Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada.
Adv Nutr. 2022 Mar;13(2):439-454. doi: 10.1093/advances/nmab118. Epub 2023 Feb 10.
The association between dairy product consumption and cardiovascular health remains highly debated. We quantitatively synthesized prospective cohort evidence on the associations between dairy consumption and risk of hypertension (HTN), coronary heart disease (CHD), and stroke. We systematically searched PubMed, Embase, and Web of Science through August 1, 2020, to retrieve prospective cohort studies that reported on dairy consumption and risk of HTN, CHD, or stroke. We used random-effects models to calculate the pooled RR and 95% CI for the highest compared with the lowest category of intake and for a 1-serving/d increase in consumption. We rated the quality of evidence using NutriGrade. Fifty-five studies were included. Total dairy consumption was associated with a lower risk of HTN (RR for highest compared with lowest level of intake: 0.91, 95% CI: 0.86, 0.95, I = 73.5%; RR for 1-serving/d increase: 0.96, 95% CI: 0.94, 0.97, I = 66.5%), CHD (highest compared with lowest level of intake: 0.96, 95% CI: 0.92, 1.00, I = 46.6%; 1-serving/d increase: 0.98, 95% CI: 0.95, 1.00, I = 56.7%), and stroke (highest compared with lowest level of intake: 0.90, 95% CI: 0.85, 0.96, I = 60.8%; 1-serving/d increase: 0.96, 95% CI: 0.93, 0.99, I = 74.7%). Despite moderate to considerable heterogeneity, these associations remained consistent across multiple subgroups. Evidence on the relation between total dairy and risk of HTN and CHD was of moderate quality and of low quality for stroke. Low-fat dairy consumption was associated with lower risk of HTN and stroke and high-fat dairy with a lower risk of stroke. Milk, cheese, or yogurt consumption showed inconsistent associations with the cardiovascular outcomes in high compared with low intake and dose-response meta-analyses. Total dairy consumption was associated with a modestly lower risk of hypertension, CHD, and stroke. Moderate to considerable heterogeneity was observed in the estimates, and the overall quality of the evidence was low to moderate.
乳制品消费与心血管健康之间的关系仍存在很大争议。我们定量综合了前瞻性队列研究中关于乳制品消费与高血压（HTN）、冠心病（CHD）和中风风险之间关系的证据。我们通过 2020 年 8 月 1 日的 PubMed、Embase 和 Web of Science 系统检索了报告乳制品消费与 HTN、CHD 或中风风险之间关系的前瞻性队列研究。我们使用随机效应模型计算了最高摄入量与最低摄入量之间以及摄入量每增加 1 份/天的 RR 和 95%CI。我们使用 NutriGrade 对证据质量进行了评级。纳入了 55 项研究。总乳制品消费与 HTN 风险降低相关（最高摄入量与最低摄入量相比：RR 为 0.91，95%CI：0.86，0.95，I=73.5%；RR 每增加 1 份/天：0.96，95%CI：0.94，0.97，I=66.5%），CHD（最高摄入量与最低摄入量相比：RR 为 0.96，95%CI：0.92，1.00，I=46.6%；RR 每增加 1 份/天：0.98，95%CI：0.95，1.00，I=56.7%）和中风（最高摄入量与最低摄入量相比：RR 为 0.90，95%CI：0.85，0.96，I=60.8%；RR 每增加 1 份/天：0.96，95%CI：0.93，0.99，I=74.7%）。尽管存在中度到高度的异质性，但这些关联在多个亚组中仍然一致。关于总乳制品与 HTN 和 CHD 风险之间关系的证据质量为中等，而中风的证据质量为低。低脂乳制品消费与 HTN 和中风风险降低相关，而高脂肪乳制品与中风风险降低相关。牛奶、奶酪或酸奶的消费与摄入量较高和剂量反应meta 分析中与心血管结局的关联不一致。总乳制品消费与 HTN、CHD 和中风的风险略有降低相关。估计值存在中度到高度的异质性，证据的总体质量为低到中等。
