Intake of dairy foods and risk of Parkinson disease
Abstract
Objective:
To prospectively examine the association between commonly consumed dairy products and the risk of Parkinson disease (PD) in women and men.
Methods:
Analyses were based on data from 2 large prospective cohort studies, the Nurses' Health Study (n = 80,736) and the Health Professionals Follow-up Study (n = 48,610), with a total of 26 and 24 years of follow-up, respectively. Both US-based studies were conducted via mailed biennial questionnaires. Dietary intake was assessed with food frequency questionnaires administered repeatedly over the follow-up period. Incident cases of PD (n = 1,036) were identified via questionnaires and subsequently confirmed by reviewing medical records. We also conducted a meta-analysis to combine our study with 3 previously published prospective studies on total milk intake and PD risk and 1 study on total dairy intake and PD risk.
Results:
While total dairy intake was not significantly associated with PD risk in our cohorts, intake of low-fat dairy foods was associated with PD risk. The pooled, multivariable-adjusted hazard ratio (HR) comparing people who consumed at least 3 servings of low-fat dairy per day to those who consumed none was 1.34 (95% confidence interval [CI] 1.01–1.79, p trend = 0.04). This association appeared to be driven by an increased risk of PD associated with skim and low-fat milk (HR 1.39, 95% CI 1.12–1.73, p trend <0.01). Results were similar in women and men (p for heterogeneity >0.05). In the meta-analysis, the pooled relative risk comparing extreme categories of total milk intake was 1.56 (95% CI 1.30–1.88), and the association between total dairy and PD became significant (HR 1.27, 95% CI 1.04–1.55).
Conclusions:
Frequent consumption of dairy products appears to be associated with a modest increased risk of PD in women and men.
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© 2017 American Academy of Neurology.
Publication History
Received: October 3, 2016
Accepted: February 27, 2017
Published online: June 8, 2017
Published in print: July 4, 2017
Disclosure
K. Hughes reports no disclosures relevant to the manuscript. X. Gao has served on committees of the Sleep Research Society, American Academy of Sleep Medicine, and Parkinson Study Group and received funding from the NIH/National Institute of Neurological Disorders and Stroke. He serves on the editorial boards of Advances in Nutrition and Journal of Human Genetics. I. Kim reports no disclosures relevant to the manuscript. M. Wang receives research support from the National Institute of Allergy and Infectious Diseases, National Institute of Environmental Health Sciences, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Arthritis and Musculoskeletal and Skin Diseases, American Institute for Cancer Research, and the Breast Cancer Research Foundation. M. Weisskopf serves on the scientific advisory board for the Kaiser Permanente Research Biobank and the National Institute of Environmental Health Sciences Gulf Long-term Follow-up Study. He has been funded by NIH grants R01ES 019188, R01ES024165, R21ES024700, R21ES019982, and R56NS082105. He has also received research support from the Muscular Dystrophy Association. He serves as an associate editor for Environmental Health Perspectives and the co–editor in chief of Current Environmental Health Reports. M. Schwarzschild was a consultant for Biotie Therapies. He serves on the Scientific Advisory Board of CBD Solutions. He is funded by NIH grants NS090259 and NS090246, Department of Defense grants W81XWH-11-1-0150 and W81XWH-14-1-0131, the Parkinson's Disease Foundation, Target ALS, and the Michael J. Fox Foundation for Parkinson's Research. A. Ascherio receives research grants from the NIH, the National Multiple Sclerosis Society, and the Department of Defense and served on a medical advisory board for Bayer HealthCare. Go to Neurology.org for full disclosures.
Study Funding
This study was supported by NIH grants UM1 CA186107, UM1 CA167552, and R01 NS061858 and by Department of Defense grant W81XWH-14-0131.
Authors
Author Contributions
Drafting/revising the manuscript (K.C.H., X.G., I.Y.K., M.W., M.G.W., M.A.S., A.A.), study concept/design (A.A., X.G., M.A.S.), analysis or interpretation of data (K.C.H., X.G., M.W., M.G.W., M.A.S., A.A.), statistical analysis (K.C.H.), acquisition of data (X.G., M.A.S., A.A.), study supervision (A.A.), and obtaining funding (A.A.).
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The relation between different types of dietary fats, including n-3 and n-6 fatty acids, and risk of Parkinson disease in these cohorts [1] was previously reported, [2] albeit based on a shorter follow-up and thus a smaller number of incident cases (n=359). No inverse relation was found between intakes of n-3 fatty acids and Parkinson risk. [1]
1. Hughes KC, Gao X, Kim IY, et al. Intake of dairy foods and risk of Parkinson disease. Neurology 2017;89:46-52.
2. Chen H, Zhang SM, Hernan MA, Willett WC, Ascherio A. Dietary intakes of fat and risk of Parkinson's disease. Am J Epidemiol 2003;157:1007-1014.
For disclosures, please contact the editorial office at [email protected].
While frequent consumption of dairy products may have modest increased risk for development of Parkinson disease (PD), as reported by Hughes et al, [1] whole milk could possibly have some protective effect against development of PD. It may depend upon the fatty-acid or omega-3 and omega-6 constituents of the butterfat content.
While both omega-3 and omega-6 fatty acids are essential, they must be in the proper proportion for optimal nutrition. Western diets typically contain a ratio of 10 to 15 times more omega-6 fatty acids as omega-3 fatty acids, while the optimal ratio is estimated to be closer to 2:3. [2]
Cattle from organic farms consuming more grass and legumes produce milk with higher omega-3 fatty acid concentration and fewer saturated fats while grain-fed dairy cattle have predominantly omega-6 fatty acids in their milk. [3]
An omega-3 fatty acid (docosahexaenoic acid) appears to have a protective effect on dopaminergic neurons against cell death in experimental animals treated with MPTP (1- methyl-4-phenyl-1,2,3,6-tetrahydropyridine), a laboratory model of PD. [4]
Rather than the overall effect of dairy products on development of PD, the amount of essential fatty acids with the ratio of omega-3 to omega-6 fatty acids in the overall diet may be the essential component to investigate with reference to risk of PD development.
1. Hughes KC, Gao X, Kim IY, et al. Intake of dairy foods and risk of Parkinson disease. Neurology 2017;89:46-52.
2. Benbrook CM, Butler G, Latif MA, Leifert C, Davis DR. Organic production enhances milk nutritional quality by shifting fatty acid composition: a United States- wide, 18-month study. PLoS One 2013;8:e82429.
3. Newmark LM. Getting More Omega-3 Fatty Acids from Milk. In: SPLASH! milk science update: April 2014 issue [online]. Available at:http://milkgenomics.org/article/getting-omega-3-fatty-acids-milk/. Accessed August 9, 2017.
4. Hacioglu G, Seval-Celik Y, Tanriover G, et al. Docosahexaenoic acid provides protective mechanism in bilaterally MPTP-lesioned rat model of Parkinson's disease. Folia Histochem Cytobiol 2012;50:228-238.
For disclosures, please contact the editorial office at [email protected].