We examined whether consumption of total dairy and dairy subgroups was related to incident stroke and coronary heart disease (CHD) in a general older Dutch population.
The study involved 4,235 participants of the Rotterdam Study aged 55 and over who were free of cardiovascular disease (CVD) and diabetes at baseline (1990–1993). Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) for the intake of total dairy and dairy subgroups in relation to incident CVD events.
Median intake of total dairy was 397 g/day, which mainly comprised low-fat dairy products (median intake of 247 g/day). During a median follow-up time of 17.3 years, 564 strokes (182 fatal) and 567 CHD events (350 fatal) occurred. Total dairy, milk, low-fat dairy, and fermented dairy were not significantly related to incident stroke or fatal stroke (p > 0.2 for upper vs. lower intake categories). High-fat dairy was significantly inversely related to fatal stroke (HR of 0.88 per 100 g/day; 95 % CI 0.79, 0.99), but not to incident stroke (HR of 0.96 per 100 g/day; 95 % CI 0.90, 1.02). Total dairy or dairy subgroups were not significantly related to incident CHD or fatal CHD (HRs between 0.98 and 1.05 per 100 g/day, all p > 0.35).
In this long-term follow-up study of older Dutch subjects, total dairy consumption or the intake of specific dairy products was not related to the occurrence of CVD events. The observed inverse association between high-fat dairy and fatal stroke warrants confirmation in other studies.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Anatomical therapeutic chemical
Coronary heart disease
Semiquantitative food frequency questionnaire
Mensink RP, Zock PL, Kester AD, Katan MB (2003) Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 77:1146–1155
Soedamah-Muthu SS, Ding EL, Al-Delaimy WK, Hu FB, Engberink MF, Willett WC, Geleijnse JM (2011) Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr 93:158–171. doi:10.3945/ajcn.2010.29866
Goldbohm RA, Chorus AM, Galindo garre F, Schouten LJ, van den Brandt PA (2011) Dairy consumption and 10-y total and cardiovascular mortality: a prospective cohort study in the Netherlands. Am J Clin Nutr 93:615–627. doi:10.3945/ajcn.110.000430
Sonestedt E, Wirfalt E, Wallstrom P, Gullberg B, Orho-Melander M, Hedblad B (2011) Dairy products and its association with incidence of cardiovascular disease: the Malmo diet and cancer cohort. Eur J Epidemiol 26:609–618. doi:10.1007/s10654-011-9589-y
Patterson E, Larsson SC, Wolk A, Akesson A (2013) Association between dairy food consumption and risk of myocardial infarction in women differs by type of dairy food. J Nutr 143:74–79. doi:10.3945/jn.112.166330
Louie JC, Flood VM, Burlutsky G, Rangan AM, Gill TP, Mitchell P (2013) Dairy consumption and the risk of 15-year cardiovascular disease mortality in a cohort of older Australians. Nutrients 5:441–454. doi:10.3390/nu5020441
Kondo I, Ojima T, Nakamura M, Hayasaka S, Hozawa A, Saitoh S, Ohnishi H, Akasaka H, Hayakawa T, Murakami Y, Okuda N, Miura K, Okayama A, Ueshima H, Group NDR (2013) Consumption of dairy products and death from cardiovascular disease in the Japanese general population: the NIPPON DATA80. J Epidemiol 23:47–54
Soedamah-Muthu SS, Masset G, Verberne L, Geleijnse JM, Brunner EJ (2012) Consumption of dairy products and associations with incident diabetes, CHD and mortality in the Whitehall II study. Br J Nutr:1–9. doi 10.1017/S0007114512001845
Dalmeijer GW, Struijk EA, van der Schouw YT, Soedamah-Muthu SS, Verschuren WM, Boer JM, Geleijnse JM, Beulens JW (2013) Dairy intake and coronary heart disease or stroke—a population-based cohort study. Int J Cardiol 167:925–929. doi:10.1016/j.ijcard.2012.03.094
Larsson SC, Virtamo J, Wolk A (2012) Dairy consumption and risk of stroke in Swedish women and men. Stroke 43:1775–1780. doi:10.1161/STROKEAHA.111.641944
Bernstein AM, Pan A, Rexrode KM, Stampfer M, Hu FB, Mozaffarian D, Willett WC (2012) Dietary protein sources and the risk of stroke in men and women. Stroke 43:637–644. doi:10.1161/STROKEAHA.111.633404
Hofman A, van Duijn CM, Franco OH, Ikram MA, Janssen HL, Klaver CC, Kuipers EJ, Nijsten TE, Stricker BH, Tiemeier H, Uitterlinden AG, Vernooij MW, Witteman JC (2011) The Rotterdam Study: 2012 objectives and design update. Eur J Epidemiol 26:657–686. doi:10.1007/s10654-011-9610-5
