(OR19-06-23) Modelled Replacement of Meats by Dairy in Relation to Incident Cardiovascular Disease: European Investigation Into Cancer and Nutrition (EPIC)-Norfolk Study

Objectives: To examine the associations between modelled isoenergetic replacement of saturated fatty acids (SFA) from total or types of meat by SFA from total or types of dairy and the incidence of cardiovascular diseases (CVD) in UK adults.

Methods: A total of 21,846 participants (56.4% female; age: 40-79 years) from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study, without prevalent CVD, were prospectively followed to 31 March 2018. Dietary intake was assessed using a food frequency questionnaire at baseline (1993-1998). Fatal and non-fatal CVD endpoints were ascertained by hospital and death records. Multivariable-adjusted Cox regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for incident CVD associated with an isoenergetic replacement of SFA (5% of total energy) from total (red, white, processed), red (unprocessed and processed) or processed meat by SFA from total dairy (milk, yogurt, cheese), milk, cheese or yogurt.

Results: During a median follow-up of 21 years, a total of 5904 incident cases of CVD were identified. In multivariable-adjusted analyses, including demographic, lifestyle, energy, dietary and other risk factors, an isoenergetic replacement of SFA (5% of total energy) from total meat by total dairy was associated with lower incidence of CVD (HR, 0.80; 0.68-0.94). According to the analyses of individual food groups, replacing SFA from red meat by milk (0.80; 0.65-0.98) or cheese (0.68; 0.54-0.86), but not yogurt (0.88; 0.55-1.41), was associated with lower incident CVD. Similar effects of replacing processed meat by dairy products were estimated, with HR of 0.76 (0.57-0.99) for milk; 0.63 (0.47-0.85) for cheese and 0.82 (0.50-1.36) for yogurt.

Conclusions: Among adults in Mid-East England, modelled replacement of SFA from meat by dairy products, in particular milk and cheese, but not yogurt, was associated with lower incidence of CVD. This finding supports the notion that SFA from different food sources have differential effects on cardiovascular risk.

Funding Sources: Rank Prize Funds, Dutch Dairy Association, and the Danish Dairy Research Foundation.