WASHINGTON: Consumption of fermented dairy foods was associated with lower risks of all-cause and cardiovascular mortality among US adults in a recent observational study published in Scientific Reports. However, the analysis found that the association was not statistically significant at intakes of around 150 grams per day or more.
Researchers analyzed data from 37,366 adults participating in 10 cycles of the US National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Participants were followed for a median of 9.4 years, through December 31, 2019.
The study found that people who reported consuming fermented dairy had an 18% lower adjusted hazard of all-cause mortality and a 20% lower adjusted hazard of cardiovascular mortality compared with those who reported no consumption.
Association Was Strongest Below About 150 Grams a Day
The researchers used restricted cubic spline and segmented regression analyses to examine the relationship between fermented dairy intake and mortality.
The results indicated a J-shaped dose-response pattern. Intake below approximately 150 grams per day was associated with lower all-cause and cardiovascular mortality risk, with the segmented analysis indicating that higher intake within this range remained associated with lower mortality.
At 150 grams per day or more, however, the researchers did not detect a statistically significant association with either outcome.
The study did not establish a specific amount of fermented dairy that should be consumed for health benefits.
More Than 5,600 Deaths Recorded During Follow-Up
During follow-up, 5,646 participants died, including 1,791 cardiovascular deaths.
Among fermented-dairy consumers, observed all-cause mortality was 12.7%, compared with 18.1% among non-consumers. Cardiovascular mortality was 3.9% among consumers, compared with 5.9% among non-consumers.
After adjustment for a range of factors, including age, sex, race, education, economic status, physical activity, smoking, alcohol consumption, comorbidities and BMI, the associations remained statistically significant.
However, the two groups also differed in several baseline characteristics. Fermented-dairy consumers were more likely to be women, married or living with a partner and more physically active, and they had lower reported prevalences of hypertension, diabetes, coronary heart disease and stroke.
These differences are important when interpreting findings from an observational study.
Study Used Dietary Recall Data
Fermented dairy consumption was assessed using 24-hour dietary recalls. The earlier NHANES cycles used one dietary recall, while later cycles used the average of two recalls conducted several days apart.
The analysis included products classified as fermented dairy foods, including cheese, yogurt, sour cream and buttermilk.
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The researchers also conducted subgroup and sensitivity analyses, including adjustments for total energy intake, and reported broadly comparable associations.
Possible Biological Mechanisms
The authors noted several possible mechanisms that could contribute to the observed associations.
Fermentation can alter the nutritional and biological characteristics of dairy products and may generate bioactive peptides with antioxidant or antihypertensive properties. Fermented products can also contain microorganisms such as Lactobacillus and Bifidobacterium, while fermentation-related metabolites, including short-chain fatty acids and polyamines, have been investigated for potential effects on inflammation and metabolic health.
Fermented dairy foods also provide nutrients such as protein, calcium, phosphorus and vitamins B2 and B12.
However, these mechanisms were not directly tested in the NHANES mortality analysis. Therefore, they should be considered possible explanations rather than demonstrated reasons for the observed mortality associations.
Observational Findings Do Not Establish Causation
The study provides population-level evidence of an association between reported fermented dairy consumption and mortality outcomes, but it cannot establish that consuming fermented dairy itself reduces the risk of death.
Dietary intake was based on dietary recalls, and observational analyses can be affected by residual confounding and other differences between consumers and non-consumers.
The authors therefore interpret the findings as an association rather than evidence of a causal effect.
Dairy Industry Takeaway
The findings add to growing research interest in fermented dairy products and their relationship with long-term health. For the dairy sector, the study highlights the potential research and communication value of fermented products such as yogurt, cheese and cultured dairy foods.
At the same time, the results should not be presented as proof that fermented dairy products extend lifespan or that consuming less than 150 grams per day is a clinically established recommendation.
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