van der Pols J C, Gunnell D, Williams G M, Holly J M P, Bain C, Martin R M
Cancer and Population Studies Group, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, Australia, QLD 4006, Australia.
Heart. 2009 Oct;95(19):1600-6. doi: 10.1136/hrt.2009.168716. Epub 2009 Jul 29.
Dairy consumption in childhood may have long-term effects on cardiovascular mortality through influencing the development of risk factors or programming effects.
To investigate whether dairy and calcium consumption in childhood is associated with adult mortality due to coronary heart disease (CHD), stroke and all causes.
In 1937-9, 4999 children in England and Scotland participated in a study of family food consumption, assessed from 7-day household food inventories. Cause of death was ascertained between 1948 and 2005 in 4374 traced cohort members with complete data. Per capita household intake estimates for dairy products and calcium were used as proxies for individual intake.
No strong evidence that a family diet in childhood high in dairy products was associated with CHD or stroke mortality was found. However, childhood calcium intake was inversely associated with stroke mortality (multivariable adjusted hazard ratio (HR) for highest versus lowest calcium group: 0.41; 95% confidence interval (CI) 0.16 to 1.05; p for trend = 0.04), but not CHD mortality. All-cause mortality was lowest in those with the highest family dairy (HR = 0.77; 95% CI 0.61 to 0.98; p for trend = 0.04) and calcium intake (HR = 0.77, 95% CI 0.60 to 0.98; p for trend = 0.05).
Children whose family diet in the 1930s was high in calcium were at reduced risk of death from stroke. Furthermore, childhood diets rich in dairy or calcium were associated with lower all-cause mortality in adulthood. Replication in other study populations is needed to determine whether residual confounding explains part of these findings.
儿童时期摄入乳制品可能通过影响危险因素的发展或编程效应，对心血管疾病死亡率产生长期影响。
调查儿童时期摄入乳制品和钙是否与因冠心病（CHD）、中风及所有原因导致的成人死亡率相关。
1937年至1939年，英格兰和苏格兰的4999名儿童参与了一项家庭食物消费研究，通过7天的家庭食物清单进行评估。在4374名有完整数据的追踪队列成员中，确定了1948年至2005年期间的死亡原因。用家庭乳制品和钙的人均摄入量估计值作为个体摄入量的替代指标。
未发现有力证据表明儿童时期家庭饮食中高乳制品摄入量与冠心病或中风死亡率相关。然而，儿童时期的钙摄入量与中风死亡率呈负相关（最高钙组与最低钙组的多变量调整风险比（HR）：0.41；95%置信区间（CI）0.16至1.05；趋势p值 = 0.04），但与冠心病死亡率无关。家庭乳制品摄入量最高者（HR = 0.77；95% CI 0.61至0.98；趋势p值 = 0.04）和钙摄入量最高者（HR = 0.77，95% CI 0.60至0.98；趋势p值 = 0.05）的全因死亡率最低。
20世纪30年代家庭饮食中钙含量高的儿童中风死亡风险降低。此外，儿童时期富含乳制品或钙的饮食与成年期较低的全因死亡率相关。需要在其他研究人群中进行重复研究，以确定残余混杂因素是否能解释这些发现的部分原因。
