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

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Milk and dairy products in human nutrition
(2006) concluded from reviewing three well-controlled human studies 39 that cheese
does not increase plasma cholesterol. However, one older study (Appleby et al.,
1999, cited in Tholstrup, 2006) found that both meat and cheese consumption were
positively associated with total cholesterol concentration and dietary fibre intake
was inversely associated with total cholesterol concentration in both men and
women. Tholstrup (2006) recommends that a possible beneficial effect of cheese on
CHD risk factors be further investigated. The author also notes that CHD mortality
is low in France, where cheese consumption is high, whereas CHD mortality
was high in the Scandinavian studies, where milk consumption is high, but that
ecological studies such as these are not easy to interpret, and the author could not
establish causality. A recent large prospective cohort study found no association
between consumption of cheese and stroke risk (Larsson, Virtamo and Wolk, 2012).
With regard to fermented milk, Tholstrup (2006) wrote that some specific
bacterial strains may have cholesterol-reducing properties, while some fermented
products (especially those produced using Lactobacillus helveticus) can decrease
hypertension. In addition, a recent study reported a statistically significant inverse
relationship between fermented milk consumption and CVD, with the highest level
of intake (238 g/day for women, 273 g/day for men) being associated with 15 percent
decreased incidence of CVD compared with the lowest level of intake (40 g/day
for women and 43 g/day for men) (Sonestedt et al., 2011). Goldbohm et al. (2011)
also reported that consumption of fermented full-fat milk was inversely associated
with all-cause mortality for men (RR continuous = 0.91; 95 percent CI: 0.86–0.97
per 100 ml/day) and for women (RR continuous = 0.92; 95 percent CI: 0.85–1.00 per
100 ml/day), and nonsignificantly with stroke mortality in both men and women.
Recently, Dalmeijer et al. (2012) reported a borderline inverse association between
intake of fermented dairy products and risk of stroke (HR = 0.92; 95 percent CI:
0.83–1.01), supporting this result. However, another smaller study (van Aerde et al.,
2012) did not find fermented dairy products to be statistically significantly associated
with CVD mortality or all-cause mortality.
Elwood et al. (2010) records the few available studies dealing with cream, yoghurt
and ice cream, but draws no firm conclusions. They note that a very small number
of the cohort studies provide evidence on individual dairy foods, and that there is no
convincing evidence of harm or benefit from consumption of the separate food items.
4.8.5 Summary
Interpreting the interactions between consumption of dairy products and CVD is
difficult, not least because of the limitations of the studies reviewed outlined in the
39 The first study (Tholstrup et al., 2004, cited in Tholstrup et al., 2006) compared the effects of isoenergetic
amounts of milk, cheese and butter (adjusted to the same content of lactose and casein)
on fasting and postprandial blood lipids and lipoproteins, and on postprandial glucose and insulin
response. All food items other than milk, cheese and butter were constant and identical in the three
test diets. The cheese diet contained 205 g of hard cheese, “Samsø”. The second study (Biong et al.,
2004, cited in Tholstrup, 2006) compared the effects of Jarlsberg cheese with butter on serum lipoproteins,
haemostatic variables and homocysteine. The third study (Nestel et al., 2005, cited in Tholstrup,
2006) compared the effects of a daily consumption of 40 g of dairy fat as butter or as matured
cheddar cheese.