Dairy Consumption and Risk of Stroke: A Systematic Review and Updated Dose-Response Meta-Analysis of Prospective Cohort Studies
Abstract
BACKGROUND: A higher milk consumption may be associated with a lower stroke risk. We conducted a comprehensive systematic review and dose-response meta-analysis of milk and other dairy products in relation to stroke risk.
METHODS AND RESULTS: Through a systematic literature search, prospective cohort studies of dairy foods and incident stroke in stroke-free adults were identified. Random-effects meta-analyses with summarized dose-response data were performed, taking into account sources of heterogeneity, and spline models were used to systematically investigate nonlinearity of the associations. We included 18 studies with 8 to 26 years of follow-up that included 762 414 individuals and 29 943 stroke events. An increment of 200 g of daily milk intake was associated with a 7% lower risk of stroke (relative risk 0.93; 95% CI 0.88-0.98; P=0.004; I(2)=86%). Relative risks were 0.82 (95% CI 0.75-0.90) in East Asian and 0.98 (95% CI 0.95-1.01) in Western countries (median intakes 38 and 266 g/day, respectively) with less but still considerable heterogeneity within the continents. Cheese intake was marginally inversely associated with stroke risk (relative risk 0.97; 95% CI 0.94-1.01 per 40 g/day). Risk reductions were maximal around 125 g/day for milk and from 25 g/day onwards for cheese. Based on a limited number of studies, high-fat milk was directly associated with stroke risk. No associations were found for yogurt, butter, or total dairy.
CONCLUSIONS: Milk and cheese…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 762 participants or records.
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