Theoretical substitutions between dairy products and all-cause and cause-specific mortality. Results from the Danish diet, cancer and health cohort

2021 ◽  
pp. 1-10
Author(s):  
Anne Sofie D. Laursen ◽  
Anne L. Thomsen ◽  
Anne Beck ◽  
Kim Overvad ◽  
Marianne U. Jakobsen
Keyword(s):  
Cancer Mortality ◽  
Dairy Products ◽  
Proportional Hazards ◽  
Dairy Product ◽  
Daily Intake ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Low Fat ◽  
Specific Mortality ◽  
Optimal Health

Abstract A daily intake of dairy products is recommended in many countries in order to maintain optimal health throughout life. However, evidence regarding the association between intake of individual dairy products and mortality is limited. We therfore, explored associations between intake of different dairy products and all-cause and cause-specific mortality using specified theoretical substitution analyses. We analysed data from 55 775 Danish men and women aged 50–64 years between 1993 and 1997. Information about dairy product intake at baseline was collected using a validated food frequency questionnaire. Information about vital status and causes of death was obtained through national registers. Measures of associations were calculated using Cox proportional hazards regression. During a median follow-up of 19·0 years, 11 586 participants died. For all-cause mortality, we observed that the intake of low-fat milk, whole-fat milk or low-fat yogurt products in place of cheese was associated with a higher rate of death (hazard ratios between 1·03 and 1·12 per serving/d substituted). The same pattern was present for CVD mortality. For cancer mortality, whole-fat milk and low-fat yogurt products in place of cheese were also associated with a higher rate of death for men while for women, whole-fat milk in place of buttermilk was associated with a higher cancer mortality rate. The results appeared robust in several sensitivity analyses. Our results suggest that intake of low-fat milk, whole-fat milk or low-fat yogurt products in place of cheese is associated with a higher rate of all-cause and cause-specific mortality.

scholarly journals Dairy Product Intake and Cardiometabolic Diseases in Northern Sweden: A 33-Year Prospective Cohort Study

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 284 ◽  
Author(s):  
Ingegerd Johansson ◽  
Anders Esberg ◽  
Lena M Nilsson ◽  
Jan-Håkan Jansson ◽  
Patrik Wennberg ◽  
...  
Keyword(s):  
Dairy Products ◽  
Proportional Hazards ◽  
Dairy Product ◽  
Fermented Milk ◽  
Cox Proportional Hazards ◽  
Milk Intake ◽  
Effect Sizes ◽  
Case Group ◽  
Low Fat ◽  
Increased Risk

Dairy products are important constituents of most diets, and their association with adverse health outcomes remains a focus. We characterized dairy food intake and examined associations with the incidence of type 2 diabetes (T2D), myocardial infarction (MI) or stroke among 108,065 Swedish men and women. Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazards models in a population characterized by high milk tolerance. During a mean follow-up of 14.2 years, 11,641 first-time events occurred. Non-fermented milk intake decreased, whereas butter intake increased over the period. For high intake of non-fermented milk, the HR (95% CI) for developing T2D and MI was 1.17 (1.03, 1.34) and 1.23 (1.10, 1.37), respectively, in men. A greater intake of butter, fermented milk, and cheese tended to be associated with a reduced risk of T2D and/or MI. Non-consumers and those who chose low-fat variants of the targeted dairy products had increased risk for T2D, MI, or stroke compared to those in the non-case group. Generally, effect-sizes were small. This prospective study found that non-fermented milk was associated with an increased risk for developing T2D and MI and that subjects abstaining from dairy products or choosing low-fat variants were at greater risk. However, the overall cardiometabolic risk of non-fermented milk intake was judged as low, since the effect sizes were small.

scholarly journals Substitutions between dairy product subgroups and risk of type 2 diabetes: the Danish Diet, Cancer and Health cohort

2017 ◽  
Vol 118 (11) ◽  
pp. 989-997 ◽  
Author(s):  
Daniel B. Ibsen ◽  
Anne Sofie D. Laursen ◽  
Lotte Lauritzen ◽  
Anne Tjønneland ◽  
Kim Overvad ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dairy Products ◽  
Proportional Hazards ◽  
Dairy Product ◽  
Cox Proportional Hazards ◽  
Low Fat ◽  
Baseline Information ◽  
Diabetes Register

