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Published in: European Journal of Epidemiology 8/2011

01-08-2011 | CARDIOVASCULAR DISEASE

Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort

Authors: Emily Sonestedt, Elisabet Wirfält, Peter Wallström, Bo Gullberg, Marju Orho-Melander, Bo Hedblad

Published in: European Journal of Epidemiology | Issue 8/2011

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Abstract

It is unclear whether specific dairy products are associated with risk of cardiovascular disease (CVD). The aim of this project was therefore to examine the association between intake of milk, cheese, cream and butter, and incidence of CVD in the Swedish Malmö Diet and Cancer cohort. Milk was separated into fermented (yoghurt and cultured sour milk) versus non-fermented milk, and low-fat versus high-fat milk. Among 26,445 individuals without a history of myocardial infarction, stroke and diabetes (44–74 years; 62% females), 2,520 CVD cases (coronary and stroke events) were identified during a mean follow-up time of 12 years. Dietary data was collected using a modified diet history method. Overall consumption of dairy products was inversely associated with risk of CVD (P trend = 0.05). Among the specific dairy products, a statistically significant inverse relationship was observed only for fermented milk. The highest versus lowest intake category of fermented milk was associated with 15% (95% CI: 5–24%; P trend = 0.003) decreased incidence of CVD. We observed a statistically significant interaction between sex and cheese intake (P = 0.046). Cheese intake was significantly associated with decreased CVD risk in women (P trend = 0.03), but not in men (P trend = 0.98). The main finding was that a high intake of fermented milk may reduce the risk of CVD. This study suggests that it is important to examine dairy products separately when investigating their health effects.
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Literature
1.
go back to reference Sacks FM, Katan M. Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease. Am J Med. 2002;113(Suppl 9B):13S–24S.PubMedCrossRef Sacks FM, Katan M. Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease. Am J Med. 2002;113(Suppl 9B):13S–24S.PubMedCrossRef
2.
go back to reference Riserus U, Willett WC, Hu FB. Dietary fats and prevention of type 2 diabetes. Prog Lipid Res. 2009;48:44–51.PubMedCrossRef Riserus U, Willett WC, Hu FB. Dietary fats and prevention of type 2 diabetes. Prog Lipid Res. 2009;48:44–51.PubMedCrossRef
3.
go back to reference Nordiska ministerr*det. Nordic Nutrition Recommendations 2004: integrating nutrition and physical activity. Copenhagen: Nordic Council of Ministers; 2004. Nordiska ministerr*det. Nordic Nutrition Recommendations 2004: integrating nutrition and physical activity. Copenhagen: Nordic Council of Ministers; 2004.
4.
go back to reference Gibson RA, Makrides M, Smithers LG, et al. The effect of dairy foods on CHD: a systematic review of prospective cohort studies. Br J Nutr. 2009;102:1267–75.PubMedCrossRef Gibson RA, Makrides M, Smithers LG, et al. The effect of dairy foods on CHD: a systematic review of prospective cohort studies. Br J Nutr. 2009;102:1267–75.PubMedCrossRef
5.
go back to reference Elwood PC, Pickering JE, Givens DI, Gallacher JE. The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: an overview of the evidence. Lipids 2010. Elwood PC, Pickering JE, Givens DI, Gallacher JE. The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: an overview of the evidence. Lipids 2010.
6.
go back to reference Soedamah-Muthu SS, Ding EL, Al-Delaimy WK, et al. 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.PubMedCrossRef Soedamah-Muthu SS, Ding EL, Al-Delaimy WK, et al. 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.PubMedCrossRef
7.
