
Association of dairy intake with cardiovascular disease and mortality - bookofjoe
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31812-9/fulltext
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dooglius
Title should be changed to something like the interpretation section: "Dairy
consumption was associated with lower risk of mortality and major
cardiovascular disease events in a diverse multinational cohort."

The study does not, and does not purport to, show a causal relationship.

EDIT: It appears that the title here has been changed, but to the article
title, which is a bit less than ideal since it implies a positive correlation
when the study shows a negative correlation (or at least it reads that way to
me).

~~~
dcolkitt
The condition "diverse multinational cohort" is very important. The primary
driver of population level variance in dairy consumption is lactose tolerance.
For example Northern Europeans have much higher lactose tolerance than
Aboriginal Australians.

So, we have to be really careful that dairy consumption isn't just proxying
for ancestry. Because there are huge genetic variations in CVD mortality
across different sub-populations. For example African-Americans have
signficantly higher CVD, BP and diabetes risk because of higher rates of APOL1
polymorphism.

[1][https://jasn.asnjournals.org/content/26/2/247](https://jasn.asnjournals.org/content/26/2/247)

~~~
nostromo
I suspect lactose intolerance in the US is inversely correlated with wealth --
so this could just be another study showing that wealthy folks live longer.

~~~
mac01021
> actose intolerance in the US is inversely correlated with wealth

I'm not well informed about the causes of lactose intolerance. Is this
correlation diet-induced/environmental? Or is it a congenital/racial thing
where white people be rich and everyone else is genetically intolerant?

~~~
mr_toad
Lactose intolerance is the norm. Tolerance is unusual in adult mammals.

In humans, it appears to be a very recent mutation, probably associated with
the domestication of livestock.

[https://en.wikipedia.org/wiki/Lactase_persistence](https://en.wikipedia.org/wiki/Lactase_persistence)

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NeedMoreTea
lol. Everything food and health related comes full circle, doesn't it?

Never did like semi-skimmed milk or margarine, so I just kept on with full fat
milk, butter and everything my whole life. Which occasionally has been
difficult when in a shop with endless reduced and half fat choices...

~~~
golemotron
It's funny to go to high end health food stores and see 0% carb, all fat and
protein foods on the shelf next to 0% fat, all carb foods - both with
labelling professing their health.

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graeme
They mentioned funding. I looked on scihub. As far as I can tell it does _not_
have dairy industry funding. Instead it has unrestricted grants from some
governments and pharmaceutical companies worldwide.

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mirimir
FYI: [https://sci-hub.tw/10.1016/S0140-6736(18)31812-9](https://sci-
hub.tw/10.1016/S0140-6736\(18\)31812-9)

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foxyv
_" Dietary intakes of dairy products for 136 384 individuals were recorded
using country-specific validated food frequency questionnaires."_

These questionnaires are not very good methodology. This is why you get so
many contradicting dietary recommendations. Dietary studies tend to rely on
them because they are the cheapest option. But they make okay headlines.

~~~
moltar
I think it depends on a type of question asked.

I think low fat or normal fat dairy preference is a pretty conscious choice
and eventually is habitual.

Most people would be able to answer with good accuracy what type of dairy they
prefer.

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tempsy
If you believe in keto, then it's the consumption of whole fats, not
necessarily dairy, that "lowers risk of mortality."

You don't need to consume dairy to be on keto.

~~~
graeme
....the people in the study were not on a ketogenic diet. Ketosis vs. non-
ketosis is a big step change. The central premise of keto re: fat is “fats are
good....because they lead to ketosis”

You’re reasoning wildly outside of the study here.

~~~
TheRealSteel
Keto (and a lack of surprise) came to my mind when I read the title too, but
your point is important for anyone learning about the ketogenic diet - keto is
a binary state, you're either in it or you're not (and you can do a urine test
at home to tell).

There are still benefits to cutting carbs without going full keto, but not
because you'll be '50% keto' or anything, just because there are other health
improvements from lowering carbohydrate intake other than possible ketosis.

~~~
spraak
Most of the longest living people eat a high (complex) carbohydrate diet. What
benefit do you see in lowering carbohydrate intake, unless you're conflating
e.g. processed white bread with sweet potatoes?

