Abstract

Prevalence of type 2 diabetes mellitus (T2DM) is rapidly increasingly and is a key risk for CVD development, now recognised as the leading cause of death globally. Dietary strategies to reduce CVD development include reduction of saturated fat intake. Milk and dairy products are the largest contributors to dietary saturated fats in the UK and reduced consumption is often recommended as a strategy for risk reduction. However, overall evidence from prospective cohort studies does not confirm a detrimental association between dairy product consumption and CVD risk. The present review critically evaluates the current evidence on the association between milk and dairy products and risk of CVD, T2DM and the metabolic syndrome (collectively, cardiometabolic disease). The effects of total and individual dairy foods on cardiometabolic risk factors and new information on the effects of the food matrix on reducing fat digestion are also reviewed. It is concluded that a policy to lower SFA intake by reducing dairy food consumption to reduce cardiometabolic disease risk is likely to have limited or possibly negative effects. There remain many uncertainties, including differential effects of different dairy products and those of differing fat content. Focused and suitably designed and powered studies are needed to provide clearer evidence not only of the mechanisms involved, but how they may be beneficially influenced during milk production and processing.

Highlights

  • Cardiovascular diseases cause more than a quarter of all deaths in the UK, or about 155 000 deaths per year with about 41 000 of these in individuals under the age of 75 years(1) and are the largest cause of death globally with 17·5 million deaths in 2012(2)

  • A study by Michaëlsson et al(37) reported that milk intake was significantly associated with markedly higher total and CVD mortality in 61 433 Swedish women from the Swedish Mammography Cohort. This relationship was observed in a cohort of 45 339 Swedish men, the relationship was considerably weaker(37). When these data were re-examined, an inverse association was observed for the number of CVD deaths against milk consumption(38) and, in a subset of 33 636 women from the Swedish Mammography Cohort, Patterson et al(39) reported that total dairy food intake was inversely associated with myocardial infarction (MI) risk and milk intake was not significantly associated with MI risk

  • Soedamah-Muthu et al(125) concluded that the results indicate that low-fat dairy products and milk could contribute to the prevention of hypertension, further confirmation is needed from randomised controlled trials (RCT)

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Summary

Introduction

Cardiovascular (heart and circulatory) diseases cause more than a quarter of all deaths in the UK, or about 155 000 deaths per year with about 41 000 of these in individuals under the age of 75 years(1) and are the largest cause of death globally with 17·5 million deaths in 2012(2). This relationship was observed in a cohort of 45 339 Swedish men, the relationship was considerably weaker(37) When these data were re-examined, an inverse association was observed for the number of CVD deaths against milk consumption(38) and, in a subset of 33 636 women from the Swedish Mammography Cohort, Patterson et al(39) reported that total dairy food intake was inversely associated with myocardial infarction (MI) risk (multivariable adjusted HR 0·77; 95 % CI 0·63, 0·95) and milk intake was not significantly associated with MI risk. A recent meta-analysis by Qin et al(34), which included a total of twenty-two prospective cohort studies, showed an inverse association between dairy product consumption and overall risk of CVD (nine studies; RR 0·88; 95 % CI 0·81, 0·96) and stroke (twelve studies; RR 0·87; 95 % CI 0·77, 0·99).

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