Milk consumption corresponding to ≥3 glasses of milk a day (mean 680g/day) compared with <1 glass a day (mean 60g/day), was associated with a hazard ratio (HR) of total mortality of 1.93 (95% CI, 1.80 to 2.06) in women, with approximately similar estimates for cardiovascular mortality and somewhat lower for cancer mortality (1.44, 1.23 to 1.69). For women who consumed ≥3 glasses of milk a day, HR for any fracture was 1.16 (1.08 to 1.25) and for hip fracture , 1.60 (1.39 to 1.84). In an analysis based on a single exposure assessment, men in the Cohort of Swedish Men also had a higher rate of death with higher milk consumption. However, the excess risk was less pronounced than in women, with an adjusted HR of 1.10 (1.03 to 1.17) for ≥3 glasses of milk a day (mean 830g/day) compared with <1 glass a day (mean 50g/day) and was mainly associated with an increased rate of cardiovascular death. No reduction in all fractures or hip fracture rates with increasing milk intake was observed in men.
An editorial notes that the potential harms of milk with an interesting inner mechanism involving D-galactose, is consistent with ecological evidence and animal studies. However it reiterates that these findings should be interpreted cautiously as they are based on observational not experimental evidence, potentially reflecting correlation not causation. As milk features in many dietary guidelines and both hip fractures and cardiovascular disease are relatively common among older people, the editorial suggests that improving the evidence base for dietary recommendations could have substantial benefits for everyone.