Introduction
Methodology
The E3N cohort study
Dietary data and dairy product assessment
Hypertension assessment
Covariate assessment
Statistical analysis
Results
Median weekly dairy servings (range) | Q1 (N = 8106) 7.1 (< 9.1) | Q2 (N = 8105) 11.1 (9.1–12.6) | Q3 (N = 8105) 14.3 (12.6–16.1) | Q4 (N = 8105) 18.3 (16.1–21.0) | Q5 (N = 8105) 25.5 (> 21.0) |
---|---|---|---|---|---|
Risk factors (mean (sd)) | |||||
Age (years) | 51.8 (6.3) | 51.7 (6.3) | 51.6 (6.3) | 51.4 (6.1) | 51.5 (6.1) |
Family history of hypertension (%) | 28.8 | 29.0 | 28.3 | 29.7 | 27.7 |
Body mass index | 22.0 (2.7) | 22.1 (2.6) | 22.2 (2.7) | 22.4 (2.7) | 22.5 (2.8) |
Diabetes (%) | 0.4 | 0.35 | 0.6 | 0.4 | 0.5 |
Hypercholesterolemia (%) | 5.2 | 4.8 | 5.0 | 4.1 | 4.3 |
Smoking status (%) | |||||
Never | 51.1 | 50.9 | 52.6 | 52.6 | 52.4 |
Former | 32.0 | 34.3 | 34.5 | 34.2 | 34.1 |
Current | 16.9 | 14.8 | 12.9 | 13.2 | 13.5 |
Physical activity (Mets/week) | 53.1 (30.0) | 54.0 (29.4) | 54.8 (29.6) | 54.7 (29.9) | 55.3 (30.0) |
With high school diploma (%) | 90.0 | 90.6 | 90.88 | 90.2 | 89.6 |
Dietary Factors (median (sd)) | |||||
Energy without alcohol (kcal/d) | 1803.5 (453.3) | 1953.3 (458.2) | 2071.5 (474.7) | 2196.4 (503.8) | 2432.5 (557.7) |
Alcohol (g/d) | 7.4 (14.8) | 7.2 (13.8) | 7.2 (13.0) | 6.9 (13.2) | 6.2 (13.1) |
Processed meat (g/d) | 20.3 (18.2) | 22.7 (18.6) | 23.7 (19.0) | 24.6 (20.4) | 25.7 (23.2) |
Fruits and vegetables (g/d) | 560.5 (256.2) | 599.2 (246.1) | 625.5 (259.2) | 648.9 (265.5) | 681.3 (300.4) |
Sodium (mg/d) | 2275.3 (755.7) | 2531.5 (750.2) | 2716.7 (798.4) | 2926.0 (844.4) | 3311.1 (959.7) |
Potassium (mg/d) | 3257.8 (884.0) | 3478.8 (881.3) | 3691.9 (895.1) | 3915.6 (951.0) | 4342.2 (1129.3) |
Magnesium (mg/d) | 380.6 (133.3) | 400.4 (130.3) | 417.1 (133.6) | 434.3 (139.1) | 468.8 (153.3) |
Milk (servings/week) | 0 (1.0) | 0 (1.3) | 1.0 (1.4) | 3.0 (1.6) | 6.5 (1.9) |
Cheese (servings/week) | 3.4 (2.2) | 5.2 (2.7) | 6.7 (3.4) | 8.4 (4.3) | 12.0 (7.4) |
Yoghurt (servings/week) | 1.4 (1.8) | 2.9 (2.5) | 3.6 (2.8) | 4.3 (3.1) | 5.0 (4.1) |
Cottage cheese (servings/week) | 0.3 (1.0) | 0.6 (1.3) | 0.7 (1.4) | 0.8 (1.6) | 1.0 (1.9) |
Mediterranean diet score | −0.12 (0.85) | −0.06 (0.88) | −0.01 (0.89) | 0.02 (0.93) | 0.08 (1.00) |
Dairy products (servings/week) | Cases | Person-years | M1 | M2 | M3 | |||
