TABLE 2.
Summary of the individual information extracted from each included prospective cohort study evaluating the relation of fermented dairy intake with risk for CMD (CV mortality, stroke, IHD, T2D, obesity, and MetS)1
| Study (year) (ref) | Study, country | Design | Follow-up, y | Total n | Cases, n | Age range, y | Measurement | Adjusted variables | Outcome | Dairy exposures analyzed | Dairy products subgroups | Comparison | OR, RR, or HR (95% CI) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. CV mortality, stroke, and IHD (n = 8) | |||||||||||||
| Key et al. (2019) (29) | EPIC cohort, 10 countries2 | PC | 12.6 | 409,885 | 7198 | 41–70 | 24-h recalls | Age, smoking status, and number of cigarettes per day, history of diabetes, previous hypertension, prior hyperlipidemia, Cambridge physical activity index, employment status, level of education completed, BMI, current alcohol consumption, observed intakes of energy, fruit and vegetables combined, sugars and fiber from cereals, and stratified by sex and EPIC center | CV mortality | Yogurt | Total yogurt | Q5 (150 g/d) vs Q1 (0 g/d) | [HR: 0.90 (0.84–0.97)] |
| Johansson et al. (2019) (22) | VIP and MONICA, Sweden | PC | 14.2 | 120,061 | 11,641 | 40–60 | FFQ | Dairy product categories, sex, age, screening year, BMI, education, physical activity, smoking, family history of CV disease or T2D, screening project, quintiles of red meat, whole-grain, fruit and vegetables and energy | Myocardial infarctionStroke | FMFM | Total FMTotal FM | M: Q4 vs no consumptionW: Q4 vs no consumtionM: Q4 vs no consumption W: Q4 vs no consumption | [HR: 0.92 (0.82, 1.03)][HR: 1.00 (0.84, 1.18)][HR:0.91 (0.79, 1.05)][HR:0.87 (0.75, 1.03)] |
| Dehghan et al. (2018) (25) | PURE study, from 21 countries3 | PC | 9.1 | 136,384 | 7828 | 35–70 | Validated FFQ | Age, sex, education, urban or rural location, smoking status, physical activity, history of diabetes, family history of CV, family history of cancer, and quintiles of fruit, vegetable, red meat, starchy foods intake, and energy | CV disease | Yogurt | Total yogurt | >244 g/d vs 0 g/d | [HR: 0.82 (0.72–0.93)] |
| Farvid et al. (2016) (26) | Golestan study, Iran | PC | 8 | 42,402 | 1467 | 36–85 | Validated FFQ, 116 items | Age, gender, BMI, physical activity, ethnicity, education, marital status, residency, smoking, opium use, alcohol, SBP, family history of cancer, wealth score, medication use, energy intake | CV mortality | Yogurt | Total yogurt | Q5 (207 g/d) vs Q1 (23 g/d) | [HR: 0.84 (0.70–1.00)] |
| Goldbohm et al. (2011) (23) | Netherlands Cohort study, Netherlands | PC | 10 | 120,852 | 16,136 | 55–69 | Validated FFQ, 150 items | Age, education, smoking, physical activity, BMI, multivitamin use, alcohol, energy, energy-adjusted mono- and polyunsaturated fat intakes, and vegetable and fruit consumption | CV mortality | FM | Whole-fat FM | M: Q2 (53 g/d) vs Q1 (0 g/d)W: Q2 (53 g/d) vs Q1 (0 g/d) | [RR: 0.93 (0.88–0.98)][RR: 0.93 (0.87–1.00)] |
| Low-fat FM | M: Q3 (146 g/d) vs Q1 (0 g/d)W: Q3 (192 g/d) vs Q1 (0 g/d) | [RR: 0.97 (0.93–1.03)][RR: 1.02 (0.95–1.09)] | |||||||||||
