known whether childhood cod liver oil intake is related to variations in bone mineral density (BMD) or fractures in adult life. In 2001, a total of 3,052 Norway women aged 50–70 years had forearm BMD measured in a substudy of the population-based Nord-Trøndelag Health Study. Women reporting no childhood cod liver oil intake had statistically significantly higher BMD than those with any ingestion of cod liver oil. The odds ratio for low BMD (>1 standard deviation below age-specific mean) in women reporting cod liver oil intake throughout the year as compared with women with no intake was 2.3 (95% confidence interval: 1.4, 3.9), adjusted for body mass index, smoking, menopausal status, estrogen use, and current milk consumption. There were indications of a negative dose-response effect of childhood cod liver oil intake on bone. Although the vitamin A content of commercial cod liver oil was recently reduced by 75% in Norway, the past high concentration remains a possible explanation for the observed negative association between childhood cod liver oil intake and forearm BMD.

bone density; cod liver oil; densitometry; menopause; public health; vitamin A; vitamin D; women


Abbreviations: BMD, bone mineral density; HUNT, Nord-Trøndelag Health Study


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