Hypertension is a public health priority in developed countries and worldwide, and is strongly associated with increased risk and progression of cardiovascular and renal diseases. A systematic review and meta-analysis were conducted to examine the association between dairy food intake during adulthood and the development of elevated blood pressure (EBP), specifically comparing the association of EBP with consumption of low-fat dairy foods versus high-fat dairy foods, as well as cheese versus fluid dairy foods (milk or yogurt). Seven databases were searched and five cohort studies selected for inclusion, involving nearly 45 000 subjects and 11 500 cases of EBP. Meta-analysis of consumption of dairy foods and EBP in adults gave a relative risk (RR) of 0.87 (95% confidence interval (CI) 0.81–0.94). Separation of high- and low-fat dairy foods, however, indicated a significant association with low-fat dairy foods only (RR of 0.84 (95% CI 0.74–0.95)). Additional analyses showed no association between EBP and cheese, although fluid dairy foods were significantly associated with a reduced development in EBP (RR of 0.92 (95% CI 0.87–0.98)). Little heterogeneity was observed among the data presented. This meta-analysis supports the inverse association between low-fat dairy foods and fluid dairy foods and risk of EBP. Understanding these relationships can aid in the development of public health messages involving dairy foods, and supports current recommendations.
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Theoretical attributable risk analysis and Disability Adjusted Life Years (DALYs) based on increased dairy consumption
BMC Public Health Open Access 27 August 2022
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Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J . Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365 (9455): 217–223.
Centers for Disease Control and Prevention. Hypertension. Center for Disease Control and Prevention, 2010 (cited Feburary 2010); Available from: http://www.cdc.gov/nchs/fastats/hyprtens.htm.
Australian Institute of Health and Welfare. High blood pressure in Australia. (cited Feburary 2010); Available from: http://www.aihw.gov.au/cvd/high_blood_pressure.cfm.
Australian Heart Foundation. Guide to management of hypertension 2008: assessing and managing raised blood pressure in adults, 2009 (updated August; cited Feburary 2010); Available from: http://www.heartfoundation.org.au/SiteCollectionDocuments/HypertensionGuidelines2008to2010Update.pdf.
Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Hypertension 2006; 114 (1): 82–96.
Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, FM S . Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 2006; 47: 296–308.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R . Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.
Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336 (16): 1117–1124.
Alonso A, Beunza JJ, Delgado-Rodríguez M, Martínez JA, Martínez-González MA . Low-fat dairy consumption and reduced risk of hypertension: the Seguimiento Universidad de Navarra (SUN) Cohort. Am J Clin Nutr 2005; 82 (5): 972–979.
Alonso A, Zozaya C, Vazquez Z, Alfredo Martinez J, Martinez-Gonzalez MA . The effect of low-fat versus whole-fat dairy product intake on blood pressure and weight in young normotensive adults. J Hum Nutr Diet 2009; 22 (4): 336–342.
Djoussé L, Pankow JS, Hunt SC, Heiss G, Province MA, Kabagambe EK et al. Influence of saturated fat and linolenic acid on the association between intake of dairy products and blood pressure. Hypertension 2006; 48 (2): 335–341.
Engberink MF, Hendriksen MA, Schouten EG, van Rooij FJ, Hofman A, Witteman JC et al. Inverse association between dairy intake and hypertension: the Rotterdam Study. Am J Clin Nutr 2009b; 89 (6): 1877–1883.
Pereira MA, Jacobs DRJ, VanHorn L, Slattery ML, Kartashov AI, Ludwig DS . Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. JAMA 2002; 287 (16): 2081–2089.
Ruidavets JB, Bongard V, Simon C . Independent contribution of dairy products and calcium intake to blood pressure variations at a population level. J Hypertens 2006; 24: 671–681.
Snijder MB, van der Heijden AA, van Dam RM, Stehouwer CD, Hiddink GJ, Nijpels G, Heine RJ et al. Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study. Am J Clin Nutr. 2007; 85 (4): 989–995.
Steffen LM, Kroenke CH, Yu X, Pereira MA, Slattery ML, Van Horn L et al. Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2005; 82 (6): 1169–1177.
Toledo E, Delgado-Rodríguez M, Estruch R, Salas-Salvadó J, Corella D, Gomez-Gracia E et al. Low-fat dairy products and blood pressure: follow-up of 2290 older persons at high cardiovascular risk participating in the PREDIMED study. Br J Nutr 2009; 101 (1): 59–67.
Wang L, Manson JE, Buring JE, Lee I, Sesso HD . Dietary intake of dairy products, calcium, and vitamin D and the risk of hypertension in middle-aged and older women. Hypertension 2008; 51 (4): 1073–1079.
American Heart Association. Eat a wide variety of foods. 2010 (cited 31 May 2010); Available from: http://my.americanheart.org/professional/StatementsGuidelines/ByPublicationDate/PreviousYears/Guidelines-for-Weight-Management-Programs-for-Healthy-Adults_UCM_423812_Article.jsp.
US Department of Health and Human Services and US Department of Agriculture. Dietary Guidelines for Americans, 2005. US Government Printing Office: Washington, DC, 2005. HHS publication number: HHS-ODPHP-2005-01-DGA-A.
National Health and Medical Research Council. A Guide to the Development, Implementation and Evaluation of Clinical Practice Guidelines. National Health and Medical Research Council: Canberra, ACT, 1998.
American Dietetic Association. Evidence Analysis Manual: Steps in the ADA Evidence Analysis Process. Scientific Affairs and Research, American Dietetic Association: Chicago, IL, 2008.
