Study analysis · American Journal of Epidemiology · 2017

Yogurt and cheese could save your life—but milk might not help at all.

People who ate more yogurt and cheese lived longer, especially if they weren't overweight, but drinking milk didn't make any difference.

Reading level
Moderate certainty
Level 2b · Individual cohort studyAssociation, not causationNo causal claims

Overview

What the study found

The study in plain English — the bottom line, every takeaway we extracted, and what to do with them.

In simple terms

This study watched what people ate for 11 years and noticed that those who ate more yogurt and cheese tended to live longer. But it didn’t make them eat more—it just watched. So we can’t say yogurt and cheese made them live longer, just that they were linked.

What’s the bottom line?

Scientists tracked what 42,000 people in Iran ate for 11 years to see if dairy foods like yogurt and cheese affected how long they lived.

How strong is this study?

This study is pretty strong because it followed tens of thousands of people for a long time and asked them lots of questions about their lives. But since people chose what they ate on their own, we can’t be 100% sure it was the food that helped—not other things like how much they exercised or how much stress they had.

Reporting

40 / 100

  • COI disclosure+40/40
  • Data availabilitydata not shared
  • Code availabilitycode not shared
Methodology

38 / 100

  • Randomizationnot randomized
  • Blindingblinding unclear
  • Control groupno control group
  • Sample size (n=42403)+20/20
  • Follow-up+10/10
Publication

100 / 100

Statistical

77 / 100

  • P-values+15/15
  • Effect size+20/20
  • Confidence intervals+15/15
  • Pre-registrationnot pre-registered

Each component is scored out of 100 and then capped by the study design — a case series cannot reach the ceiling a randomised trial can, however well it is reported.

Where it sits

RCT reviews

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Cohort Studies
Level 2b
60

60 / 100

Probability of being correct

Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.

This design cannot establish causation — the findings describe an association, not a cause. This is an observational cohort study with no randomization or intervention. While it adjusts for many confounders, it cannot rule out residual confounding or reverse causation, so it cannot establish cause-effect relationships.

No Conflicts

No conflicts of interest identified

No conflicts of interest were disclosed, and the study was funded by independent academic and public health institutions with no evidence of industry influence.

Funders

Digestive Disease Research Center of Tehran University of Medical Sciences
US National Cancer Institute
World Health Organization's International Agency for Research on Cancer
Harvard T.H. Chan School of Public Health

Conflict Details

Maryam S Farvid
Funding
Employee

Harvard T.H. Chan School of Public Health: Author affiliated with institution that received funding

Christian C Abnet
Funding
Employee

US National Cancer Institute: Author affiliated with institution that received funding

Sanford M Dawsey
Funding
Employee

US National Cancer Institute: Author affiliated with institution that received funding

Paul Brennan
Funding
Employee

International Agency for Research on Cancer: Author affiliated with institution that received funding

Paolo Boffetta
Funding
Employee

International Agency for Research on Cancer: Author affiliated with institution that received funding

+2 more conflicts

Independent Analysis Safeguards

  • Analysis conducted using STATA by authors at academic institutions
  • Statistical models adjusted for multiple confounders
  • Data reviewed by multiple institutions with independent IRB approvals

The study was conducted by academic institutions with no industry funding. All authors are affiliated with universities or public research organizations. No industry ties, employment, or financial relationships with commercial entities were disclosed. The funding sources are all non-industry and public health entities.

Key takeaways

  1. 01

    People who ate more yogurt and cheese were 16–26% less likely to die from heart disease, and 11–16% less likely to die from any cause.

  2. 02

    People who ate milk or high-fat dairy didn't show any benefit.

  3. 03

    The benefit only happened in people who weren't obese.

  4. 04

    Yes — eating yogurt and cheese regularly may help people live longer, especially if they're not overweight, but milk and butter don't seem to help or hurt.

Surprising findings

  • Cheese was linked to a 26% lower risk of cardiovascular death—more than yogurt or any other dairy.Most people assume yogurt is the 'healthy' fermented dairy, but cheese—often seen as indulgent—had the strongest protective effect in this study.
  • Milk consumption showed no benefit—even in people who drank it regularly.Global health guidelines often promote milk for calcium and bone health, but this massive study found zero mortality benefit, contradicting prior Western studies.
  • The protective effect of dairy vanished in obese individuals.Most nutrition studies assume benefits are universal, but here, obesity completely negated the advantage—suggesting metabolic health may be the real gatekeeper.

Practical takeaways

Swap one serving of milk or butter daily for yogurt or cheese—especially if you're not obese.

This study was done in Iran, where dairy is minimally processed and unfortified. Results may not directly apply to fortified or ultra-processed dairy in Western diets.

medium confidence

If you're overweight or obese, focus on weight loss first—dairy alone won't reduce your mortality risk if your BMI is 30+.

The study didn't test weight loss interventions—so we don't know if losing weight restores dairy's benefits.

low confidence

Don't feel guilty about full-fat cheese—it didn't increase risk in this study.

This doesn't mean you should eat unlimited cheese. Portion control and overall diet quality still matter.

medium confidence

Why this study matters

Fermented Dairy = Longevity Boost

Those who ate the most yogurt and cheese had up to a 26% lower risk of dying from heart disease and 16% lower risk of dying from any cause, according to a 11-year study of 42,403 Iranians. The effect was strongest for low-fat versions, which made up 97% of cheese and 89% of yogurt consumed.

This flips the script on the 'all dairy is bad' myth—fermented dairy like yogurt and cheese may be uniquely protective, even in populations with low overall dairy intake.

Obesity Blocks Dairy's Benefits

The mortality-reducing effects of dairy disappeared entirely in people with a BMI of 30 or higher. Non-obese individuals saw a 22% lower risk of death from any cause with high dairy intake, but obese participants saw no benefit at all.

It’s not just what you eat—it’s who you are. This suggests obesity may interfere with the biological mechanisms that make dairy protective.

Milk Is a Non-Factor

Despite being the most commonly consumed dairy product globally, milk showed zero association with reduced risk of death from heart disease, cancer, or any cause—even at moderate intake levels up to 0.6 servings per day.

This contradicts decades of public health messaging that equate milk with health. In Iran, where most milk is high-fat and unfortified, it simply didn’t move the needle.

High-Fat Dairy Isn't the Villain

Contrary to popular belief, high-fat dairy like butter and full-fat milk showed no increased risk of death—even though they’re packed with saturated fat. The study found HR=1.01 for all-cause mortality.

This challenges the long-standing dogma that saturated fat = heart disease death. Food matrix and fermentation may matter more than fat content alone.

Want the whole report?

Detailed mode opens the full scientific breakdown — every score component, the methodology, conflicts of interest, the evidence analysis behind each claim, and the raw study data.

Standing

Who’s using this study?

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1 video from Physionic cite this study, drawing 6 claims from it.

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References
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