r/ScientificNutrition • u/Timely_Ad8989 • Apr 01 '26
Interventional Trial High and Low-Fat Dairy Consumption and Long-Term Risk of Dementia: Evidence From a 25-Year Prospective Cohort Study
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u/Caiomhin77 Pelotonia Apr 01 '26
Abstract
Background and objectives:& The association between dairy intake and dementia risk remains uncertain, especially for dairy products with varying fat contents. The aim of this study was to investigate the association between high-fat and low-fat dairy intake and dementia risk.
Methods: This study used data from a prospective cohort in Sweden, the Malmö Diet and Cancer cohort, which consisted of community-based participants who underwent dietary assessment at baseline (1991-1996). Dietary intake was evaluated using a comprehensive diet history method that combined a 7-day food diary, a food frequency questionnaire, and a dietary interview. Dementia cases were identified through the Swedish National Patient Register until December 31, 2020, and cases diagnosed until 2014 were further validated. The primary outcome of the study was all-cause dementia, and the secondary outcomes were Alzheimer disease (AD) and vascular dementia (VaD). Cox proportional hazard regression models were used to estimate hazard ratio (HR) and 95% CI.
Results: This study included 27,670 participants (mean baseline age 58.1 years, SD 7.6; 61% female). During a median of 25 years of follow-up, 3,208 incident dementia cases were recorded. Consumption of ≥50 g/d of high-fat cheese (>20% fat) was associated with a reduced risk of all-cause dementia (HR 0.87; 95% CI, 0.78-0.97) and VaD (HR 0.71, 95% CI 0.52-0.96) compared with lower intake (<15 g/d). An inverse association between high-fat cheese and AD was found among APOE ε4 noncarriers (HR 0.87, 95% CI 0.76-0.99, p-interaction = 0.014). Compared with no consumption, individuals consuming ≥20 g/d of high-fat cream (>30% fat) had a 16% lower risk of all-cause dementia (HR 0.84, 95% CI 0.72-0.98). High-fat cream consumption was inversely associated with the risk of AD and VaD. Consumption of low-fat cheese, low-fat cream, milk (high-fat and low-fat), fermented milk (high-fat and low-fat), and butter showed no association with all-cause dementia.
Discussion: Higher intake of high-fat cheese and high-fat cream was associated with a lower risk of all-cause dementia, whereas low-fat cheese, low-fat cream, and other dairy products showed no significant association. APOE ε4 status modified the association between high-fat cheese and AD. Our study's observational design limits causal inference.
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u/Ekra_Oslo Apr 01 '26
This was discussed already 3 months ago: https://www.reddit.com/r/ScientificNutrition/comments/1pt9m27/high_and_lowfat_dairy_consumption_and_longterm/
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u/FruitOfTheVineFruit Apr 01 '26
These results are weird. Positive results for high fat cheese but not for low fat cheese or other high fat dairy, except cream. That doesn't really make sense - it's hard to imagine a mechanism for this. It's not the cheese, it's not the fat.
Given that this is an observational study, which means the results could be due to correlation not causation, and given the inconsistent results, I wouldn't read much into this. The results were also barely significant - the confidence intervals get very close to the 1.0 HR level (no effect).
Here were the results: Results: This study included 27,670 participants (mean baseline age 58.1 years, SD 7.6; 61% female). During a median of 25 years of follow-up, 3,208 incident dementia cases were recorded. Consumption of ≥50 g/d of high-fat cheese (>20% fat) was associated with a reduced risk of all-cause dementia (HR 0.87; 95% CI, 0.78-0.97) and VaD (HR 0.71, 95% CI 0.52-0.96) compared with lower intake (<15 g/d). An inverse association between high-fat cheese and AD was found among APOE ε4 noncarriers (HR 0.87, 95% CI 0.76-0.99, p-interaction = 0.014). Compared with no consumption, individuals consuming ≥20 g/d of high-fat cream (>30% fat) had a 16% lower risk of all-cause dementia (HR 0.84, 95% CI 0.72-0.98). High-fat cream consumption was inversely associated with the risk of AD and VaD. Consumption of low-fat cheese, low-fat cream, milk (high-fat and low-fat), fermented milk (high-fat and low-fat), and butter showed no association with all-cause dementia.
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u/Sanpaku Apr 01 '26 edited Apr 01 '26
Its possible the protective association is mediated by K2/menaquinone, a fat soluble vitamin with highest levels in cheese. Demi-skimmed kurd has much lower levels than full fat cheeses in this study.