Butrum R, Cannon G, Heggie S, Kroke A, Miles L, Norman H et al. Systematic Literature Review Specification Manual. World Cancer Research Fund/American Institute for Cancer Research: Washington, DC, 2007.
Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 345 (18): 1291–1297.
U.S. Department of Health and Human Services. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, MD: U.S. Department of Health and Human Services: 2004. NIH publication no. 04-5230.
Engberink MF, Geleijnse JM, de Jong N, Smit HA, Kok FJ, Verschuren WM et al. Dairy intake, blood pressure, and incident hypertension in a general Dutch population. J Nutr 2009a; 139 (3): 582–587.
Higgins JPT, Green S . Cochrane Handbook for systematic reviews of interventions. Version 5.0.1; 2008 (updated September; cited January 2010); Available from: http://www.cochrane-handbook.org/.
British Medical Journal. Clinical Evidence Glossary. BMJ: London, UK, 2007 (cited 3 December 2009); Available from: http://clinicalevidence.bmj.com/ceweb/resources/glossary.jsp.
Davies HT, Crombie IK, Tavakoli M . When can odds ratios mislead? BMJ 1998; 316 (7136): 989–991.
Higgins JP, Thompson SG . Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21 (22): 1539–1558.
Higgins JP, Thompson SG . Measuring inconsistency in meta-analyses. BMJ 2003; 327 (7414): 557–560.
Griffith LE, Guyatt GH, Cook RJ, Bucher HC, Cook DJ . The influence of dietary and nondietary calcium supplementation on blood pressure: an updated meta-analysis of randomized controlled trials. Am J Hypertens 1999; 12 (1 Part 1): 84–92.
Bucher HC, Cook RJ, Guyatt GH, Lang JD, Cook DJ, Hatala R et al. Effects of dietary calcium supplementation on blood pressure: a meta-analysis of randomized controlled trials. JAMA 1996; 175 (13): 1016–1022.
Allender PS, Cutler JA, Follmann D, Cappuccio FP, Pryer J, Elliott P . Dietary calcium and blood pressure: a meta-analysis of randomized clinical trials. Ann Intern Med 1996; 124 (9): 825–831.
Jee SH, Miller III ER, Guallar E, Singh VK, Appel LJ, Klag MJ . The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens 2002; 15 (8): 691–696.
Adrogué HJ, Madias NE . Sodium and potassium in the pathogenesis of hypertension. N Engl J Med 2007; 356 (19): 1966–1978.
Nemerovski CW, Dorsch MP, Simpson RU, Bone HG, Aaronson KD, Bleske BE . Vitamin D and cardiovascular disease. Pharmacotherapy 2009; 29 (6): 691–708.
Boelsma E, Kloek J . Lactotripeptides and antihypertensive effects: a critical review. Br J Nutr 2009; 101 (6): 776–786.
Séverin S, Wenshui X . Milk biologically active components as nutraceuticals: review. Crit Rev Food Sci Nutr 2005; 45 (7–8): 645–656.
Vaskonen T . Dietary minerals and modification of cardiovascular risk factors. J Nutr Biochem 2003; 14: 492–506.
United States Department of Agriculture Agricultural Research Service. National Nutrient Database for standard reference, 2009 (cited 20 Nov 2009); Available from: http://www.nal.usda.gov/fnic/foodcomp/search/.
Lichtenstein AH, Yetley EA, Lau J . Application of systematic review methodology to the field of nutrition. J Nutr 2008; 138 (12): 2297–2306.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 2000; 283 (15): 2008–2012.
Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF . Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Lancet 1999; 354 (9193): 1896–1900.
Smith A, Kellett E, Schmerlaib Y . The Australian Guide to Healthy Eating: Background Information for Nutrition Educators. Australian Government Department of Health and Ageing: Canberra, ACT, 1998.
Health Canada. Eating Well with Canada's Food Guide. Health Canada: Ottawa, Ontario, 2007. Publication number: 4651.
The Dairy Council. Dairy and bones, 2007 (cited November 2010); Available from: http://www.milk.co.uk/page.aspx?intPageID=92.
We acknowledge the National Health and Medical Research Council, Australia (http://www.nhmrc.gov.au/) for funding this project and the Dietitians Association of Australia for overseeing the project and administering the contract. Source of support: this work was undertaken as part of a systematic literature review to update the Dietary Guidelines for Australians by the Dietitians Association of Australia under contract to the National Health and Medical Research Council, Australia. Authorship: RR conducted the November 2009 search, determined studies for exclusion and inclusion, extracted data from retrieved studies, performed the meta-analysis, and drafted the manuscript excepting the introduction. JL recovered the publications, determined studies for exclusion and inclusion, extracted data from retrieved studies and drafted the introduction. HT oversaw and advised the entire study, contributed ideas throughout the review and helped with manuscript revision. CP determined studies for exclusion and inclusion, extracted data from included studies and contributed to manuscript revision. KW oversaw and advised the entire study, designed the review process, chose studies to be retrieved and contributed to manuscript preparation and revision. All authors approved the final manuscript.
The authors declare no conflict of interest.
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Ralston, R., Lee, J., Truby, H. et al. A systematic review and meta-analysis of elevated blood pressure and consumption of dairy foods. J Hum Hypertens 26, 3–13 (2012). https://doi.org/10.1038/jhh.2011.3
- blood pressure
- dairy products
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