Modelled replacement of meats by dairy products and incident coronary heart disease: Evidence from the UK Biobank Study

There is uncertainty about the impact of replacing meats by dairy products (milk, yogurt, cheese) on the risk of coronary heart disease (CHD) (1,2) . Our objective was to examine the modelled replacement of red meat (unprocessed), processed meat, and poultry meat by milk, yogurt, and cheese in relation to CHD incidence in the UK adult population. Prospective longitudinal data were used of 117,216 participants in the UK Biobank Study, who were free of CHD at entry, had completed at least two 24hr dietary assessments and had complete covariate data. We modelled the replacement of 1 serving of red meat (unprocessed) (100 g/d) or processed meat (50 g/d) or poultry meat (100 g/d) by 1 serving of milk (200 g/d), yogurt (120 g/d) and cheese (30 g/d). These portion sizes were chosen based on previously reported portion sizes (3) . Information on the incident cases of non-fatal or fatal CHD events were obtained from hospital inpatient admissions and death registries. The hazard ratios (HR) and 95% confidence intervals (CI) were derived from Cox regression models and multivariable adjustments included sociodemographic, lifestyle, family history, total energy, dietary factors, and BMI. In our study population, 57% were female. The mean ± SD was 56 ± 7.8 years for age and 26.6 ± 4.6 kg/m 2 for BMI. During a median follow-up of 11 years, a total of 7060 cases of incident CHD were found. There was a lower risk of CHD for the modelled replacement of 1 serving of red meat (unprocessed) by 1 serving of cheese (HR: 0.90; 95% CI: 0.84, 0.97), but not by milk (0.93; 0.87, 1.00) or yogurt (0.94; 0.87, 1.02). Similarly, replacement of 1 serving of poultry meat by 1 serving of cheese was associated with lower risk of CHD (0.92; 0.85, 0.98) and no significant associations were observed with replacement by milk (0.97; 0.90, 1.04) or yogurt (0.98; 0.90, 1.05). Replacing 1 serving of processed meat by 1 serving of milk (0.92; 0.87, 0.97), yogurt (0.93; 0.87, 0.99) or cheese (0.87; 0.82, 0.92) was associated with lower CHD incidence. Our study findings support current recommendations for CVD prevention of limiting intake of meats, especially processed meat. Data suggest benefits of dairy foods, in comparison with meats, for reducing the risk of CHD. These findings should be replicated in other cohorts with different intake ranges.