Fat content determines the association between milk consumption and cardiovascular disease: Analysis of the NHANES from 2003-2018

Background: the relationship between milk fat content and cardiovascular disease (CVD) remains controversial. This research aimed to examine the relationship between whole (3.5 % fat), reduced-fat (2 % fat), low-fat (1 % fat), and skimmed milk (< 0.5 % fat) and various CVDs. Methods: this cross-sectional analysis was based on data gathered from the 2003-2018 National Health and Nutrition Examination Survey (NHANES), which enrolled 18,282 participants (9,017 men and 9,265 women). Participants were organized into four groups based on the type of milk consumed, as reported in the Diet Behavior and Nutrition Questionnaire. Coronary heart disease (CHD), heart failure (HF), and stroke were assessed via standard questionnaires. Weighted logistic regression models with multivariable adjustment were used to assess the association between varying levels of milk fat content and CVD, adjusting for a range of covariates, including dietary data from two 24-hour dietary recalls. Additionally, interaction, subgroup, and sensitivity analyses were conducted to assess effect modification and test result robustness. Results: after adjusting for confounders, the consumption of whole milk was linked to a reduced prevalence of CHD (odds ratio [OR] = 0.582, 95 % confidence interval [CI] = 0.418-0.810, p = 0.002) than skimmed milk. Furthermore, whole milk consumption was not associated with HF (OR = 1.518, 95 % CI = 0.939-2.455, p = 0.09); however, it was associated with an increased prevalence of stroke (OR = 1.586, 95 % CI = 1.023-2.457, p = 0.039). Subgroup and sensitivity analyses confirmed the reproducibility of our findings. Conclusions: our results suggest that consuming whole milk may be linked to reduced CHD but elevated stroke prevalence compared to skimmed milk.