appendix figure a. directed acyclic graph (dag) for milk ...oct 30, 2014  · 0.1.2.3 0 5 10 15 20...

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Appendix Figure A. Directed Acyclic Graph (DAG) for milk intake and fracture risk.

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Page 1: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Appendix Figure A. Directed Acyclic Graph (DAG) for milk intake and fracture risk.

Page 2: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

0.1.2.3

05

1015

2025

Follo

w−u

p (y

ears

)

Kap

lan−

Mei

er fa

ilure

est

imat

e hi

p fra

ctur

eC

umul

ativ

e in

cide

nce

hip

fract

ure

Cum

ulat

ive

inci

denc

e m

orta

lity

<1 g

lass

/day

0.1.2.3

05

1015

2025

Follo

w−u

p (y

ears

)

1 to

less

than

2 g

lass

es/d

ay

0.1.2.3

05

1015

2025

Follo

w−u

p (y

ears

)

2 to

less

than

3 g

lass

es/d

ay

0.1.2.3

05

1015

2025

Follo

w−u

p (y

ears

)

≥3 g

lass

es/d

ay

App

endi

x Fi

gure

B. C

umul

ativ

e in

cide

nce

curv

es fo

r hip

frac

ture

and

all-

caus

e m

orta

lity

by m

ilk in

take

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort.

The

solid

line

repr

esen

ts th

e K

apla

n-M

eier

failu

re e

stim

ate

for h

ip fr

actu

re. T

he fi

gure

indi

cate

s tha

t the

ov

eres

timat

ion

of h

ip fr

actu

re in

cide

nce

by th

e K

apla

n-M

eier

failu

re e

stim

ate

is sm

all a

nd d

oes n

ot d

iffer

by

cate

gorie

s of m

ilk

inta

ke a

nd th

at a

n ap

prox

imat

ion

to su

rviv

al m

etho

ds is

acc

epta

ble.

Page 3: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

P trend=0.0240.0

0.1

0.2

0.3

0.4

0.5A

djus

ted

urin

e 8−

iso−

PG

F 2α

(nm

ol/m

mol

cre

atin

ine)

0 0.5 1 1.5 2

Servings of fermented milk or yoghurt/day

P trend=0.0290

1

2

3

4

5

6

7

Adj

uste

d se

rum

IL−6

(mg/

ml)

0 0.5 1 1.5 2

Servings of fermented milk or yoghurt/day

A

P trend=0.650.0

0.1

0.2

0.3

0.4

0.5

Adj

uste

d ur

ine

8−is

o−P

GF 2

α(n

mol

/mm

ol c

reat

inin

e)

0 1 2 3 4 5 6

Slices of cheese/day

P trend=0.690

1

2

3

4

5

6

7A

djus

ted

seru

m IL−6

(mg/

ml)

0 1 2 3 4 5 6

Slices of cheese/day

B

Appendix Figure C. Adjusted predictions of urine log(8-iso-PGF2 ), a marker of oxidative stress (n=700) and serum log(IL-6; n=633), a marker of inflammation, after cubic spline regression with fermented milk/yogurt consumption (panel A) and cheese consumption (panel B). Consumption was assessed among men aged 71 years and measurement of inflammatory markers was at age 77 years. Covariates were age, BMI, energy intake, education, smoking status and physical activity. One serving of fermented milk/yogurt corresponds to 100 grams and one slice of cheese corresponds to 20 grams.

Page 4: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le A

. Bas

elin

e ch

arac

teris

tics o

f the

wom

en in

the

Swed

ish

Mam

mog

raph

y C

ohor

t (19

87-9

0) a

nd o

f the

men

in th

e C

ohor

t of S

wed

ish

Men

(199

7) b

y ca

tego

ries o

f che

ese

inta

ke. V

alue

s are

num

bers

(per

cent

ages

) unl

ess s

tate

d ot

herw

ise

C

ateg

orie

s of d

aily

che

ese

inta

ke

<2

0 g/

d 20

-39

g/d

40-5

9 g/

d

T

he S

wed

ish

Mam

mog

raph

y C

ohor

t

N

o 22

678

2260

6 69

56

9193

M

ean

(SD

) age

at e

ntry

(yea

rs)

57.2

(10.

6)

50.9

(7.7

) 61

.9 (5

.8)

45.7

(4.9

) M

ean

(SD

) bod

y m

ass i

ndex

(kg/

m2 )

25.3

(4.0

) 24

.6 (3

.8)

25.0

(3.8

) 23

.6 (3

.6)

Mea

n (S

D) h

eigh

t (cm

) 16

3.3

(5.8

) 16

4.5

(5.7

) 16

3.3

(5.6

) 16

5.4

(5.7

) M

ean

(SD

) nut

rient

inta

ke:

En

ergy

(kca

l/d)

1434

(446

) 15

55 (4

12)

1774

(448

) 18

81 (4

60)

C

alci

um (m

g/d)

81

2 (1

92)

863

(166

) 96

6 (1

63)

992

(163

)

Phos

phor

us (m

g/d)

13

44 (2

27)

1371

(193

) 14

46 (1

83)

1440

(183

)

Vita

min

D (m

g/d)

4.

6 (1

.6)

4.4

(1.3

) 4.