go back to reference Cani PD, Delzenne NM. The role of the gut microbiota in energy metabolism and metabolic disease. Curr Pharm Des. 2009;15:1546–58.PubMedCrossRef Cani PD, Delzenne NM. The role of the gut microbiota in energy metabolism and metabolic disease. Curr Pharm Des. 2009;15:1546–58.PubMedCrossRef
8.
go back to reference Berglund G, Elmstahl S, Janzon L, Larsson SA. The Malmo Diet and Cancer Study. Design and feasibility. J Intern Med. 1993;233:45–51.PubMedCrossRef Berglund G, Elmstahl S, Janzon L, Larsson SA. The Malmo Diet and Cancer Study. Design and feasibility. J Intern Med. 1993;233:45–51.PubMedCrossRef
9.
go back to reference Manjer J, Elmstahl S, Janzon L, Berglund G. Invitation to a population-based cohort study: differences between subjects recruited using various strategies. Scand J Public Health. 2002;30:103–12.PubMed Manjer J, Elmstahl S, Janzon L, Berglund G. Invitation to a population-based cohort study: differences between subjects recruited using various strategies. Scand J Public Health. 2002;30:103–12.PubMed
10.
go back to reference Callmer E, Riboli E, Saracci R, et al. Dietary assessment methods evaluated in the Malmo food study. J Intern Med. 1993;233:53–7.PubMedCrossRef Callmer E, Riboli E, Saracci R, et al. Dietary assessment methods evaluated in the Malmo food study. J Intern Med. 1993;233:53–7.PubMedCrossRef
11.
go back to reference Taylor HL, Jacobs DR Jr, Schucker B, et al. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis. 1978;31:741–55.PubMedCrossRef Taylor HL, Jacobs DR Jr, Schucker B, et al. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis. 1978;31:741–55.PubMedCrossRef
12.
go back to reference Manjer J, Carlsson S, Elmstahl S, et al. The Malmo Diet and Cancer Study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev. 2001;10:489–99.PubMedCrossRef Manjer J, Carlsson S, Elmstahl S, et al. The Malmo Diet and Cancer Study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev. 2001;10:489–99.PubMedCrossRef
13.
go back to reference Hedblad B, Nilsson P, Engstrom G, et al. Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death. Diabet Med. 2002;19:470–5.PubMedCrossRef Hedblad B, Nilsson P, Engstrom G, et al. Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death. Diabet Med. 2002;19:470–5.PubMedCrossRef
14.
go back to reference Kathiresan S, Melander O, Anevski D, et al. Polymorphisms associated with cholesterol and risk of cardiovascular events. N Engl J Med. 2008;358:1240–9.PubMedCrossRef Kathiresan S, Melander O, Anevski D, et al. Polymorphisms associated with cholesterol and risk of cardiovascular events. N Engl J Med. 2008;358:1240–9.PubMedCrossRef
15.
go back to reference Calling S, Hedblad B, Engstrom G, et al. Effects of body fatness and physical activity on cardiovascular risk: risk prediction using the bioelectrical impedance method. Scand J Public Health. 2006;34:568–75.PubMedCrossRef Calling S, Hedblad B, Engstrom G, et al. Effects of body fatness and physical activity on cardiovascular risk: risk prediction using the bioelectrical impedance method. Scand J Public Health. 2006;34:568–75.PubMedCrossRef
16.
go back to reference Socialstyrelsen. Värdering av diagnoskvaliteten för akut hjärtinfarkt i patientregistret 1987 och 1995. Stockholm 2000. Socialstyrelsen. Värdering av diagnoskvaliteten för akut hjärtinfarkt i patientregistret 1987 och 1995. Stockholm 2000.
17.
go back to reference Zia E, Pessah-Rasmussen H, Khan FA, et al. Risk factors for primary intracerebral hemorrhage: a population-based nested case-control study. Cerebrovasc Dis. 2006;21:18–25.PubMedCrossRef Zia E, Pessah-Rasmussen H, Khan FA, et al. Risk factors for primary intracerebral hemorrhage: a population-based nested case-control study. Cerebrovasc Dis. 2006;21:18–25.PubMedCrossRef
18.