| Praagman et al. (2014) (27) | Rotterdam Study, Netherlands | PC | 13.3 | 4235 | 564 | >55 | SFFQ, 170 items | Age, gender, total energy intake, BMI, smoking, education level, alcohol, vegetables, fruit, meat, bread, fish coffee, and tea intake | Stroke | FD | Buttermilk, yogurt, curd, cheese | >100 g/d vs <50 g/d | [HR: 1.08 (0.87–1.34)] |
| Yogurt | Total yogurt | >100 g/d vs <50 g/d | [HR: 1.10 (0.90–1.34)] | ||||||||||
| Cheese | Total cheese | >40 g/d vs <20 g/d | [HR: 0.96 (0.75–1.22)] | ||||||||||
| Age, gender, total energy intake, BMI, smoking, education level, alcohol, vegetables, fruit, meat, bread, fish coffee, and tea intake | IHD | FD | Buttermilk, yogurt, curd, cheese | >100 g/d vs <50 g/d | [HR: 1.01 (0.82–1.24)] | ||||||||
| Yogurt | Total yogurt | >100 g/d vs <50 g/d | [HR: 1.11 (0.91–1.35)] | ||||||||||
| Cheese | Total cheese | >40 g/d vs <20 g/d | [HR: 1.01 (0.79–1.30)] | ||||||||||
| Soedamah-Muthu et al. (2013) (28) | Whitehall II study, UK | PC | 10 | 4526 | 323 | 35–55 | Validated FFQ | Age, ethnicity, employment grade, smoking, alcohol intake, BMI, physical activity and family history of IHD/hypertension, fruit and vegetables, bread, meat, fish, coffee, tea and total energy intake | IHD | Yogurt | Total yogurt | T3 (117 g/d) vs T1 (0 g/d) | [HR: 1.23 (0.93–1.63)] |
| Cheese | Total cheese | T3 (31 g/d) vs (6 g/d) | [HR: 0.82 (0.61–1.09)] | ||||||||||
| FD | Total yogurt and cheese | T3 (105 g/d) vs (17 g/d) | [HR: 0.97 (0.73–1.28)] | ||||||||||
| Sonestedt et al. (2011) (24) | MDC study, Sweden | PC | 12 | 26,445 | 2520 | 44–74 | FFQ, 168 item | Age, gender, season, method, energy intake, BMI, smoking, alcohol consumption, physical activity, education, intakes of vegetables, fruit, berries, fish shellfish, meat, coffee, whole grains | CV disease | FM | Total FM | Q4 (55 g/d) vs Q1 (0 g/d) | [HR: 0.87 (0.77–0.97)] |
| 2. T2D risk (n = 9) | |||||||||||||
| Jeon et al. (2019) (30) | KoGES, Korea | PC | 7.3 | 10,030 | 1173 | 40–69 | SFFQ | Age, sex, BMI, residential area, education level, household income, physical activity, alcohol consumption, and smoking status, history of hypertension, family history of T2D, use of antihypertensive medication, use of dietary supplements, intakes of vegetables, fruits, red meat, processed meat, soft drinks, coffee, and tea | T2D | Yogurt | Total yogurt | 625 g/wk vs 0 g/wk | [HR: 0.73 (0.61–0.88)] |
| Hruby et al. (2017) (31) | FHS Offspring, USA | PC | 12 | 2809 | 902 | 45–63 | FFQ, 126 items | Age, gender, energy intake, history of diabetes, smoking, dyslipidemia, hypertension or treatment, intake of coffee, nuts, fruits, vegetables, meats, alcohol, and fish, glycemic index, low-fat, high-fat dairy intake, BMI, weight change follow-up | T2D | Yogurt | Total yogurt | 277 g/d vs 0 g/d | [HR: 1.24 (0.67–2.29)] |
| Díaz-López et al. (32) | PREDIMED study, Spain | PC | 2.5–5.7 | 3454 | 270 | 55–80 | Validated FFQ, 137 items | Age, gender, BMI, intervention group, physical activity, educational level, smoking, hypertension, antihypertensive use, fasting glucose, HDL, and TG concentrations | T2D | Yogurt | Low-fat yogurtWhole-fat yogurtTotal yogurt | T3 (120 g/d) vs T1 (3 g/d)T3 (45 g/d) vs T1 (0 g/d)T3 (128 g/d) vs T1 (13 g/d) | [HR: 0.61 (0.43–0.85)][HR: 0.64 (0.46–0.89)][HR: 0.53 (0.37–0.75)] |
| Cheese | Total cheese | T3 (40 g/d) vs T1 (11 g/d) | [HR: 1.31 (0.94–1.83)] | ||||||||||
