Dairy Consumption, Lactase Persistence, and Mortality Risk in a Cohort From Southern Sweden

Abstract

Background: Whether high dairy consumption is related to longevity is still unclear, and additional studies of prospective cohorts with high-quality dietary data from populations with wide consumption ranges are needed.Objective: To examine the association between dairy consumption and mortality in a Swedish cohort.Design: Among 26,190 participants (62% females, 45–73 years old) without diabetes and cardiovascular disease from the population-based Malmö Diet and Cancer cohort, 7,156 individuals died during a mean follow-up time of 19 years. Data on intake of dairy (non-fermented milk, fermented milk, cheese, cream and butter) were collected from 7 day food records and food questionnaires. A genetic marker (rs4988235) associated with lactase persistence was detected among 22,234 individuals born in Sweden.Results: Higher intakes up to 1,000 g/day of non-fermented milk were associated with only marginal higher mortality rates after adjusting for potential confounders. However, intakes above 1,000 g/day (1.5% of the population) were associated with 34% (95% CI: 14, 59%, p-trend=0.002) higher mortality compared to that with < 200 g/day. Fermented milk and cheese intake were inversely associated with mortality. Cream showed a protective association only among men. Butter was not associated with mortality. CT/TT genotype carriers (i.e., individuals with lactase persistence) had a 27% higher reported consumption of non-fermented milk, and non-significant higher mortality risk (HR = 1.08; 95% CI = 0.96, 1.23; p = 0.20) than CC genotype carriers.Conclusions: Higher mortality rates were mainly observed among participants consuming more than 1,000 g of non-fermented milk per day. In contrast, fermented milk and cheese were associated with lower mortality. Because dairy products differ in composition, it is important to examine them separately in their relation to health and disease. The use of a genetic variant as an objective marker of lactose-containing milk intake should be examined in relation to mortality in a larger population.

Cheese consumption and multiple health outcomes: an umbrella review and updated meta-analysis of prospective studies

“…The updated meta-analysis of 21 studies [ [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] ], including 136,298 cases among >1,030,243 participants, revealed an inverse association between cheese consumption and all-cause mortality (highest compared with lowest: RR = 0.95; 95% CI: 0.92, 0.99; P = 0.0052; I 2 = 34%) ( Figure 2 and Supplemental Figure 2 ). In the dose–response meta-analysis of 14 studies [ 77 , 79 , [81] , [82] , [83] , [84] , [85] , [87] , [88] , [89] , [90] , [91] ], each 30-g/d cheese increment was associated with a 2% lower risk of all-cause mortality (RR = 0.98; 95% CI: 0.96, 1.00; P = 0.027; I 2 = 60%) ( Figure 4 and Supplemental Figure 3 ). Nonlinear analyses further showed a U-shaped association, where the lowest risk of all-cause mortality was observed at ∼40 g/d of cheese consumption ( P -nonlinearity < 0.001) ( Figure 5 A).…”

Milk intake, lactase persistence genotype, plasma proteins and risks of cardiovascular events in the Swedish general population

“…Genotyping was performed on the iScan System (Illumina, San Diego, CA, USA) according to the manufacturer’s recommended protocols. The quality control and imputation of rs4988235 have been described previously [ 7 ]. The LCT rs4988235 is a well-established genetic marker for non-fermented milk intake [ 7 ].…”

“…The quality control and imputation of rs4988235 have been described previously [ 7 ]. The LCT rs4988235 is a well-established genetic marker for non-fermented milk intake [ 7 ]. The rs4988235 genotype was categorized as CC (lactase deficiency), CT (lactase persistence), and TT (lactase persistence).…”

“…While meta-analyses have generally not found consistent association between milk intake and mortality, several large cohorts in Sweden showed that non-fermented milk Yan Borné and Emily Sonestedt are joint senior authors. intake was associated with a higher risk of mortality [2,7,8]. Fermented milk intake has been associated with a lower risk of cardiovascular disease (CVD) and mortality in several studies [9][10][11].…”

High consumption of dairy products and risk of major adverse coronary events and stroke in a Swedish population

“…We categorised the intake of dairy products (g/d) in groups to get as wide intake ranges as possible but still with enough number of participants in each group. The cut-offs have been used in a previous publication (16) . Non-fermented milk was categorised into 0–200, 200–400, 400–600, 600–800, 800–1000 and above 1000 g/d; fermented milk was categorised into 0, 0–100, 100–200, 200–300 and above 300 g/d; cheese was categorised into 0–20, 20–40, 40–60, 60–80, 80–100 and >100 g/d; cream intake was categorised into 0–10, 10–20, 20–30, 30–40, 40–50 and >50 g/d and butter intake was categorised into 0, 0–10, 10–20, 20–30, 30–40, 40–50 and >50 g/d.…”