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大家好，祝大家周末愉快。 欢迎大家收看本周的科研新鲜事。 不知道大家平时喜欢喝什么饮品呢？ 小编我最喜欢的就是牛奶了，特别是温热的，喝进嘴里有一种非常温暖的香甜感。由其是最近入秋了，天气渐渐的凉了下来，买上一大袋奶粉，睡前喝一杯，睡觉的时候都是暖和的。 但是，家人总是时不时会告诫我说，少喝点啦，牛奶凉寒，对身体不好。 学医的，都特别讲究证据。多年潜伏，终于被小编等到了。 9 月 11 日《柳叶刀》上刊登了一篇重量级证据：《Association of dairy intake with cardiovascular disease andmortality in 21 countries from five continents (PURE): a prospective cohortstudy》（《涉及五大洲的21个国家的乳制品摄入量与心血管疾病和死亡率的关系（PURE）：一项前瞻性队列研究》）。 看到这个题目的第一眼，就有一种终于等到你的感觉。 全世界范围内，心血管疾病都备受医务工作人员的关注。本研究共纳入了 21 个国家，超过 13 万位研究对象。这些研究对象多来源于心血管疾病高发的国家，其中也包含了中国。 研究相关的乳制品包括牛奶、奶酪和酸奶。研究人员将这些食物又分为全脂和低脂乳制品。该研究中，设定了一份标准份量的乳制品：一杯牛奶（244 克）、一杯酸奶（244 克）、一片奶酪（15 克）和一茶匙黄油（5 克）； 根据乳制品摄入量，对参与者分为 4 组：无摄入（28,674 人）、每天少于1 份（5551 人）、每天 1-2 份（24,423 人）、每天超过 2 份（27,636 人）。 研究发现高乳制品摄入组（平均每天 3.2 份）的死亡率、非心血管疾病死亡率等指标风险较低。而且，全脂和低脂乳制品相比，全脂乳制品摄入量较高者与更低的总死亡率（3.3% 和 4.4%）和主要的心血管疾病（3.7% 和 5.0%）的发生率相关。 所以总体而言，多喝牛奶，多摄入乳制品对身体也是有好处的，如果担心太过寒凉，不如像小编一样把牛奶加热了再喝？而且，在买牛奶的时候也没有必要非要买低脂和脱脂的，全脂的牛奶效果就不错，而且经鉴定，口感也会更好一点呢。 当然了，目前还需要进一步的研究明确乳制品可以降低心血管疾病发病率的具体的有关机制。不过，至少下次再有人阻止和牛奶的时候，就可以把这篇文章拿出来，和对方认真地探讨一下啦。 最后补充一句，不要贪杯哦。还有乳糖不耐受的朋友们，不要灰心，总会找到适合你们的食品的。 以下是该研究的摘要。 Background Dietary guidelines recommend minimising consumption of whole-fat dairy products, as they are a source of saturated fats and presumed to adversely affect blood lipids and increase cardiovascular disease and mortality. Evidence for this contention is sparse and few data for the effects of dairy consumption on health are available from low-income and middle-income countries. Therefore, we aimed to assess the associations between total dairy and specific types of dairy products with mortality and major cardiovascular disease.Methods The Prospective Urban Rural Epidemiology (PURE) study is a large multinational cohort study of individuals aged 35–70 years enrolled from 21 countries in five continents. Dietary intakes of dairy products for 136 384 individuals were recorded using country-specific validated food frequency questionnaires. Dairy products comprised milk, yoghurt, and cheese. We further grouped these foods into whole-fat and low-fat dairy. The primary outcome was the composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure). Hazard ratios (HRs) were calculated using multivariable Cox frailty models with random intercepts to account for clustering of participants by centre.Findings Between Jan 1, 2003, and July 14, 2018, we recorded 10 567 composite events (deaths [n=6796] or major cardiovascular events [n=5855]) during the 9.1 years of follow-up. Higher intake of total dairy (>2 servings per day compared with no intake) was associated with a lower risk of the composite outcome (HR 0.84, 95% CI 0.75–0.94; Ptrend=0.0004), total mortality (0.83, 0.72–0.96; Ptrend=0.0052), non-cardiovascular mortality (0.86, 0.72–1.02; Ptrend=0.046), cardiovascular mortality (0.77, 0.58–1.01; Ptrend=0.029), major cardiovascular disease (0.78, 0.67–0.90; Ptrend=0.0001), and stroke (0.66, 0.53–0.82; p trend=0.0003). No significant association with myocardial infarction was observed (HR 0.89, 95% CI 0.71–1.11; Ptrend=0.163).Higher intake (>1 serving vs no intake) of milk (HR 0.90, 95% CI 0.82–0.99; Ptrend=0.0529) and yogurt (0.86, 0.75–0.99; Ptrend=0.0051) was associated with lower risk of the composite outcome, whereas cheese intake was not significantly associated with the composite outcome (0.88, 0.76–1.02; Ptrend=0.1399). Butter intake was low and was not significantly associated with clinical outcomes (HR 1.09, 95% CI 0.90–1.33; Ptrend=0.4113).Interpretation Dairy consumption was associated with lower risk of mortality and major cardiovascular disease events in a diverse multinational cohort.
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