Abstract
Previous systematic reviews and meta-analyses have evaluated the association of dairy consumption and the risk of cardiovascular disease (CVD). However, the findings were inconsistent. No quantitative analysis has specifically assessed the effect of yogurt intake on the incident risk of CVD. We searched the PubMed and the Embase databases from inception to 10 January 2017. A generic inverse-variance method was used to pool the fully-adjusted relative risks (RRs) and the corresponding 95% confidence intervals (CIs) with a random-effects model. A generalized least squares trend estimation model was used to calculate the specific slopes in the dose-response analysis. The present systematic review and meta-analysis identified nine prospective cohort articles involving a total of 291,236 participants. Compared with the lowest category, highest category of yogurt consumption was not significantly related with the incident risk of CVD, and the RR (95% CI) was 1.01 (0.95, 1.08) with an evidence of significant heterogeneity (I2 = 52%). However, intake of ≥200 g/day yogurt was significantly associated with a lower risk of CVD in the subgroup analysis. There was a trend that a higher level of yogurt consumption was associated with a lower incident risk of CVD in the dose-response analysis. A daily dose of ≥200 g yogurt intake might be associated with a lower incident risk of CVD. Further cohort studies and randomized controlled trials are still demanded to establish and confirm the observed association in populations with different characteristics.
Highlights
Cardiovascular disease (CVD) is still an important public health problem around the world [1].The prevalence of coronary heart disease (CHD) and stroke has progressively increased during the past decades [1,2,3]
Inclusive criteria: (1) studies reporting the relationship of yogurt intake and the incident risk of CVD (CHD or stroke) by using adjusted relative risks (RRs), hazard ratios (HRs), or odds ratios (ORs) and their corresponding 95% confidence intervals (CIs); (2) studies in which exposures were the fermented milk, but yogurt was the largest contribution to the total fermented milk; and (3) the study design was based on prospective cohort
Yogurt intake was assessed by a food-frequency questionnaire (FFQ), and the incidences of CVD were ascertained from medical records or registries in all included articles
Summary
Cardiovascular disease (CVD) is still an important public health problem around the world [1]. Previous systematic reviews and meta-analyses have evaluated the association of dairy consumption and the risk of CVD [11,12,13,14,15]. Nutrients 2017, 9, 315 subgroup analysis of yogurt intake, no association was established between yogurt intake and CVD or stroke in three previous meta-analyses [11,12,13]. Hu et al observed a protective role of yogurt intake on stroke, but only three studies were included in the pooled analysis [15]. To the best of our knowledge, no quantitative analysis has assessed the effect of yogurt intake on the risk of incident CVD. We performed a systematic review and meta-analysis to pool the evidence from prospective cohort studies on the relationship of yogurt intake and the incident risk of CVD. We attempted to evaluate the potential dose-response pattern of the association
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