Relationship between milk consumption and prostate cancer: a short review

Epidemiological evidence based on both case–control and prospective cohort studies points to an overall positive relationship between consumption of milk/dairy products and the risk of developing prostate cancer. There are inconsistencies in the data, but taken together, the increased relative risk does not seem to be high. A number of mechanisms have been proposed to account for the relationship, with most attention being focused on the involvement of calcium/vitamin D, insulin-like growth factor-1 and oestrogens, although it is unlikely that a single factor in milk is implicated. In any event, any added risk of prostate cancer from increased milk consumption has to be set alongside other evidence, which shows that increased milk consumption can provide substantially reduced risk of coronary heart disease, stroke and colorectal cancer, particularly because cardiovascular disease accounts for vastly more deaths than prostate cancer (although the latter is of course restricted to men).

Does milk consumption contribute to cardiometabolic health and overall diet quality?

Although milk consumption is recommended in most dietary guidelines around the world, its contribution to overall diet quality remains a matter of debate in the scientific community as well as in the public. This paper summarizes the discussion among experts in the field on the place of milk in a balanced, healthy diet. The evidence to date suggests at least a neutral effect of milk intake on health outcomes. The possibility that milk intake is simply a marker of higher nutritional quality diets cannot be ruled out. This review also identifies a number of key research gaps pertaining to the impact of milk consumption on health. These need to be addressed to better inform future dietary guidelines.

Milk: white elixir or white poison? An examination of the associations between dairy consumption and disease in human subjects

Implications Overall, milk consumption provides health benefits to all age groups. Effects of cheese, butter, and fat-reduced and saturated fat-reduced milk and dairy products are less clear and require more research. Public health nutrition policy related to milk consumption should be based on the evidence presented and not solely on the believed negative effects of dietary fat. Milk is not a white elixir since no study has reported eternal youth from drinking it, but there is certainly no evidence that milk is a white poison!

Improving the nutritional quality of milk

Epidemiological evidence suggests high milk consumption protects against certain chronic diseases, and yet the high saturated fatty acid (SFA) concentration of milk fat has lead to research into reducing SFA and trans- fatty acid content, and enhancing conjugated linoleic acid (CLA) content. The most successful method of reducing SFA content is by feeding dairy cows supplemental oilseeds, although amount, type and form of oilseed influence the degree of effect. Also, the high unsaturated fatty acid content of oilseeds leads to increases in milk fat trans- fatty acids unless the oilseed is protected from rumen metabolism.

Milk and meat in our diet: good or bad for health?

Foods derived from animals are an important source of nutrients in the diet but there is considerable uncertainty about whether or not these foods contribute to increased risk of various chronic diseases. For milk in particular there appears to be an enormous mismatch between both the advice given on milk/dairy foods items by various authorities and public perceptions of harm from the consumption of milk and dairy products, and the evidence from long-term prospective cohort studies. Such studies provide convincing evidence that increased consumption of milk can lead to reductions in the risk of vascular disease and possibly some cancers and of an overall survival advantage from the consumption of milk, although the relative effect of milk products is unclear. Accordingly, simply reducing milk consumption in order to reduce saturated fatty acid (SFA) intake is not likely to produce benefits overall though the production of dairy products with reduced SFA contents is likely to be helpful. For red meat there is no evidence of increased risk of vascular diseases though processed meat appears to increase the risk substantially. There is still conflicting and inconsistent evidence on the relationship between consumption of red meat and the development of colorectal cancer, but this topic should not be ignored. Likewise, the role of poultry meat and its products as sources of dietary fat and fatty acids is not fully clear. There is concern about the likely increase in the prevalence of dementia but there are few data on the possible benefits or risks from milk and meat consumption. The future role of animal nutrition in creating foods closer to the optimum composition for long-term human health will be increasingly important. Overall, the case for increased milk consumption seems convincing, although the case for high-fat dairy products and red meat is not. Processed meat products do seem to have negative effects on long-term health and although more research is required, these effects do need to be put into the context of other risk factors to long-term health such as obesity, smoking and alcohol consumption.

Milk and dairy products: dietary partners for life?

The importance of milk in the human diet as a supplier of energy, high quality protein and other key nutrients, including calcium, is broadly accepted yet in the mind of many there remains uncertainty about whether or not these foods contribute to increased risk of cardiovascular and other chronic diseases. The evidence from long term prospective cohort studies that high milk consumption does not increase cardiovascular disease risk and indeed may provide benefit is now pretty unequivocal, although the effects of butter and cheese and benefits of fat reduced milk and saturated fat reduced milk are less certain. Milk is a crucial supplier of calcium, phosphorus and magnesium for bone growth and development in children and it is concerning that due to reduced milk consumption intake of these nutrients is often sub-optimal, particularly for female children. In addition, specific health issues in pregnant women and the elderly can be alleviated by milk or components of milk and these effects are not all explained by traditional nutrition.

