Um Caroline Y, Judd Suzanne E, Flanders W Dana, Fedirko Veronika, Bostick Roberd M
a Nutrition and Health Sciences Graduate Program , Emory University , Atlanta , Georgia , USA.
b Department of Biostatistics , University of Alabama at Birmingham , Birmingham , Alabama , USA.
Nutr Cancer. 2017 Nov-Dec;69(8):1185-1195. doi: 10.1080/01635581.2017.1367946. Epub 2017 Nov 10.
Associations of calcium and dairy product intakes with cardiovascular disease risk and cancer mortality are controversial. We investigated associations of calcium and dairy product intakes with mortality in the prospective REasons for Geographic and Racial Differences in Stroke study (n = 30,239). Of 2,966 total deaths, 32.3% were from CVD and 28.8% from cancer. For those in the upper relative to the lowest quintile of intakes, from Cox proportional hazards regression models, the multivariable-adjusted hazard ratios (HRs) for all-cause mortality were 1.13 (95% confidence intervals [CI] 0.95-1.35; P-trend 0.004) for whole milk, and 0.75 (CI 0.61-0.93; P-trend 0.001) for nonfat milk; for CVD mortality the corresponding HRs were 0.80 (CI 0.55-1.16; P-trend 0.80) and 0.72 (CI 0.49-1.05; P-trend 0.06); and for cancer mortality they were 1.56 (CI 1.17-2.08; P-trend 0.006) and 0.89 (CI 0.62-1.28; P-trend 0.86). Calcium (total, dietary, supplemental) and total dairy product intakes were not associated with all-cause, cardiovascular, or cancer mortality. These results suggest that whole milk consumption may be directly associated with cancer mortality; non-fat milk consumption may be inversely associated with all-cause and cardiovascular- and cancer-specific mortality; and calcium intake independent of milk product intakes may not be associated with mortality.
钙和乳制品摄入量与心血管疾病风险及癌症死亡率之间的关联存在争议。我们在“中风地理和种族差异原因”前瞻性研究(n = 30,239)中调查了钙和乳制品摄入量与死亡率之间的关联。在总共2966例死亡病例中,32.3%死于心血管疾病,28.8%死于癌症。对于摄入量处于最高五分位数相对于最低五分位数的人群,根据Cox比例风险回归模型,全脂牛奶的全因死亡率多变量调整风险比(HR)为1.13(95%置信区间[CI] 0.95 - 1.35;P趋势 = 0.004),脱脂牛奶为0.75(CI 0.61 - 0.93;P趋势 = 0.001);心血管疾病死亡率的相应HR分别为0.80(CI 0.55 - 1.16;P趋势 = 0.80)和0.72(CI 0.49 - 1.05;P趋势 = 0.06);癌症死亡率的相应HR分别为1.56(CI 1.17 - 2.08;P趋势 = 0.006)和0.89(CI 0.62 - 1.28;P趋势 = 0.86)。总钙、膳食钙、补充钙以及总乳制品摄入量与全因、心血管或癌症死亡率均无关联。这些结果表明,饮用全脂牛奶可能与癌症死亡率直接相关;饮用脱脂牛奶可能与全因、心血管疾病及特定癌症死亡率呈负相关;而独立于奶制品摄入量的钙摄入量可能与死亡率无关。