Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy.
Medical Statistics Unit, Luigi Vanvitelli University of Campania, Naples, Italy.
Am J Clin Nutr. 2019 Nov 1;110(5):1220-1230. doi: 10.1093/ajcn/nqz183.
The relation of dairy product consumption to health and mortality is controversial.
We investigated associations of consumption of various dairy products with mortality in the Italian cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Italy study.
Dairy product consumption was assessed by validated semiquantitative FFQs. Multivariable Cox models stratified by center, age, and sex and adjusted for confounders estimated associations of milk (total, full fat, and reduced fat), yogurt, cheese, butter, and dairy calcium consumption with mortality for cancer, cardiovascular disease, and all causes. Nonlinearity was tested by restricted cubic spline regression.
After a median follow-up of 14.9 y, 2468 deaths were identified in 45,009 participants: 59% from cancer and 19% from cardiovascular disease. No significant association of consumption of any dairy product with mortality was found in the fully adjusted models. A 25% reduction in risk of all-cause mortality was found for milk intake from 160 to 120 g/d (HR: 0.75; 95% CI: 0.61, 0.91) but not for the highest (>200 g/d) category of intake (HR: 0.95; 95% CI: 0.84, 1.08) compared with nonconsumption. Associations of full-fat and reduced-fat milk consumption with all-cause and cause-specific mortality were similar to those for milk as a whole.
In this Italian cohort characterized by low to average milk consumption, we found no evidence of a dose-response association between milk consumption and mortality and also no association of consumption of other dairy products investigated with mortality.
乳制品消费与健康和死亡率的关系存在争议。
我们研究了意大利欧洲癌症前瞻性调查和营养研究(EPIC-Italy)队列中各种乳制品的消费与死亡率之间的关系。
通过经过验证的半定量 FFQ 评估乳制品的消费情况。多变量 Cox 模型按中心、年龄和性别分层,并调整混杂因素,估计牛奶(全脂、低脂和脱脂)、酸奶、奶酪、黄油和乳制品钙的消费与癌症、心血管疾病和所有原因的死亡率之间的关系。通过限制三次样条回归测试非线性。
在中位随访 14.9 年后,在 45009 名参与者中发现了 2468 例死亡:59%死于癌症,19%死于心血管疾病。在完全调整的模型中,没有发现任何乳制品消费与死亡率之间的显著关联。与不消费相比,摄入牛奶(160-120 克/天)可降低 25%的全因死亡率风险(HR:0.75;95%CI:0.61,0.91),但摄入最高(>200 克/天)组别的风险没有降低(HR:0.95;95%CI:0.84,1.08)。全脂和低脂牛奶的摄入与全因和特定原因的死亡率的关联与整体牛奶的关联相似。
在以低到中等牛奶消费为特征的意大利队列中,我们没有发现牛奶消费与死亡率之间存在剂量反应关系的证据,也没有发现所研究的其他乳制品的消费与死亡率之间存在关联。