This article was downloaded by: [George Mason University] On: 09 January 2015, At: 22:25 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of the American College of Nutrition Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uacn20
Optimal Dairy Intake Is Predicated on Total, Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort a
Lin-Yuan Huang MPH , Mark L. Wahlqvist MD DrPH
abd
c
, Yi-Chen Huang MPH & Meei-Shyuan Lee
abd
a
Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan b
School of Public Health, Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, REPUBLIC OF CHINA c
Click for updates
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, REPUBLIC OF CHINA d
Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, AUSTRALIA Published online: 31 Jul 2014.
To cite this article: Lin-Yuan Huang MPH, Mark L. Wahlqvist MD, Yi-Chen Huang MPH & Meei-Shyuan Lee DrPH (2014) Optimal Dairy Intake Is Predicated on Total, Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort, Journal of the American College of Nutrition, 33:6, 426-436, DOI: 10.1080/07315724.2013.875328 To link to this article: http://dx.doi.org/10.1080/07315724.2013.875328
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Original Research
Optimal Dairy Intake Is Predicated on Total, Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort Lin-Yuan Huang, MPH, Mark L. Wahlqvist, MD, Yi-Chen Huang, MPH, Meei-Shyuan Lee, DrPH
Downloaded by [George Mason University] at 22:25 09 January 2015
Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan, (L.-Y.H., M.L.W.); School of Public Health (M.L.W., M.-S.L.); and Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, REPUBLIC OF CHINA (Y.-C.H.); Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, AUSTRALIA (M.L.W., M.-S.L.) Key words: all-cause mortality, stroke, cancer, optimal intake Objective: Dairy foods help achieve essential nutrient adequacy. This role may be conflicted where so-called chronic diseases prevail. We have examined associations between dairy intake and mortality where dairy foods have not been traditional. Methods: A representative Taiwanese cohort of 3810 subjects, aged 19–64 years, derived from the Nutrition and Health Survey in Taiwan (NAHSIT, 1993–1996) was linked to death registration (1993–2008). Participants were categorized by 4 dairy weekly intake frequencies from 0 to >7 times. Mortality hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional-hazards models. Results: Nonconsumers of dairy products included 30.7% of the men and 22.1% of the women. Adverse sociodemographic and personal behaviors were generally significantly associated with lower dairy consumption. After adjustment for covariates, together with body mass index (BMI) and supplement use, those with 3–7 times/week intakes had an HR (95% CI) for all-cause mortality of 0.61 (0.39–0.96) with a significant dose– response trend (p = 0.043). Similarly, the HR for cardiovascular disease (CVD) mortality with dairy weekly intake frequency >7 was 0.14 (0.02–0.97) with a significant linear trend (p = 0.007). For stroke, the corresponding HR (95% CI) was 0.03 (0.00–0.28) with a linear trend. By age and with adjustment for dietary quality, food, and calcium or vitamin D intake, significance and dose–response relationships remained. Dairy intake and cancer mortality were not associated. Conclusion: In a Chinese food culture, a dairy foods intake in adults up to 7 times a week does not increase mortality and may have favorable effects on stroke.
INTRODUCTION
sumption also reflects attitudes and concerns, including that it is “an inappropriate food habit” (32.%), “actual dislike” (17.%), there being “no right time” (10%), or “fear” [2]. Trends in dairy consumption are flat for men and downwards for women [4]. Elsewhere in notheast Asia, there have been major increases in imported dairy products in China [6] with continued relatively low consumption in Japan compared to other developed economies [7]. The main advocacy for dietary dairy products has been on the basis of analogy to breast milk as the starting point in human nutrition and its unique and broad nutrient spectrum. This applies particularly to proteins, fats, oligosaccharides [8], and
Cancers and cardiovascular disease are the leading causes of death among Taiwanese [1]. The shift in disease patterns has occurred against a background of major economic development, changing personal behaviors, and an evolving food system. This has included the progressive inclusion of milk and dairy products into a diet that does not traditionally include these foods. Their consumption is greater among the socioeconomically advantaged [2,3] and dependent on age and gender [4,5]; older people tend to use imported powdered milk, whereas younger people use locally produced fresh dairy products [2]. Dairy con-
Address correspondence to: Professor Meei-Shyuan Lee, School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, Taiwan 114, REPUBLIC OF CHINA. E-mail: [email protected] Abbreviations: BMI = body mass index, CI = confidence interval, CVD = cardiovascular disease, FFQ = food frequency questionnaire, HR = hazard ratio, ICD-9 = the International Classification of Diseases, 9th Revision, IHD = ischemic heart disease, MUAMC = mid-arm muscle circumference, NAHSIT = The Nutrition and Health Survey in Taiwan, ODI-R = Overall Dietary Intake–Revised.
