British Journal of Nutrition

Systematic Review

The effect of dairy foods on CHD: a systematic review of prospective cohort studies

Robert A. Gibsona1a2a3 c1, Maria Makridesa1a2a4, Lisa G. Smithersa1a2a4a5, Melanie Voevodina6 and Andrew J. Sinclaira7

a1 Child Youth and Women's Health Service, Women's and Children's Health Research Institute, Level 7, Clarence Reiger Building, 72 King William Road, North Adelaide, SA 5006, Australia

a2 Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia

a3 School of Agriculture, Food and Wine, University of Adelaide, Waite Campus, Urrbrae, Adelaide, SA 5064, Australia

a4 School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA 5064, Australia

a5 School of Paediatrics and Child Health, Flinders University, Bedford Park, SA 5042, Australia

a6 Food School, PO Box 1337, Camberwell, Melbourne, Vic. 3124, Australia

a7 School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia

Abstract

There is interest in the degree to which fats in dairy foods contribute to CHD. We undertook a systematic review to investigate the effect of dairy consumption on CHD using prospective cohort studies. A systematic search of electronic databases identified studies relating dairy food intake in adulthood to episodes or death from CHD, IHD and myocardial infarction. Included studies were assessed for quality based on study methodology, validity of dietary assessment, success of follow-up, standardised assessment of CHD, IHD or myocardial infarction end points and appropriateness of statistical adjustment. Data from twelve cohorts involving >280 000 subjects were included. Most studies had follow-up of >80 %, adjusted statistically for three or more confounders and used standard criteria to determine end points. About half the studies used a validated FFQ, administered the FFQ more than once or had follow-up of >20 years. Fewer than half the studies involved subjects representative of the general population. Four of the twelve cohorts found no association between dairy intake and CHD. Eight studies reported varying relationships between different dairy foods and CHD or differential associations based on race, sex or over time. Although dairy foods contribute to the SFA composition of the diet, this systematic review could find no consistent evidence that dairy food consumption is associated with a higher risk of CHD. This could be due to the limited sensitivity of the dietary assessment methods to detect an effect of a single food in a mixed diet on complex clinical outcomes.

(Received September 26 2008)

(Revised April 07 2009)

(Accepted April 14 2009)

(Online publication August 17 2009)

Correspondence:

c1 Corresponding author: Robert A. Gibson, fax +61 8 8303 7135, email robert.gibson@adelaide.edu.au