Systematic Literature Review of Dairy Consumption and Cardiometabolic Outcomes

Background: Current evidence is mixed regarding associations between dairy consumption and cardiometabolic outcomes, and limited synthesis has been conducted specifically regarding the type of dairy fat (e.g. full-fat, low-fat, no fat). Given the importance of nutrition for long-term health, we conducted a systematic literature review (SLR) to better understand associations between cardiometabolic outcomes and dairy consumption by type of dairy fat. Methods: Literature searches were conducted in February 2025 to identify published randomized controlled trials, as well as cohort and case-control studies that included individuals older than 2 years of age and without dairy sensitivities. Studies of dairy (including milk, cheese, or yogurt) that specified the type of dairy fat and reported outcomes including cardiovascular disease (CVD), coronary heart disease (CHD), stroke, myocardial infarction (MI), hypertension, cholesterol, metabolic syndrome, and body mass index (BMI) were included. Results: The SLR identified 137 studies specifying the fat type of dairy for inclusion; the majority were prospective cohorts (n=89, 65%) and conducted outside of the United States (US) (n=92, 67%). Adults were examined in 120 (88%) studies. Overall, the studies with significant associations were not consistent in direction of effect by type of dairy fat (no, low, or full-fat), specific dairy product (all dairy, milk, cheese, or yogurt), or specific outcome. For both CVD and CHD, higher quantities of low-fat dairy (but not high-fat or non-fat) trended in the direction of a protective effect, but risk estimates were heterogeneous across studies and often imprecise. Conclusions: The results of this SLR indicate the potential for dairy exposure, and specifically the type of dairy fat, to impact cardiovascular health across global populations. However, interpretation is difficult given the heterogeneity in populations, outcome measures, dairy assessments, and study design and analysis across studies.