Table 1.
Characteristics of 29 prospective cohort studies on dairy consumption and CHD, CVD risk or mortality
| References | Study, country | Men (%) | Mean age, year | Mean BMI, kg/m2 | Follow-up time | No. of cases | No. of subjects | Dairy types included in meta-analysis | Dietary assessment | Outcome; ascertainment | Main confounders |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Kahn et al. [12] | California Seventh-Day Adventists, USA | 40 | – | – | 21 | 6180 deaths | 27,530 | Milk, Cheese | FFQ (unvalidated) | All-cause mortality; deaths were matched by computer tapes | Age, sex, smoking history, history of major chronic disease |
| Mann et al. [13] | Vegetarian, semi-vegetarians, and meat eaters; UK | 38 | 34 | 22.3 | 13.3 | 392 deaths (64 fatal IHD) | 10,802 | Milk, Cheese | FFQ (unvalidated) | All-cause mortality, fatal IHD; National Health Service Central Register, causes of death was coded by investigator blinded | Age, sex, smoking, social class |
| Appleby et al. [14] | Oxford Vegetarian Study; UK | – | 34 | 22.3 | 12 | 63 fatal CHD | 10,800 | Milk, Cheese | Simple FFQ (unvalidated) | Fatal IHD; National death certificate | Age, sex, smoking, socioeconomic status |
| Bostick et al. [15] | Postmenopausal women, Iowa; USA | 0 | 61.5 | 26.8 | 8 | 387 fatal IHD | 34,486 | Total dairy, High-fat dairy | FFQ (validated) | Fata IHD; Registry and follow-up questionnaire | Age, total energy intake, body mass index, waist: ratio, history of diabetes mellitus, cigarette smoking status, postmenopausal oestrogen use, alcohol intake, education, marital status, physical activity, dietary vitamin E and saturated fat intake |
| Hu et al. [16] | Nurses’ Health Study; USA | 0 | 46.5 | 24.2 | 14 | 939 CHD | 41,254 | Total dairy, High-fat dairy, Low-fat dairy, Milk | FFQ (validated) | CHD (fatal and nonfatal); medical records reviewed by physicians blind to risk factors; deaths from registry, jps[ota; records or autopsy | Age, time period, BMI, smoking, menopausal status (including hormone replacement therapy), parental history of MI, vitamin E supplement, alcohol, history of hypertension, aspirin, physical activity, total energy intake |
| Fortes et al. [17] | Elderly residents from public home in Rome; Italy | 32 | 80 | 25.6 | 5 | 53 deaths | 162 | Cheese | FFQ (validated) | All-cause mortality; Registry | Age, sex, education, BMI, smoking, cognitive function, chronic diseases |
| Ness et al. [18] | Working men in west of Scotland; UK | 100 | 48 | 25.3 | 25 | 2350 deaths (1212 fatal CVD, 892 fatal CHD) | 5765 | Milk | Questionnaire (check by interview) | All-cause mortality, fatal CVD, fatal CHD; National Healthy Service Central Registry | Age, smoking, BP, cholesterol, BMI, forced expiratory volume, social class, education, deprivation, siblings, car user, angina, ECG ischemia, bronchitis, alcohol |
| Al-Delaimy et al. [19] | Health Professionals Follow-up Study | 100 | 53 | 25.4 | 12 | 14,468 IHD (fatal and non-fatal) | 39,800 | Total dairy, High-fat dairy, Low-fat dairy, Milk | FFQ (validated) | IHD (fatal and nonfatal); medical records reviewed, autopsy reports, death certificates | Age, time period, energy intake, history of diabetes, history of hypercholesterolemia and hypertension, family history of MI, smoking history, aspirin, BMI, alcohol intake, physical activity, vitamin E, trans fatty acids, PUFA:SFA ratio, total protein intake, fibre, folate, n-3 fatty acids, and a-linolenic acid |
| Elwood et al. [20] | Caerphilly cohort; UK | 100 | 52 | 26.1 | 22 | 811 deaths, 628 CVD, 493 IHD | 2512 | Milk | FFQ (validated) | All-cause mortality, CVD (fatal and nonfatal), IHD (fatal and nonfatal); ECG examination, GP and hospital records | Age, total energy, smoking, social class, BMI, systolic BP, alcohol and fat, prior vascular disease |
