title: Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies.
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.
authors.affiliation: Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK. jing.guo@pgr.reading.ac.uk.
authors.forename: Jing
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, 2200, Copenhagen, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Astrup
authors.affiliation: Hugh Sinclair Unit of Human Nutrition, Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AP, UK.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Lovegrove
authors.affiliation: Division of Human Nutrition, Wageningen University and Research, 6708 WE, Wageningen, The Netherlands.
authors.forename: Lieke
authors.initials: L
authors.lastname: Gijsbers
authors.affiliation: Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK.
authors.forename: David I
authors.initials: DI
authors.lastname: Givens
authors.affiliation: Division of Human Nutrition, Wageningen University and Research, 6708 WE, Wageningen, The Netherlands.
authors.forename: Sabita S
authors.initials: SS
authors.lastname: Soedamah-Muthu
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003611:Dairy Products / Q000706:statistics & numerical data*; D004032:Diet / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008892:Milk / Q000706:statistics & numerical data*; D009026:Mortality; D011446:Prospective Studies; D012307:Risk Factors
keywords: All-cause mortality; Cardiovascular disease; Dairy; Dose–response meta-analysis; Fermented dairy; Milk