Meta-analysisindependent cross-checkabstract only checked I-DRY-02 standard review
29 cohorts: dairy neutral for heart disease and mortality
Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies.
Overview
Guo J et al.. Eur J Epidemiol 2017 · PMID 28374228 · DOI 10.1007/s10654-017-0243-1
No association for milk or total dairy; fermented dairy slightly inverse.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Dairy and CVD/mortality.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
938,465 people.
- What was actually found?
Neutral.
- How large was the observed effect?
Fermented dairy RR 0.98 per 20 g/d.
- What do the results mean in everyday life?
Dairy not linked to earlier death.
- What are the study's limitations?
Industry COI; heterogeneity.
- What does it say about Elawady's specific claim?
Contradicts mortality claim.
- Do the results apply to Germany and Europe?
Includes Europe.
- What can explicitly not be concluded from this study?
Causation.
Scientific in-depth review
1. Full reference
- Authors
- Guo J et al.
- Journal
- Eur J Epidemiol
- Year
- 2017
- Identifier
- PMID 28374228 DOI 10.1007/s10654-017-0243-1
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
SSSM received funding from the Global Dairy Platform, Dairy Research Institute and Dairy Australia for a meta-analysis on cheese and blood lipids (2012) and this meta-analysis of dairy and mortality (2015). SSSM has also received the Wiebe Visser International Dairy Nutrition Prize from the Dutch Dairy Association’s (NZO) Utrecht Group. AA is recipient of research grants from Arla Foods, DK; Danish Dairy Research Foundation; Global Dairy Platform; Danish Agriculture and Food Council; GEIE European Milk Forum, France. He is member of advisory boards for Dutch Beer Knowledge Institute, NL; IKEA, SV; Lucozade Ribena Suntory Ltd, UK; McCain Foods Limited, USA; McDonald’s, USA; Weight Watchers, USA. He is consultant for Nestlé Research Center, Switzerland; Nongfu Spring Water, China. Astrup receives honoraria as Associate Editor of American Journal of Clinical Nutrition, and for membership of the Editorial Boards of Annals of Nutrition and of Metabolism and Annual Review of Nutrition. He is recipient of travel expenses and/or modest honoraria (<$2000) for lectures given at meetings supported by corporate sponsors. He received financial support from dairy organizations for attendance at the Eurofed Lipids Congress (2014) in France and the meeting of The Federation of European Nutrition Societies (2015) in Germany; DIG and JG received funding from the Global Dairy Platform, DIG and JAL have received funding from The Dairy Council and AHDB Dairy for dietary pattern analysis of diets defined by dairy food content (2012–2015).
2. Research question
Milk and dairy and CVD, CHD and all-cause mortality.
3. Study design and population
- Study design
- Meta-analysis – Dose-response meta-analysis of prospective cohorts.
- Population
938,465 participants in 29 cohorts
- Country
Multinational
- Period
Search to Sept 2016
- Sample size
29 cohorts
- Inclusion and exclusion criteria
Prospective cohorts.
4. Methods and endpoints
- Exposure / intervention
Total, high/low-fat dairy, milk, fermented dairy, cheese, yogurt.
- Comparator
Per dose
- Endpoints
Mortality, CHD, CVD.
- Statistical methods
Random-effects dose-response; spline models.
5. Actual results
- Results
No associations for total (high/low-fat) dairy and milk with mortality, CHD or CVD. Fermented dairy per 20 g/d: mortality RR 0.98 (0.97-0.99), CVD 0.98 (0.97-0.99); cheese per 10 g/d CVD 0.98 (0.95-1.00); inverse associations attenuated after removing one large Swedish study.
- Absolute risks
not reported
- Authors' conclusion
Neutral associations between dairy products and cardiovascular and all-cause mortality.
6. Strengths
- Large dose-response synthesis
7. Weaknesses
- Dairy-industry funding/COI declared by several authors
- High heterogeneity (I2 up to 94%)
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Industry COI; heterogeneity.
9. Assessment of the statistical interpretation
Mostly null; tiny inverse associations for fermented dairy.
10. Relevance to the specific claim
Contradicts C-DRY-03.
11. Independent contrary findings
12. Transferability to Germany and Europe
Includes Europe.
13. Overall methodological judgement
Neutral overall; COI noted.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Replacement foods.
15. Linked fact checks
- High milk consumption raises mortality (women drinking 3+ glasses/day had 93% higher mortality) and increases rather than prevents hip fractures. – Studies contradicting or limiting the claim