Abstract
In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for CVD prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥18 years from the NutriNet-Santé cohort (2009-2019). Daily dietary intakes were collected using 24-h dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n 1952) included cerebrovascular disease (n 878 cases) and CHD (n 1219 cases). Multivariable Cox models were performed to investigate associations. This analysis included 104805 French adults (mean age at baseline 42·8 (sd 14·6) years, mean follow-up 5·5 (sd 3·0) years, i.e. 579155 person-years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared with intakes below 57 g/d (hazard ratio = 0·81 (95 % CI 0·66, 0·98), Ptrend = 0·01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomised controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.
Highlights
Cardiovascular diseases (CVD), including coronary heart diseases (CHD) and cerebrovascular diseases such as strokes are still a leading cause of mortality worldwide, causing 17.9 million deaths every year (1),(2)
Participants consumed on average 222g/d of dairy foods (SD 151), including 110g/d of milk (SD 127), 37.7g/d of cheese (SD 28.3) and 79.1g/d of yogurt (SD 84.9), which was similar to the consumption levels observed in the general French population (9)
It is recommended to limit dietary saturated fat (SFA) intakes for CVD prevention; this study did not reveal any direct association between the consumption of dairy products and total CVD or CHD risk, despite contributing to 28.9% of dietary SFA (Appendix 2b)
Summary
Cardiovascular diseases (CVD), including coronary heart diseases (CHD) and cerebrovascular diseases such as strokes are still a leading cause of mortality worldwide, causing 17.9 million deaths every year (1),(2). Lifestyle factors such as nutritional status and dietary habits, have been identified as one of the main modifiable risk factors of CVD (4).public health guidelines around the world target the consumption of specific nutrients and food groups as a strategy for reducing CVD risk at a population level. In France, public health guidelines suggest a consumption of SFA below 12% of dietary energy (without alcohol), with an emphasis on three fatty acids that should remain below 8% of dietary energy (lauric C12:0, myristic C14:0 and palmitic C16:0 acids) (7). The French National Health and Nutrition Programme (PNNS) focuses on recommendations related to food groups, and suggests a daily consumption of two servings of dairy products per day for adults, to be chosen among milk, cheese and yogurts, but not including butter, cream or dairy desserts (e.g. custard, ice cream and cheese cake) (8)
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