go back to reference Wirfalt E, Mattisson I, Johansson U, et al. A methodological report from the Malmo Diet, Cancer study: development, evaluation of altered routines in dietary data processing. Nutr J. 2002;1:3.PubMedCrossRef Wirfalt E, Mattisson I, Johansson U, et al. A methodological report from the Malmo Diet, Cancer study: development, evaluation of altered routines in dietary data processing. Nutr J. 2002;1:3.PubMedCrossRef
19.
go back to reference Riboli E, Elmstahl S, Saracci R, et al. The Malmo Food Study: validity of two dietary assessment methods for measuring nutrient intake. Int J Epidemiol. 1997;26(Suppl 1):S161–73.PubMedCrossRef Riboli E, Elmstahl S, Saracci R, et al. The Malmo Food Study: validity of two dietary assessment methods for measuring nutrient intake. Int J Epidemiol. 1997;26(Suppl 1):S161–73.PubMedCrossRef
20.
go back to reference Elmstahl S, Riboli E, Lindgarde F, et al. The Malmo Food Study: the relative validity of a modified diet history method and an extensive food frequency questionnaire for measuring food intake. Eur J Clin Nutr. 1996;50:143–51.PubMed Elmstahl S, Riboli E, Lindgarde F, et al. The Malmo Food Study: the relative validity of a modified diet history method and an extensive food frequency questionnaire for measuring food intake. Eur J Clin Nutr. 1996;50:143–51.PubMed
21.
go back to reference Mente A, de Koning L, Shannon HS, Anand SS. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med. 2009;169:659–69.PubMedCrossRef Mente A, de Koning L, Shannon HS, Anand SS. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med. 2009;169:659–69.PubMedCrossRef
22.
go back to reference Sonestedt E, Wirfalt E, Gullberg B, Berglund G. Past food habit change is related to obesity, lifestyle and socio-economic factors in the Malmo Diet and Cancer Cohort. Public Health Nutr. 2005;8:876–85.PubMedCrossRef Sonestedt E, Wirfalt E, Gullberg B, Berglund G. Past food habit change is related to obesity, lifestyle and socio-economic factors in the Malmo Diet and Cancer Cohort. Public Health Nutr. 2005;8:876–85.PubMedCrossRef
23.
go back to reference Sonestedt E, Gullberg B, Wirfalt E. Both food habit change in the past and obesity status may influence the association between dietary factors and postmenopausal breast cancer. Public Health Nutr. 2007;10:769–79.PubMedCrossRef Sonestedt E, Gullberg B, Wirfalt E. Both food habit change in the past and obesity status may influence the association between dietary factors and postmenopausal breast cancer. Public Health Nutr. 2007;10:769–79.PubMedCrossRef
24.
go back to reference Becker W, Pearson M. Riksmaten 1997-98: kostvanor och näringsintag i Sverige: metod- och resultatanalys. Uppsala: Livsmedelsverket 2002. Becker W, Pearson M. Riksmaten 1997-98: kostvanor och näringsintag i Sverige: metod- och resultatanalys. Uppsala: Livsmedelsverket 2002.
25.
go back to reference Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010.
26.
27.
go back to reference Jacobs DR Jr, Tapsell LC. Food, not nutrients, is the fundamental unit in nutrition. Nutr Rev. 2007;65:439–50.PubMedCrossRef Jacobs DR Jr, Tapsell LC. Food, not nutrients, is the fundamental unit in nutrition. Nutr Rev. 2007;65:439–50.PubMedCrossRef
28.
go back to reference Warensjo E, Jansson JH, Cederholm T, et al. Biomarkers of milk fat and the risk of myocardial infarction in men and women: a prospective, matched case-control study. Am J Clin Nutr. 2010;92:194–202.PubMedCrossRef Warensjo E, Jansson JH, Cederholm T, et al. Biomarkers of milk fat and the risk of myocardial infarction in men and women: a prospective, matched case-control study. Am J Clin Nutr. 2010;92:194–202.PubMedCrossRef
29.
go back to reference Agerholm-Larsen L, Bell ML, Grunwald GK, Astrup A. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur J Clin Nutr. 2000;54:856–60.PubMedCrossRef Agerholm-Larsen L, Bell ML, Grunwald GK, Astrup A. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur J Clin Nutr. 2000;54:856–60.PubMedCrossRef
30.