~~~
gif653490
These are very short, low IQ populations though, and i'm not.
(Kitavas,Tsimane,Okinawans which again they have one of the lowest IQ & Height
levels per prefecture in Japan)

>What benefit do you see in lowering carbohydrate intake, unless you're
conflating e.g. processed white bread with sweet potatoes?

Being able to control my weight, my appetite, much improved HbA1c, lower
LDL/TG levels, increased energy levels, no more food cravings, and fasting as
part of my daily life. whereas none of these was possible on my high Complex
carbs years, and i'm not talking for white bread but whole grains, beans and
legumes.

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open-source-ux
The NHS website have a good summary and analysis of this study.

 _Moderate dairy consumption may help heart health_

[https://www.nhs.uk/news/food-and-diet/moderate-dairy-
consump...](https://www.nhs.uk/news/food-and-diet/moderate-dairy-consumption-
may-help-heart-health/)

From the intro:

>An international team of researchers looked at dairy consumption among more
than 136,000 people in 21 countries worldwide.

>They found people who had more than 2 servings of dairy products a day were
16% less likely to die or have a heart attack or stroke during an average of 9
years of follow-up.

...

>Most of the benefit seemed to come from milk and yoghurt, and the effect was
strongest in low and middle-income countries, where dairy consumption is
generally much lower than the UK.

>The question of whether benefits come from low-fat or full-fat dairy products
wasn't conclusively answered in the study.

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vixen99
Interesting association: France is the single country with the highest
saturated fat intake in Europe and the lowest rate of CHD deaths.

~~~
ahartmetz
France has low obesity, too.

~~~
jobigoud
According to Wikipedia:

> the incidence of obesity in French women in 2014 was 24.0% and among French
> men 23.8%. Overall adult obesity rates in France were significantly ahead of
> the Netherlands at 19.8%, Germany at 20.1% and Italy at 21.0%, but behind
> the United Kingdom and the United States at 28.1% and 33.7% respectively.

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tonyedgecombe
One hypothesis I’ve heard is whole fat tends to be more satiating so you
consume less overall.

~~~
rufius
Anecdotally accurate for me. I've tended to prefer higher fat foods -
preferably things like olive oil and nuts, which helps keep my mindless
consumption down.

~~~
TheRealSteel
+1. I feel like I consume less (a healthier amount) overall when I consume
nuts, fruit and cheese as snacks versus high carb foods, even tho nuts and
cheese are quite calorie dense. I just don't find myself feeling hungry again
as quickly. I haven't been logging my food recently but I definitely _feel
better_. Same with vegetables and meat vs, say, pasta.

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jnordwick
This fits in well with the data that cheese consumption is linked with death
by getting tangled in bedsheets.

[https://www.tylervigen.com/spurious-
correlations](https://www.tylervigen.com/spurious-correlations)

Sounds legit

~~~
mtVessel
Or that the divorce rate in Maine correlates with per capita consumption of
margarine! (ibid)

~~~
jnordwick
Dairy is really bad for you.

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tus88
> Dairy consumption was associated with lower risk of mortality and major
> cardiovascular disease events in a diverse multinational cohort

I am personally very pleased to read that, notwithstanding the need to not
base anything on a single study.

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motbob
This summary only talks about the effects of dairy, rather than whole-fat
dairy specifically. Does the article say more?

~~~
ac29
Yes, and interestingly, the effect is only statistically significant for the
group whose dairy consumption was exclusively whole-fat dairy. The group with
both whole-fat and low-fat dairy had lower incidence of the studied outcomes,
but it wasn't statistically significant (and both groups were large: several
tens of thousands of people).

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rexgallorum2
Pass the butter, please.

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devmunchies
i can't see the funding unless i pay for it?

~~~
dredmorbius
Try [https://sci-hub.tw](https://sci-hub.tw) or
[https://gen.lib.rus.ec](https://gen.lib.rus.ec)

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denton-scratch
"Risk of mortality" is 100%, whatever you choose to eat.

~~~
yjftsjthsd-h
Eh, just assume "per amount of time" and it works.

