Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults1,2,3

  1. Frank B Hu4–6*
  1. 4Departments of Nutrition and
  2. 5Epidemiology, Harvard TH Chan School of Public Health, Boston, MA;
  3. 6Channing Division of Network Medicine and
  4. 7Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
  5. 8Department of Epidemiology and Biostatistics, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  1. *To whom correspondence should be addressed. E-mail: frank.hu{at}channing.harvard.edu.
  • 1 Supported by the NIH (grants R01 HL034594, UM1 CA176726, UM1 CA186107, R01 HL35464, R01 HL088521, R01 CA67262, HL60712, and UM1 CA167552).

  • 2 The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • 3 Supplemental Figure 1 is available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.

Abstract

Background: Few prospective studies have examined dairy fat in relation to cardiovascular disease (CVD).

Objective: We aimed to evaluate the association between dairy fat and incident CVD in US adults.

Design: We followed 43,652 men in the Health Professionals Follow-Up Study (1986–2010), 87,907 women in the Nurses’ Health Study (1980–2012), and 90,675 women in the Nurses’ Health Study II (1991–2011). Dairy fat and other fat intakes were assessed every 4 y with the use of validated food-frequency questionnaires.

Results: During 5,158,337 person-years of follow-up, we documented 14,815 incident CVD cases including 8974 coronary heart disease cases (nonfatal myocardial infarction or fatal coronary disease) and 5841 stroke cases. In multivariate analyses, compared with an equivalent amount of energy from carbohydrates (excluding fruit and vegetables), dairy fat intake was not significantly related to risk of total CVD (for a 5% increase in energy from dairy fat, the RR was 1.02; 95% CI: 0.98, 1.05), coronary heart disease (RR: 1.03; 95% CI: 0.98, 1.09), or stroke (RR: 0.99; 95% CI: 0.93, 1.05) (P > 0.05 for all). In models in which we estimated the effects of exchanging different fat sources, the replacement of 5% of energy intake from dairy fat with equivalent energy intake from polyunsaturated fatty acid (PUFA) or vegetable fat was associated with 24% (RR: 0.76; 95% CI: 0.71, 0.81) and 10% (RR: 0.90; 95% CI: 0.87, 0.93) lower risk of CVD, respectively, whereas the 5% energy intake substitution of other animal fat with dairy fat was associated with 6% increased CVD risk (RR: 1.06; 95% CI: 1.02, 1.09).

Conclusions: The replacement of animal fats, including dairy fat, with vegetable sources of fats and PUFAs may reduce risk of CVD. Whether the food matrix may modify the effect of dairy fat on health outcomes warrants further investigation.

Keywords:
  • Received March 10, 2016.
  • Accepted July 28, 2016.

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