Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study

Dehghan, Mahshid; Mente, Andrew; Rangarajan, Sumathy; Sheridan, Patrick; Mohan, Viswanathan; Iqbal, Romaina; Gupta, Rajeev; Lear, Scott A.; Wentzel-Viljoen, Edelweiss; Avezum, Álvaro; López‐Jaramillo, Patricio; Mony, Prem; Varma, Ravi Prasad; Kumar, Rajesh; Chifamba, Jephat; AlHabib, Khalid F.; Mohammadifard, Noushin; Oğuz, Aytekin; Lanas, Fernando; Różańska, Dorota; Boström, Kristina Bengtsson; Yusoff, Khalid; Tsolkile, Lungiswa P; Dans, Antonio L.; Yusufali, Afzalhussein; Orlandini, Andrés; Poirier, Paul; Khatib, Rasha; Hu, Bo; Li, Wei; Lu, Yin; Deeraili, Ai; Yeates, Karen; Yusuf, Rita; Ismail, Noorhassim; Mozaffarian, Dariush; Teo, Koon; Anand, Sonia S.; Yusuf, Salim

doi:10.1016/s0140-6736(18)31812-9

Cited by 366 publications

(322 citation statements)

References 28 publications

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“…The study found that dairy consumption was significantly associated with lower risk of mortality and major cardiovascular disease events (Dehghan et al, ). The risk of stroke was also significantly lower with higher dairy consumption (i.e., more than two servings per day; Dehghan et al, ). However, myocardial infarction was not significantly associated with dairy intake (Dehghan et al, ).…”

Section: Diet‐related Harms and Benefitsmentioning

confidence: 99%

“…However, myocardial infarction was not significantly associated with dairy intake (Dehghan et al, ). The study's findings supported the hypothesis that the consumption of dairy products may be beneficial for mortality and cardiovascular disease, especially in low‐ and middle‐income nations where dairy intake tends to be substantially lower than in Europe and North America (Dehghan et al, ).…”

Section: Diet‐related Harms and Benefitsmentioning

confidence: 99%

“…Dairy products play a crucial role in human nutrition and are an important source of protein, vitamins and minerals (Hess et al, ; Kliem & Givens, ; Pereira, ), but concerns have been raised regarding the potential health harms associated with the consumption of milk and dairy products (Haug et al, ; Malekinejad & Rezabakhsh, ; Melnik, ; Pereira, ; Rodrigues, ). Overall, the majority of recent studies suggest that the moderate consumption of dairy products does not increase the risk for most chronic conditions and may actually provide protection against cardiovascular disease, stroke, certain forms of cancer, and mortality (Dehghan et al, ; Haug et al, ; Hess et al, ; Kliem & Givens, ; Pereira, ). However, there is substantial heterogeneity in the literature and even the strongest associations between dairy consumption and beneficial health effects were countered by studies with contrasting results (Hess et al, ).…”

Section: Diet‐related Harms and Benefitsmentioning

confidence: 99%

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A Review of Potential Public Health Impacts Associated With the Global Dairy Sector

et al. 2020

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Strong demand for dairy products has led to a global increase in dairy production. In many parts of the world, dairy systems are undergoing rapid intensification. While increased production may contribute to food security, higher dairy stocking rates in some regions have resulted in increased pressure on natural resources with the potential to affect public health and wellbeing. The aim of this review was to identify and describe the potential health harms and benefits associated with dairy production and consumption. Electronic databases Medline, Embase, Scopus, Web of Science, PubMed, and Google Scholar were searched for published literature that investigated human health impacts of dairy production and consumption. Occupational hazards, environmental health impacts, ecosystem health impacts, foodborne hazards, and diet‐related chronic diseases were identified as potential public health hazards. Some impacts, notably climate change, extend beyond directly exposed populations. Dairy production and consumption are also associated with important health benefits through the provision of nutrients and economic opportunities. As the global dairy sector increases production, exposure to a range of hazards must be weighed with these benefits. The review of impacts presented here can provide an input into decision making about optimal levels of dairy production and consumption, local land use, and identification and management of specific hazards from this sector. Future research should consider multiple exposure routes, socioeconomic implications, and environmental factors, particularly in regions heavily dependent on dairy farming.

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Section: Diet‐related Harms and Benefitsmentioning

confidence: 99%

Section: Diet‐related Harms and Benefitsmentioning

confidence: 99%

Section: Diet‐related Harms and Benefitsmentioning

confidence: 99%

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A Review of Potential Public Health Impacts Associated With the Global Dairy Sector

et al. 2020

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“…Guidelines generally recommend a reduction in saturated fat intake to reduce coronary heart disease risk as a preamble to any drug therapy . However, recent reports challenge the merit of such dietary advice . The association of dairy intake with CVD and mortality was examined prospectively in 21 countries in 136 000 subjects over 9 years .…”

Section: Lipid Interventions: An Overview Of Clinical Trialsmentioning

confidence: 99%

An updated review of lipid‐modifying therapy

Simons

2019

Medical Journal of Australia

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Summary Statin drugs reduce low‐density lipoprotein (LDL)‐cholesterol (LDL‐C) and cardiovascular risk. Ezetimibe may be used to supplement statin therapy, or used alone in cases of statin intolerance. Statin‐associated side effects do occur, especially muscle symptoms and new onset diabetes, but they do not detract from the benefits of statin therapy. Inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce LDL‐C and cardiovascular risk. Evolocumab is subsidised in Australia for patients with familial hypercholesterolaemia when LDL‐C is not adequately controlled with maximum doses of statin or ezetimibe or when statin therapy is contraindicated. Fenofibrate reduces triglycerides and cardiovascular risk in patients with type 2 diabetes when triglycerides are elevated and high‐density lipoprotein (HDL) is low. A role for dietary omega‐3 fatty acids and esters in reducing cardiovascular risk remains controversial. All cases of secondary cardiovascular disease prevention merit intensive lipid therapy, unless a contraindication exists. Lipid therapy is justified in cases of primary prevention when absolute risk is high, especially when lipids are highly elevated or when multiple risk factors are present. Clinical management requires a focus on the predominant lipid disorder present, namely hypercholesterolaemia, hypertriglyceridaemia or combined hyperlipidaemia. There is an ongoing problem of poor long term persistence on lipid therapy, as well as reduced awareness by practitioners of poor risk factor control.

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“…Nevertheless, many studies now strongly suggest that dietary saturated fats (SFA) are not causally related to CVD . However, SFA from meat is associated with higher and from dairy with lower CVD risk, suggesting additional mediators such as trimethylamine N‐oxide, a byproduct of the microbiome in response to red meat . High intake of simple carbohydrates (CHO) appeared to be most strongly associated with mortality, most strongly shown in the PURE study, in which 135 335 persons from 18 countries were compared.…”

mentioning

confidence: 99%

Notes from the world congress on insulin resistance, diabetes, and cardiovascular disease

Bloomgarden

Handelsman

2019

Journal of Diabetes

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Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study

Cited by 366 publications

References 28 publications

A Review of Potential Public Health Impacts Associated With the Global Dairy Sector

A Review of Potential Public Health Impacts Associated With the Global Dairy Sector

An updated review of lipid‐modifying therapy

Notes from the world congress on insulin resistance, diabetes, and cardiovascular disease

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