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BMJ. 2019 Nov 27;367:l6204. doi: 10.1136/bmj.l6204.

Associations of dairy intake with risk of mortality in women and men: three prospective cohort studies.

Ding M1, Li J2,3, Qi L2,4, Ellervik C5,6,7, Zhang X8, Manson JE3,7,8, Stampfer M3,8, Chavarro JE2,3,8, Rexrode KM9, Kraft P3, Chasman D7,10,11, Willett WC2,3,8, Hu FB2,3,8.

Author information

1
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA mid829@mail.harvard.edu.
2
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
3
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
4
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
5
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
6
Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.
7
Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
8
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
9
Division of Women's Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
10
Division of Genetics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
11
Broad Institute of MIT and Harvard, Cambridge, MA, USA.

Abstract

OBJECTIVE:

To examine the association of consumption of dairy foods with risk of total and cause specific mortality in women and men.

DESIGN:

Three prospective cohort studies with repeated measures of diet and lifestyle factors.

SETTING:

Nurses' Health Study, Nurses' Health Study II, and the Health Professionals Follow-up Study, in the United States.

PARTICIPANTS:

168 153 women and 49 602 men without cardiovascular disease or cancer at baseline.

MAIN OUTCOME MEASURE:

Death confirmed by state vital records, the national death index, or reported by families and the postal system. During up to 32 years of follow-up, 51 438 deaths were documented, including 12 143 cardiovascular deaths and 15 120 cancer deaths. Multivariable analysis further adjusted for family history of cardiovascular disease and cancer, physical activity, overall dietary pattern (alternate healthy eating index 2010), total energy intake, smoking status, alcohol consumption, menopausal status (women only), and postmenopausal hormone use (women only).

RESULTS:

Compared to the lowest category of total dairy consumption (average 0.8 servings/day), the multivariate pooled hazard ratio for total mortality was 0.98 (95% confidence interval 0.96 to 1.01) for the second category of dairy consumption (average 1.5 servings/day), 1.00 (0.97 to 1.03) for the third (average 2.0 servings/day), 1.02 (0.99 to 1.05) for the fourth (average 2.8 servings/day), and 1.07 (1.04 to 1.10) for highest category (average 4.2 servings/day; P for trend <0.001). For the highest compared to the lowest category of total dairy consumption, the hazard ratio was 1.02 (0.95 to 1.08) for cardiovascular mortality and 1.05 (0.99 to 1.11) for cancer mortality. For subtypes of dairy products, whole milk intake was significantly associated with higher risks of total mortality (hazard ratio per 0.5 additional serving/day 1.11, 1.09 to 1.14), cardiovascular mortality (1.09, 1.03 to 1.15), and cancer mortality (1.11, 1.06 to 1.17). In food substitution analyses, consumption of nuts, legumes, or whole grains instead of dairy foods was associated with a lower mortality, whereas consumption of red and processed meat instead of dairy foods was associated with higher mortality.

CONCLUSION:

These data from large cohorts do not support an inverse association between high amount of total dairy consumption and risk of mortality. The health effects of dairy could depend on the comparison foods used to replace dairy. Slightly higher cancer mortality was non-significantly associated with dairy consumption, but warrants further investigation.

PMID:
31776125
PMCID:
PMC6880246
DOI:
10.1136/bmj.l6204
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from the National Institutes of Health for the submitted work; FBH reports support from grants HL60712, HL118264, and DK112940 from the National Institutes of Health, research support from the California Walnut Commission, honorariums for lectures from Metagenics and Standard Process, and honorariums from Diet Quality Photo Navigation, outside the submitted work; the remaining authors report no other relationships or activities that could appear to have influenced the submitted work.

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