Journal of the American College of Nutrition, Vol. 33, No. 6, 426–436 (2014) C American College of Nutrition Published by Taylor & Francis Group, LLC 426
Downloaded by [George Mason University] at 22:25 09 January 2015
Dairy Intake and Mortality micronutrients like calcium, phosphorus, magnesium, and vitamin B-2, all essential for human health [9]. Prospective studies suggest that increased dairy consumption is associated with reduced risk of cardiovascular disease (CVD) and cancer mortalities [10]. In the case of CVD, the evidence varies for whether there might be benefits for ischemic heart disease (IHD) or cerebrovascular disease and stroke [11,12]. The rationale for these findings is varied and tends to focus on a narrow range of classical pathways or intermediates thought to explain CVD risk, including body fat, serum lipoproteins, and blood pressure [13]. If dairy foods are considered, outcomes may differ for milk, cheese, and yogurt [13,14]. Food-based explanatory models might include dairy calcium, its modest vitamin D content, bioactive peptides, or other components, and effects on gut microflora [15,16]. Whether effects are seen at all may be dependent on its fatty acids, especially saturated, but also the trans- and conjugated linoleic fatty acid content and profile in dairy foods, at least for CVD risk [17]. The question is to what extent the advent of dairy consumption has contributed to health and longevity in Taiwan, where there have been significant gains in both [1]. In the present study, we examined the association between dairy consumption and mortalities of adults aged 19 to 64 years in Taiwan.
SUBJECTS AND METHODS Study Population and Outcome Ascertainment The Nutrition and Health Survey in Taiwan (NAHSIT, 1993– 1996) [18] served as the baseline for this cohort study. Subjects with an average age of 13.7 ± 0.02 years were followed until the end of 2008. Survivorship and date and cause of death were obtained by linking the NAHSIT data sets to the national death registration (provided by the Department of Health, Taiwan) by participants’ personal IDs. Cause of death was coded by the International Classification of Diseases, 9th Revision (http://icd9.chrisendres.com/index.php). In addition to all-cause mortality, we identified deaths from CVD (codes 390–459 for coronary heart disease and cerebrovascular disease; codes 430– 438 for stroke) and cancer (codes 140–239). A total of 3810 participants aged 19 to 64 years with both dairy consumption data and survivorship information were legitimate for analysis. Ethics approval was granted by the Institutional Review Boards of Academia Sinica and the National Health Research Institutes.
Dairy Consumption Assessment The frequency of dairy intake was ascertained from a simplified food frequency questionnaire (SFFQ), which asked subjects how many times dairy foods (which included liquid milk and fat-free, low-fat, high-fat, and flavored dairy products) were consumed per week. The correlation coefficients between the dairy intake frequency from the SFFQ and repeated 24-h recalls were
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION
0.678 for men and 0.759 for women [19]. To take energy intake into account, dairy intake was adjusted for energy intake using a residual method [20]. The participants were categorized into 4 groups by their weekly dairy intake frequency (0, 7 times).
Other Covariate Measurements Food intake obtained from the SFFQ and a 24-h recall provided for the derivation of a dietary quality score referred to as the Overall Dietary Index–Revised (ODI-R) as previously described [21]. Anthropometric measurements including weight, height, skinfold thickness, and circumference allowed for the assessment or calculation of waist circumference, mid-arm muscle circumference, and BMI [18,21]. Weight was classified as underweight, normal, overweight, and obesity using Taiwanese criteria where the cut points are 18.5, 24, and 27 kg/m2, respectively.
Statistical Analysis Analysis of variance and chi-square tests were used to examine the distributions of demographics among the dairy intake frequency groups. The association between dairy consumption and mortality was examined with Cox proportional-hazards models to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for each dairy intake group by using the group who ate no dairy as the reference. Models were developed with adjustments for age, gender, weight status (underweight, normal, overweight, and obesity), region (Hakka, mountain areas, eastern, Penghu, metropolitan areas, provincial cities and class I townships, and class II rural townships), ethnicity (Fukienese, Hakka, Mainlander, Indigenous), education level (primary school or lower, high school, and college or higher), marriage (unmarried, married and living with spouse, married but spouse died, and divorced or separated), dietary supplement use, smoking, drinking, chewing betel nut, exercise, dietary quality (ODI-R), and calcium and vitamin D intakes. Age subgroup analysis was undertaken because of the likely differences in mortality profiles by age. Data were analyzed using SAS 9.1 for Windows (SAS Institute, Inc., Cary, NC) and SUDAAN (Ver. 9.0, Research Triangle Institute, Research Triangle Park, NC) [22] for weighting and adjusting design effect with cluster sampling. p < 0.05 was considered significant.
