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

Chapter 4 – Milk and dairy products as part of the diet 151
(95 percent CI: 0.78–0.98) for cerebral infarction. Consumption of total dairy, fullfat
dairy and milk were not associated with stroke risk. In the second study, which
looked at dietary protein sources and the risk of stroke, Bernstein et al. (2012)
found that compared with one serving of red meat/day, one serving of low-fat
dairy/day was associated with an 11 percent lower risk of stroke (95 percent CI:
5 percent–17 percent), and one serving of whole-fat dairy/day with a 10 percent
lower risk (95 percent CI: 4 percent–16 percent).
4.8.4 Other dairy products and risk of cardiovascular disease
There is a paucity of studies examining individual dairy food items and CVD risk
(Elwood et al., 2010). Butter has a higher concentration of milk fat than any other
dairy product, and is cholesterolemic (Tholstrup, 2006). However, controlled studies
have demonstrated that milk and butter have similar cholesterolemic effects;
the effects on other CHD risk markers have not been fully elucidated (Tholstrup,
2006). An inconsistency between results from cohort studies and case-controlled
studies with respect to butter has been highlighted by Elwood et al. (2010): a metaanalysis
of data from three cohorts suggested a possible reduction in vascular disease
risk (0.93; 95 percent CI: 0.84–1.02), although this was not statistically significant
(P = 0.33), while two case-control studies suggested an increase of vascular disease,
and one case-control study an increase in peripheral arterial disease from the consumption
of butter. A more recent study (Goldbohm et al., 2011) reported a slightly
increased risk of all-cause and IHD mortality for both butter and dairy fat intake
(per 10 g/day; rate ratio mortality = 1.04; 95 percent CI: 1.01–1.06) only in women. As
Elwood et al. (2010) concluded, the main message of these data is that the evidence
on butter and the other dairy items is inadequate.
Ghee, an important source of fat in the Indian diet derived from cow and buffalo
milk, is rich in SFAs and cholesterol (Nath and Ramamurthy, 1988; Rawashdeh,
2002; Mohammadifard et al., 2010). High consumption of vegetable ghee, 38 clarified
butter (Indian ghee) and milk, in conjunction with a sedentary lifestyle and higher
BMI have been reported to be significant risk factors for CVD in Indians (Singh
et al., 1996). However, Indian men consuming 1 kg or more of ghee per month
have been found to have a significantly lower prevalence of CHD than those who
consumed less than 1 kg/month (Gupta and Prakash, 1997). Shankar et al. (2002,
2005) found that consumption of ghee at the level of 10 percent of dietary energy
in a vegetarian diet had no effect on serum lipid profiles or lipoprotein profiles in
healthy young subjects.
Evidence on cheese and vascular disease is also limited (Elwood et al., 2010).
Although six cohort studies evaluating cheese and CVD risk were available, sufficient
data for a meta-analysis were given in only two, yielding an overall estimate of
risk from cheese of 0.90 (95 percent CI: 0.79–1.03) (Elwood et al., 2010). Tholstrup
38 Vegetable ghee is solidified vegetable oil, made to mimic anhydrous butter oil, i.e. ghee.