---|---|---|---|---|---|---|---|---|
HR [95% CI] | p | HR [95% CI] | p | HR [95% CI] | p | |||
Total dairy | ||||||||
Q1 (< 9.1) | 1858 | 98,273 | Reference | 0.38 | Reference | 0.41 | Reference | 0.86 |
Q2 (9.1–12.6) | 1820 | 99,380 | 0.97 [0.90; 1.03] | 0.97 [0.90; 1.03] | 0.97 [0.91; 1.03] | |||
Q3 (12.6–16.1) | 1890 | 98,609 | 1.01 [0.87; 1.04] | 0.99 [0.93; 1.06] | 1.00 [0.94; 1.07] | |||
Q4 (16.1–21.0) | 1903 | 98,791 | 1.02 [0.85; 1.07] | 0.99 [0.83; 1.06] | 1.00 [0.94; 1.07] | |||
Q5 (> 21.0) | 1868 | 98,257 | 0.99 [0.93: 1.07] | 0.96 [0.89; 1.03] | 0.97 [0.91; 1.04] | |||
Milk | ||||||||
Q1 (0) | 4042 | 210,401 | Reference | 0.54 | Reference | 0.66 | Reference | 0.23 |
Q2 (0–2.1) | 1630 | 91,719 | 0.93 [0.88; 0.98] | 0.93 [0.87; 0.99] | 0.95 [0.88; 1.03] | |||
Q3 (2.1–4.2) | 1861 | 97,132 | 1.02 [0.96; 1.09] | 0.98 [0.92; 1.05] | 0.94 [0.90; 0.99] | |||
Q4 (> 4.2) | 1807 | 94,057 | 0.99 [0.91; 1.07] | 1.01 [0.94; 1.08] | 0.96 [0.61; 1.01] | |||
Yogurt | ||||||||
Q1 (0) | 1206 | 57,794 | Reference | 0.04 | Reference | 0.10 | Reference | 0.09 |
Q2 (0–2.9) | 3078 | 169,861 | 0.92 [0.85; 0.98] | 0.93 [0.87; 1.00] | 0.99 [0.94; 1.05] | |||
Q3 (2.9–5.0) | 2550 | 137,645 | 0.94 [0.87; 1.01] | 0.95 [0.88; 1.02] | 0.99 [0.94; 1.05] | |||
Q4 (> 5.0) | 2506 | 128,009 | 1.02 [0.94; 1.10] | 1.02 [0.94; 1.10] | 1.06 [1.00; 1.12] | |||
Cottage cheese | ||||||||
Q1 (0) | 2463 | 131,350 | Reference | 0.72 | Reference | 0.38 | Reference | 0.23 |
Q2 (0–0.6) | 2256 | 119,169 | 1.05 [0.99; 1.11] | 1.03 [0.97; 1.10] | 1.03 [0.97; 1.09] | |||
Q3 (0.6–1.6) | 2237 | 120,049 | 1.03 [0.97; 1.09] | 1.02 [0.96; 1.08] | 1.05 [0.99; 1.11] | |||
Q4 (> 1.6) | 2384 | 122,742 | 1.03 [0.97; 1.10] | 1.00 [0.94; 1.06] | 0.98 [0.92; 1.05] | |||
Cheese | ||||||||
Q1 (< 3.7) | 2300 | 122,557 | Reference | 0.53 | Reference | 0.57 | Reference | 0.51 |
Q2 (3.7–6.4) | 2344 | 123,830 | 1.04 [0.98; 1.10] | 1.05 [0.99; 1.11] | 1.02 [0.96; 1.08] | |||
Q3 (6.4–9.7) | 2404 | 123,130 | 1.01 [1.01; 1.16] | 1.09 [1.02; 1.17] | 1.05 [0.99; 1.11] | |||
Q4 (> 9.7) | 2292 | 123,792 | 0.94 [0.94; 1.12] | 1.03 [0.95; 1.14] | 0.98 [0.92; 1.05] |
Cheeses (servings/week) | Cases | Person-years | M1 | M2 | M3 | |||
---|---|---|---|---|---|---|---|---|
HR [95% CI] | p | HR [95% CI] | p | HR [95% CI] | p | |||
Soft cheese | ||||||||