| FD | Total yogurt and cheese | T3 (167 g/d) vs T1 (39 g/d) | [HR: 0.63 (0.45–0.87)] | ||||||||||
| Ericson et al. (33) | Malmö Diet and Cancer cohort study, Sweden | PC | 14 | 26,930 | 2860 | 45–74 | Validated FFQ, 168 items | Age, sex, method version, season, total energy intake, physical activity, smoking, alcohol intake, and education, BMI | T2D | FD | Low- fat yogurt, sour milk, and cheeseHigh-fat yogurt, sour milk, and cheese | 480 g/d vs 0 g/d792 g/d vs 66 g/d | [HR: 1.06 (0.95, 1.18)][HR: 0.89 (0.79, 1.01)] |
| Chen et al. (34) | HPFS, USA | PC | 24 | 51,529 | 3364 | 40–75 | 131-item FFQ | Age, BMI and other lifestyle and dietary risk factors, total dairy consumption | T2D | Yogurt | Total yogurt | Q4 (732 g/wk) vs Q1 (61 g/wk) | [RR: 0.95 (0.84–1.08)] |
| NHS I, USA | PC | 30 | 121,700 | 7841 | 30–55 | 61–131 item FFQ | Age, BMI and other lifestyle and dietary risk factors, total dairy consumption | T2D | Yogurt | Total yogurt | Q4 (708 g/wk) vs Q1 (0 g/wk) | [RR: 0.84 (0.76–0.91)] | |
| NHS II, USA | PC | 16 | 116,671 | 3951 | 25–42 | 131-item FFQ | Age, BMI, and other lifestyle and dietary risk factors, total dairy consumption | T2D | Yogurt | Total yogurt | Q4 (659 g/wk) vs Q1 (0 g/wk) | [RR: 0.90 (0.81–1.00)] | |
| Soedamah-Muthu et al. (28) | Whitehall II study, UK | PC | 10 | 4526 | 273 | 35–55 | Validated FFQ | Age, ethnicity, employment grade, smoking, alcohol intake, BMI, physical activity and family history of IHD/hypertension, fruit and vegetables, bread, meat, fish, coffee, tea and total energy intake | T2D | YogurtCheeseFD | Total yogurtTotal Cheese Total yogurt and cheese | T3 (117 g/d) vs T1 (0 g/d)T3 (31 g/d) vs (6 g/d)T3 (105 g/d) vs (17 g/d) | [HR: 1.04 (0.77–1.42)][HR: 1.20 (0.88–1.64)][HR: 1.17 (0.87–1.58)] |
| Struijk et al. (35) | Inter99 study, Denmark | PC | 5 | 5953 | 214 | 30–60 | Validated FFQ, 198 items | Age, gender, intervention group, diabetes family history, education level, physical activity smoking, alcohol intake, whole-grain cereal, meat, fish, coffee, tea, fruit, vegetables, energy intake, change in diet from baseline to 5-y follow-up, waist circumference | T2D | FMCheese | Total FMTotal cheese | 150 g/d vs 0 g/d20 g/d vs 0 g/d | [OR: 0.88 (0.69–1.11)][OR: 0.97 (0.82–1.15)] |
| Grantham et al. (36) | AusDiab, Australia | PC | 5 | 5582 | 209 | >25 | Validated FFQ, 121 items | Age, sex, energy intake, family history of diabetes, education level, physical activity, smoking status, TG, HDL cholesterol, SBP, waist circumference and hip circumference | T2D | Yogurt | Total yogurt | T3 (>380 g/d) vs T1 (<240 g/d) | [HR: 1.14 (0.78, 1.67)] |
| Margolis et al. (37) | Women's Health Initiative, USA | PC | 8 | 82,076 | 3946 | 50–79 | Validated SFFQ | Age, race/ethnicity, total energy intake, income, education, smoking, alcohol intake, family history of diabetes, use of postmenopausal hormone therapy, SBP, DBP, BMI, physical activity, an interaction term between quintiles of yogurt intake and time | T2D | Yogurt | Total yogurt | >500 g/wk vs <250 g/mo | [HR: 0.46 (0.31, 0.68)] |
| 3. Obesity risk (n = 1) | |||||||||||||
