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

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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