Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: Dose-response meta-analysis of prospective cohort studies

Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 11/2010; 93(1):158-71. DOI: 10.3945/ajcn.2010.29866
Source: PubMed


The consumption of dairy products may influence the risk of cardiovascular disease (CVD) and total mortality, but conflicting findings have been reported.
The objective was to examine the associations of milk, total dairy products, and high- and low-fat dairy intakes with the risk of CVD [including coronary heart disease (CHD) and stroke] and total mortality.
PubMed, EMBASE, and SCOPUS were searched for articles published up to February 2010. Of > 5000 titles evaluated, 17 met the inclusion criteria, all of which were original prospective cohort studies. Random-effects meta-analyses were performed with summarized dose-response data. Milk as the main dairy product was pooled in these analyses.
In 17 prospective studies, there were 2283 CVD, 4391 CHD, 15,554 stroke, and 23,949 mortality cases. A modest inverse association was found between milk intake and risk of overall CVD [4 studies; relative risk (RR): 0.94 per 200 mL/d; 95% CI: 0.89, 0.99]. Milk intake was not associated with risk of CHD (6 studies; RR: 1.00; 95% CI: 0.96, 1.04), stroke (6 studies; RR: 0.87; 95% CI: 0.72, 1.05), or total mortality (8 studies; RR per 200 mL/d: 0.99; 95% CI: 0.95, 1.03). Limited studies of the association of total dairy products and of total high-fat and total low-fat dairy products (per 200 g/d) with CHD showed no significant associations.
This dose-response meta-analysis of prospective studies indicates that milk intake is not associated with total mortality but may be inversely associated with overall CVD risk; however, these findings are based on limited numbers.

