Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Adv Nutr. 2023 Sep;14(5):1170-1186. doi: 10.1016/j.advnut.2023.06.007. Epub 2023 Jun 15.
This umbrella review aims to provide a systematic and comprehensive overview of current evidence from prospective studies on the diverse health effects of cheese consumption. We searched PubMed, Embase, and Cochrane Library to identify meta-analyses/pooled analyses of prospective studies examining the association between cheese consumption and major health outcomes from inception to August 31, 2022. We reanalyzed and updated previous meta-analyses and performed de novo meta-analyses with recently published prospective studies, where appropriate. We calculated the summary effect size, 95% prediction confidence intervals, between-study heterogeneity, small-study effects, and excess significance bias for each health outcome. We identified 54 eligible articles of meta-analyses/pooled analyses. After adding newly published original articles, we performed 35 updated meta-analyses and 4 de novo meta-analyses. Together with 8 previous meta-analyses, we finally included 47 unique health outcomes. Cheese consumption was inversely associated with all-cause mortality (highest compared with lowest category: RR = 0.95; 95% CI: 0.92, 0.99), cardiovascular mortality (RR = 0.93; 95% CI: 0.88, 0.99), incident cardiovascular disease (CVD) (RR = 0.92; 95% CI: 0.89, 0.96), coronary heart disease (CHD) (RR = 0.92; 95% CI: 0.86, 0.98), stroke (RR = 0.93; 95% CI: 0.89, 0.98), estrogen receptor-negative (ER-) breast cancer (RR = 0.89; 95% CI: 0.82, 0.97), type 2 diabetes (RR = 0.93; 95% CI: 0.88, 0.98), total fracture (RR = 0.90; 95% CI: 0.86, 0.95), and dementia (RR = 0.81; 95% CI: 0.66, 0.99). Null associations were found for other outcomes. According to the NutriGrade scoring system, moderate quality of evidence was observed for inverse associations of cheese consumption with all-cause and cardiovascular mortality, incident CVD, CHD, and stroke, and for null associations with cancer mortality, incident hypertension, and prostate cancer. Our findings suggest that cheese consumption has neutral to moderate benefits for human health.
这项伞式综述旨在提供系统全面的综述，总结前瞻性研究中关于奶酪摄入对各种健康影响的现有证据。我们检索了 PubMed、Embase 和 Cochrane Library，以确定对奶酪摄入与主要健康结果之间关联的前瞻性研究的荟萃分析/汇总分析，检索时间从研究开始至 2022 年 8 月 31 日。我们对以前的荟萃分析进行了重新分析和更新，并对最近发表的前瞻性研究进行了适当的新荟萃分析。我们计算了每个健康结果的汇总效应大小、95%预测置信区间、研究间异质性、小样本研究效应和过度显著性偏差。我们确定了 54 项符合条件的荟萃分析/汇总分析文章。在添加新发表的原始文章后，我们进行了 35 项更新的荟萃分析和 4 项新的荟萃分析。加上 8 项以前的荟萃分析，我们最终纳入了 47 项独特的健康结果。奶酪摄入与全因死亡率呈负相关（与最低类别相比最高类别：RR = 0.95；95%CI：0.92，0.99），心血管死亡率（RR = 0.93；95%CI：0.88，0.99），心血管疾病事件（RR = 0.92；95%CI：0.89，0.96），冠心病（RR = 0.92；95%CI：0.86，0.98），中风（RR = 0.93；95%CI：0.89，0.98），雌激素受体阴性（ER-）乳腺癌（RR = 0.89；95%CI：0.82，0.97），2 型糖尿病（RR = 0.93；95%CI：0.88，0.98），总骨折（RR = 0.90；95%CI：0.86，0.95）和痴呆（RR = 0.81；95%CI：0.66，0.99）。其他结果则没有关联。根据 NutriGrade 评分系统，奶酪摄入与全因和心血管死亡率、心血管疾病事件、冠心病和中风呈负相关，与癌症死亡率、高血压事件和前列腺癌无关联，这些关联的证据质量为中等。我们的研究结果表明，奶酪摄入对人类健康具有中性到中等的益处。
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