Milk-and-Dairy-Products-in-Human-Nutrition-FAO

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Table 4.4 (continued) Reference Dietary item Type of review Total CVD CHD Stroke Hypertension Ischaemic heart disease Ralston et al. (2011) Ralston et al. (2011) Soedamah- Muthu et al. (2011) Soedamah- Muthu et al. (2011) Soedamah- Muthu et al. (2011) Soedamah- Muthu et al. (2011) Tholstrup (2006) Tholstrup (2006) Tholstrup (2006) Fluid dairy foods Cheese Milk Total dairy Total high-fat dairy Total low-fat dairy products RR – relative risk; CI – confidence interval. Systematic review and meta-analysis of 5 cohorts Systematic review and meta-analysis Meta-analysis. Six prospective cohort studies Meta-analysis. Four prospective cohorts Meta-analysis. Four prospective cohorts Meta-analysis. Three prospective cohorts Reduced (modest inverse association) in 4 studies (RR = 0.94; 95% CI: 0.89–0.99). No significant association (RR = 1.02; 95% CI: 0.93–1.11). No significant association (RR = 1.04; 95% CI: 0.89–1.21). No significant association (RR = 0.93; 95% CI: 0.74–1.17) No association in 6 studies. (RR = 1.0; 95% CI: 0.96–1.04) Dairy products Narrative review No strong evidence that dairy products increase risk of CHD Regular hard cheese Narrative review Probable beneficial effect Inverse association, but not statistically significant in 6 studies (RR = 0.87; 95% CI: 0.72–1.05) Reduced (RR = 0.92; 95% CI: 0.87–0.98) No association Fermented milk Narrative review May be beneficial Chapter 4 – Milk and dairy products as part of the diet 149
150 Milk and dairy products in human nutrition associated with higher risk of CHD. Elwood et al. (2008) conclude that the available data indicate a possible beneficial effect of milk and dairy consumption on risk of CVD. A recently published meta-analysis by the same group (Elwood et al., 2010) reported a 13 percent (95 percent CI: 2 percent–23 percent) reduction in risk of all-cause mortality in individuals with the highest dairy intake relative to those with the lowest intake and 8 percent (95 percent CI: 1 percent–20 percent) and 21 percent (95 percent CI: 9 percent–32 percent) reductions in risk of ischaemic heart disease (IHD) and stroke. From data from a total of 259 162 participants and 4 391 CHD cases (fatal and nonfatal) analysed in six prospective cohort, Soedamah-Muthu et al. (2011) concluded that milk intake was not associated with risk of CHD, stroke or total mortality. Using a subset of the data (13 518 participants and 2 283 CVD cases in four prospective cohort studies) the authors found that milk was modestly inversely associated with total CVD risk (RR: 0.94 per 200 ml/day; 95 percent CI: 0.89–0.99), although they caution that these findings are based on limited numbers. Furthermore, limited studies of the association of total high-fat and total low-fat dairy products showed no significant association with CHD risk (Soedamah-Muthu et al., 2011). A narrative review concluded that when guiding dietary principles such as balance, variety and moderation are stressed, there is no strong evidence that dairy products increase the risk of CHD in healthy men of all ages or in healthy young and middle-aged women (Tholstrup, 2006). Several new studies have been published since these reviews. A small 16-year prospective study of 1 529 adult Australians suggests that full-fat dairy may contribute to a reduction of CVD risk (Bonthuis et al., 2010). However, analysis of data from the Nurses Health Study (a large prospective cohort study of more than 100 000 participants) found that high-fat dairy products were significantly associated with elevated risk of CHD (Bernstein et al., 2010). Goldbohm et al. (2011) found that dairy fat intake (per 10 g/day; rate ratio (mortality) = 1.04; 95 percent CI: 1.01–1.06) is associated with slightly increased all-cause and IHD mortality rates in women, while a small prospective cohort study of 1 956 Dutch participants found that highfat dairy was associated with an increased risk of CVD mortality (van Aerde et al., 2012). The authors also report that when high-fat dairy was split into “desserts” and “non-desserts”, a statistically significant association with increased risk of CVD was seen only with the “non-desserts” (hazard ratio [HR] per standard deviation [SD] increase = 1.28; 95 percent CI: 1.06–1.55), suggesting that fat rather than sugar was responsible. Total dairy intake and low-fat dairy were not found to be statistically significantly associated with CVD mortality or all-cause mortality (van Aerde et al., 2012). Another recent prospective cohort (33 625 participants, 13-year follow-up) also found that total dairy was intake was not significantly associated with risk of CHD (HR per SD increase = 0.99; 95 percent CI: 0.94–1.05) or stroke (HR per SD increase = 95; 95 percent CI: 0.85–1.05), nor were high-fat dairy and low-fat dairy (Dalmeijer et al., 2012). Two recent large prospective cohort studies have reported results with regard to dairy consumption and stroke. Larsson, Virtamo and Wolk (2012) found that consumption of low-fat dairy foods was inversely associated with risk of total stroke and cerebral infarction. The relative risks reported for the highest quintile of low-fat dairy consumption (four servings/day) compared with the lowest quintile (zero servings/day) were 0.88 (95 percent CI: 0.80–0.97) for total stroke and 0.87
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MILK dairy products in and human nu
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cover photo credits front: © EADD/
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iv 2.7 Emerging issues and challeng
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vi 5.2 Dairy components 209 5.2.1 M
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viii 9.2 Key trends and emerging is
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x 2.5 Per capita energy intake from
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xii Preface Billions of people arou
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xiv The publication serves a variet
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xvi (Research Assistant Professor,
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xviii Permissions granted by extern
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xx FPCM fat and protein-corrected m
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xxii Contributors Anthony Bennett j
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xxiv from the National University o
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xxvi Award 2010 along with colleagu
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2 Milk and dairy products in human
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11 Chapter 2 Milk availability: Cur
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Chapter 2 - Milk availability: Curr
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Table 2.5 Volume and share of milk
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41 Chapter 3 Milk and dairy product
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Chapter 3 - Milk and dairy product
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Table 3.1 Proximate composition of
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Table 3.2 (continued) Vitamins Ribo
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Table 3.4 Mineral composition in mi
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Table 3.6 (continued) Riboflavin Vi
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Chapter 4 - Milk and dairy products
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207 Chapter 5 Dairy components, pro
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Annex Table 5.2 EU register of dair
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Table 5.2 (continued) Claim type Ar
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243 Chapter 6 Safety and quality Ma
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Chapter 6 - Safety and quality 245
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276 Milk and dairy products in huma
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Table 7.1 (continued) Country/organ
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Table 7.1 (continued) 308 Country/o
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