The association between dairy product intake and cardiovascular disease mortality in Chinese adults

Purpose To evaluate the relation of dairy intake with risk of CVD mortality in middle-aged and elderly Chinese in Singapore. Methods The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998 in Singapore. A validated 165-item semiquantitative food-frequency questionnaire was used to assess usual diet at recruitment. Mortality information was obtained via registry linkage up to December 31, 2011. Cox proportional hazard models were used to calculate hazard ratios (HRs) and corresponding 95 % confidence intervals (95 % CIs) with adjustment for potential confounders, including socio-demographic, lifestyle, and other dietary factors. Results Among those without prior history of CVD, the multivariate-adjusted HRs (95 % CIs) comparing the highest (median intake 252 g/d) with lowest (median intake 1.32 g/d) quartiles of total dairy intake were 0.95 (0.87-1.04; P-trend = 0.64) for CVD death, 0.99 (0.89-1.11; P-trend = 0.76) for coronary heart disease (CHD) death, and 0.82 (0.69-0.97; P-trend = 0.03) for stroke death. The significant inverse association with stroke mortality was stronger in men (comparing the highest with the lowest quartiles, HR = 0.71; 95 % CI 0.55-0.92; P-trend = 0.006) than in women (HR = 0.86; 0.65-1.12; P-trend = 0.23), and the interaction test was significant (P = 0.03). No statistically significant associations between total dairy intake and CVD mortality were observed in participants with prior history of CVD (all P-trend >0.40). Conclusions In a cohort of Chinese adults with generally low dairy consumption, higher intake of dairy products was associated with a decreased risk of stroke mortality, particularly in men.