Cardiovascular disease (CVD) is the leading cause of death worldwide. The major types include ischemic heart disease (IHD), especially myocardial infarction (MI), and stroke. Without proper care and habit changes, the chance for CVD to recur is high. Changing unhealthy lifestyle habits such as smoking, physical inactivity, alcohol use, and a poor diet are critical in the prevention of recurrent CVD.

 

    Dairy foods have been promoted for many health benefits related to CVD, such as yogurt has been suggested to lower the risk of diabetes, a major risk factor for heart disease. However, dairy is a diverse food group of milk-based products varying in terms of consistency, fat content, and micronutrients so that their health effects can be different.

 

    To understand the associations of types of dairy and long-term mortality risk in drug-treated post-MI patients, Cruijsen et al. studied 4365 Dutch patients from the Alpha Omega Cohort aged 60–80 years old (21% women) with an MI ≤10 years before enrollment. Dietary data were collected at baseline (2002–2006) using a 203-item Food Frequency Questionnaire (FFQ) and patients were followed for cause-specific mortality through December 2018 for ~ 12 years.

 

    Most MI patients included in the study were Dutch, 24% were obese, 20% had diabetes, and 97% used cardiovascular medication. Median dairy food intakes were 39 g/day for plain yogurt, 88 g/day for total non-fermented milk, and 17 g/day for hard cheeses. Of the cohort, 10% consumed high-fat milk. During ∼12 y of follow-up, 2035 deaths occurred, including 903 from CVD, 558 from IHD, and 170 from stroke.

 

    Dairy foods were grouped as follows: total dairy, yogurt, hard cheeses, total fermented dairy, liquid fermented dairy, milk, low-fat milk, high-fat milk, and butter. Yogurt was inversely associated with CVD mortality and all-cause mortality. Associations for milk and other dairy products were neutral or inconsistent.

 

    Yogurt consumption of >50 g/day compared with <25 g/day was associated with a lower risk (-14% risk) of CVD mortality using the fully adjusted model (HR: 0.86; 95% CI: 0.74, 0.99). When analyzed continuously, a 4% lower risk of CVD mortality was observed per 25-g/day increment in yogurt intake (HR: 0.96; 95% CI: 0.93, 0.99). In relation to all-cause mortality risk, yogurt intakes > 50 g/day compared with <25 g/day were associated with a lower all-cause mortality risk (-13% risk) (HR: 0.87; 95% CI: 0.78, 0.96) .

 

   Total fermented dairy intakes of ≥50–100 g/day compared with <50 g/day were also associated with a lower all-cause mortality risk (-12% risk) (HR: 0.88; 95% CI: 0.78, 0.98).  When analyzed continuously, a trend toward a nonlinear association was found for total fermented dairy.

 

    No associations were observed for total milk, hard cheeses, low-fat milk, total dairy, liquid fermented dairy, and butter with all-cause mortality. High-fat milk intake was associated with an increased risk of all-cause mortality (HR: 1.30; 95% CI: 1.13, 1.49).

 

    This prospective analysis of 4365 Dutch post-MI patients who received state-of-the-art drug treatment showed inverse associations of yogurt with CVD and all-cause mortality. Associations of milk and other dairy products with mortality were generally neutral, except for elevated risk in the small group of high-fat milk consumers.

 

    This study showed that the risks of all-cause, CVD, and stroke mortality tended to be lower for higher intake of fermented dairy products. Probiotics in fermented dairy may beneficially affect the gut microbiota and intestinal health, possibly enhancing the body’s immune system and reducing low-grade inflammation.

 

    Fermented dairy is a diverse group of products, including solid foods (e.g., cheese), semisolid foods (e.g., yogurt), and drinks (e.g., buttermilk), which differ in calories, nutrient density, and level of processing. Cheese is an important contributor to salt intake in the Dutch diet. Yogurt may contain added sugar, although in this study mainly plain yogurt was consumed. In light of dietary recommendations, the authors considered risk estimates for separate fermented dairy groups more relevant than those for total fermented dairy. They suggested that unsweetened yogurt may be preferable to cheese (containing added salt) in IHD patients.

 

    You can find additional blogs related to the health benefits of dairy foods: Drinking Milk with Breakfast is a Good Strategy for Glucose Management and Want to Reduce Acne and Hair Loss?. Feel free to contact us for any questions you may have Contact Cal Nutrition Group for Questions.

 

Reference:

 

Esther Cruijsen, Maria G Jacobo Cejudo, Leanne K Küpers , Maria C Busstra , Johanna M Geleijnse . Dairy consumption and mortality after myocardial infarction: a prospective analysis in the Alpha Omega Cohort. Am J Clin Nutr. 2021 Jul 1;114(1):59-69. doi: 10.1093/ajcn/nqab026.