Abstract MP049: Fermented vs. Non-fermented Dairy and Risk of Coronary Heart Disease in Men: the Kuopio Ischaemic Heart Disease Risk Factor Study

Abstract

Introduction: Most of the recent dairy studies, including multiple meta-analyses, show either no relationship or an inverse association between total dairy intake and risk of cardiovascular diseases. Some of these studies have suggested that especially fermented rather than non-fermented dairy might provide benefits on cardiovascular health, but the data is inconclusive. Also, the average dairy intake has been modest in many study populations, which reduces the generalizability of the findings to populations with high dairy intake. Hypothesis: We assessed the hypothesis that fermented and non-fermented dairy products have distinct associations with the risk of coronary heart disease (CHD) in men from eastern Finland, a population with high intake of dairy products. Methods: A total of 1981 men from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study from eastern Finland, aged 42-60 years, with no CHD at baseline, were included. The consumption of foods was assessed with instructed 4-day food recording by household measures. Dairy products with fat content <3.5% were considered low-fat. Multivariable Cox regression analyses included age, examination year, smoking, leisure-time physical activity, education, family history of CHD, and intakes of alcohol, energy, fiber, polyunsaturated fatty acids, and fruits, berries and vegetables. Fatal and non-fatal CHD events were ascertained from national registries, with no loss to follow-up. Results: The mean±SD intakes were 733±375 g/d for total, 187±218 g/d for fermented and 546±345 g/d for non-fermented dairy. Low-fat products comprised 87% (162±218 g/d) of the fermented and 43% (317±291 g/d) of the non-fermented dairy intake. During the mean follow-up of 20.1 years, 472 CHD events occurred. The multivariable-adjusted hazard ratio (95% CI) in the highest (>280 g) vs. the lowest (<26 g) quartile of total fermented dairy was 0.73 (0.56-0.95, P-trend=0.02) and in the highest (>727 g) vs. the lowest (<258 g) quartile of total non-fermented dairy 1.44 (1.06-1.94, P-trend=0.009). When low-fat and high-fat dairy were evaluated separately, only low-fat products were associated with the risk. The extreme-quartile hazard ratios (95% CIs) were 0.74 (0.57-0.96, P-trend=0.02) for low-fat fermented dairy and 1.47 (1.08-1.99, P-trend=0.02) for low-fat non-fermented dairy. Intakes of total dairy (extreme-quartile HR 1.03, 95% CI 0.74-1.42, P-trend=0.727), high-fat fermented dairy (HR 0.92, 95% CI 0.69-1.22, P-trend=0.32) or high-fat non-fermented dairy (HR 1.09, 95% CI 0.77-1.56, P-trend=0.44) were not associated with the risk of CHD. Conclusions: Our results suggest that low-fat fermented dairy products are associated with a lower risk of CHD, whereas low-fat non-fermented dairy products are associated with a higher risk in a population with high intake of dairy products.