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Whole milk consumption and risk of cardiovascular disease and mortality: Isfahan Cohort Study

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Abstract

Background

The association between milk intake and cardiovascular disease (CVD) and mortality risk is still controversial but data from Middle-Eastern populations are scarce. We aimed to study these associations in an Iranian population.

Methods

We used the Isfahan Cohort Study, a population-based prospective study of 6504 adult Iranians. In this analysis, we included 5432 participants free of CVD at baseline with at least one follow-up. Data on whole milk intake and other dietary factors were collected by a food frequency questionnaire at baseline. Cox proportional hazard regression was used to predict risk of CVD events, comprising coronary heart disease (CHD) and stroke, and mortality according to frequency of whole milk intake with adjustment for other potential confounders.

Results

During a median 10.9 years of follow-up, we documented 705 new cases of CVD comprising 564 CHD and 141 stroke cases. Compared with non-consumers, less than daily intake of whole milk was significantly associated with lower risk of CVD (HR 0.80, 95% CI 0.65–0.97), CHD (HR 0.81, 95% CI 0.65–0.99), and a non-significant lower risk of stroke (HR 0.79, 95% CI 0.50–1.27). Daily intake of whole milk was not significantly associated with CVD (HR 1.25, 95% CI 0.89–1.75), CHD, and stroke, but was associated with higher risk of all-cause mortality (HR 1.54, 95% CI 1.04–2.29).

Conclusions

Less than daily intake of whole milk was associated with a statistically significant, although modest, lower risk of CVD compared with non-consumption, but this potential benefit may not extend to daily intake in this population.

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Acknowledgements

This project would not have succeeded without the sincere efforts of the ICS staff, especially Mansoureh Boshtam as well as staff of Surveillance Unit. We would like to express our thanks to Dr. Rokhsareh Iranipour who assisted us with preparing information for adjudication panel and for administering verbal autopsies. We are also appreciative to all of our participants. The baseline survey was supported by Iranian Budget and Programming Organization, Deputy for Research of the Ministry of Health and Medical Education, Grant number 31309304. The Isfahan Cardiovascular Research Centre, affiliated to Isfahan University of Medical Sciences, supported the biannual follow-ups.

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Authors and Affiliations

  1. Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 #11-01A, Singapore, 117549, Singapore

    Mohammad Talaei & Rob M. van Dam

  2. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohammad Talaei, Naeimeh Hosseini, Shahram Oveisgharan, Minoo Dianatkhah & Nizal Sarrafzadegan

  3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Rob M. van Dam

  4. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

    Masoumeh Sadeghi

  5. Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran

    Shahram Oveisgharan

  6. Alzheimer’s Disease Center, Rush University Medical Center, Chicago, USA

    Shahram Oveisgharan

  7. School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Nizal Sarrafzadegan

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  1. Mohammad Talaei
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Contributions

The idea of this paper was developed by MT. MT designed the ICS follow-up projects; design of the baseline survey was the same as IHHP by NS and colleagues. Data collection was managed by MT with NH assistance; SO and MS were the key members of diagnostic panel. Data analysis was performed by NH and MD under MT supervision. First draft was prepared by MT with NH assistance. Statistical analysis plan was amended by RVD and he further critically revised the manuscript.

Corresponding author

Correspondence to Mohammad Talaei.

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Talaei, M., Hosseini, N., van Dam, R.M. et al. Whole milk consumption and risk of cardiovascular disease and mortality: Isfahan Cohort Study. Eur J Nutr 58, 163–171 (2019). https://doi.org/10.1007/s00394-017-1581-1

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