Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Epidemiology
Published in: European Journal of Epidemiology 4/2017

Open Access 01-04-2017 | META-ANALYSIS

Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose–response meta-analysis of prospective cohort studies

Authors: Jing Guo, Arne Astrup, Julie A. Lovegrove, Lieke Gijsbers, David I. Givens, Sabita S. Soedamah-Muthu

Published in: European Journal of Epidemiology | Issue 4/2017

Login to get access

Abstract

With a growing number of prospective cohort studies, an updated dose–response meta-analysis of milk and dairy products with all-cause mortality, coronary heart disease (CHD) or cardiovascular disease (CVD) have been conducted. PubMed, Embase and Scopus were searched for articles published up to September 2016. Random-effect meta-analyses with summarised dose–response data were performed for total (high-fat/low-fat) dairy, milk, fermented dairy, cheese and yogurt. Non-linear associations were investigated using the spine models and heterogeneity by subgroup analyses. A total of 29 cohort studies were available for meta-analysis, with 938,465 participants and 93,158 mortality, 28,419 CHD and 25,416 CVD cases. No associations were found for total (high-fat/low-fat) dairy, and milk with the health outcomes of mortality, CHD or CVD. Inverse associations were found between total fermented dairy (included sour milk products, cheese or yogurt; per 20 g/day) with mortality (RR 0.98, 95% CI 0.97–0.99; I2 = 94.4%) and CVD risk (RR 0.98, 95% CI 0.97–0.99; I2 = 87.5%). Further analyses of individual fermented dairy of cheese and yogurt showed cheese to have a 2% lower risk of CVD (RR 0.98, 95% CI 0.95–1.00; I2 = 82.6%) per 10 g/day, but not yogurt. All of these marginally inverse associations of totally fermented dairy and cheese were attenuated in sensitivity analyses by removing one large Swedish study. This meta-analysis combining data from 29 prospective cohort studies demonstrated neutral associations between dairy products and cardiovascular and all-cause mortality. For future studies it is important to investigate in more detail how dairy products can be replaced by other foods.
Appendix
Available only for authorised users
Literature
1.
Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, Vollset SE, Ozgoren AA, Abdalla S, Abd-Allah F, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385:117–71.CrossRef
2.
Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation. 2016;133:187–225.CrossRefPubMedCentralPubMed
3.
Lamarche B, Givens DI, Soedamah-Muthu S, Krauss RM, Jakobsen MU, Bischoff-Ferrari HA, Pan A, Després JP. Does milk consumption contribute to cardiometabolic health and overall diet quality? Can J Cardiol. 2016;32:1026–32.CrossRefPubMed
4.
Alexander DD, Bylsma LC, Vargas AJ, Cohen SS, Doucette A, Mohamed M, Irvin SR, Miller PE, Watson H, Fryzek JP. Dairy consumption and CVD: a systematic review and meta-analysis. Br J Nutr. 2016;115:737–50.CrossRefPubMed
5.
Soedamah-Muthu SS, Ding EL, Al-Delaimy WK, Hu FB, Engberink MF, Willett WC, Geleijnse JM. Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr. 2011;93:158–71.CrossRefPubMed
6.
Michaelsson K, Wolk A, Langenskiold S, Basu S, Warensjo Lemming E, Melhus H, Byberg L. Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ. 2014;349:g6015.CrossRefPubMedCentralPubMed
7.
8.
Labos C, Brophy J. Statistical problems with study on milk intake and mortality and fractures. BMJ. 2014;349:g6991.CrossRefPubMed
9.
de Goede J, Soedamah-Muthu SS, Pan A, Gijsbers L, Geleijnse JM. Dairy consumption and risk of stroke: a systematic review and updated dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc. 2016;5:e002787.CrossRefPubMedCentralPubMed
10.
Pimpin L, Wu JH, Haskelberg H, Del Gobbo L, Mozaffarian D. Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality. PLoS ONE. 2016;11:e0158118.CrossRefPubMedCentralPubMed