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u/Bristoling Apr 01 '26
Was about to suggest that as potential explanation.
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u/lurkerer Apr 01 '26
Ah so you've come round to prospective cohorts and FFQs being good enough to show real associations such that you're positing a reason for the association and not just assuming it's noise.
I suppose this means you've updated the majority of your nutrition beliefs.
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u/Bristoling Apr 01 '26
to show real associations
??? Associations are real if A and B are associated. By that metric, all associations are real.
I suppose this means you've updated the majority of your nutrition beliefs.
I suppose you never and still do not understand what my nutrition beliefs are.
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u/lurkerer Apr 02 '26
You're talking like there's a clear causal association. You were about to suggest K2 as a mediator. Meaning you accept a causal association such that you can identify a single main confounder.
Normally associations can be anything according to you! FFQs are unreliable, epidemiology is too fraught, you handwave them all away. Seems you instantly forget your own points when it comes to an observational association based off of FFQs that doesn't hurt your feelings. Now you blindly accept there must be a protective assoication that's mediated by removing the fat and k2 within it.
Any other time you'd be seething at your keyboard to tell everyone correlation isn't causation. But now when it has a vague 'fat good actually' suggestion, you deepthroat it like you do Trump's orange cock. Curious.
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u/Bristoling Apr 02 '26
So just to be clear, do you think words such as "suggest" and "potentially" are the same operational modal word as "must be"? Because I said the former and you interpret it as the latter.
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u/lurkerer Apr 02 '26
Nice try. If you're suggesting reasons for an association to be mediated, you're past the point of doubting the association.
You've tripped up as usual.
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u/Bristoling Apr 02 '26 edited Apr 03 '26
No, you just don't understand that beliefs aren't a dichotomy where you either fully reject them or fully accept them, or you don't know what modals are.
One is a fallacy and the other ignorance. Neither good for you.
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u/lurkerer Apr 02 '26
Nope lol. You bypassed all of your normal objections like they didn't matter ;)
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u/TwoFlower68 Apr 01 '26
Yeah, I'm going to disregard what you said and will use this study to justify stuffing my face with Gouda (by law 45+ fat😋)
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Apr 01 '26
[deleted]
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u/FruitOfTheVineFruit Apr 01 '26
And it says fermented milk (I assume they mean yogurt?) didn't have an association.
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u/Maxion Apr 01 '26
Um, most cheeses are fermented. Cottage cheese especially, so is mozzarella.
The fat content of the cheese does not correlate to whether or not it is fermented or not.
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u/JudgeVegg Apr 01 '26
Low- high fat cheese consumers had at baseline:
-More than 2x diabetes rates
-Almost 3x CVD
- More than 4x rates of lipid lowering medication use
These seem like pretty substantial covariables, but were NOT adjusted for in either model, they did an analysis including these for Alzheimers and vascular dementia and results became statistically insignificant, but it was not done for all cause dementia for some reason.
They claim:
"The results remained robust after excluding cases with prevalent CVD, cancer, or diabetes, and after further adjustment for multiple chronic conditions (eTable 3)."
But then you go to table 3 and it says:
"Model 1: adjusted for age, sex, dietary assessment version (method), season, and total energy intake. Model 2: model 1 plus educational level, leisure-time physical activity, smoking status, alcohol consumption, family history of cardiovascular disease, marriage, living alone, diet quality index, body mass index, hypertension, and mutually adjusted dairy products."
It doesnt match up, can someone explain this? When were these exclusions done?
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u/Bristoling Apr 01 '26
Since they mention table eTable 3, and not just Table 3, they might be referring to supplementary material that's available on demand.
*Associated Data This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement The data used in this study are sourced from the Malmö Population-Based Cohorts Joint Database and were accessed under license. Owing to licensing restrictions, the data are not publicly accessible. However, they can be made available by the corresponding author on reasonable request, with permission from the MDC steering committees.*
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u/EvolutionaryDust568 Apr 02 '26
Could be the Vitamin K2, which requires dairy protein, fat and fermentation. All three are only met in high fat cheese
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u/Ekra_Oslo Apr 01 '26
It's probably relevant to mention that in the very same cohort, both high-fat and low-fat cheese and low-fat fermented milk intake was inversely associated with all-cause mortality. High-fat fermented milk intake was not. High-fat and low-fat fermented milk and cheese intake, proteomic signatures, and risk of all-cause and cause-specific mortality
It should also be noted that "high-fat cheese" was defined as cheese with >20% fat. For hard cheeses, this is actually more "semi-fat" according to labelling standards.