TY - JOUR
T1 - Associations of dairy intake with risk of mortality in women and men
T2 - Three prospective cohort studies
AU - Ding, Ming
AU - Li, Jun
AU - Qi, Lu
AU - Ellervik, Christina
AU - Zhang, Xuehong
AU - Manson, Joann E.
AU - Stampfer, Meir
AU - Chavarro, Jorge E.
AU - Rexrode, Kathryn M.
AU - Kraft, Peter
AU - Chasman, Daniel
AU - Willett, Walter C.
AU - Hu, Frank B.
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PY - 2019/11/27
Y1 - 2019/11/27
N2 - OBJECTIVE: To examine the association of consumption of dairy foods with risk of total and cause specific mortality in women and men.DESIGN: Three prospective cohort studies with repeated measures of diet and lifestyle factors.SETTING: Nurses' Health Study, Nurses' Health Study II, and the Health Professionals Follow-up Study, in the United States.PARTICIPANTS: 168 153 women and 49 602 men without cardiovascular disease or cancer at baseline.MAIN OUTCOME MEASURE: Death confirmed by state vital records, the national death index, or reported by families and the postal system. During up to 32 years of follow-up, 51 438 deaths were documented, including 12 143 cardiovascular deaths and 15 120 cancer deaths. Multivariable analysis further adjusted for family history of cardiovascular disease and cancer, physical activity, overall dietary pattern (alternate healthy eating index 2010), total energy intake, smoking status, alcohol consumption, menopausal status (women only), and postmenopausal hormone use (women only).RESULTS: Compared to the lowest category of total dairy consumption (average 0.8 servings/day), the multivariate pooled hazard ratio for total mortality was 0.98 (95% confidence interval 0.96 to 1.01) for the second category of dairy consumption (average 1.5 servings/day), 1.00 (0.97 to 1.03) for the third (average 2.0 servings/day), 1.02 (0.99 to 1.05) for the fourth (average 2.8 servings/day), and 1.07 (1.04 to 1.10) for highest category (average 4.2 servings/day; P for trend <0.001). For the highest compared to the lowest category of total dairy consumption, the hazard ratio was 1.02 (0.95 to 1.08) for cardiovascular mortality and 1.05 (0.99 to 1.11) for cancer mortality. For subtypes of dairy products, whole milk intake was significantly associated with higher risks of total mortality (hazard ratio per 0.5 additional serving/day 1.11, 1.09 to 1.14), cardiovascular mortality (1.09, 1.03 to 1.15), and cancer mortality (1.11, 1.06 to 1.17). In food substitution analyses, consumption of nuts, legumes, or whole grains instead of dairy foods was associated with a lower mortality, whereas consumption of red and processed meat instead of dairy foods was associated with higher mortality.CONCLUSION: These data from large cohorts do not support an inverse association between high amount of total dairy consumption and risk of mortality. The health effects of dairy could depend on the comparison foods used to replace dairy. Slightly higher cancer mortality was non-significantly associated with dairy consumption, but warrants further investigation.
AB - OBJECTIVE: To examine the association of consumption of dairy foods with risk of total and cause specific mortality in women and men.DESIGN: Three prospective cohort studies with repeated measures of diet and lifestyle factors.SETTING: Nurses' Health Study, Nurses' Health Study II, and the Health Professionals Follow-up Study, in the United States.PARTICIPANTS: 168 153 women and 49 602 men without cardiovascular disease or cancer at baseline.MAIN OUTCOME MEASURE: Death confirmed by state vital records, the national death index, or reported by families and the postal system. During up to 32 years of follow-up, 51 438 deaths were documented, including 12 143 cardiovascular deaths and 15 120 cancer deaths. Multivariable analysis further adjusted for family history of cardiovascular disease and cancer, physical activity, overall dietary pattern (alternate healthy eating index 2010), total energy intake, smoking status, alcohol consumption, menopausal status (women only), and postmenopausal hormone use (women only).RESULTS: Compared to the lowest category of total dairy consumption (average 0.8 servings/day), the multivariate pooled hazard ratio for total mortality was 0.98 (95% confidence interval 0.96 to 1.01) for the second category of dairy consumption (average 1.5 servings/day), 1.00 (0.97 to 1.03) for the third (average 2.0 servings/day), 1.02 (0.99 to 1.05) for the fourth (average 2.8 servings/day), and 1.07 (1.04 to 1.10) for highest category (average 4.2 servings/day; P for trend <0.001). For the highest compared to the lowest category of total dairy consumption, the hazard ratio was 1.02 (0.95 to 1.08) for cardiovascular mortality and 1.05 (0.99 to 1.11) for cancer mortality. For subtypes of dairy products, whole milk intake was significantly associated with higher risks of total mortality (hazard ratio per 0.5 additional serving/day 1.11, 1.09 to 1.14), cardiovascular mortality (1.09, 1.03 to 1.15), and cancer mortality (1.11, 1.06 to 1.17). In food substitution analyses, consumption of nuts, legumes, or whole grains instead of dairy foods was associated with a lower mortality, whereas consumption of red and processed meat instead of dairy foods was associated with higher mortality.CONCLUSION: These data from large cohorts do not support an inverse association between high amount of total dairy consumption and risk of mortality. The health effects of dairy could depend on the comparison foods used to replace dairy. Slightly higher cancer mortality was non-significantly associated with dairy consumption, but warrants further investigation.
KW - Adult
KW - Dairy Products/adverse effects
KW - Diet/mortality
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Proportional Hazards Models
KW - Prospective Studies
KW - Risk Factors
KW - United States
UR - http://www.scopus.com/inward/record.url?scp=85075714620&partnerID=8YFLogxK
U2 - 10.1136/bmj.l6204
DO - 10.1136/bmj.l6204
M3 - Article
C2 - 31776125
AN - SCOPUS:85075714620
SN - 0959-8146
VL - 367
SP - l6204
JO - The BMJ
JF - The BMJ
M1 - l6204
ER -