| Knoops et al. [21] | HALE study (combination of SENECA and FINE studies) | 66 | 75 | – | 10 | 1382 deaths | 3117 | Total dairy | Dietary history | All-cause mortality; general practitioners and/or hospital registers or vital status | Age, sex, alcohol, physical activity, smoking, number of years of education, BMI, chronic diseases, study centre |
| Paganini-Hill et al. [22] | Leisure World Cohort Study; USA | 37 | 74 | 23.5 | 23 | 11,386 deaths | 13,624 | Milk | Questionnaire (unvalidated) | All-cause mortality; hospital discharge data, death indexes and ascertainment of death certificates | Age, sex, smoking, exercise, BMI, alcohol, hypertension, angina, MI, stroke, diabetes, rheumatoid arthritis, cancer |
| Engberink et al. [40] | The Rottedam Study, Netherlands | 38 | 66.9 | 26.2 | 11.2 | 1111 death (307 from CVD) | 3971 | Total dairy, High-fat dairy, Low-fat dairy, Cheese | FFQ (validated) | All-cause mortality, CVD mortality; medical record and digital record linkage | Age, sex, BMI, SBP, total cholesterol, family history of MI, use of oestrogen, smoking, educational level, alcohol consumption, total energy, saturated fat, intake of fruit, vegetables, meat, fish, coffee, and tea |
| Panagiotakos et al. [23] | ATTICA Study; Greece | 50 | 53 | 27 | 5 | 30 CVD (fatal and non-fatal) | 686 | Total dairy, Cheese, Yogurt, Milk | FFQ (validated) | CVD (fatal and non-fatal); medical records | Age, sex, BMI, hypertension, diabetes, hypercholesterolemia, current smoking, physical activity |
| Bonthuis et al. [24] | Community-based sample, Australia | 43 | 49.8 | 26.2 | 14.4 | 177 death (61 from CVD) | 1529 | Total dairy, High-fat dairy, Low-fat dairy, Milk, Yogurt, Full-fat cheese | FFQ (validated) | All-cause mortality, CVD mortality; National Death Index of Australia | Age, sex, total energy intake, body mass index, alcohol intake, school leaving age, physical activity level, pack years of smoking, dietary supplement use, b-carotene treatment during trial, presence of any medical condition, and dietary calcium intake. |
| Goldbohm et al. [25] | Netherland Cohort Study | 48 | 61.6 | 24.4 | 10 | 16,136 death (2689 from IHD) | 120,852 | Total dairy, High-fat dairy, Low-fat dairy, High-fat fermented dairy, Low-fat fermented dairy, Cheese | 150 item FFQ (validated) | All-cause mortality, IHD mortality; Dutch Central Bureau of Genealogy and the Dutch Central Bureau of Statistics | Age, education, cigarette, cigar, and pipe smoking, nonoccupational physical activity, occupational physical activity, BMI, multivitamin use, alcohol, energy, energy-adjusted mono- and polyunsaturated fat intakes, and vegetable and fruit consumption |
| Sonestedt et al. [26] | The Malmo diet and cancer cohort, Sweden | 38 | 57.3 | 25.2 | 12 | 2520 CVD | 26,445 | Total dairy, High-fat dairy, Low-fat dairy, Fermented dairy, Milk, Cheese | Dietary assessment method | CVD (fatal and non-fatal) | Sex, season, method, energy intake, BMI, smoking, alcohol consumption, leisure-time physical activity, and education |
| Dalmeijer et al. [27] | EPIC-NL; Netherlands | 25.5 | 48.7 | 25.6 | 10 | 1184 death, 1807 total CVD, 1309 total CHD, | 33,625 | Total dairy, High-fat dairy, Low-fat dairy, Fermented dairy, Cheese | 79-item FFQ (validated) | All-cause mortality, CVD (fatal and nonfatal), CHD (fatal and nonfatal); Register of hospital discharge diagnoses | Gender, age, total energy intake, physical activity, smoking, education, BMI, ethanol, coffee, fruit, vegetables, fish, meat and bread |