RESULTS Population Characteristics More than a quarter of participants (27%) did not consume any dairy products. Women had greater consumption than men (p < 0.001). Of those who lived in mountainous areas, 44.8% did not consume dairy products and in metropolitan areas this
427
Dairy Intake and Mortality
Table 1. Basic Characteristics of Adults (aged 19–64 years) in Taiwan by Dairy Consumption (N = 3810) Dairy Consumption Frequency (times/week)a,b
Downloaded by [George Mason University] at 22:25 09 January 2015
Totalc Number (%) Mean ± SE and range of dairy consumption frequency Average follow-up (years) Age (years) Gender Men Women Region Hakka Mountain areas Eastern Penghu Metropolitan areas Provincial cities and class I townships Class II rural townships Ethnicity Fukienese Hakka Mainlander Indigenous Education level Primary and below High school College and above Marriage Unmarried Married Widow/widower Divorced or separated Supplement use Yes No Cigarette smoking Yes No Alcohol consumption Yes Former No Betel nut chewing Yes No Exercise Yes No Disease history (%) Diabetes Cardiovascular disease Cancer
3.44 ± 0.14 (0–82.2) 13.7 ± 0.02 35.6 ± 0.29
0
0.1–3.0
3.1–7.0
>7.0
1359 (27.0) 0 — 13.4 ± 0.10 38.8 ± 0.47
1062 (33.3) 1.38 ± 0.04 (0.12–3.00) 13.8 ± 0.09 33.2 ± 0.22
704 (21.3) 5.01 ± 0.12 (3.003–7.00) 13.9 ± 0.09 35.1 ± 0.81
685 (18.5) 10.3 ± 0.33 (7.001–82.2) 13.8 ± 0.06 35.9 ± 0.59
30.7 22.1
33.8 32.6
21.1 21.4
14.4 23.9
p Valued
Journal of the American College of Nutrition Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uacn20
Optimal Dairy Intake Is Predicated on Total, Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort a
Lin-Yuan Huang MPH , Mark L. Wahlqvist MD DrPH
abd
c
, Yi-Chen Huang MPH & Meei-Shyuan Lee
abd
a
Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan b
School of Public Health, Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, REPUBLIC OF CHINA c
Click for updates
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, REPUBLIC OF CHINA d
Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, AUSTRALIA Published online: 31 Jul 2014.
To cite this article: Lin-Yuan Huang MPH, Mark L. Wahlqvist MD, Yi-Chen Huang MPH & Meei-Shyuan Lee DrPH (2014) Optimal Dairy Intake Is Predicated on Total, Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort, Journal of the American College of Nutrition, 33:6, 426-436, DOI: 10.1080/07315724.2013.875328 To link to this article: http://dx.doi.org/10.1080/07315724.2013.875328
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Original Research
Optimal Dairy Intake Is Predicated on Total, Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort Lin-Yuan Huang, MPH, Mark L. Wahlqvist, MD, Yi-Chen Huang, MPH, Meei-Shyuan Lee, DrPH
Downloaded by [George Mason University] at 22:25 09 January 2015
Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan, (L.-Y.H., M.L.W.); School of Public Health (M.L.W., M.-S.L.); and Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, REPUBLIC OF CHINA (Y.-C.H.); Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, AUSTRALIA (M.L.W., M.-S.L.) Key words: all-cause mortality, stroke, cancer, optimal intake Objective: Dairy foods help achieve essential nutrient adequacy. This role may be conflicted where so-called chronic diseases prevail. We have examined associations between dairy intake and mortality where dairy foods have not been traditional. Methods: A representative Taiwanese cohort of 3810 subjects, aged 19–64 years, derived from the Nutrition and Health Survey in Taiwan (NAHSIT, 1993–1996) was linked to death registration (1993–2008). Participants were categorized by 4 dairy weekly intake frequencies from 0 to >7 times. Mortality hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional-hazards models. Results: Nonconsumers of dairy products included 30.7% of the men and 22.1% of the women. Adverse sociodemographic and personal behaviors were generally significantly associated with lower dairy consumption. After adjustment for covariates, together with body mass index (BMI) and supplement use, those with 3–7 times/week intakes had an HR (95% CI) for all-cause mortality of 0.61 (0.39–0.96) with a significant dose– response trend (p = 0.043). Similarly, the HR for cardiovascular disease (CVD) mortality with dairy weekly intake frequency >7 was 0.14 (0.02–0.97) with a significant linear trend (p = 0.007). For stroke, the corresponding HR (95% CI) was 0.03 (0.00–0.28) with a linear trend. By age and with adjustment for dietary quality, food, and calcium or vitamin D intake, significance and dose–response relationships remained. Dairy intake and cancer mortality were not associated. Conclusion: In a Chinese food culture, a dairy foods intake in adults up to 7 times a week does not increase mortality and may have favorable effects on stroke.
