The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: an overview of the evidence.
The health effects of milk and dairy food consumption would best be determined in randomised controlled trials. No adequately powered trial has been reported and none is likely because of the numbers required. The best evidence comes, therefore, from prospective cohort studies with disease events and death as outcomes. Medline was searched for prospective studies of dairy food consumption and incident vascular disease and Type 2 diabetes, based on representative population samples. Reports in which evaluation was in incident disease or death were selected. Meta-analyses of the adjusted estimates of relative risk for disease outcomes in these reports were conducted. Relevant case-control retrospective studies were also identified and the results are summarised in this article. Meta-analyses suggest a reduction in risk in the subjects with the highest dairy consumption relative to those with the lowest intake: 0.87 (0.77, 0.98) for all-cause deaths, 0.92 (0.80, 0.99) for ischaemic heart disease, 0.79 (0.68, 0.91) for stroke and 0.85 (0.75, 0.96) for incident diabetes. The number of cohort studies which give evidence on individual dairy food items is very small, but, again, there is no convincing evidence of harm from consumption of the separate food items. In conclusion, there appears to be an enormous mis-match between the evidence from long-term prospective studies and perceptions of harm from the consumption of dairy food items.
Elwood
Peter C
PC
Department of Primary Care and Public Health, Cardiff University, University Hospital of Wales, Cardiff, UK. pelwood@doctors.org.uk
Pickering
Janet E
JE
Givens
D Ian
DI
Gallacher
John E
JE
D000818:Animals; D016022:Case-Control Studies; D015331:Cohort Studies; D003611:Dairy Products / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D008892:Milk / Q000009:adverse effects*; D015203:Reproducibility of Results; D014652:Vascular Diseases / Q000453:epidemiology*
J Thromb Haemost. 2003 Aug;1(8):1744-52
12911588
Stroke. 1999 Sep;30(9):1772-9
10471422
J Epidemiol Community Health. 2001 Jun;55(6):375
11350990
Stroke. 1996 May;27(5):813-8
8623098
Br J Nutr. 2006 Aug;96 Suppl 1:S94-9
16923261
J Natl Cancer Inst. 2005 Dec 7;97(23):1768-77
16333032
Stroke. 2008 Sep;39(9):2449-56
18635855
J Dairy Sci. 2000 Jun;83(6):1187-95
10877382
Am J Epidemiol. 1984 May;119(5):775-87
6720674
J Nutr. 2005 Jul;135(7):1678-82
15987849
Diabetes Care. 2005 Dec;28(12):2926-32
16306556
J Nutr. 2001 Jul;131(7):1875-8
11435500
Arch Intern Med. 2009 Apr 13;169(7):659-69
19364995
Am J Clin Nutr. 2008 May;87(5):1540-1; author reply 1541
18469284
BMJ. 1991 Mar 30;302(6779):785-6
2021772
J Intern Med. 2006 Jun;259(6):583-91
16704559
Diabetes Care. 2006 Oct;29(10):2238-43
17003299
Am J Clin Nutr. 2009 Apr;89(4):1059-67
19225116
Am J Epidemiol. 2005 Feb 1;161(3):239-49
15671256
Eur J Clin Nutr. 2004 May;58(5):711-7
15116073
Arch Intern Med. 2005 May 9;165(9):997-1003
15883237
Am J Hypertens. 1999 Jan;12(1 Pt 1):84-92
10075392
Epidemiology. 1997 Mar;8(2):144-9
9229205
Epidemiology. 2009 May;20(3):355-60
19057387
Int J Epidemiol. 1992 Feb;21(1):36-9
1544755
Br J Nutr. 2007 Aug;98(2):380-7
17391555
Am J Clin Nutr. 2004 Sep;80(3):550-9
15321792
J Am Diet Assoc. 2008 Nov;108(11):1881-7
18954578
J Epidemiol. 1999 Aug;9(4):268-74
10510585
BMJ. 1990 Mar 24;300(6727):771-3
2322737
Am J Clin Nutr. 1988 Sep;48(3 Suppl):739-48
3046303
J Epidemiol Community Health. 2005 Jun;59(6):502-5
15911647
Heart. 1997 Nov;78(5):450-5
9415002
Br J Haematol. 2001 May;113(2):514-20
11380425
Atherosclerosis. 1983 May;47(2):187-98
6870999
Scand J Soc Med. 1992 Dec;20(4):204-8
1475646
Curr Opin Lipidol. 2006 Feb;17(1):1-10
16407709
Am J Clin Nutr. 2003 Apr;77(4):814-8
12663277
Hypertension. 1984 May-Jun;6(3):322-8
6547404
BMJ. 2003 Oct 4;327(7418):777-82
14525873
Int J Food Sci Nutr. 2008 Mar;59(2):155-65
17886080
Am J Clin Nutr. 1999 Dec;70(6):1001-8
10584044
Br J Nutr. 2009 Nov;102(9):1267-75
19682399
Am J Clin Nutr. 2007 Oct;86(4):929-37
17921367
Control Clin Trials. 1989 Dec;10(4):428-33
2691208
BMJ. 2009 Jul 21;339:b2535
19622551
Stroke. 2006 Jan;37(1):20-6
16339476
J Epidemiol Community Health. 2002 Jun;56(6):471-2
12011208
Prev Med. 1984 Sep;13(5):490-500
6527990
Am J Epidemiol. 1999 Jan 15;149(2):151-61
9921960
J Epidemiol Community Health. 2001 Jun;55(6):379-82
11350992
Heart. 2009 Oct;95(19):1600-6
19643770
Am J Clin Nutr. 1994 May;59(5 Suppl):1117S-1123S
8172111
Am J Clin Nutr. 2009 Jun;89(6):1877-83
19369377
Am J Clin Nutr. 2003 May;77(5):1146-55
12716665
J Am Coll Nutr. 1998 Jun;17(3):263-9
9627913
Int J Epidemiol. 2003 Aug;32(4):536-43
12913025
BMJ. 2001 Jul 14;323(7304):101-5
11451790
Am J Clin Nutr. 1996 Jun;63(6):897-903
8644684
J Am Coll Nutr. 2008 Dec;27(6):723S-34S
19155432
J Epidemiol Community Health. 2007 Aug;61(8):695-8
17630368