Productivity of crossbred dairy cows suckling their calves for 12 or 24 weeks post calving

An experiment on restricted suckling of crossbred dairy cows was conducted at the Livestock Research Centre, Tanga in northeast Tanzania. Thirty-six Bos taurus (Holstein Friesian and Jersey) x Bos indicus (East African Zebu) cows were allocated alternately as they calved to suckling their calves for either 12 or 24 weeks after calving. Cows grazed improved pastures and were offered 4 kg concentrate daily. Milking occurred twice daily by hand; calves were allowed to suck residual milk for 30 min following each milking. Calves were also allowed access to grazing and were offered a maximum of I kg concentrate daily to 24 weeks of age. Weaning age had no significant effect on lactation milk yield for human consumption, the mean (SE) yield being 1806 (102.0) L and 1705 (129. 1) L for 12- and 24-week weaning, respectively. Cows from the two treatments suffered similar losses of live weight and body condition score during lactation and neither group had returned to the original body condition score 40 weeks following calving. Post-partum anoestrous intervals were prolonged. Although not significant, cows suckling calves to 24 weeks had a mean interval to first oestrus extended by 38 days compared with cows suckling calves to 12 weeks. The mean (SE) daily live weight gains of the calves to 52 weeks were 263 (14.1) g/day and 230 (18.1) g/day for calves weaned at 12 and 24 weeks, respectively, such that 12-month weights were 119 (5.6) kg and 110 (7.3) kg, respectively. Twelve-week-weaned calves consumed more concentrate (p < 0.05) from 13 to 24 weeks than did 24-week weaned calves. Calculation of residual milk consumption removed by calves from birth to 12 weeks indicated that it accounted for 28% of total yield. No benefits in cow and calf performance and welfare were found to justify prolonging the suckling period to 24 weeks.

Does dairy food intake predict arterial stiffness and blood pressure in men? Evidence from the Caerphilly prospective study

Arterial stiffness is an independent predictor of cardiovascular disease events and mortality, and like blood pressure, may be influenced by dairy food intake. Few studies have investigated the effects of consumption of these foods on prospective measures of arterial stiffness. The present analysis aimed to investigate the prospective relationship between milk, cheese, cream, and butter consumption and aortic pulse wave velocity, augmentation index, systolic and diastolic blood pressure, as well as cross-sectional relationships between these foods and systolic and diastolic blood pressure and metabolic markers using data from the Caerphilly Prospective Study. Included in this cohort were 2512 men, aged 45 to 59 years, who were followed up at 5-year intervals for a mean of 22.8 years (number follow-up 787). Augmentation index was 1.8% lower in subjects in the highest quartiles of dairy product intake compared with the lowest (P trend=0.021), whereas in the highest group of milk consumption systolic blood pressure was 10.4 mm Hg lower (P trend=0.033) than in nonmilk consumers after a 22.8-year follow-up. Cross-sectional analyses indicated that across increasing quartiles of butter intake, insulin (P trend=0.011), triacylglycerol (P trend=0.023), total cholesterol (P trend=0.002), and diastolic blood pressure (P trend=0.027) were higher. Across increasing groups of milk intake and quartiles of dairy product intake, glucose (P trend=0.032) and triglyceride concentrations (P trend=0.031) were lower, respectively. The present results confirm that consumption of milk predicts prospective blood pressure, whereas dairy product consumption, excluding butter, is not detrimental to arterial stiffness and metabolic markers. Further research is needed to better understand the mechanisms that underpin these relationships.

Dairy and cardiovascular health: friend or foe?

Cardiovascular disease (CVD) prevalence at a global level is predicted to increase substantially over the next decade due to the increasing ageing population and incidence of obesity. Hence, there is an urgent requirement to focus on modifiable contributors to CVD risk, including a high dietary intake of saturated fatty acids (SFA). As an important source of SFA in the UK diet, milk and dairy products are often targeted for SFA reduction. The current paper acknowledges that milk is a complex food and that simply focusing on the link between SFA and CVD risk overlooks the other beneficial nutrients of dairy foods. The body of existing prospective evidence exploring the impact of milk and dairy consumption on risk factors for CVD is reviewed. The current paper highlights that high milk consumption may be beneficial to cardiovascular health, while illustrating that the evidence is less clear for cheese and butter intake. The option of manipulating the fatty acid profile of ruminant milk is discussed as a potential dietary strategy for lowering SFA intake at a population level. The review highlights that there is a necessity to perform more well-controlled human intervention-based research that provides a more holistic evaluation of fat-reduced and fat-modified dairy consumption on CVD risk factors including vascular function, arterial stiffness, postprandial lipaemia and markers of inflammation. Additionally, further research is required to investigate the impact of different dairy products and the effect of the specific food matrix on CVD development.

Manipulation of lipids in animal-derived foods: can it contribute to public health nutrition?