INTRODUCTION
sumption also reflects attitudes and concerns, including that it is “an inappropriate food habit” (32.%), “actual dislike” (17.%), there being “no right time” (10%), or “fear” [2]. Trends in dairy consumption are flat for men and downwards for women [4]. Elsewhere in notheast Asia, there have been major increases in imported dairy products in China [6] with continued relatively low consumption in Japan compared to other developed economies [7]. The main advocacy for dietary dairy products has been on the basis of analogy to breast milk as the starting point in human nutrition and its unique and broad nutrient spectrum. This applies particularly to proteins, fats, oligosaccharides [8], and
Cancers and cardiovascular disease are the leading causes of death among Taiwanese [1]. The shift in disease patterns has occurred against a background of major economic development, changing personal behaviors, and an evolving food system. This has included the progressive inclusion of milk and dairy products into a diet that does not traditionally include these foods. Their consumption is greater among the socioeconomically advantaged [2,3] and dependent on age and gender [4,5]; older people tend to use imported powdered milk, whereas younger people use locally produced fresh dairy products [2]. Dairy con-
Address correspondence to: Professor Meei-Shyuan Lee, School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, Taiwan 114, REPUBLIC OF CHINA. E-mail: [email protected] Abbreviations: BMI = body mass index, CI = confidence interval, CVD = cardiovascular disease, FFQ = food frequency questionnaire, HR = hazard ratio, ICD-9 = the International Classification of Diseases, 9th Revision, IHD = ischemic heart disease, MUAMC = mid-arm muscle circumference, NAHSIT = The Nutrition and Health Survey in Taiwan, ODI-R = Overall Dietary Intake–Revised.
Journal of the American College of Nutrition, Vol. 33, No. 6, 426–436 (2014) C American College of Nutrition Published by Taylor & Francis Group, LLC 426
Downloaded by [George Mason University] at 22:25 09 January 2015
Dairy Intake and Mortality micronutrients like calcium, phosphorus, magnesium, and vitamin B-2, all essential for human health [9]. Prospective studies suggest that increased dairy consumption is associated with reduced risk of cardiovascular disease (CVD) and cancer mortalities [10]. In the case of CVD, the evidence varies for whether there might be benefits for ischemic heart disease (IHD) or cerebrovascular disease and stroke [11,12]. The rationale for these findings is varied and tends to focus on a narrow range of classical pathways or intermediates thought to explain CVD risk, including body fat, serum lipoproteins, and blood pressure [13]. If dairy foods are considered, outcomes may differ for milk, cheese, and yogurt [13,14]. Food-based explanatory models might include dairy calcium, its modest vitamin D content, bioactive peptides, or other components, and effects on gut microflora [15,16]. Whether effects are seen at all may be dependent on its fatty acids, especially saturated, but also the trans- and conjugated linoleic fatty acid content and profile in dairy foods, at least for CVD risk [17]. The question is to what extent the advent of dairy consumption has contributed to health and longevity in Taiwan, where there have been significant gains in both [1]. In the present study, we examined the association between dairy consumption and mortalities of adults aged 19 to 64 years in Taiwan.
SUBJECTS AND METHODS Study Population and Outcome Ascertainment The Nutrition and Health Survey in Taiwan (NAHSIT, 1993– 1996) [18] served as the baseline for this cohort study. Subjects with an average age of 13.7 ± 0.02 years were followed until the end of 2008. Survivorship and date and cause of death were obtained by linking the NAHSIT data sets to the national death registration (provided by the Department of Health, Taiwan) by participants’ personal IDs. Cause of death was coded by the International Classification of Diseases, 9th Revision (http://icd9.chrisendres.com/index.php). In addition to all-cause mortality, we identified deaths from CVD (codes 390–459 for coronary heart disease and cerebrovascular disease; codes 430– 438 for stroke) and cancer (codes 140–239). A total of 3810 participants aged 19 to 64 years with both dairy consumption data and survivorship information were legitimate for analysis. Ethics approval was granted by the Institutional Review Boards of Academia Sinica and the National Health Research Institutes.
