title: Dairy Food Intake and All-Cause, Cardiovascular Disease, and Cancer Mortality: The Golestan Cohort Study.
abstract: We investigated the association between dairy product consumption and all-cause, cardiovascular disease (CVD), and cancer mortality in the Golestan Cohort Study, a prospective cohort study launched in January 2004 in Golestan Province, northeastern Iran. A total of 42,403 men and women participated in the study and completed a diet questionnaire at enrollment. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. We documented 3,291 deaths (1,467 from CVD and 859 from cancer) during 11 years of follow-up (2004-2015). The highest quintile of total dairy product consumption (versus the lowest) was associated with 19% lower all-cause mortality risk (hazard ratio (HR) = 0.81, 95% confidence interval (CI): 0.72, 0.91; Ptrend = 0.006) and 28% lower CVD mortality risk (HR = 0.72, 95% CI: 0.60, 0.86; Ptrend = 0.005). High consumption of low-fat dairy food was associated with lower risk of all-cause (HR = 0.83, 95% CI: 0.73, 0.94; Ptrend = 0.002) and CVD (HR = 0.74, 95% CI: 0.61, 0.89; Ptrend = 0.001) mortality. We noted 11% lower all-cause mortality and 16% lower CVD mortality risk with high yogurt intake. Cheese intake was associated with 16% lower all-cause mortality and 26% lower CVD mortality risk. Higher intake of high-fat dairy food and milk was not associated with all-cause or CVD mortality. Neither intake of individual dairy products nor intake of total dairy products was significantly associated with overall cancer mortality. High consumption of dairy products, especially yogurt and cheese, may reduce the risk of overall and CVD mortality.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Maryam S
authors.initials: MS
authors.lastname: Farvid
authors.affiliation: Digestive Disease Research Center, Digestive Disease, Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Digestive Oncology Research Center, Digestive Disease, Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Akbar F
authors.initials: AF
authors.lastname: Malekshah
authors.affiliation: Digestive Disease Research Center, Digestive Disease, Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Digestive Oncology Research Center, Digestive Disease, Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Liver and Pancreatic Biliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical SCiences, Tehran, Islamic Republic of Iran.
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
authors.affiliation: Digestive Disease Research Center, Digestive Disease, Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.
authors.forename: Sadaf G
authors.initials: SG
authors.lastname: Sepanlou
authors.affiliation: Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharafkhah
authors.affiliation: Golestan Research Center of Gastroentreology and Hepatology, Golestan University of Medical Sciences, Gorgan, Golestan, Islamic Republic of Iran.|Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Khoshnia
authors.affiliation: Harvard/Massachusetts General Hospital Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Farvid
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento, California, USA.
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA.
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.affiliation: International Agency for Research on Cancer, 69372 Lyon CEDEX 08, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.affiliation: Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK.|Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Pharoah
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D003611:Dairy Products / Q000009:adverse effects*; D004034:Diet Surveys; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies
keywords: Golestan Cohort Study; cancer; cardiovascular disease; cheese; dairy products; milk; mortality; yogurt