AbstractThe aim of this study was to investigate the associations for specified substitutions between different subgroups of dairy products and the risk of type 2 diabetes. We used data from the Danish Diet, Cancer and Health cohort including 54 277 men and women aged 50–64 years at baseline. Information regarding intake of dairy products was obtained from a validated FFQ, and cases of type 2 diabetes were identified through the Danish National Diabetes Register. Cox proportional hazards regressions were used to estimate associations. During a median follow-up of 15·3 years, 7137 cases were identified. Low-fat yogurt products in place of whole-fat yogurt products were associated with a higher rate of type 2 diabetes (hazard ratio (HR) 1·17; 95 % CI 1·06, 1·29) per serving/d substituted. Whole-fat yogurt products in place of low-fat milk, whole-fat milk or buttermilk were associated with a lower rate of type 2 diabetes (HR 0·89; 95 % CI 0·83, 0·96; HR 0·89; 95 % CI 0·82, 0·96; HR 0·89; 95 % CI 0·81, 0·97; per serving/d substituted, respectively). The pattern of associations was similar when intake was expressed as kJ/d (kcal/d). These findings suggest that intake of whole-fat yogurt products in place of low-fat yogurt products, low-fat milk, whole-fat milk and buttermilk are associated with a lower rate of type 2 diabetes.

scholarly journals Substitutions between dairy products and risk of stroke: results from the European Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) cohort

2019 ◽  
Vol 121 (12) ◽  
pp. 1398-1404 ◽  
Author(s):  
Anne Sofie D. Laursen ◽  
Ivonne Sluijs ◽  
Jolanda M. A. Boer ◽  
W. M. Monique Verschuren ◽  
Yvonne T. van der Schouw ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Dairy Products ◽  
Proportional Hazards ◽  
Dairy Product ◽  
Haemorrhagic Stroke ◽  
Cox Proportional Hazards ◽  
Low Fat ◽  
Men And Women ◽  
Proportional Hazards Regression

AbstractThe association between intake of different dairy products and the risk of stroke remains unclear. We therefore investigated substitutions between dairy product subgroups and risk of stroke. We included 36 886 Dutch men and women. Information about dairy product intake was collected through a FFQ. Dairy products were grouped as low-fat milk, whole-fat milk, buttermilk, low-fat yogurt, whole-fat yogurt, cheese and butter. Incident stroke cases were identified in national registers. We used Cox proportional hazards regression to calculate associations for substitutions between dairy products with the rate of stroke. During a median follow-up of 15·2 years we identified 884 stroke cases (503 ischaemic and 244 haemorrhagic). Median intake of total dairy products was four servings/d. Low-fat yogurt substituted for whole-fat yogurt was associated with a higher rate of ischaemic stroke (hazard ratio (HR) = 2·58 (95 % CI 1·11, 5·97)/serving per d). Whole-fat yogurt as a substitution for any other subgroup was associated with a lower rate of ischaemic stroke (HR between 0·33 and 0·36/serving per d). We did not observe any associations for haemorrhagic stroke. In conclusion, whole-fat yogurt as a substitution for low-fat yogurt, cheese, butter, buttermilk or milk, regardless of fat content, was associated with a lower rate of ischaemic stroke.

scholarly journals Dietary selenium intake and mortality in two population-based cohort studies of 133 957 Chinese men and women

2016 ◽  
Vol 19 (16) ◽  
pp. 2991-2998 ◽  
Author(s):  
Jiang-Wei Sun ◽  
Xiao-Ou Shu ◽  
Hong-Lan Li ◽  
Wei Zhang ◽  
Jing Gao ◽  
...  
Keyword(s):  
Cancer Mortality ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Health Study ◽  
Chinese Populations ◽  
Urban City ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios

AbstractObjectiveTo investigate the potential influence of dietary Se intake on mortality among Chinese populations.DesignWe prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women’s Health Study (SWHS) and the Shanghai Men’s Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI.SettingUrban city in China.SubjectsChinese adults (n 133 957).ResultsDuring an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 μg/d for women and 51·34 μg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; Ptrend<0·0001) and 0·80 (95 % CI 0·66, 0·98; Ptrend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; Ptrend=0·0001) and 0·66 (95 % CI 0·54, 0·82; Ptrend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses.ConclusionsDietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.

scholarly journals Substitution of Milk with Whole-Fat Yogurt Products or Cheese Is Associated with a Lower Risk of Myocardial Infarction: The Danish Diet, Cancer and Health cohort

