Cardiovascular Disease and Milk Products: Summary of Evidence
Milk products, regardless of their fat content, do not appear to increase cardiovascular risk. In fact, a growing body of evidence indicates that milk products are associated with a reduced risk of cardiovascular disease.
The bad press surrounding saturated fat has often harmed the reputation of milk products. However, recent scientific evidence indicates that the saturated fat found in milk products may not be detrimental to health. Furthermore, there is increasing evidence to suggest that milk product consumption may reduce the risk of cardiovascular disease.
In addition, there are numerous milk components that may be related to the prevention or management of cardiovascular risk factors, including vitamin D, calcium, potassium, magnesium, phosphorus, protein and bioactive peptides, and dairy fatty acids.
A 2015 meta-analysis of prospective cohort studies examined the association between dairy consumption and the risk of cardiovascular disease. Specific analyses were conducted to evaluate the association between low-fat dairy, high-fat dairy, yogurt, cheese and butter and the risk of stroke and coronary heart disease. Twenty-two studies were included, with over 900,000 participants and follow-ups ranging from 8 to 26 years.1
- Dairy consumption was associated with a 12% and 13% reduced risk of cardiovascular disease and stroke, respectively;
- There was no association between dairy consumption and the risk of coronary heart disease;
- Low-fat dairy was associated with a 7% lower risk of stroke;
- Cheese was associated with a 9% and 6% reduced risk of stroke and coronary heart disease, respectively;
- There was no association between butter and the risk of coronary heart disease and stroke.
Chowdhury et al. conducted a meta-analysis of prospective cohort studies to evaluate the association between different types of fatty acids with respect to coronary outcomes. Among others, they examined circulating saturated fatty acids that are biomarkers of dairy intake and found the following:2
- Margaric acid (17:0) was associated with a 23% risk reduction in coronary outcomes;
- Myristic (14:0) and pentadecanoic (15:0) acids were not associated with coronary outcomes;
- The findings suggest that saturated fatty acids in dairy products do not have deleterious effects on cardiovascular health
Hu et al. conducted a dose-response meta-analysis evaluating the association between different dairy foods and stroke. The analysis comprised 15 prospective cohort studies and 764,635 participants.3
- Total dairy consumption was associated with a stroke risk reduction of 12%;
- Low-fat dairy, fermented milk and cheese were associated with a decreased risk of stroke by 9%, 20% and 6%, respectively;
- High-fat dairy, non-fermented milk, butter and cream were not associated with stroke risk;
- Associations appeared stronger for the risk reduction of stroke mortality, as compared to incidence.
In another meta-analysis, the association between food sources of saturated fat and cardiovascular mortality was examined. With respect to dairy foods, the authors observed that total dairy, milk and cheese consumption were not associated with the risk of cardiovascular mortality.4
Furthermore, a systematic review of observational studies that were published between 2009 and 2013 concluded that the consumption of dairy products, including full-fat milk, cheese and yogurt, does not contribute to the development of cardiovascular disease. Instead, the evidence indicated that they might have a protective cardiovascular effect.5
Evidence from national surveys also suggests that dairy consumption may help protect against cardiovascular disease. For instance, the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) survey, which is a nationwide study, found the following:6
- Higher intakes of whole-fat milk, yogurt, and cheese were associated with better cardiovascular health;
- No association was observed between dairy desserts, ice cream and butter and cardiovascular health;
- Having at least 3 servings of dairy products per day was associated with the greatest cardiovascular health score.
In a nationally representative cohort of 3,810 Taiwanese adults, the association between dairy consumption and cardiovascular mortality was examined. The authors observed a linear relationship between higher intakes of dairy products (>7 times weekly) and reduced cardiovascular mortality. The results also indicated a protective effect on stroke mortality.7
The mechanistic pathways underlying the protective cardiovascular effects of dairy products remain to be elucidated. Several nutrients found in dairy products may be beneficial to cardiovascular health (summarized in the table below). Nonetheless, there is evidence to suggest that the complex matrix of dairy foods, rather than individual milk components, may be as important to improving cardiovascular health.5
|Milk component||Potential mechanistic action|
|Protein and bioactive peptides||
|Dairy fatty acids, e.g., conjugated linoleic acid||
More studies are needed to fully elucidate the relationship between different subtypes of milk products and subtypes of cardiovascular disease, including coronary heart disease and stroke.
Milk products are complex foods containing many key nutrients. Additional mechanistic studies are needed to fully understand how these components or the dairy food matrix may help reduce cardiovascular risk.
- Qin LQ et al. Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr 2015;24:90-100.
- Chowdhury R et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med 2014;160:398-406.
- Hu D et al. Dairy foods and risk of stroke: a meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis 2014;24:460-469.
- O’Sullivan TA et al. Food sources of saturated fat and the association with mortality: a meta-analysis. Am J Public Health 2013;103:e31-42.
- Rice BH. Dairy and cardiovascular disease: a review of recent observational research. Curr Nutr Rep 2014;3:130-138.
- Crichton GE and Alkerwi A. Dairy food intake is positively associated with cardiovascular health: findings from Observation of Cardiovascular Risk Factors in Luxembourg study. Nutr Res 2014;34:1036-1044.
- Huang LY et al. Optimal dairy intake is predicated on total, cardiovascular, and stroke mortalities in a Taiwanese cohort. J Am Coll Nutr 2014;33:426-436.