Dairy consumption and mortality after myocardial infarction: a prospective analysis in the Alpha Omega Cohort

Abstract

Background Population-based studies generally show neutral associations between dairy consumption and ischemic heart disease (IHD) mortality, whereas weak inverse associations were found for cardiovascular disease (CVD) and stroke mortality. Whether dairy consumption affects long-term survival after myocardial infarction (MI) is unknown. Objectives We studied types of dairy and long-term mortality risk in drug-treated post-MI patients. Methods We included 4365 Dutch patients from the Alpha Omega Cohort aged 60–80 y (21% women) with an MI ≤10 y before enrollment. Dietary data were collected at baseline (2002–2006) using a 203-item FFQ and patients were followed for cause-specific mortality through December 2018. HRs of CVD, IHD, stroke, and all-cause mortality for types of dairy were obtained from Cox models, adjusting for age, sex, energy intake, physical activity, smoking, alcohol intake, diabetes, obesity, and dietary factors. Results Most patients were Dutch, 24% were obese, 20% had diabetes, and 97% used cardiovascular medication. Median intakes were 39 g/d for plain yogurt, 88 g/d for total nonfermented milk, and 17 g/d for hard cheeses. Of the cohort, 10% consumed high-fat milk. During ∼12 y of follow-up (48,473 person-years) 2035 deaths occurred, including 903 from CVD, 558 from IHD, and 170 from stroke. Yogurt was linearly inversely associated with CVD mortality (HR: 0.96; 95% CI: 0.93, 0.99; per 25 g/d) and nonlinearly inversely associated with all-cause mortality. Milk was not associated with any of the outcomes (HRs: ∼1.0 per 100 g/d), except for a higher mortality risk in high-fat milk consumers (HR: 1.30; 95% CI: 1.13, 1.49). Other dairy groups were not associated with mortality risk. Conclusions In Dutch post-MI patients, yogurt consumption was inversely associated with CVD mortality and all-cause mortality. Associations for milk and other dairy products were neutral or inconsistent. This trial was registered at clinicaltrials.gov as NCT03192410.

Dairy Consumption and 3-Year Risk of Type 2 Diabetes after Myocardial Infarction: A Prospective Analysis in the Alpha Omega Cohort

“…Dietary guidelines for adult populations generally include two-three daily servings of dairy [10,42]. In our cohort of post-MI patients, we previously found an inverse association between (plain) yogurt consumption and long-term risk of CVD mortality [21]. The present analysis showed neutral findings for T2D, so the cardioprotective association that we observed for yogurt may be related to other (yet unknown) pathways.…”

“…In Dutch post-MI patients from the Alpha Omega Cohort, a healthy dietary pattern was associated with a~30% lower mortality risk [20], on top of cardiovascular drug treatment. In a more recent analysis in this cohort, yogurt consumption was inversely associated with cardiovascular mortality (HR: 0.96; 95% CI: 0.93 to 0.99, per 25 g/d) [21]. Whether dairy consumption affects the risk of T2D after MI is at present unknown.…”

“…Intake of butter, milk and creamers from non-dairy sources, such as soy milk, were not included in this study. Dairy intake was estimated in g/d, and grouped by dairy type as follows: total dairy, total milk, low-fat milk, full-fat milk, hard cheese, total (plain) yogurt, low-fat yogurt, full-fat yogurt, total fermented dairy, liquid fermented dairy, (ice)-cream, and dairy desserts (Supplemental Table S1), as reported previously [21]. Daily intake of total energy (kcal/d) and nutrients (g/d) was calculated through linkage with the 2006 Dutch Food Composition Database (NEVO 2006) [26].…”

Dairy Foods: Is Its Cardiovascular Risk Profile Changing?

“…In contrast, a recent report suggests a protective link between yogurt consumption and CVD. Cruijsen et al have recently reported that during a 12year follow-up of the Alpha Omega Cohort from the Netherlands, that included 48,473 person-years and 2035 deaths, yogurt consumption was inversely associated with CVD mortality (HR 0.96 per 25 g/d) and all-cause mortality (HR 0.98 per 25 g/d) in patients with a history of myocardial infarction [12].…”

Dairy Lactic Acid Bacteria and Their Potential Function in Dietetics: The Food–Gut-Health Axis

“…Studies conducted in recent years stated that there is a negative relationship between the consumption of fermented milk products and the risk of CVD [ 59 , 62 ]. In post-MI patients, each 25 g/d increase in yogurt consumption, regardless of fat content, was found to reduce the CVD-related mortality risk by 4% and the overall mortality risk by 2%, while no such association was observed in other dairy products such as milk and cheese [ 89 ].…”