go back to reference Larsen N, Vogensen FK, van den Berg FW, et al. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults. PLoS One. 2010;5:e9085.PubMedCrossRef Larsen N, Vogensen FK, van den Berg FW, et al. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults. PLoS One. 2010;5:e9085.PubMedCrossRef
31.
go back to reference Jauhiainen T, Korpela R. Milk peptides and blood pressure. J Nutr. 2007;137:825S–9S.PubMed Jauhiainen T, Korpela R. Milk peptides and blood pressure. J Nutr. 2007;137:825S–9S.PubMed
32.
go back to reference Severin S, Wenshui X. Milk biologically active components as nutraceuticals: review. Crit Rev Food Sci Nutr. 2005;45:645–56.PubMedCrossRef Severin S, Wenshui X. Milk biologically active components as nutraceuticals: review. Crit Rev Food Sci Nutr. 2005;45:645–56.PubMedCrossRef
33.
go back to reference Nilsson M, Stenberg M, Frid AH, et al. Glycemia and insulinemia in healthy subjects after lactose-equivalent meals of milk and other food proteins: the role of plasma amino acids and incretins. Am J Clin Nutr. 2004;80:1246–53.PubMed Nilsson M, Stenberg M, Frid AH, et al. Glycemia and insulinemia in healthy subjects after lactose-equivalent meals of milk and other food proteins: the role of plasma amino acids and incretins. Am J Clin Nutr. 2004;80:1246–53.PubMed
34.
go back to reference Holst JJ, Orskov C. Incretin hormones—an update. Scand J Clin Lab Invest Suppl. 2001;234:75–85.PubMed Holst JJ, Orskov C. Incretin hormones—an update. Scand J Clin Lab Invest Suppl. 2001;234:75–85.PubMed
35.
go back to reference Ostman EM, Liljeberg Elmstahl HG, Bjorck IM. Inconsistency between glycemic and insulinemic responses to regular and fermented milk products. Am J Clin Nutr. 2001;74:96–100.PubMed Ostman EM, Liljeberg Elmstahl HG, Bjorck IM. Inconsistency between glycemic and insulinemic responses to regular and fermented milk products. Am J Clin Nutr. 2001;74:96–100.PubMed
36.
go back to reference Nestel PJ, Chronopulos A, Cehun M. Dairy fat in cheese raises LDL cholesterol less than that in butter in mildly hypercholesterolaemic subjects. Eur J Clin Nutr. 2005;59:1059–63.PubMedCrossRef Nestel PJ, Chronopulos A, Cehun M. Dairy fat in cheese raises LDL cholesterol less than that in butter in mildly hypercholesterolaemic subjects. Eur J Clin Nutr. 2005;59:1059–63.PubMedCrossRef
37.
go back to reference Biong AS, Muller H, Seljeflot I, et al. A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine. Br J Nutr. 2004;92:791–7.PubMedCrossRef Biong AS, Muller H, Seljeflot I, et al. A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine. Br J Nutr. 2004;92:791–7.PubMedCrossRef
38.
go back to reference Tholstrup T, Hoy CE, Andersen LN, et al. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr. 2004;23:169–76.PubMed Tholstrup T, Hoy CE, Andersen LN, et al. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr. 2004;23:169–76.PubMed
39.
go back to reference Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart. 1997;78:450–5.PubMed Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart. 1997;78:450–5.PubMed
40.
go back to reference Gartside PS, Wang P, Glueck CJ. Prospective assessment of coronary heart disease risk factors: the NHANES I epidemiologic follow-up study (NHEFS) 16-year follow-up. J Am Coll Nutr. 1998;17:263–9.PubMed Gartside PS, Wang P, Glueck CJ. Prospective assessment of coronary heart disease risk factors: the NHANES I epidemiologic follow-up study (NHEFS) 16-year follow-up. J Am Coll Nutr. 1998;17:263–9.PubMed
Metadata
Title
Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort
Authors
Emily Sonestedt
Elisabet Wirfält
Peter Wallström
Bo Gullberg
Marju Orho-Melander
Bo Hedblad
Publication date
01-08-2011
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 8/2011
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-011-9589-y

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