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    • "Due to its high concentration of saturated fatty acids, dairy fat intake has been associated with increased risk of cardiovascular diseases and type 2 diabetes in humans [1,2]. However, recent meta-analysis of data from prospective cohort-studies shows an inverse association between intake of dairy products and the incidence of both cardiovascular diseases and type 2 diabetes [3], and available data do not indicate any increased risk of high-fat dairy products compared to low-fat dairy products [4]. Similarly, studies using the odd-chained fatty acids C15:0 and C17:0 as validated biomarkers of dairy fat intake showed that a higher intake of dairy fat was associated with a decreased risk of myocardial-infarction and development of the metabolic syndrome [5-8]. "
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    ABSTRACT: Background Phytanic acid (PA) is a chlorophyll metabolite with potentials in regulating glucose metabolism, as it is a natural ligand of the peroxisome proliferator-activated receptor (PPAR) that is known to regulate hepatic glucose homeostasis. This study aimed to establish primary porcine myotubes as a model for measuring glucose uptake and glycogen synthesis, and to examine the impact of physiological amounts of PA on glucose uptake and glycogen synthesis either alone or in combination with insulin. Methods Porcine satellite cells were cultured into differentiated myotubes and tritiated 2-deoxyglucose (2-DOG) was used to measure glucose uptake, in relation to PA and 2-DOG exposure times and also in relation to PA and insulin concentrations. The MIXED procedure model of SAS was used for statistical analysis of data. Results PA increased glucose uptake by approximately 35%, and the presence of insulin further increased the uptake, but this further increase in uptake was non- additive and less pronounced at high insulin concentrations. There was no effect of PA alone on glycogen synthesis, while the insulin stimulation of glycogen was increased by 20% in the presence of PA. PA neither stimulated glucose uptake nor glycogen synthesis in insulin-resistant myotubes generated by excess glucose exposure. Conclusions Primary porcine myotubes were established as a model of skeletal muscles for measuring glucose uptake and glycogen synthesis, and we showed that PA can play a role in stimulating glucose uptake at no or inadequate insulin concentrations.
    Lipids in Health and Disease 02/2013; 12(1):14. DOI:10.1186/1476-511X-12-14 · 2.22 Impact Factor
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    • "The association of fermented milk and nonfermented milk with risk of total stroke events was 0.80 (0.71e0.89) and 1.02 (0.89e1.17), but the difference was not significant (P Z 0.09). For doseeresponse analysis, dairy milk was estimated to be on average 200 ml for each serving [32]. Data from 6 studies [22,24e28] including 16 715 stroke cases were included. "
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    ABSTRACT: Background and Aims Epidemiological studies evaluating the association of dairy foods with risk of stroke have produced inconsistent results. We conducted a meta-analysis to summarize the evidence from prospective cohort studies regarding the association between dairy foods and risk of stroke. Methods and Results Pertinent studies were identified by searching Embase (1950-November, 2013), Web of Knowledge (1950-November, 2013) and Pubmed (1945- November, 2013). Random-effect model was used to combine the results. Dose-response relationship was assessed by restricted cubic spline. Eighteen separate results from fifteen prospective cohort studies, with 28 138 stroke events among 764 635 participants, were included. Total dairy [relative risk (95% CI): 0.88 (0.82-0.94)], low-fat dairy [0.91 (0.85-0.97)], fermented milk [0.80 (0.71-0.89)] and cheese [0.94 (0.89-0.995)] were significantly associated with reduced risk of stroke, but whole/high-fat dairy, nonfermented milk, butter and cream were not significantly associated with risk of stroke. Stronger association was found for stroke mortality than incidence, and for studies conducted in Asia than Europe, while the association did not differ significantly by sex. Limited data did not find any significant association with either ischemic or hemorrhagic stroke. A non-linear dose-response relationship (P=2.80*10-13) between milk and risk of stroke was found, and the relative risk of stroke was 0.88 (0.86-0.91), 0.82 (0.79-0.86), 0.83 (0.79-0.86), 0.85 (0.81-0.89), 0.86 (0.82-0.91), 0.91 (0.84-0.98) and 0.94 (0.86-1.02) for 100, 200, 300, 400, 500, 600 and 700 ml/day of milk, respectively. Conclusions Dairy foods might be inversely associated with the risk of stroke.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 01/2013; 24(5). DOI:10.1016/j.numecd.2013.12.006 · 3.32 Impact Factor
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    • "It is currently unclear how these specific dairy products like high-fat dairy, low-fat dairy, cheese, or fermented dairy are associated with CVD. This is also supported by review articles and meta-analysis papers [16–21]. Some state that there is no clear evidence that higher dairy food consumption is consistently associated with a higher risk of CVD [17–19]. "
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    ABSTRACT: Purpose Existing data from prospective cohort studies on dairy consumption and cardiovascular diseases are inconsistent. Even though the association between total dairy and cardiovascular diseases has been studied before, little is known about the effect of different types of dairy products on cardiovascular diseases (CVD). The objective of this study was to examine the relationship between (type of) dairy intake and CVD mortality and all-cause mortality in a Dutch population. Methods We examined the relationship between dairy intake and CVD mortality and all-cause mortality in 1956 participants of the Hoorn Study (aged 50–75 years), free of CVD at baseline. Hazard ratios with 95 % CIs were obtained for CVD mortality and all-cause mortality per standard deviation (SD) of the mean increase in dairy intake, with adjustment for age, sex, BMI, smoking, education, total energy intake, alcohol consumption, physical activity, and dietary intakes. Results During 12.4 years of follow-up, 403 participants died, of whom 116 had a fatal CVD event. Overall dairy intake was not associated with CVD mortality or all-cause mortality. Each SD increase in high-fat dairy intake was associated with a 32 % higher risk of CVD mortality (95 % CI; 7–61 %). Conclusion In this prospective cohort study, the intake of high-fat dairy products was associated with an increased risk of CVD mortality.
    European Journal of Nutrition 05/2012; 52(2). DOI:10.1007/s00394-012-0363-z · 3.47 Impact Factor
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