Abstract
BackgroundThe association between milk and dairy intake and the incidence of cardiometabolic diseases, cancer and mortality has been evaluated in many studies, but these studies have had conflicting results with no clear conclusion on causal or confounding associations. The present study aims to further address this association by cross-sectional and longitudinal evaluation of the associations between exposure to various types of dairy products and metabolic risk markers among inhabitants in northern Sweden while taking other lifestyle factors into account.MethodsRespondents in the Västerbotten Intervention Programme with complete and plausible diet data between 1991 and 2016 were included, yielding 124,934 observations from 90,512 unique subjects. For longitudinal analysis, 27,682 participants with a visit 8–12 years after the first visit were identified. All participants completed a validated Food Frequency Questionnaire. Metabolic risk markers, including body mass index (BMI), blood pressure, serum (S) cholesterol and triglycerides, and blood glucose, were measured. Participants were categorized into quintiles by intake of dairy products, and risk (odds ratios, OR) of undesirable levels of metabolic risk markers was assessed in multivariable logistic regression analyses. In longitudinal analyses, intake quintiles were related to desirable levels of metabolic risk markers at both visits or deterioration at follow-up using Cox regression analyses.ResultsThe OR of being classified with an undesirable BMI decreased with increasing quintiles of total dairy, cheese and butter intake but increased with increasing non-fermented milk intake. The OR of being classified with an undesirable S-cholesterol level increased with increasing intake of total dairy, butter and high fat (3%) non-fermented milk, whereas an undesirable S-triglyceride level was inversely associated with cheese and butter intake in women. In longitudinal analyses, increasing butter intake was associated with deterioration of S-cholesterol and blood glucose levels, whereas increasing cheese intake was associated with a lower risk of deterioration of S-triglycerides.ConclusionsConfounding factors likely contribute to the demonstrated association between dairy intake and mortality, and other medical conditions and analyses should be stratified by dairy type.
Highlights
The association between milk and dairy intake and the incidence of cardiometabolic diseases, cancer and mortality has been evaluated in a large number of observational studies, meta-analyses and gene based Mendelian randomization studies [1,2,3]
Does increased all-cause mortality concurrent with the consumption of non-fermented milk and butter represent a causal association or residual confounding by associated lifestyle factors? The present study aims to address this question by cross-sectional and longitudinal evaluations of the associations between exposure to different types of dairy products and risk markers for cardiovascular diseases in a large cohort of inhabitants in northern Sweden while taking other lifestyle factors into account
The difference was mainly driven by differences in high fat non-fermented milk and butter intake, whereas intake of other dairy products was more stable between the sexes and 10-year age groups (Additional file 1)
Summary
The association between milk and dairy intake and the incidence of cardiometabolic diseases, cancer and mortality has been evaluated in a large number of observational studies, meta-analyses and gene based Mendelian randomization studies [1,2,3]. Most studies were carried out in countries with low milk consumption concurrent with a high prevalence of lactose intolerance. In this respect, Sweden represents contrasting environmental and genetic exposure. The association between milk and dairy intake and the incidence of cardiometabolic diseases, cancer and mortality has been evaluated in many studies, but these studies have had conflicting results with no clear conclusion on causal or confounding associations.
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