Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies


Objective: Milk consumption is considered a risk factor for vascular disease on the basis of relevant biological mechanisms and data from ecological studies. The aim was to identify published prospective studies of milk drinking and vascular disease, and conduct an overview.

Design: The literature was searched for cohort studies, in which an estimate of the consumption of milk, or the intake of calcium from dairy sources, has been related to incident vascular disease.

Main outcome measures: Ischaemic heart disease and ischaemic stroke.

Results: In total, 10 studies were identified. Their results show a high degree of consistency in the reported risk for heart disease and stroke, all but one study suggesting a relative risk of less than one in subjects with the highest intakes of milk. A pooled estimate of relative odds in these subjects, relative to the risk in subjects with the lowest consumption, is 0.87 (95% CI 0.74–1.03) for ischaemic heart disease and 0.83 (0.77–0.90) for ischaemic stroke. The odds ratio for any vascular event is 0.84 (0.78–0.90).

Conclusions: Cohort studies provide no convincing evidence that milk is harmful. While there still could be residual confounding from unidentified factors, the studies, taken together, suggest that milk drinking may be associated with a small but worthwhile reduction in heart disease and stroke risk.

Sponsorship: The University of Wales College of Medicine and Bristol University. Current support is from the Food Standards Agency.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  • Abbott RD, Curb JD, Rodriguez BL, Sharp DS, Birchfield CM & Yano K (1996): Effect of dietary calcium & milk consumption on risk of thrombo-embolic stroke in older middle aged men: The Honolulu Heart Program . Stroke 27, 813–818.

    CAS  Article  Google Scholar 

  • Barr SI, McCarron DA, Heaney RP, Dawson-Hughes B, Berga SL, Stern JS & Oparil S (2000): Effects if increased consumption of fluid milk on energy and nutrient intake, body weight, and cardiovascular risk factors in healthy older adults. J. Am. Diet. Assoc. 100, 810–817.

    CAS  Article  Google Scholar 

  • Bostic RM, Kushi LH, Wu Y, Meyer KA, Sellers TA & Folsom AR (1999): Relation of calcium, vitamin D, and dairy food intake to ischaemic heart disease mortality among postmenopausal women. Am. J. Epidemiol. 149, 151–161.

    Article  Google Scholar 

  • Buonapane GJ, Kilara A, Smith JS & McCarthy RD (1992): Effect of skim milk supplementation on blood cholesterol concentration, blood pressure and triglycerides in a free-living human population. J. Am. Coll. Nutr. 11, 56–67.

    Article  Google Scholar 

  • D’Avanso B, Negri E, Nobili A & Vecchia C (1995): Frequency of consumption of selected indicator foods and serum cholesterol. GISSI-EFRIM investigators. Eur. J. Epidemiol. 11, 269–274.

    Article  Google Scholar 

  • Elwood PC, Pickering JE, Fehily AM, Hughes J & Ness AR (2004): Milk drinking, ischaemic heart disease and ischaemic stroke. I. Evidence from the Caerphilly Cohort. Eur. J. Clin. Nutr. 58, 711–717.

    CAS  Article  Google Scholar 

  • Gramenzi A, Gentile A, Fasoli M, Negri E, Parazzini F & Vecchi CL (1990): Association between certain foods and risk of acute myocardial infarction in women. BMJ 300, 771–773.

    CAS  Article  Google Scholar 

  • Grant WB (1998): Milk and other dietary influences on coronary heart disease. Altern. Med. Rev. 3, 281–294.

    CAS  PubMed  Google Scholar 

  • Iso H, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH, Colditz GA, Speizer FE & Willett WC (1999): Prospective study of calcium, potassium and magnesium intake and risk of stroke in women. Stroke 30, 1772–1779.

    CAS  Article  Google Scholar 

  • Jacobsen BK & Stensvold I (1992): Milk — a better drink? Relationships with total serum cholesterol in a cross sectional survey. The Nordland Health Study. Scand. J. Soc. Med. 20, 204–208.

    CAS  Article  Google Scholar 

  • Jorde R & Bonna KH (2001): Calcium from dairy products, vitamin D intake and blood pressure: the Tromso Study. Am. J. clin. Nutr. 73, 659–660

    CAS  Article  Google Scholar 

  • Kinjo Y, Beral V, Akiba S, Key T, Mizuno S, Appleby P, Yamaguchi N, Watanabe S & Doll R (1999): Possible protective effect of milk and fish for cerebrovascular disease mortality in Japan. J. Epidemiol. 9, 268–274.

    CAS  Article  Google Scholar 

  • Knox EG (1973): Ischaemic heart disease mortality and dietary intake of calcium. Lancet 1, 1465–1467.

    CAS  Article  Google Scholar 

  • Kromhout D, Bosschieter EB & Coulanderr CD (1985): Potassium, calcium, alcohol intake and blood pressure: The Zutpgen Study. Am. J. Clin. Nutr. 45, 1299–1304.

