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
Review
. 2019 May 1;10(suppl_2):S164-S189.
doi: 10.1093/advances/nmy099.

Milk and Dairy Product Consumption and Cardiovascular Diseases: An Overview of Systematic Reviews and Meta-Analyses

Javier Fontecha  1 , Maria Visitación Calvo  1 , Manuela Juarez  1 , Angel Gil  2   3   4   5 , Vicente Martínez-Vizcaino  6   7
Affiliations
Review

Milk and Dairy Product Consumption and Cardiovascular Diseases: An Overview of Systematic Reviews and Meta-Analyses

Javier Fontecha et al. Adv Nutr. .

Abstract

Milk and dairy products containing milk fat are major food sources of saturated fatty acids, which have been linked to increased risk of cardiovascular-related clinical outcomes such as cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Therefore, current recommendations by health authorities advise consumption of low-fat or fat-free milk. Today, these recommendations are seriously questioned by meta-analyses of both prospective cohort studies and randomized controlled trials (RCTs) reporting inconsistent results. The present study includes an overview of systematic reviews and meta-analyses of follow-up studies, an overview of meta-analyses involving RCTs, and an update on meta-analyses of RCTs (2013-2018) aiming to synthesize the evidence regarding the influence of dairy product consumption on the risk of major cardiovascular-related outcomes and how various doses of different dairy products affect the responses, as well as on selected biomarkers of cardiovascular disease risk, i.e., blood pressure and blood lipids. The search strategies for both designs were conducted in the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception to April 2018. From the 31 full-text articles retrieved for cohort studies, 17 met the eligibility criteria. The pooled risk ratio estimated for the association between the consumption of different dairy products at different dose-responses and cardiovascular outcomes (CVD, CHD, and stroke) showed a statistically significant negative association with RR values <1, or did not find evidence of significant association. The overview of 12 meta-analyses involving RCTs as well as the updated meta-analyses of RCTs did not result in significant changes on risk biomarkers such as systolic and diastolic blood pressure and total cholesterol and LDL cholesterol. Therefore, the present study states that the consumption of total dairy products, with either regular or low fat content, does not adversely affect the risk of CVD.

Keywords: cardiovascular diseases; coronary heart disease; dairy products; milk consumption; stroke.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram for the research of meta-analyses of cohort studies addressing the effects of the consumption of dairy products and major events of cardiovascular diseases.
FIGURE 2
FIGURE 2
Forest plot for meta-analyses evaluating the influence of high compared with low dairy product consumption on CVD. The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis. CVD, cardiovascular disease.
FIGURE 3
FIGURE 3
Forest plot for meta-analyses evaluating the influence of dose-response of dairy product consumption on CVD. The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis. CVD, cardiovascular disease.
FIGURE 4
FIGURE 4
Forest plot for meta-analyses evaluating the influence of high compared with low dairy product consumption on CHD. The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis. CHD, coronary heart disease.
FIGURE 5
FIGURE 5
Forest plot for meta-analyses evaluating the influence of dose-response of dairy product consumption on CHD. The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis. CHD, coronary heart disease.
FIGURE 6
FIGURE 6
Forest plot for meta-analyses evaluating the influence of high compared with low dairy product consumption on stroke. The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis.
FIGURE 7
FIGURE 7
Forest plot for meta-analyses evaluating the influence of dose-response of dairy product consumption on stroke. The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis.
FIGURE 8
FIGURE 8
Forest plot for meta-analyses of randomized controlled trials evaluating the influence of consumption of dairy products on blood lipids: total-C (A) and LDL-C (B). The ES and 95% CI for fully adjusted random effects are depicted for each meta-analysis. ES, effect size; LDL-C, LDL cholesterol; total-C, total cholesterol.
FIGURE 9
FIGURE 9
Forest plot for meta-analyses of randomized controlled trials evaluating the influence of consumption of dairy products on SBP (A) and DBP (B). The effect size and 95% CI for fully adjusted random effects are depicted for each meta-analysis. DBP, diastolic blood pressure; IPP-VPP, isoleucine, proline, proline-valine, proline, proline; SBP, systolic blood pressure.
FIGURE 10
FIGURE 10
Forest plot for the updated meta-analyses of randomized controlled trials included from 2013 to 2018 evaluating the influence of consumption of dairy products on total-C (A) and LDL cholesterol (B) plasma concentrations. The effect size and 95% CI for fully adjusted random effects are depicted for each RCT. Pooled effect estimate is represented by the black diamond. (A) Total-C: overall effect Z = −0.96, P = 0.34; heterogeneity I2 = 97.0% (91.76%, 98.78%) (Q = 411.55, df = 12, P < 0.001). (B) LDL cholesterol: overall effect Z = −1.26, P = 0.21; heterogeneity I2 = 96.9% (91.36%, 98.40%) (Q = 572.86, df = 15, P < 0.001). RE, random effects; Total-C, total cholesterol.
FIGURE 11
FIGURE 11
Forest plot for the updated meta-analysis of randomized controlled trials included from 2013 to 2018 evaluating the influence of consumption of dairy products on SBP (A) and DBP (B). The effect size and 95% CI for fully adjusted random effects are depicted for each RCT. Pooled effect estimate is represented by the black diamond. (A) SBP: overall effect Z = −0.61, P = 0.54; heterogeneity I2 = 0.0% (0.00%, 20.28%) (Q = 4.83, df = 11, P = 0.93); (B) DBP: overall effect Z = −1.45, P = 0.15; heterogeneity I2 = 0.0% (0.00%, 30.14%) (Q = 6.11, df = 11, P = 0.87). DBP, diastolic blood pressure; RE, random effects; SBP, systolic blood pressure.
See this image and copyright information in PMC

Comment in

References

    1. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1345–422. - PMC - PubMed
    1. WHO. Noncommunicable Diseases Progress Monitor, 2017. [Internet] Geneva, World Health Organization; 2017. Available from: http://www.who.int/nmh/publications/ncd-progress-monitor-2017/en/.
    1. Fontecha J, Juárez M. Recent advances in dairy ingredients and cardiovascular diseases with special interest in milk fat components. In: Watson RR, Collier RJ, Preedy VR, editors. Milk in Human Health and Disease Across the Lifespan. London: Academic Press; 2017. pp. 251–61.
    1. Mensink R, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77:1146–55. - PubMed
    1. Mensink RP. Effects of Saturated Fatty Acids on Serum Lipids and Lipoproteins: A Systematic Review and Regression Analysis. Geneva: World Health Organization; 2016.

Publication types