Whole milk intake linked to CVD-related, all-cause deaths

Consumption of whole milk appears to increase the risks of cardiovascular disease (CVD)-related and all-cause mortality, while low-fat milk does not, suggests a study.

“[A]ssociations between milk intake and CVD-related and all-cause mortality varied by type of milk, with positive associations found for whole milk and a modestly inverse association with ischaemic heart disease (IHD)-related and all-cause mortality found for low-fat milk when compared with whole milk,” the investigators said.

A total of 73,860 adults (mean age 41.2 years at baseline, 49 percent females) invited to repeated health screening in the Norwegian Counties Study (>80-percent attendance) were included in this population-based cohort study. Their dietary intake was evaluated using food frequency questionnaires at each screening from 1974 to 1988.

The investigators estimated hazard ratios (HRs) with 95 percent confidence intervals (CIs) for the associations between milk intake (assessed as cumulative mean intake from repeated questionnaires) and risk of death from all CVD, IHD, acute myocardial infarction (AMI), and all causes through Cox regression analysis.

Over a median follow-up of 33 years, 26,393 deaths occurred (8,590 from CVD, 4,372 from IHD, and 3,047 from AMI). [Am J Clin Nutr 2025;122:1075-1085]

The highest quintile of overall milk intake significantly correlated with a greater risk of CVD-related deaths (HR, 1.12, 95 percent CI, 1.03‒1.21) and all-cause mortality (HR, 1.22, 95 percent CI, 1.16‒1.28) compared with the lowest quintile.

High consumption of whole milk showed a positive association with CVD (HR, 1.07, 95 percent CI, 0.88‒1.16), IHD (HR, 1.13, 95 percent CI, 1.01‒1.27), and all-cause mortality (HR, 1.15, 95 percent CI, 1.10‒1.21) compared with no intake.

On the other hand, low-fat milk intake correlated with lower CVD-, IHD-, AMI-related, and all-cause mortality compared with whole milk consumption. However, these associations were attenuated when analyses considered only baseline intakes.

Saturated fats

Although milk is a rich source of essential nutrients, it also contains saturated fatty acids (SFAs). Both SFA and trans-fatty acids elevate serum low-density lipoprotein cholesterol and apolipoprotein B, which are major atherogenic risk factors. [Eur Heart J 2020;41:2313-2330; Atherosclerosis 2024;389:117433]

“Intake of SFA was also positively associated with CVD-related and all-cause mortality in this cohort,” the investigators said. “These associations were stronger for palmitic and myristic acid, the predominant SFAs in dairy fat.” [Br J Nutr 2024;132:466-478]

Additionally, milk is a source of ruminant trans-fatty acids, which have been shown to increase the risk of CVD-related and coronary artery disease-related mortality among females. [Br J Nutr 2012;108:743-754]

“The milk fat content may thus be a plausible explanation of the positive associations with mortality, particularly IHD-related mortality,” the investigators said.

However, a Swedish cohort study found differential association of fat from milk and fat from cheese with all-cause mortality, indicating an interaction between dairy fat and other components. [Eur J Nutr 2018;57:2869-2876]