| Kondo et al. [28] | National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged, Japan | 44 | 50.3 | 22.7 | 24 | 893 CVD death, 174 CHD death; | 9243 | Milk | Weighed diet records and dietary interviews | CVD mortality, CHD mortality; follow-up surveys | Age, body mass index, smoking status, alcohol drinking habit, history of diabetes, use of antihypertensive, work category, and total energy intake |
| Soedamah-Muthu et al. [31] | Whitehall II Study, United Kingdom | 72 | 56 | 25.9 | 10 | 323 CHD; 237 all-cause mortality | 4526 | Total dairy, High-fat dairy, Low-fat dairy, Milk, Fermented dairy, Cheese, Yogurt | 114 item FFQ (validated) | All-cause mortality, CHD (fatal and non-fatal); Death was collected from NHS Central Registry, cases of MI were identified from twelve-lead electrocardiograms | Age, ethnicity and employment grade, smoking, alcohol intake, BMI, physical activity and family history of CHD/hypertension, fruit and vegetables, bread, meat, fish, coffee, tea and total energy intake |
| Louie et al. [29] | The Blue Mountain Eye | 44 | 65.4 | 26.2 | 15 | 1048 death | 2900 | Total dairy, | 145-item FF1 (validated) | CVD mortality, CHD mortality; | Age, sex, total energy, baseline |
| Study, Australia | (548 from CVD, 432 from CHD) | High-fat dairy, Low-fat dairy | Australian National Death Index | BMI, change in weight during follow up, physical activity level (METs), previous acute myocardial infarction, previous stroke, smoking status, stage II hypertension, type 2 diabetes status, use of antihypertensive medication, use of statins and change in dairy intake | |||||||
| Ruesten et al. [33] | EPIC-Potsdam Study; German | 39 | 50 | – | 8 | 363 CVD | 23,531 | High-fat dairy, Low-fat dairy, High-fat cheese, Low-fat cheese | FFQ (validated) | CVD (fatal and non-fatal); self-administered follow-up questionnaires and medically verified | Age, sex, smoking status, pack-years of smoking, alcohol consumption, leisure-time physical activity, BMI, waist-to-hip ratio, prevalent hypertension at baseline, history of high blood lipid levels at baseline, education, vitamin supplementation and total energy intake |
| Van Aerde et al. [32] | The Hoorn Study; | 43.8 | 61.1 | 26.5 | 12.4 | 403 | 1956 | Total | 92-item FFQ | All-cause | Age, sex, BMI, |
| Netherlands | death (116 from CVD, 50 from CHD) | Dairy, High-fat dairy, Low-fat dairy, Milk, Fermented dairy, Cheese | (validated) | Mortality, fatal CVD, fatal CHD; General practitioners and the local hospital | Smoking, educational level, total energy intake, alcohol consumption, physical activity and intake of meat, fish, bread, vegetables, fruit, coffee, and tea | ||||||
| Patterson et al. [30] | Swedish Mammography cohort, Sweden | 0 | 61.2 | 24.9 | 11.6 | 1392 MI | 33,636 | Total dairy, Milk, Fermented dairy, Low-fat fermented dairy, High-fat fermented dairy, Cheese | 96-item semi quantitative FFQ (validated) | Incident cases of MI (fatal and nonfatal); Registry and record linkage | Smoking status, physical activity, waist-to-hip ratio, alcohol consumption, diagnosis of hypertension, diagnosis of high cholesterol, family history of myocardial infarction, education, aspirin usage, hormone therapy usage, energy intake, all other dairy food groups, fruit and vegetables and whole-grain foods, use of oils in cooking, and use of low-fat margarine on bread |
| Huang et al. [35] | Nutrition and Health Survey in Taiwan, Taiwan | – | 35.6 | 22.9 | 13.7 | 444 death (87 from CVD) | 3810 | Total dairy | FFQ (validated) | All-cause mortality, CVD mortality; National death registration | Age, gender, BMI, region, ethnicity, education level, marriage, history of disease (cardiovascular disease and/or cancer), smoking, drinking, chew betel nut, and supplement use, overall Dietary Index–Revised (dairy score excluded), Calcium intake, vitamin D intake |
