Milk and all-cause mortality or survival.

11 articles, providing information about 10 different cohorts were found providing information about total milk consumption in relation to total mortality, including 93,663 cases. In addition, data about survival was available from 1 additional cohort (Nube M. 1987).

Results: Significant protective effects were found in 3 cohorts (14, 19, 21), including 18,971 cases. Though the trend, but not the RR, was significant in one of these cohorts (14). No other associations were found of high vs low consumption.

Inclusion of intermediate levels of consumption:
Some protective effects were found at different intermediate levels of consumption. No (non) significantly increased risks were found at any level of consumption in any cohort.
Protective effects (RR) of total milk at any level of consumption were as follows:

  • Mann JI (1997) Significant at 284 ml/day.
  • Ness AR (2001) Significant at 190-757 ml/day.
  • Paganini-Hill A (2007) Nonsignificant at < 245 ml/day.
  • Iso H (2007) Significant at frequency of consumption ≥ 3 times/week among both men and women (not included in graphics).
  • van der Pols JC (2009) Significant at > 199 ml/day.

RRs for the association between milk consumption and all-cause mortality among men & women (ml/day):



Effect modification: Interactions with milk fat were as follows:

  • Whiteman D (1999) No difference in effect was found between whole milk and semiskimmed or skimmed milk.
  • Jamrozik K (2000) No difference in effect was found between full-fat and reduced-fat/skim milk.
  • Elwood PC (2005) No difference in effect was found between full fat milk and total milk.
  • Andersen LF (2006) A nonsignificantly increased risk (trend) of whole milk was found, while no association was found with skim/low-fat milk.

In only one out of four cohorts (Andersen 2006), a difference in effect was found between whole and (semi)skimmed milk. In addition, whole milk was (almost) the only type of milk consumed in 2 other cohorts (Fawzi W. 1994; van der Pols JC. 2009), and the RR's were < 1 in both cohorts.
The average effect for whole milk from all 4 cohorts providing an RR for the association (Fawzi W. 1994; Elwood PC. 2004; Andersen LF. 2006; van der Pols JC. 2009) gives an RR of 1.02.
No suggestion was found for possible effect modification by other confounders including gender, and continent.
Conclusion: No evidence was found for an association between high vs low milk consumption and all-cause mortality. The possibility of a protective effect at an intermediate level can not be excluded, but quantification of effects is difficult. No evidence was found for effect modification by milk fat or any other confounders.

Prospective studies of total milk and all-cause mortality:
AuthorCohort nameCasesRelative Risk (RR)
22) Bonthuis M (2010)No cohort name defined177HR = 0.93 (0.59-1.48; P = 0.78).
21) van der Pols JC (2009)The Boyd Orr Cohort1,464HR = 0.77 (0.61-0.97; P = 0.05).
19) Iso H (2007)The JACC Study8,935 men, and

6,222 women
Men: HR = 0.94 (0.89-0.98; P = 0.05).

Women: HR = 0.93 (0.88-0.99; P = < 0.05).
18) Paganini-Hill A (2007)The Leisure World Cohort Study11,386RR = 1.04 (0.98-1.10).
16) Elwood PC (2004)The Caerphilly Cohort811HR = 1.20 (0.80-1.80; P = 0.51).
14) Ness AR (2001)No cohort name defined2,350RR = 0.81 (0.61-1.09; P = 0.005).
6) Mann JI (1997)The Oxford Vegetarian Study383DRR = 87 (68-113).
5) Fawzi W (1994)No cohort name defined232RR = 0.87 (0.74-1.01).
3) Hirayama T (1990)No cohort name defined55,523RR = 0.98 (0.97-1.00).
1) Kahn HA (1984)The Adventist Health Study6,180OR = 0.98 (No 95% CI).
Total number of cases: 93,663Average RR = 0.97