Klipstein-Grobusch K, den Breeijen JH, Goldbohm RA, Geleijnse JM, Hofman A, Grobbee DE, Witteman JC (1998) Dietary assessment in the elderly: validation of a semiquantitative food frequency questionnaire. Eur J Clin Nutr 52:588–596
de Goede J, Verschuren WM, Boer JM, Kromhout D, Geleijnse JM (2012) Gender-specific associations of marine n-3 fatty acids and fish consumption with 10-year incidence of stroke. PLoS One 7:e33866. doi:10.1371/journal.pone.0033866
de Goede J, Verschuren WM, Boer JM, Kromhout D, Geleijnse JM (2013) N-6 and n-3 fatty acid cholesteryl esters in relation to incident stroke in a Dutch adult population: a nested case-control study. Nutr Metab Cardiovasc Dis 23:737–743. doi:10.1016/j.numecd.2012.03.001
Leening MJ, Kavousi M, Heeringa J, van Rooij FJ, Verkroost-van heemst J, Deckers JW, Mattace-Raso FU, Ziere G, Hofman A, Stricker BH, Witteman JC (2012) Methods of data collection and definitions of cardiac outcomes in the Rotterdam Study. Eur J Epidemiol 27:173–185. doi:10.1007/s10654-012-9668-8
Stolk RP, Pols HA, Lamberts SW, de Jong PT, Hofman A, Grobbee DE (1997) Diabetes mellitus, impaired glucose tolerance, and hyperinsulinemia in an elderly population. The Rotterdam Study. Am J Epidemiol 145:24–32
Wieberdink RG, Ikram MA, Hofman A, Koudstaal PJ, Breteler MM (2012) Trends in stroke incidence rates and stroke risk factors in Rotterdam, the Netherlands from 1990 to 2008. Eur J Epidemiol 27:287–295. doi:10.1007/s10654-012-9673-y
de Oliveira Otto MC, Mozaffarian D, Kromhout D, Bertoni AG, Sibley CT, Jacobs DR Jr, Nettleton JA (2012) Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic study of atherosclerosis. Am J Clin Nutr 96:397–404. doi:10.3945/ajcn.112.037770
Luepker RV, Apple FS, Christenson RH, Crow RS, Fortmann SP, Goff D, Goldberg RJ, Hand MM, Jaffe AS, Julian DG, Levy D, Manolio T, Mendis S, Mensah G, Pajak A, Prineas RJ, Reddy KS, Roger VL, Rosamond WD, Shahar E, Sharrett AR, Sorlie P, Tunstall-Pedoe H (2003) Case definitions for acute coronary heart disease in epidemiology and clinical research studies: a statement from the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute. Circulation 108:2543–2549. doi:10.1161/01.CIR.0000100560.46946.EA
Rossum van CTM, Fransen HP, Verkaik-Kloosterman J, Buurma-Rethans EJM, Ocké MC (2011) Dutch national food consumption survey 2006-2010. Diet of children and adults aged 7 to 69 years. Bilthoven, The Netherlands
Maruyama K, Iso H, Date C, Kikuchi S, Watanabe Y, Wada Y, Inaba Y, Tamakoshi A, Group JS (2013) Dietary patterns and risk of cardiovascular deaths among middle-aged Japanese: JACC study. Nutr Metab Cardiovasc Dis 23:519–527. doi:10.1016/j.numecd.2011.10.007
Kilkkinen A, Knekt P, Aro A, Rissanen H, Marniemi J, Heliovaara M, Impivaara O, Reunanen A (2009) Vitamin D status and the risk of cardiovascular disease death. Am J Epidemiol 170:1032–1039. doi:10.1093/aje/kwp227
Soedamah-Muthu SS, Verberne LD, Ding EL, Engberink MF, Geleijnse JM (2012) Dairy consumption and incidence of hypertension: a dose-response meta-analysis of prospective cohort studies. Hypertension 60:1131–1137. doi:10.1161/HYPERTENSIONAHA.112.195206
Dubow J, Fink ME (2011) Impact of hypertension on stroke. Curr Atheroscler Rep 13:298–305. doi:10.1007/s11883-011-0187-y
Bernstein AM, Sun Q, Hu FB, Stampfer MJ, Manson JE, Willett WC (2010) Major dietary protein sources and risk of coronary heart disease in women. Circulation 122:876–883. doi:10.1161/CIRCULATIONAHA.109.915165
This study was supported by an unrestricted grant from the Dutch Dairy Organization (NZO) for epidemiological analyses on dairy intake and cardiovascular diseases. The Rotterdam Study was funded by the Erasmus Medical Center and Erasmus University Rotterdam; The Netherlands Organization for Scientific Research; The Netherlands Organization for Health Research and Development; the Research Institute for Diseases in the Elderly; The Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam.
Conflict of interest
J.M.G and S.S.S.M received an unrestricted grant from the Dutch Dairy Organization (NZO) for epidemiological analyses on dairy intake and cardiovascular diseases. The other authors declare that they have no conflict of interest.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Praagman, J., Franco, O.H., Ikram, M.A. et al. Dairy products and the risk of stroke and coronary heart disease: the Rotterdam Study. Eur J Nutr 54, 981–990 (2015). https://doi.org/10.1007/s00394-014-0774-0
- Coronary heart disease
- Population-based study