The Consumption of Milk and Dairy Foods and the Incidence of Vascular Disease and Diabetes: An Overview of the Evidence

Abstract

The health effects of milk and dairy food consumption would best be determined in randomised controlled trials. No adequately powered trial has been reported and none is likely because of the numbers required. The best evidence comes, therefore, from prospective cohort studies with disease events and death as outcomes. Medline was searched for prospective studies of dairy food consumption and incident vascular disease and Type 2 diabetes, based on representative population samples. Reports in which evaluation was in incident disease or death were selected. Meta-analyses of the adjusted estimates of relative risk for disease outcomes in these reports were conducted. Relevant case–control retrospective studies were also identified and the results are summarised in this article. Meta-analyses suggest a reduction in risk in the subjects with the highest dairy consumption relative to those with the lowest intake: 0.87 (0.77, 0.98) for all-cause deaths, 0.92 (0.80, 0.99) for ischaemic heart disease, 0.79 (0.68, 0.91) for stroke and 0.85 (0.75, 0.96) for incident diabetes. The number of cohort studies which give evidence on individual dairy food items is very small, but, again, there is no convincing evidence of harm from consumption of the separate food items. In conclusion, there appears to be an enormous mis-match between the evidence from long-term prospective studies and perceptions of harm from the consumption of dairy food items.

Can milk proteins be a useful tool in the management of cardiometabolic health? An updated review of human intervention trials

“…However, the potential health impacts of animal-derived foods, and more specifically Proceedings of the Nutrition Society milk and dairy consumption, have been questioned owing to their high saturated fat content (for review, see (3) ). However, emerging epidemiological evidence supports the beneficial effects of milk and dairy consumption on health, particularly cardiometabolic health (4)(5)(6) .…”

Milk and meat in our diet: good or bad for health?

“…Elwood et al (2008) also examined four studies in which incident diabetes was the outcome, and RR in subjects with the highest intake of milk or dairy foods was 0.92 (95% CI 0.86, 0.97). This work has been extended to examine the evidence for the differential effects of milk, cheese and butter on the incidence of vascular disease (Elwood et al, 2010). This essentially found that there were very few prospective cohort studies available for cheese (five) and butter (six).…”

Nonfat milk attenuates acute hyperglycemia in individuals with android obesity: A randomized control trial

“…However, by selecting individuals with highly elevated android body fat, we observed a significant effect of milk on attenuating postprandial hyperglycemia. These results are consistent with the previous observation that the beneficial effects of dairy on metabolic and clinical parameters are more likely to be evident in individuals with elevated risk factors for CVD as there appears to be a distinct “basement effect” associated with dairy intake, in which little to no changes have been observed in healthy individuals with normal or low values (Elwood et al., 2010; Pereira et al., 2002; Poppitt et al., 2002). Therefore, the observed effects can likely be extended to, and perhaps greater in, older obese adults, type 2 diabetes, and those with CVD.…”

“…We found no significant differences in glycemic responses between the trials involving nonfat milk and those with the control drink that included the same amount of protein. These results confirm previous findings that at least some of the beneficial effects of milk on glycemic responses can be attributed to its protein quantity (Akhavan et al., 2010, 2014; Ballard et al., 2013; Elwood et al., 2010; Fekete et al., 2016; Gannon et al., 1992; Jakubowicz et al., 2014; Manders et al., 2014). …”

“…Importantly, the beneficial effects of dairy on metabolic and clinical parameters are evident in individuals with elevated risk of CVD (Elwood, Pickering, Givens, & Gallacher, 2010; Pereira et al., 2002). However, there appears to be a distinct “floor effect” associated with dairy intake, in which little to no changes were observed in relatively healthy individuals with normal or low baseline levels of cardiovascular risk factors (Poppitt et al., 2002).…”