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Back to Cardiovascular Disease

No Association between Milk Products and Mortality

In light of the totality of evidence, including meta-analyses and systematic reviews of prospective studies, there is no association between milk product consumption and mortality risk.

Highlights

  • Milk and milk products are not associated with all-cause, cardiovascular and cancer mortality;
  • High-fat dairy does not appear to be associated with an increased mortality risk;
  • Some studies suggest that milk product consumption is associated with a reduced risk of cardiovascular and cancer mortality.

The Evidence

In a 2013 meta-analysis of prospective cohort studies, the association between different sources of saturated fat and mortality was assessed. A total of 26 studies were examined, for a sample size of 1,800,418 participants and follow-up of 5 to 41 years.1

  • Milk, cheese, butter or total dairy consumption were not associated with all-cause mortality;
  • Total dairy consumption including milk and cheese was not associated with cardiovascular disease mortality;
  • Milk consumption was not associated with cancer mortality.

In another meta-analysis of prospective cohort studies, the association between dairy consumption and stroke risk, including stroke mortality, was evaluated. The analysis consisted of 15 studies, for a total of 764,635 participants and 28,138 stroke events.2

  • Total dairy, low-fat dairy, fermented milk and cheese were inversely associated with stroke risk;
  • Whole/high-fat dairy, non-fermented dairy, butter and cream were not associated with stroke risk;
  • Compared to stroke incidence, there was a stronger inverse association between total dairy consumption and stroke mortality, with risk ratio 0.80 (95% CI 0.76-0.84; p = 0.01);
  • A non-linear relationship was found between milk consumption and stroke mortality, with maximum protection at 200 mL/day for a 20% risk reduction (95% CI 0.77-0.84).

A 2014 systematic review evaluated the evidence on dairy and cardiovascular disease risk and mortality. The author stated that the overall evidence indicates that “dairy consumption does not contribute to the risk of all-cause or CVD-specific mortality.”3

In their 2015 prospective cohort study, Praagman et al. examined the association between fermented food products (dairy products, vegetables, meat) and mortality risk, using data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Netherlands cohort. The study sample consisted of 34,409 Dutch adults aged 20 to 70 years with a follow-up of 15 years.4

  • There were no associations between yogurt or total fermented dairy foods (yogurt, buttermilk and Quark) and mortality risk;
  • Cheese consumption was not associated with all-cause and cancer mortality;
  • Higher cheese consumption (30 g/day vs. 16 g/day) was associated with a 20% and 41% risk reduction in cardiovascular and stroke mortality, respectively.

The relationship between dairy consumption and colorectal cancer mortality was assessed in a prospective cohort study conducted in the US. The participants were 1,111 adults with a mean age of 64 years at baseline.5

  • Milk intake post-diagnosis was inversely associated with all-cause mortality;
  • Total calcium intake post-diagnosis was associated with reduced all-cause mortality and colorectal cancer-specific mortality, with risk ratios 0.72 (95% CI 0.53-0.98, ptrend = 0.02) and 0.59 (95% CI 0.33-1.05, ptrend = 0.01), respectively;
  • Dairy consumption pre-diagnosis was not associated with any mortality outcomes.

A prospective cohort study examined whether dairy consumption was associated with fatal or non-fatal risk of stroke and coronary heart disease. The study sample included 4,235 Dutch adults aged 55 years and older. Follow-up time was 17 years. The study found the following:6

  • There was no association between total dairy, low-fat dairy, milk or fermented dairy consumption and stroke mortality;
  • High-fat dairy was associated with a significant 12% risk reduction of fatal stroke, with hazard ratio 0.88 per 100 g/day (95% CI 0.79-0.99, p = 0.026);
  • An intake of >100 g/day of high-fat dairy was associated with a borderline significant 37% lower risk of fatal stroke (p = 0.07), compared to <50 g/day;
  • There was no association between total dairy, high-fat dairy, low-fat dairy, milk or fermented dairy and mortality from coronary heart disease.

Another prospective cohort study was undertaken to investigate the association between dairy consumption and mortality, where dairy foods were not part of the traditional diet. Participants were a representative cohort of 3,810 adults aged 19 to 64 years from the Nutrition and Health Survey in Taiwan. They were followed for 12 to 15 years, and data was linked to death registration.7

  • A significant inverse dose-response relationship was observed between dairy consumption and all-cause mortality (ptrend = 0.037);
  • High dairy consumption (>7 times/week compared to 0 times/week) was associated with decreased cardiovascular disease mortality, with hazard ratio 0.10 (95% CI 0.02-0.52, ptrend = 0.002);
  • An inverse but non-significant association was observed between dairy consumption and cancer mortality.

In a Swedish prospective cohort study, it was examined whether milk consumption was related to mortality. The study consisted of 2 Swedish cohorts, for a total of 61,433 women and 45,339 men, and a mean follow-up of 20 and 13 years, respectively.8

  • An association was observed between higher milk consumption and increased total, cardiovascular and cancer mortality;
  • Cheese consumption was significantly associated with a decrease in total and cardiovascular mortality, and was not associated with cancer mortality;
  • The consumption of yogurt and soured milk was associated with reduced total, cardiovascular and cancer mortality;
  • The possibility of unaccounted confounding in the analysis has been raised by the authors and other experts. Thus, the authors concluded that the results should be interpreted with caution and that independent replication is needed to confirm the findings.

Potential Mechanisms

The mechanisms by which milk and milk products may influence mortality risk remain to be fully elucidated but may be related to several health benefits associated with milk and milk products, including a reduced risk for several important conditions such as cardiovascular disease, type 2 diabetes, hypertension, and certain cancers including colorectal cancer and bladder cancer.

Conclusion

The totality of evidence suggests that milk and milk product consumption is not associated with increased mortality risk.

Additional research is needed to assess whether different types of milk products may have different effects with regards to mortality risk.

Keywords: cancer , cardiovascular disease , coronary heart disease , stroke


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