Table 3.

Effects of dairy intake on risk factors for cardiovascular disease: summary of epidemiological studies conducted between June 2010 and September 2011, using the search terms “dairy,” “milk,” and “cardiovascular disease

Reference	Characteristics of participants	Study design and objective	Mean servings of dairy per day	Results
Soedamah-Muthu et al. (2011)30	Adults from the USA, Japan, and Europe, 56 ± 13 years of age (n = 611,430)	Meta-analysis of 17 prospective cohort studies to examine the associations of milk, total dairy, and high- and low-fat dairy intakes with the risk of CVD and total mortality over a mean follow-up of 14 ± 6 years	<2	Modest inverse association between milk intake and risk of overall CVD (4 studies: RR, 0.94 per 200 mL/day; 95%CI, 0.89–0.99); milk intake was not associated with risk of CHD (6 studies: RR, 1.00; 95%CI, 0.96–1.04), stroke (6 studies: RR, 0.87; 95%CI, 0.72–1.05), or total mortality (8 studies: RR per 200 mL/day, 0.99; 95%CI, 0.95–1.03); no association between total, total high-fat, or total low-fat dairy products (200 g/day) and CHD
Bernstein et al. (2010)26	American adult women, 30–55 years of age (n = 84,136)	Prospective study to examine the relationship between foods that are major dietary protein sources and incident CHD	<1–3	Low-fat and high-fat dairy foods substituted for red meat were associated with a decreased risk of CHD (P < 0.05) and, when substituted for fish, were associated with an increased risk of CHD (P < 0.05); a serving of high-fat dairy was associated with an increased hazard ratio for CHD (1.03; 95%CI, 1.00–1.06, P < 0.05)
Panagiotakos et al. (2010)52	Greek adults, 18–89 years of age (n = 1,514 men and 1,528 women)	Cross-sectional study to investigate the association between consumption of dairy products and levels of various inflammatory markers among adults with no evidence of CVD or other chronic diseases	1–2	1.5–2 servings of dairy/day associated with lower plasma total cholesterol, TAG, and hypercholesterolemia versus <1 serving/day (P < 0.05), regardless of full-fat or low-fat dairy (P > 0.76); 2 servings/day versus <1 serving/day associated with lower CRP (1.61 ± 1.8 versus 2.26 ± 1.6 mg/L, P = 0.32), IL-6 (1.34 ± 0.32 versus 1.48 ± 0.37 ng/mL, P = 0.001), and TNF-α (5.58 ± 2.8 versus 1.48 ± 0.37 mg/dL, P < 0.001); 1 additional serving of full-fat dairy/week associated with decreased IL-6 (β = −0.071 ± 0.05 mg/L, P = 0.02) and TNF-α (β = −0.047 ± 0.02 mg/dL, P = 0.02); 1 additional serving of low-fat dairy/week associated with decreased CRP (β = −0.071 ± 0.02 mg/L, P = 0.02), IL-6 (β = −0.066 ± 0.01 ng/mL, P = 0.03). and TNF-α (β = −0.040 ± 0.01 mg/dL, P = 0.01)
Goldbohm et al. (2011)28	Dutch adults, 55–69 years of age (n = 120,852)	Prospective study to investigate the association between dairy product consumption and the risk of death from all causes, IHD, and stroke	2	Butter and dairy fat intake increased risk of all-cause and IHD mortality in women only (Rate Ratiomortality, 1.04 per 10 g/day; 95%CI, 1.01–1.06 per 10 g/day, P < 0.05); fermented full-fat milk was inversely associated with all-cause mortality
Aslibekyan et al. (2012)25	Costa Rican adults, 58–59 years of age (n = 3,360)	Case-control study to evaluate the association between dairy intake as measured by FFQ and adipose tissue content of C 15:0 and C 17:0 fatty acids with risk of nonfatal MI	1	No association between dairy consumption and risk of nonfatal MI
Bonthuis et al. (2010)27	Australian adults, 25–78 years of age (n = 1,529)	Prospective study to investigate the relationship between intake of dairy products or related nutrients and mortality due to CVD, cancer, and all causes over a follow-up period of 16 years	<1–2.5	Higher intake of full-fat dairy foods associated with decreased hazard ratios of CVD mortality (1.5 servings/day = 0.31; 95%CI, 0.12–0.79 versus <1 serving/day = 0.73; 95%CI, 0.35–1.54; P = 0.04)
Warensjö et al. (2010)31	Swedish adults, 50–60 years of age (n = 444 cases and 556 controls)	Case-control study to investigate the association between dairy intake as measured by adipose tissue content of C 15:0 and C 17:0 fatty acids and their sum with risk of first MI	1–2	Higher intake of dairy as indicated by biomarkers of milk fat was inversely associated with first MI (OR, 0.74; 95%CI, 0.58–0.94 in women); quartiles of reported intake of cheese were inversely related to first MI in men and women (P < 0.05); quartiles of reported intake of fermented milk products were inversely related to first MI in men (P < 0.05)
Esmaillzadeh & Azadbakht (2010)53	Tehrani women, 40–60 years of age (n = 486)	Cross-sectional study to assess the association between dairy consumption and circulating levels of inflammatory markers	<0.5	Low-fat dairy consumption was inversely associated with sVCAM-1 (β = −0.03, P < 0.05); high-fat dairy consumption was positively associated with serum amyloid A (β = 0.08, P < 0.05) and sVCAM-1 (β = 0.05, P < 0.05); and there was no association between overall dairy consumption and circulating markers of inflammation
Ivey et al. (2011)29	Australian women, >70 years of age (n = 1,080)	Prospective study to assess the association between dairy consumption and CCA-IMT after a period of 3 years	<0.5–1.2	Total dairy product, milk, and cheese consumption was not associated with CCA-IMT (P < 0.05); yogurt consumption was inversely associated with CCA-IMT (β = −0.075, P = 0.015); participants who consumed >0.5 servings of yogurt per day had lower CCA-IMT versus those who consumed <0.5 serving of yogurt per day (−0.023 mm, P = 0.003)

Abbreviations: C, carbon; CCA-IMT, common carotid artery intima-media thickness; CRP, C-reactive protein; CVD, cardiovascular disease; CI, confidence interval; CHD, coronary heart disease; FFQ, food frequency questionnaire; IHD, ischemic heart disease; IL-6, interleukin-6; MI, myocardial infarction; RR, relative risk; sVCAM-1, soluble vascular cell adhesion molecule; TAG, triglyceride; TNF-α, tumor necrosis factor-α.