| Martinez-Gonzalez et al. (38) | SUN project, Spain | PC | 6.6 | 8516 | 1860 | 26–48 | Validated FFQ, 136 items | Age, gender, physical activity, hours of TV watching, hours spent sitting down, smoking, snacking between meals, following a special diet, total energy intake, adherence to the Mediterranean diet, marital status, years of education, baseline BMI | Obesity | Yogurt | Low-fat yogurtWhole-fat yogurtTotal yogurt | >889 g/wk vs 0–250 g/wk>889 g/wk vs 0–250 g/wk>889 g/wk vs 0–250 g/wk | [HR: 0.84 (0.61–1.15)][HR: 0.62 (0.47–0.82)][HR: 0.80 (0.68–0.94)] |
| 4. MetS risk (n = 3) | |||||||||||||
| Kim et al. (39) | KoGES, Korea | PC | 4 | 5510 | 2103 | 40–69 | Validated FFQ, 103 items | Age, gender, BMI, residential location, educational level, household income, smoking, alcohol intake, physical activity, nutrient intakes (energy and energy-adjusted Ca, fiber) | MetS | Yogurt | Total yogurt | ≥85 g/d vs ≤ 21 g/d | [HR: 0.68 (0.58–0.79)] |
| Babio et al. (40) | PREDIMED study, Spain | PC | 2–7 | 1868 | 930 | 55–80 | Validated FFQ, 137 items | Age, gender, intervention group, physical activity, BMI, smoking and former, hypoglycemic, hypolipemic, antihypertensive or insulin treatment, mean consumption during follow-up: vegetables, fruit, legumes, cereals, fish, red meat, cookies, olive oil nuts, alcohol, MetS at baseline | MetS | Yogurt | Low-fat yogurtWhole-fat yogurtTotal yogurt | T3 (124 g/d) vs T1 (1 g/d)T3 (46 g/d) vs T1 (0 g/d)T3 (127 g/d) vs T1 (7 g/d) | [HR: 0.73 (0.62–0.86)][HR: 0.78 (0.66–0.92)][HR: 0.77 (0.65–0.91)] |
| Sayón-Orea et al. (41) | SUN project, Spain | PC | 6 | 8063 | 306 | 20–90 | Validated FFQ, 136 items | Age, gender, baseline weight, total energy, alcohol intake, soft drinks, red meat, French fries, fast food, Mediterranean diet, physical activity, sedentary behavior, hours sitting, smoking, snacking between meals, following special diet | MetS | Yogurt | Low-fat yogurtWhole-fat yogurtTotal yogurt | ≥875 g/wk vs 0–250 g/wk≥875 g/wk vs 0–250 g/wk≥875 g/wk vs 0–250 g/wk | [OR: 0.63 (0.39–1.02)][OR: 0.98 (0.68–1.41)][OR: 0.84 (0.60–1.18)] |
1
n = 20. AusDiab, Australian Diabetes Obesity and Lifestyle Study; BMI, body mass index; CV, cardiovascular; DBP, diastolic blood pressure; EPIC, European Prospective Investigation into Cancer and Nutrition; FD, fermented dairy; FFQ, food-frequency questionnaire; FHS, Framingham Heart Study; FM, fermented milk; HPFS, Health Professionals Follow-Up Study; IHD, ischemic heart disease; InterAct, Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial; KoGES, Korean Genome and Epidemiology Study; M, men; MDC, Malmö Diet Cancer; MetS, metabolic syndrome; MONICA, Monitoring Trends and Determinants in Cardiovascular Disease; NHS, Nurses' Health Study; PC, prospective cohort; PREDIMED, Prevención con Dieta Mediterránea; Pure study, Prospective Urban Rural Epidemiology; Q, quartile; ref, reference; SBP, systolic blood pressure; SFFQ, semiquantitative food-frequency questionnaire; SUN, Seguimiento Universidad de Navarra; T, tertile; T2D, type 2 diabetes; TG, triglycerides; VIP, Västerbotten Intervention Program; W, women.
2
Denmark, France, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden, United Kingdom.
3Argentina, Bangladesh, Brazil, Canada, Chile, China, Colombia, India, Iran, Malaysia, occupied Palestinian territory, Pakistan, Philippines, Poland, South Africa, Saudi Arabia, Sweden, Tanzania, Turkey, United Arab Emirates, and Zimbabwe.