2020 ◽  
Vol 150 (5) ◽  
pp. 1252-1258
Author(s):  
Karina Kvist ◽  
Anne Sofie Dam Laursen ◽  
Kim Overvad ◽  
Marianne Uhre Jakobsen
Keyword(s):  
Myocardial Infarction ◽  
Dairy Products ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Saturated Fat ◽  
Cox Proportional Hazards ◽  
Dietary Guidelines ◽  
Low Fat ◽  
Men And Women

ABSTRACT Background Food-based dietary guidelines recommend replacement of whole-fat dairy products with low-fat variants based on data suggesting that diets high in saturated fat are associated with a higher risk of ischemic heart disease. However, the health effects of saturated fat may depend on the source. Objectives The aim was to investigate substitutions between different subgroups of dairy products and the risk of myocardial infarction (MI). Methods Data were from the Danish Diet, Cancer and Health cohort and included 54,903 men and women aged 50–64 y at enrollment and without an MI diagnosis. Information about intake of dairy products was obtained by a semiquantitative food-frequency questionnaire. Incident MI cases were identified through nationwide registries. We used Cox proportional hazards regression to estimate associations between specified substitutions of dairy products and MI risk. Results During a median follow-up of 15.9 y, 3033 cases were identified. Whole-fat yogurt products in place of low-fat or whole-fat milk were associated with a lower risk of MI (HR: 0.89; 95% CI: 0.80, 0.99 per 200 g/d replaced; and HR: 0.87; 95% CI: 0.78, 0.98 per 200 g/d replaced, respectively). Substitution of 20 g/d of cheese for 200 g/d of low-fat or whole-fat milk was also associated with a lower risk of MI (HR: 0.96; 95% CI: 0.92, 0.99; and HR: 0.95; 95% CI: 0.89, 0.99, respectively). Conclusions Among middle-aged Danish men and women, intake of whole-fat yogurt products or cheese in place of milk, regardless of fat content, was associated with a lower risk of development of MI.

scholarly journals Statins Are Associated With Reduced Mortality in Multiple Myeloma

2016 ◽  
Vol 34 (33) ◽  
pp. 4008-4014 ◽  
Author(s):  
Kristen Marie Sanfilippo ◽  
Jesse Keller ◽  
Brian F. Gage ◽  
Suhong Luo ◽  
Tzu-Fei Wang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Statin Therapy ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Sensitivity Analyses ◽  
Reductase Inhibitors ◽  
Specific Mortality ◽  
Statin Use

Purpose The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) have activity in one of the pathways influenced by nitrogen-containing bisphosphonates, which are associated with improved survival in multiple myeloma (MM). To understand the benefit of statins in MM, we evaluated the association between statin use and mortality in a large cohort of patients with MM. Patients and Methods From the Veterans Administration Central Cancer Registry, we identified patients diagnosed with MM between 1999 and 2013. We defined statin use as the presence of any prescription for a statin within 3 months before or any time after MM diagnosis. Cox proportional hazards regression assessed the association of statin use with mortality, while controlling for known MM prognostic factors. Results We identified a cohort of 4,957 patients, of whom 2,294 received statin therapy. Statin use was associated with a 21% decrease in all-cause mortality (adjusted hazard ratio, 0.79; 95% CI, 0.73 to 0.86; P < .001) as well as a 24% decrease in MM-specific mortality (adjusted hazard ratio, 0.76; 95% CI, 0.67 to 0.86; P < .001). This association remained significant across all sensitivity analyses. In addition to reductions in mortality, statin use was associated with a 31% decreased risk of developing a skeletal-related event. Conclusion In this cohort study of US veterans with MM, statin therapy was associated with a reduced risk of both all-cause and MM-specific mortality. Our findings suggest a potential role for statin therapy in patients with MM. The putative benefit of statin therapy in MM should be corroborated in prospective studies.

scholarly journals Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies

2019 ◽  
Vol 40 (34) ◽  
pp. 2870-2879 ◽  
Author(s):  
Mohsen Mazidi ◽  
Niki Katsiki ◽  
Dimitri P Mikhailidis ◽  
Naveed Sattar ◽  
Maciej Banach
Keyword(s):  
Cohort Studies ◽  
Prospective Studies ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Positive Association ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Pooled Data ◽  
Specific Mortality