11.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA. 2000;283:2008–12.CrossRefPubMed
12.
Kahn HA, Phillips RL, Snowdon DA, Choi W. Association between reported diet and all-cause mortality—21-year follow-up on 27,530 adult 7th-day adventists. Am J Epidemiol. 1984;119:775–87.CrossRefPubMed
13.
14.
Appleby PN, Thorogood M, Mann JI, Key TJ. The Oxford Vegetarian Study: an overview. Am J Clin Nutr. 1999;70:525s–31s.PubMed
15.
Bostick RM, Kushi LH, Wu Y, Meyer KA, Sellers TA, Folsom AR. Relation of calcium, vitamin D, and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am J Epidemiol. 1999;149:151–61.CrossRefPubMed
16.
Hu FB, Stampfer MJ, Manson JE, Ascherio A, Colditz GA, Speizer FE, Hennekens CH, Willett WC. Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women. Am J Clin Nutr. 1999;70:1001–8.PubMed
17.
Fortes C, Forastiere F, Farchi S, Rapiti E, Pastori G, Perucci CA. Diet and overall survival in a cohort of very elderly people. Epidemiology. 2000;11:440–5.CrossRefPubMed
18.
Ness AR, Smith GD, Hart C. Milk, coronary heart disease and mortality. J Epidemiol Commun Health. 2001;55:379–82.CrossRef
19.
Al-Delaimy WK, Rimm E, Willett WC, Stampfer MJ, Hu FB. A prospective study of calcium intake from diet and supplements and risk of ischemic heart disease among men. Am J Clin Nutr. 2003;77:814–8.PubMed
20.
Elwood PC, Pickering JE, Fehily AM, Hughes J, Ness AR. Milk drinking, ischaemic heart disease and ischaemic stroke I. Evidence from the Caerphilly cohort. Eur J Clin Nutr. 2004;58:711–7.CrossRefPubMed
21.
Knoops KT, de Groot LC, Fidanza F, Alberti-Fidanza A, Kromhout D, van Staveren WA. Comparison of three different dietary scores in relation to 10-year mortality in elderly European subjects: the HALE project. Eur J Clin Nutr. 2006;60:746–55.CrossRefPubMed
22.
Paganini-Hill A, Kawas CH, Corrada MM. Non-alcoholic beverage and caffeine consumption and mortality: the Leisure World Cohort Study. Prev Med. 2007;44:305–10.CrossRefPubMed
23.
Panagiotakos D, Pitsavos C, Chrysohoou C, Palliou K, Lentzas I, Skoumas I, Stefanadis C. Dietary patterns and 5-year incidence of cardiovascular disease: a multivariate analysis of the ATTICA study. Nutr Metab Cardiovasc Dis. 2009;19:253–63.CrossRefPubMed
24.
Bonthuis M, Hughes MC, Ibiebele TI, Green AC, van der Pols JC. Dairy consumption and patterns of mortality of Australian adults. Eur J Clin Nutr. 2010;64:569–77.CrossRefPubMed
25.
Goldbohm RA, Chorus AM, Galindo Garre F, Schouten LJ, van den Brandt PA. Dairy consumption and 10-y total and cardiovascular mortality: a prospective cohort study in the Netherlands. Am J Clin Nutr. 2011;93:615–27.CrossRefPubMed
26.
Sonestedt E, Wirfält E, Wallström P, Gullberg B, Orho-Melander M, Hedblad B. Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort. Eur J Epidemiol. 2011;26:609–18.CrossRefPubMed
27.
Dalmeijer GW, Struijk EA, Van Der Schouw YT, Soedamah-Muthu SS, Verschuren WMM, Boer JMA, Geleijnse JM, Beulens JWJ. Dairy intake and coronary heart disease or stroke—a population-based cohort study. Int J Cardiol. 2013;167:925–9.CrossRefPubMed
28.
Kondo I, Ojima T, Nakamura M, Hayasaka S, Hozawa A, Saitoh S, Ohnishi H, Akasaka H, Hayakawa T, Murakami Y, Okuda N, Miura K, Okayama A, Ueshima H. Consumption of dairy products and death from cardiovascular disease in the Japanese general population: the NIPPON DATA80. J Epidemiol. 2013;23:47–54.CrossRefPubMed
29.
Louie JC, Flood VM, Burlutsky G, Rangan AM, Gill TP, Mitchell P. Dairy consumption and the risk of 15-year cardiovascular disease mortality in a cohort of older Australians. Nutrients. 2013;5:441–54.CrossRefPubMedCentralPubMed
30.
Patterson E, Larsson SC, Wolk A, Akesson A. Association between dairy food consumption and risk of myocardial infarction in women differs by type of dairy food. J Nutr. 2013;143:74–9.CrossRefPubMed
31.
