Dehghan M, et al. - Researchers examined the links between total dairy and specific types of dairy products with mortality and major cardiovascular disease. In a diverse multinational cohort, they observed a lower risk of mortality and major cardiovascular disease events in association with dairy consumption.

Methods

• The Prospective Urban Rural Epidemiology (PURE) study enrolled individuals 35–70 years of age from 21 countries across five continents.
• Country-specific validated food frequency questionnaires were used to record dietary intakes of dairy products, including milk, yoghurt, and cheese, for 136,384 individuals.
• These foods were further grouped into whole-fat and low-fat dairy.
• The composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure) was the primary outcome.
• They calculated hazard ratios (HRs) using multivariable Cox frailty models with random intercepts to account for clustering of participants by center.

Results

• Data showed that a total of 10,567 composite events (deaths [n=6,796] or major cardiovascular events [n=5,855]) during the 9.1 years of follow-up were recorded between Jan 1, 2003, and July 14, 2018.
• They observed a lower risk of the composite outcome (HR: 0.84; 95% confidence interval [CI]: 0·75–0·94; P_trend=0.0004), total mortality (HR: 0.83; 95% CI: 0.72–0.96; P_trend=0.0052), non-cardiovascular mortality (HR: 0.86; 95% CI: 0.72–1.02; P_trend=0·046), cardiovascular mortality (HR: 0.77; 95% CI: 0.58–1.01; P_trend=0.029), major cardiovascular disease (HR: 0.78; 95% CI: 0.67–0.90; P_trend=0.0001), and stroke (HR: 0.66; 95% CI: 0.53–0.82; P_trend=0.0003) in relation to a higher intake of total dairy (> 2 servings per day compared with no intake).
• They did not observe any significant association with myocardial infarction (HR: 0.89; 95% CI: 0.71–1.11; P_trend=0.163).
• Findings demonstrated a lower risk of the composite outcome in association with a higher intake (> 1 serving vs no intake) of milk (HR: 0.90; 95% CI: 0.82–0.99; P_trend=0.0529) and yogurt (HR: 0.86; 95% CI: 0.75–0.99; P_trend=0.0051), whereas cheese intake was not significantly related to the composite outcome (HR: 0.88; 95% CI: 0.76–1.02; P_trend=0.1399).
• Low intake of butter was reported and was not significantly related to clinical outcomes (HR: 1.09; 95% CI: 0.90–1.33; P_trend=0.4113).