Dairy Products, Dairy Fatty Acids, and the Prevention of Cardiometabolic Disease: a Review of Recent Evidence
Purpose of Review
To examine recent literature on dairy products, dairy fatty acids, and cardiometabolic disease. Primary questions of interest include what unique challenges researchers face when investigating dairy products/biomarkers, whether one should consume dairy to reduce disease risk, whether dairy fatty acids may be beneficial for health, and whether one should prefer low- or high-fat dairy products.
Dairy composes about 10% of the calories in a typical American diet, about half of that coming from fluid milk, half coming from cheese, and small amounts from yogurt. Most meta-analyses report no or weak inverse association between dairy intake with cardiovascular disease and related intermediate outcomes. There is some suggestion that dairy consumption was inversely associated with stroke incidence and yogurt consumption was associated with lower risk of type 2 diabetes. Odd chain fatty acids (OCFAs) found primarily in dairy (15:0 and 17:0) appear to be inversely associated with cardiometabolic risk, but causation is uncertain. Substitution analyses based on prospective cohorts suggested that replacing dairy fat with vegetable fat or polyunsaturated fat was associated with significantly lower risk of cardiovascular disease.
Current evidence suggests null or weak inverse association between consumption of dairy products and risk of cardiovascular disease. However, replacing dairy fat with polyunsaturated fat, especially from plant-based foods, may confer health benefits. More research is needed to examine health effects of different types of dairy products in diverse populations.
KeywordsDairy Saturated fat Yogurt Cardiovascular disease Odd chain fatty acids
Compliance with Ethical Standards
Conflict of Interest
Dr. Frank Hu has received research support from the California Walnut Commission and an honorarium from Metagenics. Dr. Edward Yu declares no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
- 3.Agriculture USDo. Food Availability (Per Capita) Data System 2016 [cited 2017 July 26]. Available from: https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/.
- 5.SR28 U. National Nutrient Database for Standard Reference, Release 28. US Department of Agriculture, Agricultural Research Service, Nutrient Data Laboratory http://www ars usda gov/ba/bhnrc/ndl Accessed. 2016;26.Google Scholar
- 14.National Research Council Committee on Technological Options to Improve the Nutritional Attributes of Animal P. Factors affecting the composition of milk from dairy cows. Designing foods: animal product options in the marketplace. Washington (DC): National Academies Press (US) Copyright (c) 1988 by the National Academy of Sciences.; 1988Google Scholar
- 16.Jenness R. Biochemical and nutritional aspects of milk and colostrum. Lactation/edited by Bruce L Larson; written by Ralph R Anderson [et al]. 1985.Google Scholar
- 22.Spain EGo. Relative validity and reproducibility of a diet history questionnaire in Spain. I. Foods. Int J Epidemiol. 1997;26(Suppl 1):S91–9.Google Scholar
- 26.Foulon V, Sniekers M, Huysmans E, Asselberghs S, Mahieu V, Mannaerts GP, et al. Breakdown of 2-hydroxylated straight chain fatty acids via peroxisomal 2-hydroxyphytanoyl-CoA lyase: a revised pathway for the alpha-oxidation of straight chain fatty acids. J Biol Chem. 2005;280(11):9802–12.PubMedCrossRefGoogle Scholar
- 30.Weitkunat K, Schumann S, Nickel D, Hornemann S, Petzke KJ, Schulze MB, et al. Odd-chain fatty acids as a biomarker for dietary fiber intake: a novel pathway for endogenous production from propionate. Am J Clin Nutr. 2017:ajcn152702.Google Scholar
- 31.Health UDo, Services H. 2015–2020 dietary guidelines for Americans. Washington (DC): USDA. 2015.Google Scholar
- 35.Ding M, Huang T, Bergholdt HK, Nordestgaard BG, Ellervik C, Qi L. Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study. BMJ 2017;356.Google Scholar
- 40.Chen GC, Wang Y, Tong X, Szeto IM, Smit G, Li ZN, et al. Cheese consumption and risk of cardiovascular disease: a meta-analysis of prospective studies. Eur J Nutr 2016.Google Scholar
- 42.Committee DGA. Scientific report of the 2015 dietary guidelines advisory committee. Washington (DC): USDA and US Department of Health and Human Services; 2015.Google Scholar
- 56.Liang J, Zhou Q, Kwame Amakye W, Su Y, Zhang Z. Biomarkers of dairy fat intake and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies. Crit Rev Food Sci Nutr. 2016:1–9.Google Scholar
- 57.Forouhi NG, Koulman A, Sharp SJ, Imamura F, Kröger J, Schulze MB, et al. Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study. Lancet Diabetes Endocrinol. 2014;2(10):810–8.PubMedPubMedCentralCrossRefGoogle Scholar
- 61.Santaren ID, Watkins SM, Liese AD, Wagenknecht LE, Rewers MJ, Haffner SM, et al. Serum pentadecanoic acid (15:0), a short-term marker of dairy food intake, is inversely associated with incident type 2 diabetes and its underlying disorders. Am J Clin Nutr. 2014;100(6):1532–40.PubMedPubMedCentralCrossRefGoogle Scholar
- 62.Patel PS, Sharp SJ, Jansen E, Luben RN, Khaw K-T, Wareham NJ, et al. Fatty acids measured in plasma and erythrocyte-membrane phospholipids and derived by food-frequency questionnaire and the risk of new-onset type 2 diabetes: a pilot study in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Norfolk cohort. Am J Clin Nutr. 2010;92(5):1214–22.PubMedCrossRefGoogle Scholar
- 64.Kröger J, Zietemann V, Enzenbach C, Weikert C, Jansen EH, Döring F, et al. Erythrocyte membrane phospholipid fatty acids, desaturase activity, and dietary fatty acids in relation to risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study. Am J Clin Nutr. 2011;93(1):127–42.PubMedCrossRefGoogle Scholar
- 66.Willett W. Nutritional epidemiology: Oxford University Press; 2012.Google Scholar
- 68.Rosell M, Johansson G, Berglund L, Vessby B, de Faire U, Hellenius ML. The relation between alcohol intake and physical activity and the fatty acids 14:0, 15:0 and 17:0 in serum phospholipids and adipose tissue used as markers for dairy fat intake. Br J Nutr. 2005;93(1):115–21.PubMedCrossRefGoogle Scholar
- 73.Jousilahti P, Laatikainen T, Peltonen M, Borodulin K, Männistö S, Jula A, et al. Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study. BMJ. 2016;352Google Scholar
- 75.García Yu IA-L, Sánchez-Aguadero N, Recio-Rodríguez JI. Chapter 25 - Effect of the fat component of dairy products in cardiovascular health, vascular structure and function A2 - Watson, Ronald Ross. In: Collier RJ, Preedy VR, editors. Nutrients in dairy and their implications on health and disease: Academic Press; 2017. p. 325–32.Google Scholar