• 纳入168 153名女性和49 602名男性,最长随访32年,共记录51 438例死亡事件;
  • 与最低组(0.8 份/天)总乳制品摄入相比,最高组(4.2 份/天)摄入总死亡风险高7%;
  • 按乳制品类型进行分层分析发现,全脂牛奶摄入与较高的总死亡、心血管疾病死亡和癌症死亡风险呈正相关,每天增加0.5份与死亡风险分别增加11%、9%和11%相关;
  • 用坚果、豆类和全谷物代替乳制品与较低的死亡风险相关,而用红肉和加工肉制品代替乳制品与较高的死亡风险相关。
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Associations of dairy intake with risk of mortality in women and men: three prospective cohort studies



2019-11-27, Article

Abstract & Authors:展开

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.

First Authors:
Ming Ding

Correspondence Authors:
Ming Ding

All Authors:
Ming Ding,Jun Li,Lu Qi,Christina Ellervik,Xuehong Zhang,JoAnn E Manson,Meir Stampfer,Jorge E Chavarro,Kathryn M Rexrode,Peter Kraft,Daniel Chasman,Walter C Willett,Frank B Hu