OBJECTIVE To examine the association of consumption of dairy foods with risk of total and cause specific mortality in women and men. DESIGN Three prospective cohort studies with repeated measures of diet and lifestyle factors. SETTING Nurses' Health Study, Nurses' Health Study II, and the Health Professionals Follow-up Study, in the United States. PARTICIPANTS 168 153 women and 49 602 men without cardiovascular disease or cancer at baseline. MAIN OUTCOME MEASURE Death confirmed by state vital records, the national death index, or reported by families and the postal system. During up to 32 years of follow-up, 51 438 deaths were documented, including 12 143 cardiovascular deaths and 15 120 cancer deaths. Multivariable analysis further adjusted for family history of cardiovascular disease and cancer, physical activity, overall dietary pattern (alternate healthy eating index 2010), total energy intake, smoking status, alcohol consumption, menopausal status (women only), and postmenopausal hormone use (women only). RESULTS Compared to the lowest category of total dairy consumption (average 0.8 servings/day), the multivariate pooled hazard ratio for total mortality was 0.98 (95% confidence interval 0.96 to 1.01) for the second category of dairy consumption (average 1.5 servings/day), 1.00 (0.97 to 1.03) for the third (average 2.0 servings/day), 1.02 (0.99 to 1.05) for the fourth (average 2.8 servings/day), and 1.07 (1.04 to 1.10) for highest category (average 4.2 servings/day; P for trend <0.001). For the highest compared to the lowest category of total dairy consumption, the hazard ratio was 1.02 (0.95 to 1.08) for cardiovascular mortality and 1.05 (0.99 to 1.11) for cancer mortality. For subtypes of dairy products, whole milk intake was significantly associated with higher risks of total mortality (hazard ratio per 0.5 additional serving/day 1.11, 1.09 to 1.14), cardiovascular mortality (1.09, 1.03 to 1.15), and cancer mortality (1.11, 1.06 to 1.17). In food substitution analyses, consumption of nuts, legumes, or whole grains instead of dairy foods was associated with a lower mortality, whereas consumption of red and processed meat instead of dairy foods was associated with higher mortality. CONCLUSION These data from large cohorts do not support an inverse association between high amount of total dairy consumption and risk of mortality. The health effects of dairy could depend on the comparison foods used to replace dairy. Slightly higher cancer mortality was non-significantly associated with dairy consumption, but warrants further investigation.

中文翻译：

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乳制品摄入量与女性和男性死亡风险的关联：三项前瞻性队列研究。


目的 研究乳制品消费与女性和男性总死亡风险和特定原因死亡风险之间的关系。设计三项前瞻性队列研究，重复测量饮食和生活方式因素。美国的《SETTING 护士健康研究》、《护士健康研究 II》和《健康专业人员随访研究》。参与者 168 153 名女性和 49 602 名男性在基线时没有心血管疾病或癌症。主要结果指标 由国家生命记录、国家死亡指数确认的死亡，或由家庭和邮政系统报告的死亡。在长达 32 年的随访期间，记录了 51 438 例死亡，其中包括 12 143 例心血管死亡和 15 120 例癌症死亡。多变量分析进一步调整了心血管疾病和癌症家族史、体力活动、总体饮食模式（替代健康饮食指数 2010）、总能量摄入、吸烟状况、饮酒、更年期状况（仅限女性）和绝经后激素使用（女性）仅有的）。结果 与总乳制品消费量最低类别（平均 0.8 份/天）相比，第二类乳制品消费量（平均 1.5 份/天）总死亡率的多变量汇总风险比为 0.98（95% 置信区间 0.96 至 1.01） ），第三类为 1.00（0.97 至 1.03）（平均 2.0 份/天），第四类为 1.02（0.99 至 1.05）（平均 2.8 份/天），最高类别为 1.07（1.04 至 1.10）（平均 4.2 份） /天；P 代表趋势 <0.001)。与乳制品消费总量最高类别相比，心血管死亡率的风险比为 1.02（0.95 至 1.08），癌症死亡率的风险比为 1.05（0.99 至 1.11）。 对于乳制品的亚型，全脂奶摄入量与较高的总死亡率风险（每 0.5 份额外服务/天的风险比为 1.11、1.09 至 1.14）、心血管死亡率（1.09、1.03 至 1.15）和癌症死亡率（1.11、1.11）显着相关。 1.06 至 1.17）。在食品替代分析中，食用坚果、豆类或全谷物而不是乳制品与较低的死亡率相关，而食用红肉和加工肉类而不是乳制品则与较高的死亡率相关。结论 这些来自大型队列的数据并不支持大量乳制品消费总量与死亡风险之间存在负相关关系。乳制品对健康的影响可能取决于用于替代乳制品的比较食品。略高的癌症死亡率与乳制品消费没有显着相关性，但值得进一步研究。