title: Milk Consumption and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis.
abstract: Results from epidemiological studies of milk consumption and mortality are inconsistent. We conducted a systematic review and meta-analysis of prospective studies assessing the association of non-fermented and fermented milk consumption with mortality from all causes, cardiovascular disease, and cancer. PubMed was searched until August 2015. A two-stage, random-effects, dose-response meta-analysis was used to combine study-specific results. Heterogeneity among studies was assessed with the I² statistic. During follow-up periods ranging from 4.1 to 25 years, 70,743 deaths occurred among 367,505 participants. The range of non-fermented and fermented milk consumption and the shape of the associations between milk consumption and mortality differed considerably between studies. There was substantial heterogeneity among studies of non-fermented milk consumption in relation to mortality from all causes (12 studies; I² = 94%), cardiovascular disease (five studies; I² = 93%), and cancer (four studies; I² = 75%) as well as among studies of fermented milk consumption and all-cause mortality (seven studies; I² = 88%). Thus, estimating pooled hazard ratios was not appropriate. Heterogeneity among studies was observed in most subgroups defined by sex, country, and study quality. In conclusion, we observed no consistent association between milk consumption and all-cause or cause-specific mortality.
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. susanna.larsson@ki.se.
authors.forename: Susanna C
authors.initials: SC
authors.lastname: Larsson
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. alessio.crippa@ki.se.|Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. alessio.crippa@ki.se.
authors.forename: Alessio
authors.initials: A
authors.lastname: Crippa
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. nicola.orsini@ki.se.|Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. nicola.orsini@ki.se.
authors.forename: Nicola
authors.initials: N
authors.lastname: Orsini
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. alicja.wolk@ki.se.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.affiliation: Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden. karl.michaelsson@surgsci.uu.se.
authors.forename: Karl
authors.initials: K
authors.lastname: Michaëlsson
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control; D043302:Cultured Milk Products / Q000009:adverse effects; D004032:Diet / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000009:adverse effects; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors
keywords: cancer; cardiovascular disease; meta-analysis; milk; mortality