Table 1a.
Summary of meta analyses, systematic reviews and narrative reviews reporting CVD outcomes: observational studies.
| References | No. of studies | Study design | Dairy formats | Outcomes |
|---|---|---|---|---|
| Elwood et al. (4) | Eleven studies prospective cohort | Meta-analysis | Total dairy, milk, butter, cheese | Inverse association for total dairy vs. IHD RR 0.92 (0.80, 0.99) and stroke RR 0.79 (0.68, 0.91). Mismatch between evidence from long-term prospective studies and perception of harm from consumption of dairy |
| Soedamah-Muthu et al. (5) | Seventeen studies Prospective cohort | Meta-analysis | Total dairy, low-fat, high-fat dairy | Modest inverse association for milk and CVD (4 studies) RR 0.94 per 200 mL/d, 95% CI: 0.89, 0.99; but not CHD (6 studies) RR 1.00, 95% CI: 0.96, 1.04; or stroke (6 studies) RR 0.87, 95% CI: 0.72, 1.05. No association for high-fat or low-fat dairy, per 200 g/d, with CHD. |
| Huth and Park (116) | Twenty-three studies Prospective cohort | Narrative review | Total dairy, low-fat, high-fat, milk, cheese, butter, yogurt | Most, but not all, showed no relationship or inverse association between dairy and risk of CVD and stroke |
| Astrup et al. (117) | Seventeen studies Prospective cohort | Narrative review | Milk, yogurt, mixed dairy | Modest inverse association between milk and risk of CVD, RR reduction 6%. Milk not associated with reduction in risk of CAD, stroke, or total mortality. |
| Qin et al. (6) | Twenty-two studies Prospective cohort | Meta-analysis | Total dairy, milk, low-fat dairy, high-fat dairy, cheese, butter, yogurt | Inverse association for total dairy and CVD (nine studies; RR 0.88, 95% CI: 0.81, 0.96), stroke (12 studies; RR 0.87, 95% CI: 0.77, 0.99), but not CHD |
| Alexander et al. (7) | Thirty-one studies Prospective cohort | Systematic review and meta-analysis | Total dairy, dairy products, low-fat dairy, high-fat dairy, Ca from dairy | Inverse association for total dairy (RR 0.91; 95 % CI 0.83, 0.99) and calcium from total dairy (RR = 0.69; 95 % CI 0.60, 0.81) and stroke; also cheese and CHD (RR 0.82; 95 % CI 0.72, 0.93) and stroke (RR 0.87; 95 % CI 0.77, 0.99). Low level evidence after adjustment for within-study covariance |
| Drouin-Chartier et al. (131) | Twenty-one studies Prospective cohort | Systematic review and meta-analysis | Total dairy, milk, high-fat dairy, low-fat dairy, cheese, yogurt, fermented | Favorable or neutral associations with CVD-related clinical outcomes. Moderate-quality evidence for total dairy as neutral for CVD risk High-quality evidence for total dairy and decreased hypertension risk |
| Pimpin et al. (132) | Fifteen studies Prospective cohort | Systematic review and meta-analysis | Butter fat | Not significantly associated with CVD |
| Guo et al. (133) | Twenty-nine studies Prospective cohort | Meta-analysis | Total dairy, low-fat dairy, high-fat dairy, milk | No associations for total (high-fat/low-fat) dairy, and milk with CHD or CVD |
| Wu and Sun (134) | Nine studies Prospective cohort | Meta-analysis | Yogurt | Highest category consumption ns related to incident CVD; RR 1.01, 95% CI 0.95, 1.08 |
| Gholami et al. (8) | Twenty-seven studies Prospective cohort | Meta-analysis | Total dairy | Inverse association between total dairy and CVD; no relationship for CHD |
| Dehghan et al. (130) | PURE study | Prospective cohort | Whole-fat dairy: milk, yogurt, cheese | Inverse association between higher dairy and CV events HR:0.81; 95% CI:0.77, 0.93 |
| Yu and Hu (20) | Four studies Prospective cohort | Narrative review, summarizing meta analyses of cohort studies for CVD endpoints | Total dairy, milk, cheese, yogurt | Null or weak inverse association between consumption of dairy products and risk of CVD. Milk RR 1.01, cheese RR 0.92, yogurt RR 1.03. Odd chain fats as biomarkers: inverse association of C15:0 and C17:0 with CVD |
| Guillocheau et al. (81) | Thirteen studies Prospective cohort | Narrative review of cross-sectional, case control, cohort studies | Monounsaturated trans-palmitoleic acid | Neutral or inverse associations; but inconsistent findings for CVD risk factors |
| Hirahatake and Astrup (135) | Seventeen studies Prospective cohort | Narrative review summarizing meta-analyses, systematic reviews, prospective cohort studies | Multiple dairy formats including full fat, low-fat, cheese, yogurt | Neutral or inverse association of full-fat dairy with CVD |
| Kim et al. (136) | Sixty-two studies Korean cohorts; 42 cross-sectional, 3 case-control, 17 cohort | Systematic review and meta-analysis | Total dairy, milk | Inverse association with CVD risk factors |
| Godos et al. (9) | Fifty-three studies Prospective cohort | Umbrella review of meta analyses | Total dairy, milk, high-fat dairy, low-fat dairy, cheese, butter, yogurt | Inverse association for total dairy and CVD; and for cheese and CHD, CVD and stroke risk factors in highest vs. lowest category; no association with milk |
CAD, coronary artery disease; CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio; IHD, ischemic heart disease; RR, relative risk.