    Article  Google Scholar 

  • Lip GY, Malik I, Luscombe C, McCarry M & Beevers G (1995): Dietary fat purchasing habits in whites, blacks and Asian peoples in England — implications for heart disease prevention. Int. J. Cardiol. 48, 287–293.

    CAS  Article  Google Scholar 

  • Mann JI, Appleby PN, Key TJ & Thorogood M (1997): Dietary determinants of ischaemic heart disease in health conscious individuals. Heart 78, 450–455.

    CAS  Article  Google Scholar 

  • Moss M & Freed D (2003):The cow and the coronary, biochemistry and immunology. Internal J. Cardiol. 87, 203–216.

    Article  Google Scholar 

  • Nagaya T, Yoshida H, Hayashi T, Takahashi H, Kawai M & Matsuda Y (1996): Serum lipid profile in relations to milk consumption in a Japanses population. J. Am. Coll. Nutr. 15, 625–629.

    CAS  Article  Google Scholar 

  • Naidoo J & Willis J (1994): Health Promotion: Foundation for Practice. London: Bailliere Tindall.

    Google Scholar 

  • Ness AR, Davey Smith G & Hart C (2001): Milk, coronary heart disease and mortality. J. Epidemiol. Community Health 55, 379–382.

    CAS  Article  Google Scholar 

  • Nutritional Aspects of Cardiovascular Disease (1994): Report of the Cardiovascular Review Group: the Committee on Medical Aspects of Food Policy, London: HMSO.

  • Onning G, Akesson B, Oste R & Lundquist I (1998): Effects of consumption of oat milk, soya milk, or cow's milk on plasma lipids and antioxidant capacity in healthy subjects. Ann. Nutr. Metab. 42, 211–220.

    CAS  Article  Google Scholar 

  • Oshaug A, Bugge KH & Refsum H (1998): Diet, an independent determinant for plasma total homocysteine. Eur. J. Clin. Nutr. 52, 7–11.

    CAS  Article  Google Scholar 

  • Pfeuffer M & Schrezenmeir J (2000): Bioactive substances in milk with properties decreasing risk of cardiovascular diseases. Br. J. Nutr. 85, S155–S159.

    Google Scholar 

  • Samuelson G, Bratteby LE, Mohsen R & Vessby B (2001): Dietary fat intake in healthy adolescents: inverse relationships between the estimated intake of saturated fatty acids and serum cholesterol. Br. J. Nutr. 85, 333–341.

    CAS  Article  Google Scholar 

  • Seely S (1981): Diet and coronary disease: a survey of mortality rates and food consumption statistics of 24 countries. Med. Hypotheses 7, 907–918.

    CAS  Article  Google Scholar 

  • Segall JJ (1994): Dietary lactose as a possible risk factor for ischaemic heart disease. Int. J. Cardiol. 46, 197–207.

    CAS  Article  Google Scholar 

  • Segall JJ (1977): Is milk a coronary health hazard? Br. J. Prev. Soc. Med. 31, 81–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Shaper AG, Wannamethee G & Walker M (1991): Milk, butter and heart disease. BMJ 302, 786–787.

    Google Scholar 

  • Snowdon DA, Phillips RL & Frazer GE (1984): Meat consumption and fatal ischaemic heart disease. Prev. Med. 13, 490–500.

    CAS  Article  Google Scholar 

  • Steinmetz KA, Childs MT, Stimson C, Kushi LH, McGovern PG, Potter JD & Yamanaka WK (1994): Effect of consumption of whole milk and skim milk on blood lipid profiles in healthy men. Am. J. Clin. Nutr. 59, 612–618.

    CAS  Article  Google Scholar 

  • St Onge MP, Farnworth ER & Jones PJH (2000): Consumption of fermented and non-fermented dairy products: effects on cholesterol concentrations and metabolism. Am. J. Clin. Nutr. 71, 674–681.

    CAS  Article  Google Scholar 

  • Tavani A, Gallus S, Negri E, Al & Vecchia C (2002): Milk, dairy products and coronary heart disease. J. Epidemiol. Community Health 56, 471–472.

    CAS  Article  Google Scholar 

  • Vijver L Van der, Wall M Van der, Wetterings KGC, Dekker JM, Schouten EG & Kok FJ (1992): Calcium intake and 28-year cardiovascular and coronary heart disease mortality in Dutch civil servants. Int. J. Epidemiol. 21, 36–39.

    Article  Google Scholar 

Download references


This Caerphilly study was conducted by the former MRC Epidemiology Unit (South Wales) and was funded by the Medical Research Council of United Kingdom. The archive is now maintained by the Department of Social Medicine in the University of Bristol. Janet Pickering and Janie Hughes are supported by the Food Standards Agency.

Author information

Authors and Affiliations


Corresponding author

Correspondence to P C Elwood.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Elwood, P., Pickering, J., Hughes, J. et al. Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies. Eur J Clin Nutr 58, 718–724 (2004).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • milk
  • calcium
  • ischaemic heart disease
  • stroke
  • overview
  • relative odds

Further reading


Quick links