Soedamah-Muthu SS, Masset G, Verberne L, Geleijnse JM, Brunner EJ. Consumption of dairy products and associations with incident diabetes, CHD and mortality in the Whitehall II study. Br J Nutr. 2013;109:718–26.CrossRefPubMed
32.
van Aerde MA, Soedamah-Muthu SS, Geleijnse JM, Snijder MB, Nijpels G, Stehouwer CD, Dekker JM. Dairy intake in relation to cardiovascular disease mortality and all-cause mortality: the Hoorn Study. Eur J Nutr. 2013;52:609–16.CrossRefPubMed
33.
von Ruesten A, Feller S, Bergmann MM, Boeing H. Diet and risk of chronic diseases: results from the first 8 years of follow-up in the EPIC-Potsdam study. Eur J Clin Nutr. 2013;67:412–9.CrossRef
34.
Haring B, Gronroos N, Nettleton JA, Wyler Von Ballmoos MC, Selvin E, Alonso A. Dietary protein intake and coronary heart disease in a large community based cohort: results from the Atherosclerosis Risk in Communities (ARIC) study. PLoS ONE. 2014;9:e109552.CrossRefPubMedCentralPubMed
35.
Huang LY, Wahlqvist ML, Huang YC, Lee MS. Optimal dairy intake is predicated on total, cardiovascular, and stroke mortalities in a Taiwanese cohort. J Am Coll Nutr. 2014;33:426–36.CrossRefPubMed
36.
Bergholdt HK, Nordestgaard BG, Varbo A. Ellervi k C. Milk intake is not associated with ischaemic heart disease in observational or Mendelian randomization analyses in 98,529 Danish adults. Int J Epidemiol. 2015;44:587–603.CrossRefPubMed
37.
Praagman J, Franco OH, Ikram MA, Soedamah-Muthu SS, Engberink MF, van Rooij FJ, Hofman A, Geleijnse JM. Dairy products and the risk of stroke and coronary heart disease: the Rotterdam Study. Eur J Nutr. 2015;54:981–90.CrossRefPubMed
38.
Praagman J, Dalmeijer GW, van der Schouw YT, Soedamah-Muthu SS, Monique Verschuren WM, Bas Bueno-de-Mesquita H, Geleijnse JM, Beulens JW. The relationship between fermented food intake and mortality risk in the European Prospective Investigation into Cancer and Nutrition–Netherlands cohort. Br J Nutr. 2015;113:498–506.CrossRefPubMed
39.
Wang C, Yatsuya H, Tamakoshi K, Iso H, Tamakoshi A. Milk drinking and mortality: findings from the Japan collaborative cohort study. J Epidemiol. 2015;25:66–73.CrossRefPubMed
40.
Engberink MF, Soedaman-Muthu SS, Boessenkool-Pape J, van Rooij FJA, Hofman A, Witteman JCM, Geleijnse JM. Dairy intake in relation to all-cause mortality and risk of cardiovascular disease: the Rotterdam Study. American Heart Association, San Francisco. 2010 (poster 71).
41.
Food Standards Agency. Food portion sizes. 3rd ed. Norwich: TSO; 2005.
42.
43.
44.
Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL. Plasma vitamin D levels, menopause, and risk of breast cancer: dose-response meta-analysis of prospective studies. Medicine. 2013;92:123–31.CrossRefPubMedCentralPubMed
45.
Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.CrossRefPubMed
46.
47.
Larsson SC, Crippa A, Orsini N, Wolk A, Michaelsson K. Milk consumption and mortality from all causes, cardiovascular disease, and cancer: a systematic review and meta-analysis. Nutrients. 2015;7:7749–63.CrossRefPubMedCentralPubMed
48.
Mullie P, Pizot C, Autier P. Daily milk consumption and all-cause mortality, coronary heart disease and stroke: a systematic review and meta-analysis of observational cohort studies. BMC Public Health. 2016;1:1236.CrossRef
49.
Drouin-Chartier J-P, Brassard D, Tessier-Grenier M, Côté JA, Labonté M-È, Desroches S, Couture P, Lamarche B. Systematic review of the association between dairy product consumption and risk of cardiovascular-related clinical outcomes. Adv Nutr. 2016;7:1026–40.CrossRefPubMed
50.
Chen M, Li Y, Sun Q, Pan A, Manson JE, Rexrode KM, Willett WC, Rimm EB, Hu FB. Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults. Am J Clin Nutr. 2016;104:1209–17.CrossRefPubMed
51.
52.
Qin LQ, Xu JY, Han SF, Zhang ZL, Zhao YY, Szeto IM. Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr. 2015;24:90–100.PubMed
53.