Abstract Aims Little is known about the long-term association between low-carbohydrate diets (LCDs) and mortality. We evaluated the link between LCD and overall or cause-specific mortality using both individual data and pooled prospective studies. Methods and results Data on diets from the National Health and Nutrition Examination Survey (NHANES; 1999–2010) were analysed. Multivariable Cox proportional hazards were applied to determine the hazard ratios and 95% confidence intervals (CIs) for mortality for each quartile of the LCD score, with the lowest quartile (Q1—with the highest carbohydrates intake) used as reference. We used adjusted Cox regression to determine the risk ratio (RR) and 95% CI, as well as random effects models and generic inverse variance methods to synthesize quantitative and pooled data, followed by a leave-one-out method for sensitivity analysis. Overall, 24 825 participants from NHANES study were included (mean follow-up 6.4 years). After adjustment, participants with the lowest carbohydrates intake (quartile 4 of LCD) had the highest risk of overall (32%), cardiovascular disease (CVD) (50%), cerebrovascular (51%), and cancer (36%) mortality. In the same model, the association between LCD and overall mortality was stronger in the non-obese (48%) than in the obese (19%) participants. Findings on pooled data of nine prospective cohort studies with 462 934 participants (mean follow-up 16.1 years) indicated a positive association between LCD and overall (RR 1.22, 95% CI 1.06–1.39, P < 0.001, I2 = 8.6), CVD (RR 1.13, 95% CI 1.02–1.24, P < 0.001, I2 = 11.2), and cancer mortality (RR 1.08, 95% CI 1.01–1.14, P = 0.02, I2 = 10.3). These findings were robust in sensitivity analyses. Conclusion Our study suggests a potentially unfavourable association of LCD with overall and cause-specific mortality, based on both new analyses of an established cohort and by pooling previous cohort studies. Given the nature of the study, causality cannot be proven; we cannot rule out residual bias. Nevertheless, further studies are needed to extend these important findings, which if confirmed, may suggest a need to rethink recommendations for LCD in clinical practice.

Postdiagnosis Statin Use and Mortality in Danish Patients With Prostate Cancer

2017 ◽  
Vol 35 (29) ◽  
pp. 3290-3297 ◽  
Author(s):  
Signe Benzon Larsen ◽  
Christian Dehlendorff ◽  
Charlotte Skriver ◽  
Susanne Oksbjerg Dalton ◽  
Christina Gade Jespersen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Mortality ◽  
Clinical Stage ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Prostate Cancer Mortality ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Statin Use

Purpose Increasing evidence indicates that statin use may reduce mortality from prostate cancer. In this work, we examined whether postdiagnosis statin use was associated with reduced cancer-specific mortality or all-cause mortality among patients with prostate cancer in Denmark. Material and Methods From nationwide Danish registries, we identified all patients with incident prostate adenocarcinoma from 1998 to 2011 and retrieved data on tumor and patient characteristics, drug use, and primary treatment. We defined postdiagnosis use (two or more prescriptions) of statins as a time-varying covariate with 1-year lag. Cox proportional hazards regression models used to compute hazard ratios (HRs) for prostate cancer–specific mortality and all-cause mortality through 2013 associated with postdiagnosis statin use. In secondary and sensitivity analyses, we assessed statin use within exposure periods of 1 year or 5 years after prostate cancer diagnosis and evaluated the influence of prediagnosis statin use. Results Among 31,790 patients, 7,365 died of prostate cancer and 11,811 died from other causes during a median follow-up of 2.8 years (interquartile range, 1.3 to 5.1 years) from 1 year after diagnosis. Postdiagnosis statin use was associated with adjusted HRs of 0.83 (95% CI, 0.77 to 0.89) for prostate cancer mortality and 0.81 (95% CI, 0.76 to 0.85) for all-cause mortality. Similar results were observed in 1-year and 5-year sensitivity analyses. No substantial effect measure modification was found with estimated dose or type of statin, clinical stage, Gleason score, or with prediagnosis statin use; however, patients who were diagnosed early in the study period or who underwent radical prostatectomy or endocrine therapy exhibited slightly lower HRs for prostate cancer mortality with postdiagnosis statin use than did those in the overall analyses. Conclusion Postdiagnosis statin use was associated with reduced mortality from prostate cancer; however, it remains to be established whether this association is causal.

scholarly journals Dietary Patterns, Ceramide Ratios, and Risk of All-Cause and Cause-Specific Mortality: The Framingham Offspring Study

2020 ◽  
Vol 150 (11) ◽  
pp. 2994-3004
Author(s):  
Maura E Walker ◽  
Vanessa Xanthakis ◽  
Linda R Peterson ◽  
Meredith S Duncan ◽  
Joowon Lee ◽  
...  
Keyword(s):  
Diet Quality ◽  
Dietary Patterns ◽  
Cancer Mortality ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Dietary Guidelines ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Specific Mortality ◽  
Long Chain