Foods derived from animals are an important source of nutrients for humans. Concerns have been raised that due to their SFA content, dairy foods may increase the risk of cardiometabolic disease. Prospective studies do not indicate an association between milk consumption and increased disease risk although there are less data for other dairy foods. SFA in dairy products can be partially replaced by cis-MUFA through nutrition of the dairy cow although there are too few human studies to conclude that such modification leads to reduced chronic disease risk. Intakes of LCn-3 FA are sub-optimal in many countries and while foods such as poultry meat can be enriched by inclusion of fish oil in the diet of the birds, fish oil is expensive and has an associated risk that the meat will be oxidatively unstable. Novel sources of LCn-3 FA such as kirll oil, algae, and genetically modified plants may prove to be better candidates for meat enrichment. The value of FA-modified foods cannot be judged by their FA composition alone and there needs to be detailed human intervention studies carried out before judgements concerning improved health value can be made. Practical applications: The amount and FA composition of dietary lipids are known to contribute to the risk of chronic disease in humans which is increasing and becoming very costly to treat. The use of animal nutrition to improve the FA composition of staple foods such as dairy products and poultry meat has considerable potential to reduce chronic risk at population level although judgements must not be based simply on FA composition of the foods.

The survival advantage of milk and dairy consumption: An overview of evidence from cohort studies of vascular diseases, diabetes and cancer

Objectives: To conduct it detailed evaluation, with meta-analyses, of the published evidence on milk and dairy consumption and the incidence of vascular diseases and diabetes. Also to summarise the evidence on milk and dairy consumption and cancer reported by the World Cancer Research Fund and then to consider the relevance of milk and dairy consumption to survival in the UK, a typical Western community. Finally, published evidence on relationships with whole milk and fat-reduced milks was examined. Methods: Prospective cohort studies of vascular disease and diabetes with baseline data on milk or dairy consumption and a relevant disease outcome were identified by searching MEDLINE, and reference lists in the relevant published reports. Meta-analyses of relationships in these reports were conducted. The likely effect of milk and dairy consumption on survival was then considered, taking into account the results of published overviews of relationships of these foods with cancer. Results: From meta-analysis of 15 studies the relative risk of stroke and/or heart disease in subjects with high milk or dairy consumption was 0.84 (95% CI 0.76, 0,93) and 0.79 (0.75, 0.82) respectively, relative to the risk in those with low consumption. Four studies reported incident diabetes as an outcome, and the relative risk in the Subjects with the highest intake of milk or diary foods was 0.92 (0.86, 0.97). Conclusions: Set against the proportion of total deaths attributable to the life-threatening diseases in the UK, vascular disease, diabetes and cancer, the results of meta-analyses provide evidence of an overall survival advantage from the consumption of milk and dairy foods.

The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: An overview of the evidence

The health effects of milk and dairy food consumption would best be determined in randomised controlled trials. No adequately powered trial has been reported and none is likely because of the numbers required. The best evidence comes, therefore, from prospective cohort studies with disease events and death as outcomes. Medline was searched for prospective studies of dairy food consumption and incident vascular disease and Type 2 diabetes, based on representative population samples. Reports in which evaluation was in incident disease or death were selected. Meta-analyses of the adjusted estimates of relative risk for disease outcomes in these reports were conducted. Relevant case–control retrospective studies were also identified and the results are summarised in this article. Meta-analyses suggest a reduction in risk in the subjects with the highest dairy consumption relative to those with the lowest intake: 0.87 (0.77, 0.98) for all-cause deaths, 0.92 (0.80, 0.99) for ischaemic heart disease, 0.79 (0.68, 0.91) for stroke and 0.85 (0.75, 0.96) for incident diabetes. The number of cohort studies which give evidence on individual dairy food items is very small, but, again, there is no convincing evidence of harm from consumption of the separate food items. In conclusion, there appears to be an enormous mis-match between the evidence from long-term prospective studies and perceptions of harm from the consumption of dairy food items.

Salmon consumption during pregnancy alters fatty acid composition and secretory IgA concentration in human breast milk

Fish oil supplementation during pregnancy alters breast milk composition, but there is little information about the impact of oily fish consumption. We determined whether increased salmon consumption during pregnancy alters breast milk fatty acid composition and immune factors. Women (n = 123) who rarely ate oily fish were randomly assigned to consume their habitual diet or to consume 2 portions of farmed salmon per week from 20 wk of pregnancy until delivery. The salmon provided 3.45 g long-chain (LC) (n-3) PUFA/wk. Breast milk fatty acid composition and immune factors [soluble CD14, transforming growth factor-b (TGFb)1, TGFb2, and secretory IgA] were analyzed at 1, 5, 14, and 28 d postpartum (PP). Breast milk from the salmon group had higher proportions of EPA (80%), docosapentaenoic acid (30%), and DHA (90%) on d 5 PP compared with controls (P < 0.01). The LC (n-6) PUFA:LC (n-3) PUFA ratio was lower for the salmon group on all days of PP sampling (P < 0.004), although individual (n-6) PUFA proportions, including arachidonic acid, did not differ. All breast milk immune factors decreased between d 1 and 28 PP (P < 0.001). Breast milk secretory IgA (sIgA) was lower in the salmon group (d 1–28 PP; P = 0.006). Salmon consumption during pregnancy, at the current recommended intakes, increases the LC (n-3) PUFA concentration of breast milk in early lactation, thus improving the supply of these important fatty acids to the breast-fed neonate. The consequence of the lower breast milk concentration of sIgA in the salmon group is not clear.