Q1 (< 0.4) | 2330 | 122,759 | Reference | 0.54 | Reference | 0.68 | Reference | 0.65 |
Q2 (0.4–0.8) | 2319 | 123,613 | 1.01 [0.94; 1.08] | 0.98 [0.91; 1.05] | 0.98 [0.92; 1.05] | |||
Q3 (0.8–1.4) | 2372 | 122,459 | 1.07 [0.99; 1.15] | 1.04 [0.97; 1.12] | 1.03 [0.96; 1.11] | |||
Q4 (> 1.4) | 2319 | 124,478 | 1.04 [0.96; 1.12] | 1.00 [0.92; 1.07] | 0.98 [0.91; 1.06] | |||
Processed cheese | ||||||||
Q1 (0) | 3982 | 223,391 | Reference | < 0.0001 | Reference | < 0.0001 | Reference | < 0.0001 |
Q2 (0–0.3) | 1769 | 91,166 | 1.07 [1.01; 1.14] | 1.08 [1.01; 1.15] | 1.06 [0.96; 1.18] | |||
Q3 (0.3–0.6) | 1760 | 88,328 | 1.12 [1.06; 1.14] | 1.11 [1.05; 1.18] | 1.10 [1.04; 1.16] | |||
Q4 (> 0.6) | 1829 | 90,364 | 1.14 [1.06; 1.19] | 1.12 [1.06; 1.19] | 1.12 [1.06; 1.18] | |||
Blue cheese | ||||||||
Q1 (< 0.2) | 2371 | 124,255 | Reference | 0.66 | Reference | 0.35 | Reference | 0.58 |
Q2 (0.2–0.7) | 2290 | 122,223 | 0.97 [0.91; 1.04] | 0.98 [0.91; 1.04] | 0.96 [0.90; 1.03] | |||
Q3 (0.7–1.4) | 2367 | 124,194 | 1.01 [0.94; 1.08] | 1.01 [0.94; 1.08] | 0.99 [0.94; 1.06] | |||
Q4 (> 1.4) | 2312 | 122,637 | 1.02 [0.95; 1.09] | 1.03 [0.96; 1.10] | 1.01 [0.96; 1.09] | |||
Semi-hard cheese | ||||||||
Q1 (< 0.6) | 2385 | 123,455 | Reference | 0.11 | Reference | 0.21 | Reference | 0.19 |
Q2 (0.6–1.3) | 2373 | 122,593 | 0.99 [0.91; 1.06] | 1.00 [0.93; 1.07] | 1.00 [0.93; 1.06] | |||
Q3 (1.3–2.4) | 2273 | 123,473 | 0.91 [0.85; 0.98] | 0.92 [0.85; 0.98] | 0.91 [0.90; 0.98] | |||
Q4 (> 2.4) | 2309 | 123,789 | 0.94 [0.88; 1.02] | 0.95 [0.89; 1.03] | 0.95 [0.89; 1.03] | |||
Hard cheese | ||||||||
Q1 (< 1.4) | 2314 | 122,959 | Reference | 0.83 | Reference | 0.97 | Reference | 0.64 |
Q2 (1.4–2.5) | 2338 | 123,572 | 1.05 [0.97; 1.11] | 1.05 [0.98; 1.12] | 1.04 [0.98; 1.11] | |||
Q3 (2.5–4.1) | 2431 | 122,831 | 1.11 [1.04; 1.20] | 1.11 [1.04; 1.19] | 1.10 [1.02; 1.18] | |||
Q4 (> 4.1) | 2257 | 123,948 | 1.00 [0.93; 1.10] | 1.01 [0.94; 1.10] | 1.00 [0.92; 1.08] | |||
Goat cheese | ||||||||
Q1 (< 0.1) | 2407 | 123,340 | Reference | 0.07 | Reference | 0.20 | Reference | 0.34 |
Q2 (0.1–0.2) | 2390 | 123,660 | 0.97 [0.90; 1.04] | 1.01 [0.94; 1.08] | 1.01 [0.94; 1.08] | |||
Q3 (0.2–0.4) | 2235 | 122,097 | 0.97 [0.89; 0.95] | 0.93 [0.87; 0.99] | 0.93 [0.87; 1.00] | |||
Q4 (> 0.4) | 2308 | 124,213 | 0.97 [0.86; 1.08] | 0.96 [0.90; 1.03] | 0.98 [0.91; 1.05] |