Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2017 Apr;32(4):269-287.
doi: 10.1007/s10654-017-0243-1. Epub 2017 Apr 3.

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

Jing Guo  1 , Arne Astrup  2 , Julie A Lovegrove  3 , Lieke Gijsbers  4 , David I Givens  5 , Sabita S Soedamah-Muthu  4
Affiliations
Meta-Analysis

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

Jing Guo et al. Eur J Epidemiol. 2017 Apr.

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.

Keywords: All-cause mortality; Cardiovascular disease; Dairy; Dose–response meta-analysis; Fermented dairy; Milk.

PubMed Disclaimer

Conflict of interest statement

SSSM received funding from the Global Dairy Platform, Dairy Research Institute and Dairy Australia for a meta-analysis on cheese and blood lipids (2012) and this meta-analysis of dairy and mortality (2015). SSSM has also received the Wiebe Visser International Dairy Nutrition Prize from the Dutch Dairy Association’s (NZO) Utrecht Group. AA is recipient of research grants from Arla Foods, DK; Danish Dairy Research Foundation; Global Dairy Platform; Danish Agriculture and Food Council; GEIE European Milk Forum, France. He is member of advisory boards for Dutch Beer Knowledge Institute, NL; IKEA, SV; Lucozade Ribena Suntory Ltd, UK; McCain Foods Limited, USA; McDonald’s, USA; Weight Watchers, USA. He is consultant for Nestlé Research Center, Switzerland; Nongfu Spring Water, China. Astrup receives honoraria as Associate Editor of American Journal of Clinical Nutrition, and for membership of the Editorial Boards of Annals of Nutrition and of Metabolism and Annual Review of Nutrition. He is recipient of travel expenses and/or modest honoraria (<$2000) for lectures given at meetings supported by corporate sponsors. He received financial support from dairy organizations for attendance at the Eurofed Lipids Congress (2014) in France and the meeting of The Federation of European Nutrition Societies (2015) in Germany; DIG and JG received funding from the Global Dairy Platform, DIG and JAL have received funding from The Dairy Council and AHDB Dairy for dietary pattern analysis of diets defined by dairy food content (2012–2015).

Figures

Fig. 1
Fig. 1
Flowchart of meta-analysis on dairy consumption and incident CVD, CVD mortality and all-cause mortality
Fig. 2
Fig. 2
Relative risk of all-cause mortality for an increment of 20 g/day of fermented dairy intake. Squares represent study-specific RR. Square areas are proportional to the overall specific-study weight to the overall meta-analysis. Horizontal lines represent 95% CIs. Diamonds represent the pooled relative risk and 95% CIs. By excluding the Swedish study [6] of women’s results for cheese, RR = 1.00 (95% CI 0.99–1.00), I2 = 45.2% (P = 0.02)
Fig. 3
Fig. 3
Relative risk of CVD for an increment of 20 g/day of fermented dairy intake. Squares represent study-specific RR. Square areas are proportional to the overall specific-study weight to the overall meta-analysis. Horizontal lines represent 95% Cis. Diamonds represent the pooled relative risk and 95% CIs. By excluding the Swedish study [6] of women’s results for cheese, RR = 0.99 (95% CI 0.99–1.00), I2 = 23.8% (P = 0.19)
Fig. 4
Fig. 4
Relative risks of CVD for an increment of 10 g/day of cheese. Squares represent study-specific RR. Square areas are proportional to the overall specific-study weight to the overall meta-analysis. Horizontal lines represent 95% CIs. Diamonds represent the pooled relative risk and 95% Cis. By excluding the Swedish study [6] of women’s results for cheese, RR = 0.99 (0.98–0.99), I2 = 0% (P = 0.84)
See this image and copyright information in PMC

Comment in

References

    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;385:117–171. doi: 10.1016/S0140-6736(14)61682-2. - DOI - PMC - PubMed
    1. Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation. 2016;133:187–225. doi: 10.1161/CIRCULATIONAHA.115.018585. - DOI - PMC - PubMed
    1. 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;32:1026–1032. doi: 10.1016/j.cjca.2015.12.033. - DOI - PubMed
    1. 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;115:737–750. doi: 10.1017/S0007114515005000. - DOI - PubMed
    1. 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;93:158–171. doi: 10.3945/ajcn.2010.29866. - DOI - PMC - PubMed

Publication types

LinkOut - more resources