ABSTRACT Background Prior evidence suggests that diet modifies the association of blood ceramides with the risk of incident cardiovascular disease (CVD). It remains unknown if diet quality modifies the association of very long-chain-to-long-chain ceramide ratios with mortality in the community. Objectives Our objectives were to determine how healthy dietary patterns associate with blood ceramide concentrations and to examine if healthy dietary patterns modify associations of ceramide ratios (C22:0/C16:0 and C24:0/C16:0) with all-cause and cause-specific mortality. Methods We examined 2157 participants of the Framingham Offspring Study (mean age = 66 y, 55% women). Blood ceramides were quantified using a validated assay. We evaluated prospective associations of the Dietary Guidelines Adherence Index (DGAI) and Mediterranean-style Diet Score (MDS) with incidence of all-cause and cause-specific mortality using Cox proportional hazards models. Cross-sectional associations of the DGAI and MDS with ceramides were evaluated using multivariable linear regression models. Results The C22:0/C16:0 and C24:0/C16:0 ceramide ratios were inversely associated with all-cause, CVD, and cancer mortality; multivariable-adjusted HRs (95% CIs) were 0.73 (0.67, 0.80) and 0.70 (0.63, 0.77) for all-cause mortality, 0.74 (0.60, 0.90) and 0.69 (0.55, 0.86) for CVD mortality, and 0.75 (0.65, 0.87) and 0.75 (0.64, 0.88) for cancer mortality, respectively. Inverse associations of the C22:0/C16:0 and C24:0/C16:0 ceramide ratios with cancer mortality were attenuated among individuals with a higher diet quality (DGAI or MDS above the median, all P-interaction ≤0.1). The DGAI and MDS had distinct associations with ceramide ratios (DGAI: lower C22:0/C16:0 across quartiles; MDS: higher C24:0/C16:0 across quartiles; all P-trend ≤0.01). Conclusion In our community-based sample, ceramide ratios (C22:0/C16:0 and C24:0/C16:0) were associated with a lower risk of all-cause and cause-specific mortality. Further, we observed that a higher overall diet quality attenuates the association between blood ceramide ratios and cancer mortality and that dietary patterns have distinct relations with ceramide ratios.

scholarly journals Dairy Consumption and Incidence of Breast Cancer in the ‘Seguimiento Universidad de Navarra’ (SUN) Project

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 687
Author(s):  
Inmaculada Aguilera-Buenosvinos ◽  
Cesar Ignacio Fernandez-Lazaro ◽  
Andrea Romanos-Nanclares ◽  
Alfredo Gea ◽  
Rodrigo Sánchez-Bayona ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dairy Products ◽  
Dairy Product ◽  
Inverse Association ◽  
Low Fat ◽  
Significant Inverse Association ◽  
Product Consumption ◽  
Dairy Consumption ◽  
Dairy Product Consumption

Dairy products might influence breast cancer (BC) risk. However, evidence is inconsistent. We sought to examine the association between dairy product consumption—and their subtypes—and incident BC in a Mediterranean cohort. The SUN (“Seguimiento Universidad de Navarra”) Project is a Spanish dynamic ongoing cohort of university graduates. Dairy product consumption was estimated through a previously validated 136-item food frequency questionnaire (FFQ). Incident BC was reported in biennial follow-up questionnaires and confirmed with revision of medical records and consultation of the National Death Index. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated with Cox regression models. Among 123,297 women-years of follow-up (10,930 women, median follow-up 12.1 years), we confirmed 119 incident BC cases. We found a nonlinear association between total dairy product consumption and BC incidence (pnonlinear = 0.048) and a significant inverse association for women with moderate total dairy product consumption (HRQ2vs.Q1 = 0.49 (95% CI 0.28–0.84); HRQ3vs.Q1 = 0.49 (95% CI 0.29–0.84) ptrend = 0.623) and with moderate low-fat dairy product consumption (HRQ2vs.Q1 = 0.58 (95% CI 0.35–0.97); HRQ3vs.Q1 = 0.55 (95% CI 0.32–0.92), ptrend = 0.136). In stratified analyses, we found a significant inverse association between intermediate low-fat dairy product consumption and premenopausal BC and between medium total dairy product consumption and postmenopausal BC. Thus, dairy products, especially low-fat dairy products, may be considered within overall prudent dietary patterns.

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