Dairy Product Intake and Cardiometabolic Diseases in Northern Sweden: A 33-Year Prospective Cohort Study

Abstract

Dairy products are important constituents of most diets, and their association with adverse health outcomes remains a focus. We characterized dairy food intake and examined associations with the incidence of type 2 diabetes (T2D), myocardial infarction (MI) or stroke among 108,065 Swedish men and women. Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazards models in a population characterized by high milk tolerance. During a mean follow-up of 14.2 years, 11,641 first-time events occurred. Non-fermented milk intake decreased, whereas butter intake increased over the period. For high intake of non-fermented milk, the HR (95% CI) for developing T2D and MI was 1.17 (1.03, 1.34) and 1.23 (1.10, 1.37), respectively, in men. A greater intake of butter, fermented milk, and cheese tended to be associated with a reduced risk of T2D and/or MI. Non-consumers and those who chose low-fat variants of the targeted dairy products had increased risk for T2D, MI, or stroke compared to those in the non-case group. Generally, effect-sizes were small. This prospective study found that non-fermented milk was associated with an increased risk for developing T2D and MI and that subjects abstaining from dairy products or choosing low-fat variants were at greater risk. However, the overall cardiometabolic risk of non-fermented milk intake was judged as low, since the effect sizes were small.

Intake of dairy products and associations with major atherosclerotic cardiovascular diseases: a systematic review and meta-analysis of cohort studies

“…From the Malmö Diet and Cancer cohort 16 , the results on total dairy and butter were included in the data synthesis, and from the EPIC-NL cohort 52 , the results on total dairy, low-fat dairy and high-fat dairy were included in the data synthesis due to the different exposures than in the EPIC cohort 21 . Thus, 30 studies were included in the qualitative data synthesis [12][13][14][15][16][17][18][19][20][21][22][23][36][37][38][39][40][41][42][43][44][45]47,48,[50][51][52][53]55,56 (20 studies for CHD 12,13,[16][17][18][19][20][21][22][37][38][39][40]45,48,[50]<...>…”

“…No studies on peripheral artery disease were identified. Table 1 shows the characteristics of the 20 studies on CHD 12,13,[16][17][18][19][20][21][22][37][38][39][40]45,48,[50][51][52][53]56 . Among the 20 studies, 5 presented gender-specific results 17,20,21,50,53 , 3 comprised only men 13,45,56 and 3 comprised only women 12,18,40 .…”

“…Table 1 shows the characteristics of the 20 studies on CHD 12,13,[16][17][18][19][20][21][22][37][38][39][40]45,48,[50][51][52][53]56 . Among the 20 studies, 5 presented gender-specific results 17,20,21,50,53 , 3 comprised only men 13,45,56 and 3 comprised only women 12,18,40 . A single study was from Asia 22 , 13 from Europe 13,16,[18][19][20][21][37][38][39]45,50,52,53 and 5 from North America 12,17,40,48,56 .…”

“…Any disagreement between the two reviewers over the extracted data of a particular study was resolved by discussion. We contacted (by e-mail) 12 authors [12][13][14][15][16][17][18][19][20][21][22][23] of the included studies for further information on study methods (exposure definition, quantitative amount) and…”

Changes in food intake patterns during 2000–2007 and 2008–2016 in the population-based Northern Sweden Diet Database

“…A recent review suggested that bioactive components associated with dairy lipids, especially high fat products, may be beneficial for cardio-metabolic health [27]. In a previous study in the same population, we found that the source of dairy fat, e.g., non-fermented or fermented milk, determined whether a high intake increased or decreased the risk for type 2 diabetes and myocardial infarction [28]. However, generally effect sizes were small.…”