Centre for Nutrition, Department of Clinical Science, University of Bergen, Haukelandsbakken 15, 5021 Bergen, Norway.
Centre of Care Research (West), Western Norway University of Applied Sciences (HVL), Årstadveien 17, 5009 Bergen, Norway.
Eur J Prev Cardiol. 2023 Feb 14;30(3):219-229. doi: 10.1093/eurjpc/zwac217.
The association of dairy products with cardiovascular disease and mortality risk remains heavily debated. We aimed to investigate the association between intake of total dairy and dairy products and the risk of acute myocardial infarction (AMI), stroke, and cardiovascular and all-cause mortality.
We included 1929 patients (80% men, mean age 62 years) with stable angina pectoris from the Western Norway B-vitamin Intervention Trial. Dietary data were obtained via a 169-item food frequency questionnaire. Risk associations were estimated using Cox proportional hazard regression models adjusted for relevant covariates. Non-linear associations were explored visually. The mean (±SD) dairy intake in the study population was 169 ± 108 g/1000 kcal. Median follow-up times were 5.2, 7.8, and 14.1 years for stroke, AMI, and mortality, respectively. Higher intake of total dairy and milk were positively associated with stroke risk [HR (95% CI): 1.14 (1.02, 1.27) and 1.13 (1.02, 1.27), cardiovascular mortality 1.06 (1.00, 1.12) and 1.07 (1.01, 1.13)] and all-cause mortality [1.07 (1.03, 1.11) and 1.06 (1.03, 1.10)] per 50 g/1000 kcal. Higher cheese intake was inversely associated with AMI risk [0.92 (0.83, 1.02)] per 10 g/1000 kcal. Butter was associated with increased AMI risk [1.10 (0.97, 1.24)] and all-cause mortality [1.10 (1.00, 1.20) per 5 g/1000 kcal.
Higher dairy and milk consumption were associated with increased risk of mortality and stroke. Cheese was associated with decreased, and butter with increased, risk of AMI. Dairy is a heterogenous food group with divergent health effects and dairy products should therefore be investigated individually.
乳制品与心血管疾病和死亡风险之间的关联仍存在很大争议。本研究旨在调查总乳制品和乳制品摄入量与急性心肌梗死(AMI)、中风以及心血管和全因死亡率之间的关系。
我们纳入了来自挪威西部维生素 B 干预试验的 1929 名稳定性心绞痛患者(80%为男性,平均年龄 62 岁)。通过 169 项食物频率问卷获取饮食数据。使用 Cox 比例风险回归模型,根据相关协变量进行调整,评估风险关联。通过视觉探索非线性关联。研究人群的平均(±SD)乳制品摄入量为 169±108 g/1000 kcal。中风、AMI 和死亡率的中位随访时间分别为 5.2、7.8 和 14.1 年。总乳制品和牛奶的摄入量越高,与中风风险呈正相关[风险比(95%置信区间):1.14(1.02,1.27)和 1.13(1.02,1.27)],与心血管死亡率呈正相关[1.06(1.00,1.12)和 1.07(1.01,1.13)],与全因死亡率呈正相关[1.07(1.03,1.11)和 1.06(1.03,1.10)],每 50 g/1000 kcal。每 10 g/1000 kcal 摄入奶酪越多,与 AMI 风险呈负相关[0.92(0.83,1.02)]。黄油与 AMI 风险增加相关[1.10(0.97,1.24)]和全因死亡率相关[每 5 g/1000 kcal 增加 1.10(1.00,1.20)]。
乳制品和牛奶摄入量越高,死亡率和中风风险越高。奶酪与 AMI 风险降低有关,而黄油与 AMI 风险增加有关。乳制品是一种异质食品,对健康的影响也不同,因此应该分别对乳制品进行研究。