Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden.
Food and Meal Science, Kristianstad University, Kristianstad, Sweden.
Eur J Nutr. 2018 Dec;57(8):2869-2876. doi: 10.1007/s00394-017-1556-2. Epub 2017 Oct 28.
Conflicting results in the literature exist on the role of dairy products in the context of a Nordic Healthy Diet (NHD). Two recent Swedish studies indicate both negative and positive associations with total mortality when comparing key dairy products. There is no consensus about how to include these foods into the NHD.
To study consumption of cheese and milk products (milk, sour milk and unsweetened yoghurt) by 70-year-old Swedes in relation to all-cause mortality.
Cox proportional hazard models, adjusted for potential confounders and stratified by follow-up duration, were used to assess the prediction of all-cause mortality by the above foods. The associations of fat from cheese and milk products with mortality were tested in separate models.
Cheese intake inversely predicted total mortality, particularly at high protein intakes, and this association decreased in strength with increasing follow-up time. Milk products predicted increased mortality with stable HRs over follow-up. The association between milk products and mortality was strongly influenced by the group with the highest consumption. Fat from cheese mirrored the protective association of cheese intake with mortality, whereas fat from milk products predicted excess mortality, but only in an energy-adjusted model.
Based on our results, it may be argued that the role of dairy products in the context of a Nordic healthy diet should be more clearly defined by disaggregating cheese and milk products and not necessarily focusing on dairy fat content. Future epidemiological research should consider dairy products as disaggregated food items due to their great diversity in health properties.
在北欧健康饮食(NHD)的背景下,乳制品的作用在文献中存在相互矛盾的结果。最近的两项瑞典研究表明,在比较主要乳制品时,总死亡率与两者均呈负相关和正相关。关于如何将这些食物纳入 NHD 尚无共识。
研究瑞典 70 岁老年人食用奶酪和奶制品(牛奶、酸奶和无糖酸奶)与全因死亡率的关系。
使用 Cox 比例风险模型,根据潜在混杂因素进行调整,并按随访时间分层,评估上述食物对全因死亡率的预测作用。分别测试奶酪和奶制品中脂肪与死亡率的关系。
奶酪的摄入量与总死亡率呈负相关,尤其是在高蛋白质摄入量时,这种相关性随着随访时间的增加而减弱。奶制品与死亡率呈正相关,且在随访期间 HR 稳定。奶制品与死亡率的关系受摄入量最高组的强烈影响。奶酪中的脂肪反映了奶酪摄入量与死亡率之间的保护关联,而奶制品中的脂肪则预示着死亡率过高,但仅在能量调整模型中如此。
基于我们的结果,可以认为,在北欧健康饮食的背景下,乳制品的作用应该通过分解奶酪和奶制品来更明确地定义,而不一定关注乳制品中的脂肪含量。未来的流行病学研究应考虑将乳制品作为离散的食物,因为它们在健康特性方面存在巨大差异。