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Substitutions of dairy product intake and risk of stroke: a Danish cohort study.
Eur J Epidemiol 2018; 33(2):201-212EJ

Abstract

Low fat dairy products are part of dietary guidelines to prevent stroke. However, epidemiological evidence is inconclusive with regard to the association between dairy products and stroke. We therefore investigated associations for substitutions between dairy product subgroups and risk of total stroke and stroke subtypes. We included 55,211 Danish men and women aged 50-64 years without previous stroke. Baseline diet was assessed by a food frequency questionnaire. Cases were identified through a national register and subsequently verified. The associations were analyzed using Cox proportional hazard regression. During a median follow-up of 13.4 years, we identified 2272 strokes, of which 1870 were ischemic (318 large artery atherosclerotic, 839 lacunar, 102 cardioembolic, 98 other determined types, 513 of unknown type), 389 were hemorrhages (273 intracerebral, 116 subarachnoid) and 13 of unknown etiology. Substitution of semi-skimmed fermented milk or cheese for whole-fat fermented milk was associated with a higher rate of ischemic stroke [semi-skimmed fermented milk: hazard ratio (HR) = 1.20 (95% confidence interval (CI) 0.99-1.45), cheese: HR = 1.14 (95% CI 0.98-1.31) per serving/day substituted] and substitutions of whole-fat fermented milk for low-fat milk, whole-fat milk or buttermilk were associated with a lower rate [low-fat milk: HR = 0.85 (95% CI 0.74-0.99), whole-fat milk: HR = 0.84 (95% CI 0.71-0.98) and buttermilk: HR = 0.83 (95% CI 0.70-0.99)]. We observed no associations for substitutions between dairy products and hemorrhagic stroke. Our results suggest that intake of whole-fat fermented milk as a substitution for semi-skimmed fermented milk, cheese, buttermilk or milk, regardless of fat content, is associated with a lower rate of ischemic stroke.

Authors+Show Affiliations

Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. asdl@ph.au.dk.Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.Danish Cancer Society Research Center, Copenhagen, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28608185

Citation

Laursen, Anne Sofie Dam, et al. "Substitutions of Dairy Product Intake and Risk of Stroke: a Danish Cohort Study." European Journal of Epidemiology, vol. 33, no. 2, 2018, pp. 201-212.
Laursen ASD, Dahm CC, Johnsen SP, et al. Substitutions of dairy product intake and risk of stroke: a Danish cohort study. Eur J Epidemiol. 2018;33(2):201-212.
Laursen, A. S. D., Dahm, C. C., Johnsen, S. P., Tjønneland, A., Overvad, K., & Jakobsen, M. U. (2018). Substitutions of dairy product intake and risk of stroke: a Danish cohort study. European Journal of Epidemiology, 33(2), pp. 201-212. doi:10.1007/s10654-017-0271-x.
Laursen ASD, et al. Substitutions of Dairy Product Intake and Risk of Stroke: a Danish Cohort Study. Eur J Epidemiol. 2018;33(2):201-212. PubMed PMID: 28608185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Substitutions of dairy product intake and risk of stroke: a Danish cohort study. AU - Laursen,Anne Sofie Dam, AU - Dahm,Christina Catherine, AU - Johnsen,Søren Paaske, AU - Tjønneland,Anne, AU - Overvad,Kim, AU - Jakobsen,Marianne Uhre, Y1 - 2017/06/12/ PY - 2016/11/25/received PY - 2017/06/07/accepted PY - 2017/6/14/pubmed PY - 2019/1/29/medline PY - 2017/6/14/entrez KW - Butter KW - Cheese KW - Cohort studies KW - Dairy products KW - Fermented milk KW - Stroke KW - Substitution models SP - 201 EP - 212 JF - European journal of epidemiology JO - Eur. J. Epidemiol. VL - 33 IS - 2 N2 - Low fat dairy products are part of dietary guidelines to prevent stroke. However, epidemiological evidence is inconclusive with regard to the association between dairy products and stroke. We therefore investigated associations for substitutions between dairy product subgroups and risk of total stroke and stroke subtypes. We included 55,211 Danish men and women aged 50-64 years without previous stroke. Baseline diet was assessed by a food frequency questionnaire. Cases were identified through a national register and subsequently verified. The associations were analyzed using Cox proportional hazard regression. During a median follow-up of 13.4 years, we identified 2272 strokes, of which 1870 were ischemic (318 large artery atherosclerotic, 839 lacunar, 102 cardioembolic, 98 other determined types, 513 of unknown type), 389 were hemorrhages (273 intracerebral, 116 subarachnoid) and 13 of unknown etiology. Substitution of semi-skimmed fermented milk or cheese for whole-fat fermented milk was associated with a higher rate of ischemic stroke [semi-skimmed fermented milk: hazard ratio (HR) = 1.20 (95% confidence interval (CI) 0.99-1.45), cheese: HR = 1.14 (95% CI 0.98-1.31) per serving/day substituted] and substitutions of whole-fat fermented milk for low-fat milk, whole-fat milk or buttermilk were associated with a lower rate [low-fat milk: HR = 0.85 (95% CI 0.74-0.99), whole-fat milk: HR = 0.84 (95% CI 0.71-0.98) and buttermilk: HR = 0.83 (95% CI 0.70-0.99)]. We observed no associations for substitutions between dairy products and hemorrhagic stroke. Our results suggest that intake of whole-fat fermented milk as a substitution for semi-skimmed fermented milk, cheese, buttermilk or milk, regardless of fat content, is associated with a lower rate of ischemic stroke. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/28608185/Substitutions_of_dairy_product_intake_and_risk_of_stroke:_a_Danish_cohort_study_ L2 - https://doi.org/10.1007/s10654-017-0271-x DB - PRIME DP - Unbound Medicine ER -