Evidence map›Paper›PMID 39567654›Full record

ArticleEuropean journal of clinical nutrition2025

The prolonged impact of swapping non-fermented with fermented dairy products on cardiovascular disease: the ATTICA cohort study (2002-2022).

Matina Kouvari, Thomas Tsiampalis, Rena I Kosti, Evangelia Damigou, Christina Chrysohoou, Georgia Anastasiou, Amalia D Koutsogianni, Evangelos Liberopoulos, Costas Tsioufis, Petros P Sfikakis and 3 more

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Article in European journal of clinical nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Matina KouvariDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece.
Thomas TsiampalisDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece.
Rena I KostiDepartment of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, Trikala, 38221, Greece.ORCID http://orcid.org/0000-0001-7915-6064
Evangelia DamigouDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece.
Christina ChrysohoouFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Georgia AnastasiouFirst Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece.
Amalia D KoutsogianniFirst Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece.
Evangelos LiberopoulosFirst Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece.
Costas TsioufisFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Petros P SfikakisFirst Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece.
Christos PitsavosFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Demosthenes PanagiotakosDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece. dbpanag@hua.gr.ORCID http://orcid.org/0000-0001-8583-153X
ATTICA study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesScientific evidence suggests that substituting non-fermented with fermented dairy products may confer cardiovascular health benefits. The role of fermented in relation to non-fermented dairy products on 20-year fatal/non-fatal cardiovascular disease (CVD) incidence was examined. SUBJECTS/

methodsIn 2001-2002, n = 3042 free-of-CVD men and women from Attica, Greece, were recruited. Dietary assessment was based on a validated semi-quantitative food frequency questionnaire. CVD evaluation was performed in three follow-up time points at 5, 10 and 20 years, in n = 1988 participants (718 cases).

resultsParticipants reported >2 servings/day of fermented dairy products had 1.5 times lower risk to develop CVD compared with their lower level of consumption. Multi-adjusted analysis revealed similar cardioprotective properties per 1 serving increase in dairy consumption of fermented dairy products (Hazard Ratio (HR) = 0.82, 95% Confidence Interval (95%CI) (0.58, 0.95)) as well as when the ratios of fermented:total dairy products (0.90, (0.53, 0.95)) and fermented:non-fermented dairy products (0.74, (0.39, 0.92)) were ≥0.76 and ≥2.5, respectively. The associations were more evident in case of impaired inflammation status. Replacing 1 serving of non-fermented with 1 equivalent serving of fermented dairy products reduced CVD risk (0.74, (0.53, 0.92)). Substitution of low-fat with whole-fat yogurt increased CVD risk (1.35, (1.02, 1.58)). Replacing cheese (any kind) with low-fat yogurt reduced CVD risk (all HRs<1) while with whole-fat yogurt no significance was observed.

conclusionsShift of guidelines to a daily pattern of dairy intake yet with an inclination towards emphasizing the consumption of fermented products is recommended.

Indexed as

Cardiovascular DiseasesCultured Milk ProductsDairy ProductsDietAdultAgedCohort StudiesFemaleFermentationFollow-Up StudiesGreeceHumansIncidenceMaleMiddle Aged

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.