Abstract
The role of milk and fermented milk consumption in stroke risk is unclear. We investigated associations of time-updated information on milk and fermented milk consumption (1997 and 2009) with total stroke, cerebral infarction, and hemorrhagic stroke risk among 79,618 Swedish women and men (mean age 61.3 years). During a mean follow-up of 17.7 years, we identified 9735 incident cases of total stroke, of which 7573 were cerebral infarctions, 1470 hemorrhagic strokes, and 692 unspecified strokes. Compared with an intake of 100 g/day of milk, the multivariable-adjusted hazard ratios (95% confidence interval) of cerebral infarction were 1.05 (1.02–1.08) for 0 g/day, 0.97 (0.95–0.99) for 200 g/day, 0.96 (0.92–1.00) for 400 g/day, 0.98 (0.94–1.03) for 600 g/day, and 1.01 (0.94–1.07) for 800 g/day. Corresponding estimates for hemorrhagic stroke were 0.98 (0.91–1.05) for 0 g/day, 1.02 (0.97–1.07) for 200 g/day, 1.07 (0.98–1.17) for 400 g/day, 1.13 (1.02–1.25) for 600 g/day, and 1.19 (1.03–1.36) for 800 g/day. No associations were observed between milk consumption and total stroke or for fermented milk consumption and any of the stroke outcomes. Higher long-term milk consumption based on repeated measures of intake was weakly and non-linearly associated with cerebral infarction, and was directly associated with hemorrhagic stroke.
Highlights
Milk is a rich source of several essential nutrients, such as calcium, phosphorous, vitamin D, vitamin B12, riboflavin, and protein
An increment of 200 g of milk per day was associated with 8% lower risk of total stroke in recent meta-analysis [1], while other studies showed no association between milk consumption and stroke [2,3]
The blood vessel walls may become fragile when muscle fibers and elastic fibers are replaced by amyloid plaque and studies have shown an association between cerebral amyloid angiopathy and lobar intracerebral hemorrhage [37–39]. Results from this prospective cohort study with time-updated information on exposures and covariates showed that milk consumption is not clearly associated with total stroke, is weakly and non-linearly associated with cerebral infarction, and is directly associated with hemorrhagic stroke
Summary
Milk is a rich source of several essential nutrients, such as calcium, phosphorous, vitamin D, vitamin B12, riboflavin, and protein. Results from previous studies on the relationship between milk and fermented milk consumption and stroke risk are not consistent. An increment of 200 g of milk per day was associated with 8% lower risk of total stroke in recent meta-analysis [1], while other studies showed no association between milk consumption and stroke [2,3]. These differences could be due to the population studied, e.g., whether the population have in general a low or a high consumption of milk [1,4,5], which may entail different reference categories [6].
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