Drehmer M, Pereira MA, Schmidt MI, Alvim S, Lotufo PA, Luft VC, Duncan BB. Total and full-fat, but not low-fat, dairy product intakes are inversely associated with metabolic syndrome in adults. J Nutr. 2016;146:81–9.CrossRefPubMed
54.
Kratz M, Baars T, Guyenet S. The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr. 2013;52:1–24.CrossRefPubMed
55.
Larsson SC, Bergkvist L, Wolk A. High-fat dairy food and conjugated linoleic acid intakes in relation to colorectal cancer incidence in the Swedish Mammography Cohort. Am J Clin Nutr. 2005;82:894–900.PubMed
56.
57.
Adebamowo SN, Spiegelman D, Flint AJ, Willett WC, Rexrode KM. Intakes of magnesium, potassium, and calcium and the risk of stroke among men. Int J Stroke. 2015;10:1093–100.CrossRefPubMed
58.
Tian DY, Tian J, Shi CH, Song B, Wu J, Ji Y, Wang RH, Mao CY, Sun SL, Xu YM. Calcium intake and the risk of stroke: an up-dated meta-analysis of prospective studies. Asia Pac J Clin Nutr. 2015;24:245–52.PubMed
59.
Lorenzen JK, Jensen SK, Astrup A. Milk minerals modify the effect of fat intake on serum lipid profile: results from an animal and a human short-term study. Br J Nutr. 2014;111:1412–20.CrossRefPubMed
60.
Lorenzen JK, Astrup A. Dairy calcium intake modifies responsiveness of fat metabolism and blood lipids to a high-fat diet. Br J Nutr. 2011;105:1823–31.CrossRefPubMed
61.
Chen GC, Wang Y, Tong X, Szeto IM, Smit G, Li ZN, Qin LQ. Cheese consumption and risk of cardiovascular disease: a meta-analysis of prospective studies. Eur J Nutr. 2016. doi:10.​1007/​s00394-016-1292-z.
62.
Astrup A. Yogurt and dairy product consumption to prevent cardiometabolic diseases: epidemiologic and experimental studies. Am J Clin Nutr. 2014;99:1235S–42S.CrossRefPubMed
63.
Gijsbers L, Ding EL, Malik VS, de Goede J, Geleijnse JM, Soedamah-Muthu SS. Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies. Am J Clin Nutr. 2016;103:1111–24.CrossRefPubMed
64.
Veiga P, Pons N, Agrawal A, Oozeer R, Faurie JM, van Hylckama Vlieg JE, Houghton LA, Whorwell PJ, Ehrlich SD, Kennedy SP. Changes of the human gut microbiome induced by a fermented milk product. Sci Rep. 2014;4:6328.CrossRefPubMedCentralPubMed
65.
van Hylckama Vlieg JE, Veiga P, Zhang C, Derrien M, Zhao L. Impact of microbial transformation of food on health—from fermented foods to fermentation in the gastro-intestinal tract. Curr Opin Biotechnol. 2011;22:211–9.CrossRefPubMed
66.
Yang QH, Zhang ZF, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;174:516–24.CrossRefPubMed
67.
Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus. A systematic review and meta-analysis. Circulation. 2010;121:2271–83.CrossRefPubMedCentralPubMed
68.
Chen GC, Lv DB, Pang Z, Liu QF. Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2013;67:91–5.CrossRefPubMed
Metadata
Title
Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose–response meta-analysis of prospective cohort studies
Authors
Jing Guo
Arne Astrup
Julie A. Lovegrove
Lieke Gijsbers
David I. Givens
Sabita S. Soedamah-Muthu
Publication date
01-04-2017
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 4/2017
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-017-0243-1

Other articles of this Issue 4/2017

European Journal of Epidemiology 4/2017 Go to the issue

CHRONIC DISEASES

Moderate alcohol consumption is associated with lower chronic disease burden expressed in disability-adjusted life years: a prospective cohort study

ESSAY

Tacit knowledge

MORTALITY

Time trends of cause-specific mortality among resettlers in Germany, 1990 through 2009

CORRESPONDENCE

Societal and global implications of the “dementia epidemic”: the example of the London Heathrow airport

ENVIRONMENTAL EPIDEMIOLOGY

Transportation noise exposure and cardiovascular mortality: a nationwide cohort study from Switzerland

NEURO-EPIDEMIOLOGY

Longitudinal and postural changes of blood pressure predict dementia: the Malmö Preventive Project