A Positive Association Between Dietary Intake of Higher Cow's Milk-Fat Percentage and Non-High-Density Lipoprotein Cholesterol in Young Children

J Pediatr. 2019 Aug;211:105-111.e2. doi: 10.1016/j.jpeds.2019.03.047. Epub 2019 May 17.


Objectives: To determine the association between cow's milk-fat and non-high-density lipoprotein (non-HDL) cholesterol, a marker of cardiovascular disease (CVD) risk in young children, and whether this association is mediated by the typical volume of cow's milk consumed.

Study design: A longitudinal study in 2- to 8-year-old children (n = 2890) was conducted through The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Generalized estimating equations were used to examine the relationship between parent-reported cow's milk-fat percentage intake and serum non-HDL cholesterol concentrations as well as having high non-HDL cholesterol (≥3.75 mmol/L [145 mg/dL]), adjusting for covariates including age, sex, body mass index z score, breastfeeding duration, mother's ethnicity, and parental history of CVD. Bootstrap resampling (10 000 repetitions) was used to assess whether typical volume consumed mediated the association between cow's milk-fat percentage and non-HDL cholesterol.

Results: In total, 156 (5.4%) had high non-HDL cholesterol. Each percent increase in cow's milk-fat was associated with a 0.035 mmol/L (1.35 mg/dL) (P < .001) and 0.024 mmol/L (0.92 mg/dL) (P = .01) increase in non-HDL cholesterol, unadjusted and adjusted for covariates respectively. Cow's milk-fat percentage was not associated with greater odds of having high non-HDL cholesterol. Volume of cow's milk partially mediated the association between cow's milk-fat percentage and non-HDL cholesterol, accounting for 28% of the relationship (P < .001).

Conclusions: Consumption of higher-fat cow's milk was associated with a small increase in non-HDL cholesterol but not greater odds of having high non-HDL cholesterol. Further research is needed to assess this relationship with other CVD risk factors in young children.

Trial registration: ClinicalTrials.gov: NCT01869530.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Body Mass Index
  • Breast Feeding
  • Canada / epidemiology
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular System
  • Cattle
  • Child
  • Child, Preschool
  • Cholesterol / blood*
  • Data Collection
  • Dietary Fats / administration & dosage*
  • Dietary Fats / adverse effects
  • Female
  • Humans
  • Lipoproteins / blood*
  • Longitudinal Studies
  • Male
  • Milk / adverse effects*
  • Milk / chemistry
  • Primary Health Care
  • Risk Factors
  • Treatment Outcome


  • Dietary Fats
  • Lipoproteins
  • Cholesterol

Associated data

  • ClinicalTrials.gov/NCT01869530

Grant support