Back to Cardiovascular Disease

Stroke

Synopsis

Many studies have investigated the role of milk products in cardiovascular disease. In addition, several meta-analyses assessing stroke specifically as an outcome have been published.

The current evidence suggests that dairy products, regardless of their fat content, are not associated with an increased risk of stroke, but instead may contribute to decreasing this risk.

The Evidence

In their 2016 meta-analysis of 31 prospective cohort studies on the association between dairy consumption and cardiovascular disease, Alexander et al. found the following with regard to stroke risk:¹

• Total dairy intake, including full-fat and low-fat dairy, was associated with reduced stroke risk;
• Cheese was associated with a 13% reduction in stroke risk;
• A strong inverse association was observed between calcium from dairy sources and stroke risk, with a 31% risk reduction.

Findings from another meta-analysis of prospective cohort studies by Qin et al. have also demonstrated an inverse association between dairy products and stroke risk. Moreover:²

• Consuming cheese was associated with a 9% decrease in stroke risk;
• Low-fat dairy was also found to be inversely associated with stroke risk;
• High-fat dairy, yogurt, and butter were not associated with stroke risk.

Hu et al. conducted a meta-analysis on the association between dairy foods and stroke risk. Fifteen prospective cohort studies were included, consisting of 764,635 participants.³

• Total dairy, low-fat dairy, fermented milk and cheese were significantly associated with a reduced risk of stroke;
• A non-linear dose-response relationship was observed with milk, with the lowest risk being observed at 200 mL/day;
• No association was observed between high-fat dairy, non-fermented milk, butter and cream and stroke risk.

In the Rotterdam Study, a prospective population-based cohort study of 4,235 Dutch participants aged 55 years and older, the authors investigated the association between dairy products and cardiovascular disease over a period of 17 years.⁴

• High-fat dairy was not associated with the risk of incident stroke, but each 100 g/day was associated with a 12% reduced risk of fatal stroke;
• Total dairy products or other subgroups, such as low-fat milk, yogurt and cheese, were not associated with incident or fatal stroke risk.

Potential Mechanisms

Although the mechanisms responsible for an inverse association between milk product intake and stroke remain to be confirmed, there is evidence that dairy is associated with a reduced risk of cardiovascular disease as well as various cardiovascular risk factors, including hypertension, obesity and type 2 diabetes.

Milk components such as vitamin D, calcium, potassium, magnesium, phosphorus, bioactive peptides and dairy fatty acids may also play a role in improving the cardiometabolic profile, including:⁵

• Decreasing blood pressure;
• Improving blood lipids;
• Increasing insulin sensitivity.

Conclusions

There is good evidence to date to indicate that milk product intake may reduce the risk of stroke.

Randomized controlled trials and mechanistic studies are needed to provide more conclusive answers.

More studies are needed on the role of specific milk products, including those that are higher in fat content.

Keywords: stroke , cardiovascular disease