Dairy Consumption Assessment The frequency of dairy intake was ascertained from a simplified food frequency questionnaire (SFFQ), which asked subjects how many times dairy foods (which included liquid milk and fat-free, low-fat, high-fat, and flavored dairy products) were consumed per week. The correlation coefficients between the dairy intake frequency from the SFFQ and repeated 24-h recalls were
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION
0.678 for men and 0.759 for women [19]. To take energy intake into account, dairy intake was adjusted for energy intake using a residual method [20]. The participants were categorized into 4 groups by their weekly dairy intake frequency (0, 7 times).
Other Covariate Measurements Food intake obtained from the SFFQ and a 24-h recall provided for the derivation of a dietary quality score referred to as the Overall Dietary Index–Revised (ODI-R) as previously described [21]. Anthropometric measurements including weight, height, skinfold thickness, and circumference allowed for the assessment or calculation of waist circumference, mid-arm muscle circumference, and BMI [18,21]. Weight was classified as underweight, normal, overweight, and obesity using Taiwanese criteria where the cut points are 18.5, 24, and 27 kg/m2, respectively.
Statistical Analysis Analysis of variance and chi-square tests were used to examine the distributions of demographics among the dairy intake frequency groups. The association between dairy consumption and mortality was examined with Cox proportional-hazards models to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for each dairy intake group by using the group who ate no dairy as the reference. Models were developed with adjustments for age, gender, weight status (underweight, normal, overweight, and obesity), region (Hakka, mountain areas, eastern, Penghu, metropolitan areas, provincial cities and class I townships, and class II rural townships), ethnicity (Fukienese, Hakka, Mainlander, Indigenous), education level (primary school or lower, high school, and college or higher), marriage (unmarried, married and living with spouse, married but spouse died, and divorced or separated), dietary supplement use, smoking, drinking, chewing betel nut, exercise, dietary quality (ODI-R), and calcium and vitamin D intakes. Age subgroup analysis was undertaken because of the likely differences in mortality profiles by age. Data were analyzed using SAS 9.1 for Windows (SAS Institute, Inc., Cary, NC) and SUDAAN (Ver. 9.0, Research Triangle Institute, Research Triangle Park, NC) [22] for weighting and adjusting design effect with cluster sampling. p < 0.05 was considered significant.
RESULTS Population Characteristics More than a quarter of participants (27%) did not consume any dairy products. Women had greater consumption than men (p < 0.001). Of those who lived in mountainous areas, 44.8% did not consume dairy products and in metropolitan areas this
427
Dairy Intake and Mortality
Table 1. Basic Characteristics of Adults (aged 19–64 years) in Taiwan by Dairy Consumption (N = 3810) Dairy Consumption Frequency (times/week)a,b
Downloaded by [George Mason University] at 22:25 09 January 2015
Totalc Number (%) Mean ± SE and range of dairy consumption frequency Average follow-up (years) Age (years) Gender Men Women Region Hakka Mountain areas Eastern Penghu Metropolitan areas Provincial cities and class I townships Class II rural townships Ethnicity Fukienese Hakka Mainlander Indigenous Education level Primary and below High school College and above Marriage Unmarried Married Widow/widower Divorced or separated Supplement use Yes No Cigarette smoking Yes No Alcohol consumption Yes Former No Betel nut chewing Yes No Exercise Yes No Disease history (%) Diabetes Cardiovascular disease Cancer
3.44 ± 0.14 (0–82.2) 13.7 ± 0.02 35.6 ± 0.29
0
0.1–3.0
3.1–7.0
>7.0
1359 (27.0) 0 — 13.4 ± 0.10 38.8 ± 0.47
1062 (33.3) 1.38 ± 0.04 (0.12–3.00) 13.8 ± 0.09 33.2 ± 0.22
704 (21.3) 5.01 ± 0.12 (3.003–7.00) 13.9 ± 0.09 35.1 ± 0.81
685 (18.5) 10.3 ± 0.33 (7.001–82.2) 13.8 ± 0.06 35.9 ± 0.59
30.7 22.1
33.8 32.6
21.1 21.4
14.4 23.9
p Valued
