Dairy & Cardiovascular Disease Risk

There is significant level of controversy and misinformation in the nutrition movement when it comes to the effect that dairy foods such as milk, yogurt and cheese have on potential risk for developing cardiovascular disease.

The general consensus frоm thе сurrеnt literature iѕ thаt dаirу fооdѕ either have a favorable оr neutral аѕѕосiаtiоn whеn it соmеѕ to саrdiоvаѕсulаr diѕеаѕе risk.

Dairy foods are a good source of many nutrients such as Calcium, Vitamin B12 and protein, and can play an important role nutritionally in diet patterns such as lacto-ovo vegetarian and omnivorous diets.

In this article we are going to examine the current systematic reviews and meta-analysis of the literature on dairy food consumption and cardiovascular risk/outcomes.

  1. Milk & Dairy Product Consumption & Cardiovascular Diseases
    An overview of systematic reviews and meta-analyses of follow-up studies published in 2019, plus an overview of meta-analyses involving RCTs, and an update on meta-analyses of RCTs (2013–2018) aiming to synthesize the evidence regarding the influence of dairy product consumption on the risk of major cardiovascular-related outcomes found that:

The overview of 12 meta-analyses involving RCTs as well as the updated meta-analyses of RCTs did not result in significant changes on risk biomarkers such as systolic and diastolic blood pressure and total cholesterol and LDL cholesterol.

Therefore, the present study states that the consumption of total dairy products, with either regular or low fat content, does not adversely affect the risk of CVD. [1]

  1. Cheese May Reduce Cardiovascular Disease Risk
    Cheese is an interesting and unique food in that whilst it is a rich source of saturated fats, it does not appear to have the same negative effects on blood lipid profiles that other saturated fat rich foods such as butter does.

Part of the reason for this is thought to be due to a number of potential factors such as the high calcium content of cheese, increased fecal fat/bile excretion and an attenuation of saturated fats effect on lipid/cholesterol due to the unique “food matrix” that cheese contains and MFGM(milk fat globule membrane).

A meta-analysis of prospective observational studies published in 2016 was conducted to evaluate the risks of total CVD, coronary heart disease (CHD), and stroke associated with cheese consumption.

The restricted cubic model indicated evidence of nonlinear relationships between cheese consumption and risks of total CVD (P nonlinearity < 0.001) and stroke (P nonlinearity = 0.015), with the largest risk reductions observed at the consumption of approximately 40 g/d.

This meta-analysis of prospective studies suggests a nonlinear inverse association between cheese consumption and risk of CVD. [2]

  1. Association Between Dairy Product Consumption & Risk Of Cardiovascular Related Outcomes
    A systematic review of the literature published in 2016 set out to determine if dairy product consumption is detrimental, neutral, or beneficial to cardiovascular health and if the recommendation to consume reduced-fat as opposed to regular-fat dairy is evidence-based.

The systematic review concluded:

First, there is no evidence that the consumption of any form of dairy product is detrimentally associated with the risk of any cardiovascular-related clinical outcome.

In fact, high-quality evidence supports favorable associations (i.e., decreased risk) between:

total dairy intake and the risk of hypertension, and

low-fat dairy and yogurt intake and the risk of T2D.

Moreover, moderate-quality evidence suggests favorable associations between:

intakes of total dairy, low-fat dairy, cheese, and fermented dairy products and the risk of stroke;

intakes of low-fat dairy and milk and the risk of hypertension;

intakes of total dairy and milk and the risk of MetS; and

intakes of total dairy and cheese and the risk of T2D.

On the basis of the adapted GRADE criteria, these favorable associations are very likely. However, future studies may modify risk estimates toward confirmed favorable associations or toward the null.

Finally, there is high- to moderate-quality evidence that:

consumption of total dairy, cheese, and yogurt is neutral in terms of CVD risk;

consumption of all forms of dairy, except for fermented, is neutral in terms of CAD risk;

consumption of regular- and high-fat dairy, milk, and yogurt is neutral in terms of stroke risk;

consumption of regular- and high-fat dairy, cheese, yogurt, and fermented dairy is neutral in terms of risk of hypertension; and

consumption of regular- and high-fat dairy, milk, and fermented dairy is neutral in terms of risk T2D.

Is the recommendation to consume low-fat as opposed to regular- and high-fat dairy supported by the existing evidence?

First, there is no evidence from this extensive review that the consumption of dairy fat or of regular- and high-fat dairy is detrimental to cardiovascular-related clinical outcomes. More specifically, the:

consumption of regular- and high-fat dairy is neutral in terms of risk of CAD, stroke, hypertension, and T2D, which is supported by high- to moderate-quality evidence;

consumption of low-fat dairy is neutral in terms of CAD risk, which is supported by high-quality evidence; and

Consumption of low-fat dairy is favorably associated with the risk of stroke, hypertension, and T2D, which is supported by high- to moderate-quality evidence.

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