Decreased risk of all-cause and heart-specific mortality is associated with low-fat or skimmed milk consumption compared with whole milk intake: A cohort study.

BACKGROUND&AIMS: It is controversial to preferentially choose low-fat milk or full-fat items. This study aimed to investigate the association of total and cause-specific mortality with 2 g/100 g or ≤ 1 g/100 g low-fat milk consumption compared with whole milk in general population. METHODS: Overall, 29,283 adults aged ≥20 years from US National Health and Nutrition Examination Survey 1999-2014 were recruited with a median follow-up of 8.3 years. The types of milk consumption at baseline (e.g., whole-fat, 2 g/100 g low-fat, and ≤1 g/100 g low-fat) were reported during in-house interviews. Hazard ratios for the associations between milk types and mortality were assessed with the weighted Cox proportional regression. RESULTS: During 241,572 person-years of follow-up, 4170 deaths occurred including 730 heart disease-related deaths and 846 cancer deaths. Consumption of milk contained lower fat exhibited an inverse association with total and cardiovascular mortality after multivariable adjustment. Compared with participants consuming whole-fat milk, those consuming 2 g/100 g or ≤1 g/100 g low-fat milk had a 14%-22% decrease in total mortality (p trend ≤0.001). Individuals consuming 2 g/100 g and ≤1 g/100 g low-fat milk had hazard ratios (95%CI) of 0.73 (0.55-0.97) and 0.67 (0.49-0.91) for heart-related mortality (p trend = 0.009). No significant difference was noted between whole-fat and lower-fat milk for mortality due to cancer, Alzheimer's disease, or diabetes mellitus. A similar trend was noted in the stratification and sensitivity analyses. CONCLUSION: Compared with whole milk, low-fat or skim milk intake was associated with reduced total and heart-related mortality. Low-fat milk may be more conducive than whole milk for promoting cardiovascular health in general adults.

Associations of low-carbohydrate and low-fat intakes with all-cause mortality in subjects with prediabetes with and without insulin resistance.

BACKGROUND & AIMS: We investigated the associations of low-carbohydrate and low-fat diets with all-cause mortality in people with prediabetes according to insulin resistance status using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: We analyzed the NHANES participants with prediabetes from 2005 to 2008, and their vital status was linked to the National Death Index through the end of 2011. Low-carbohydrate and low-fat diets were defined as ≦40% and ≦30% of calories from carbohydrate and fat, respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to determine insulin resistance. Weighted Cox proportional hazards regression models were used to compare the hazard ratios for the associations of low-carbohydrate and low-fat diets with all-cause mortality. RESULTS: Among the 1687 participants with prediabetes, 96 of them had died after a median follow-up of 4.5 years. Participants with a HOMA-IR >3.0 had an increase in all-cause mortality compared with those who had a HOMA-IR ≦3.0 (HR 1.797, 95% CI 1.110 to 2.909, p = 0.019). Participants with ≦40% of calories from carbohydrate and >30% from fat (3.75 per 1000 person-years) had a lower all-cause mortality rate compared with those who had >40% from carbohydrate and >30% from fat (10.20 per 1000 person-years) or >40% from carbohydrate and ≦30% from fat (8.09 per 1000 person-years), with statistical significance observed in those who had a HOMA-IR ≦3.0. CONCLUSIONS: A low-carbohydrate intake (≦40%) was associated with a lower all-cause mortality rate in people with prediabetes.

Association between dietary fat intake and mortality from all-causes, cardiovascular disease, and cancer: A systematic review and meta-analysis of prospective cohort studies.

BACKGROUND & AIMS: The association between dietary fat and mortality remains inconsistent, and recent results for the association between dietary saturated fat and chronic disease are controversial. To quantitatively assess this association, we conducted a meta-analysis of prospective cohort studies. METHODS: The PubMed and Web of Science were searched up to February 2020. A random effects model was used. RESULTS: Nineteen studies including 1,013,273participants and 195,515deaths were identified. Significant inverse associations between all-cause mortality and a 5% energy increment in intakes of total (RR = 0.99; 95% CI:0.98-1.00), monounsaturated (RR = 0.98; 95% CI:0.97-0.99), and polyunsaturated fat (RR = 0.93; 95% CI:0.89-0.97) were found. A 5% increase in energy from polyunsaturated fat was associated with 5% (RR = 0.95; 95% CI:0.91-0.98) and 4% (RR = 0.96; 95% CI:0.94-0.99) lower mortality from CVD and cancer, respectively. A 1% energy increment in dietary trans-fat was associated with 6% higher risk of mortality from all-causes (RR = 1.06; 95% CI:1.01-1.10) and CVD (RR = 1.06; 95% CI:1.02-1.11). We found a non-linear association between dietary saturated fat and all-cause mortality showing a significant increased risk up to 11% of energy from saturated fat intake. The risk of cancer mortality increased by 4% for every 5% increase in energy from saturated fat (RR = 1.04; 95% CI:1.02-1.06). CONCLUSIONS: Diets high in saturated fat were associated with higher mortality from all-causes, CVD, and cancer, whereas diets high in polyunsaturated fat were associated with lower mortality from all-causes, CVD, and cancer. Diets high in trans-fat were associated with higher mortality from all-causes and CVD. Diets high in monounsaturated fat were associated with lower all-cause mortality.