A global analysis of dairy consumption and incident cardiovascular disease.

Summary

Leveraging two large biobanks and an updated meta-analysis, this study finds heterogeneous associations of dairy with CVD across populations: in China (mainly whole milk) higher CHD and lower stroke risk; in the UK, lower risks for CVD, CHD, and ischemic stroke with notable protective associations for cheese and low-fat milk. The pooled meta-analysis supports modest risk reductions for total CVD and stroke.

Key Findings

• In China, regular dairy (mainly whole milk) was associated with a 9% higher CHD risk and a 6% lower stroke risk versus non-consumers.
• In the UK, total dairy intake was linked to lower risks of CVD, CHD, and ischemic stroke; cheese and semi-skimmed/skimmed milk contributed to reduced CVD risk.
• Meta-analysis showed total dairy associated with 3.7% lower CVD and 6% lower stroke risk.
• Inverse associations were strongest for cheese and low-fat dairy products.

Clinical Implications

Dietary counseling can emphasize cheese and low-fat dairy as potentially cardioprotective, while cautioning that whole milk patterns may differ by population context. Guidance should be tailored to local dietary patterns and overall cardiometabolic risk.

Limitations

• Observational design susceptible to residual confounding and reverse causation.
• Dietary assessment and dairy subtype classification may be imprecise; cultural dietary differences complicate comparisons.

Future Directions

Randomized or quasi-experimental substitution trials comparing dairy subtypes; mechanistic studies on fermentation, calcium, and saturated fat matrices; region-specific dietary modeling for guideline development.