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World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2019): Special Lectures Abstracts # International Osteoporosis Foundation and National Osteoporosis Foundation 2019 SL1 BEYOND NUTRIENTS: HEALTH EFFECTS OF THE DAIRY MATRIX A. Astrup Department Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark Nutrition recommendations have historically focused on nutrients, and are typically constructed to ensure that diet meets requirements for individual nutrients. Translation of nutritional requirements to dietary guidance has typically resulted in advice such as “reduce intake of cholesterol and saturated fat”. However, people consume foods not nutrients, and translation from individual nutrients to foods has proven problematic. Recent research has shown that saturated fat (SAT) does not exert the adverse effect on cardiovascular disease (CVD) previously thought, and that the various saturated fatty acids exert very different biological effects, which are substantially modified by the foodmatrix. One example is cheese, whichmight be expected to increase CVD risk due to high content of SAT and sodium, but studies indicate the opposite, with a reduction in blood pressure, and reduced risk of CVD and particularly of stroke. The evidence for reducing sodium is also challenged, as the lowering of blood pressure achieved by reducing salt intake is modest, even in hypertensives. Another example is from two large observational studies from Harvard, which found that each serving of milk per day was associated with an 8% lower risk of hip fracture (RR = 0.92). It is interesting that the effect could not be explained by the intake of calcium, vitamin D and protein from dairy, as adjustment for these nutrients did not weaken the association. This observation supports that other nutrients, or interactions within the dairy matrix, are responsible for the effect on skeletal health. It makes good sense to base dietary guidelines on foods, but these prove impossible to formulate at a global or even a regional level. Genetically, racially, ethically, and culturally different people, living in different geographical areas, eat different foods due to tradition and differences in availability. The nutrient content of any particular food may vary dramatically depending on the composition of the cultivars involved. Some of these differences may have consequences for nutrition guidelines for local populations, for harmonizing guidelines across countries, and for the health maintenance/disease prevention outcomes of the guidelines. Thus, the impact of the food matrix on health complicates the definition of dietary advice. Potential conflicts of interest AA is co-chair of the Expert Workshop on the Dairy Matrix in Relation to Musculoskeletal Health 2019, supported by an unrestricted grant from the European Milk Forum In the past 24 months he has acted as consultant for Nestlé Research Center, Switzerland. He is recipient of travel grants and honoraria as speaker for a wide range of Danish and international concerns. AA is co-inventor of a number of patents owned by UCPH, in accordance with Danish law. AA is not advocate or activist for specific diets, and is not strongly committed to any specific diet, e.g. veganism, Atkins diet, gluten-free diet, high animal protein diet, or dietary supplements. SL2 EUROPEAN GUIDANCE FOR THE DIAGNOSIS AND MANAGEMENT OF OSTEOPOROS I S I N POSTMENOPAUSALWOMEN J. A. Kanis, C. Cooper, R. Rizzoli, J.-Y. Reginster, on behalf of the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF) Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, United Kingdom, MaryMcKillop Health Institute, Australian Catholic University, Melbourne, Australia, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium, Chair for Biomarkers and Chronic Diseases, Biochemistry Osteoporosis International (2019) 30 (Suppl 2):S153–S155 https://doi.org/10.1007/s00198-019-04987-8