| Haring et al. [34] | Atherosclerosis Risk in Communities Study; USA | 44.2 | 53.8 | 27.1 | 22 | 1147 CHD | 12,066 | Total dairy, High-fat dairy, Low-fat dairy | FFQ (unvalidated) | CHD (fatal and non-fatal); study visits, yearly telephone follow-up calls, review of hospital discharge lists and medical charts, death certificates, next-of-kin interviews, and physician-completed questionnaires | Age, sex, race, study centre, total energy intake, smoking, education, systolic blood pressure, use of antihypertensive medication, HDL-cholesterol, total cholesterol, use of lipid lowering medication, body mass index, waist-to-hip ratio, alcohol intake, sports-related physical activity, leisure-related physical activity, carbohydrate intake, fibre intake, and magnesium intake |
| Michaelsson et al. [6] | Swedish Mammography Cohort, Sweden/Cohort of Swedish Men, Sweden | 0/100 | 53.7/60.3 | 24.7/25.8 | 20.1/11.2 | 15,541 death (5278 death from CVD)/10,112 death (4568 death from CVD) | 61,433/45,339 | Milk, Cheese, Fermented dairy | FFQ (validated) | All-cause mortality and CVD mortality; Swedish cause of death registries | Age, body mass index, height, total energy intake, total alcohol intake, healthy dietary pattern, calcium and vitamin D supplementation, ever use of cortisone, educational level, living alone, physical activity level estimated as metabolic equivalents, smoking status, and Charlson’s comorbidity index; and in women additionally for use of oestrogen replacement therapy and nulliparity |
| Bergholdt et al. [36] | Copenhagen General Population Study; Denmark | 12 | 56.7 | – | 5.4 | 2777 IHD | 74,965 | Milk | Self-reported questionnaire | IHD (fatal and nonfatal); National DANISH Patient Registry | Age, sex, physical activity in leisure time and at work, smoking, alcohol intake, use of lipid-lowering therapy, fruit, vegetables, fish, fast food, and soda drinks |
| Praagman et al. [37] | the Rotterdam Study, Netherlands | 38 | 66.9 | 26.2 | 17.3 | 567 CHD (350 fatal) | 4235 | Total dairy, High-fat dairy, Low-fat dairy, Fermented dairy, Cheese, Yogurt | FFQ (validated) | Total CHD and fatal CHD; medical record and digital record linkage | Age, gender, and total energy intake, BMI, smoking, education level, and alcohol intake, intakes of vegetables, fruit, meat, bread, fish coffee, and tea |
| Praagman et al. [38] | EPIC-Netherlands cohort | 57 | 48.9 | 25.6 | 15 | 2436 death (727 from CVD, 253 from CHD) | 34,409 | Fermented dairy, Yogurt, Cheese | FFQ (validated) | All-cause mortality, CVD mortality, CHD mortality; Record linkage and Central Agency for statistics | Age, sex, total energy intake, smoking habit, BMI, physical activity, education level, hypertension at baseline, intakes of alcohol and energy-adjusted intakes of fruit and vegetables |
| Wang et al. [39] | Japan Collaborative Cohort Study, Japan | 42 | 56.8 | 22.7 (men); 22.9 (women) | 19 | 21,775 death (6271 death from CVD) | 94,980 | Milk | Self-administered questionnaires | All-cause mortality and CVD mortality; The date and cause of death were confirmed with the permission of the Director-General of the Prime Minister’s Office | Age categories, smoking status, drinking status, physical activity, sleeping duration, body mass index, education level, participation in health check-ups, green-leafy vegetable intake, and history of hypertension, diabetes, and liver disease |
BMI body mass index, CVD cardiovascular disease, CHD coronary heart disease, FFQ food frequency questionnaire