2 (1

.2)

4.1

(1.2

)

Ret

inol

(mg/

d)

1.04

(0.7

2)

1.05

(0.6

5)

0.97

(0.5

3)

0.96

(0.5

5)

Pr

otei

n (g

/d)

64.4

(9.9

) 66

.7 (8

.4)

69.0

(7.8

) 71

.0 (7

.8)

To

tal f

at (g

/d)

43.6

(17.

6)

49.0

(16.

2)

59.2

(18.

0)

65.2

(19.

0)

Sa

tura

ted

fat (

g/d)

18

.4 (8

.5)

21.4

(7.7

) 27

.4 (8

.8)

30.4

(9.1

)

Alc

ohol

(g/d

) 2.

0 (3

.3)

2.9

(3.6

) 1.

9 (2

.9)

3.4

(3.8

) M

ean

(SD

) met

abol

ic e

quiv

alen

ts (k

cal/k

g an

d ho

ur)

42.2

(4.9

) 42

.6 (4

.8)

42.5

(4.8

) 42

.6 (4

.8)

Cal

cium

supp

lem

ent u

se*

6172

(27.

2)

7718

(34.

1)

2008

(28.

9)

3223

(35.

1)

Vita

min

D su

pple

men

t use

* 26

86 (1

1.8)

32

78 (1

4.5)

10

18 (1

4.6)

16

18 (1

7.6)

Ev

er o

estro

gen

repl

acem

ent u

se*

4027

(17.

8)

5486

(24.

3)

1236

(17.

8)

2801

(30.

5)

Educ

atio

n le

vel:

1899

0 (8

3.7)

17

687

(78.

2)

5737

(82.

5)

6548

(71.

2)

10

-12

year

s 14

83 (6

.5)

1753

(7.8

) 40

0 (5

.8)

899

(9.8

)

>12

year

s 70

2 (3

.1)

1158

(5.1

) 22

2 (3

.2)

861

(9.4

)

othe

r 15

03 (6

.6)

2008

(8.9

) 59

7 (8

.6)

885

(9.6

) C

harls

on c

omor

bidi

ty:

0

1972

1 (8

7.0)

20

733

(91.

7)

6131

(88.

1)

8560

(93.

1)

Page 5: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

1

2284

(10.

1)

1538

(6.8

) 61

8 (8

.9)

531

(5.8

)

2 67

3 (3

.0)

335

(1.5

) 20

7 (3

.0)

102

(1.1

) N

ullip

arou

s 28

21 (1

2.4)

21

72 (9

.6)

824

(11.

8)

881

(9.6

) Ev

er c

ortis

one

use*

11

19 (4

.9)

1098

(4.9

) 39

1 (5

.6)

413

(4.5

) Sm

oker

stat

us:*

Cur

rent

42

42 (1

8.7)

47

34 (2

0.9)

93

0 (1

3.4)

21

84 (2

3.8)

Form

er

6725

(29.

7)

6848

(30.

3)

1761

(25.

3)

3011

(32.

8)

N

ever

11

711

(51.

6)

1102

4 (4

8.8)

42

65 (6

1.3)

39

98 (4

3.5)

Li

ving

alo

ne

6549

(28.

9)

4329

(19.

1)

1823

(26.

2)

1767

(19.

2)

T

he C

ohor

t of S

wed

ish

Men

N

o 72

08

6354

11

402

2037

5 M

ean

(SD

) age

at e

ntry

(yea

rs)

60.1

(9.6

) 60

.5 (9

.7)

61.2

(9.8

) 59

.7 (9

.7)

Mea

n (S

D) b

ody

mas

s ind

ex (k

g/m

2 ) 26

.0 (3

.4)

25.8

(3.3

) 25

.8 (3

.3)

25.7

(3.3

) M

ean

(SD

) hei

ght (

cm)

176.

4 (6

.8)

176.

9 (6

.7)

177.

1 (6

.6)

177.

7 (6

.6)

Mea

n (S

D) n

utrie

nt in

take

:

Ener

gy (k

cal/d

) 21

57 (7

34)

2301

(701

) 24

98 (6

87)

3040

(810

)

Cal

cium

(mg/

d)

1178

(507

) 13

01 (4

16)

1412

(399

) 16

51 (4

32)

Ph

osph

orus

(mg/

d)

1944

(390

) 19

86 (3

24)

2040

(314

) 21

57 (3

25)

V

itam

in D

(mg/

d)

7.2

(4.1

) 6.

8 (3

.2)

6.7

(2.8

) 6.

3 (2

.5)

R

etin

ol (m

g/d)

1.

25 (1

.13)

1.

28 (0

.88)

1.

26 (0

.88)

1.

22 (0

.78)

Prot

ein

(g/d

) 96

.4 (1

7.6)

98

.7 (1

4.9)

10

0.7

(14.

0)

106.

5 (1

4.0)

Tota

l fat

(g/d

) 81

.1 (1

6.9)

85

.3 (1

4.0)

88

.1 (1

3.5)

94

.3 (1

4.1)

Satu

rate

d fa

t (g/

d)

33.9

(9.4

) 37

.2 (8

.0)

39.7

(7.8

) 45

.0 (8

.8)

A

lcoh

ol (g

/d)

13.5

(28.

6)

14.1

(19.

8)

13.4

(18.

0)

13.5

(20.

0)

Met

abol

ic e

quiv

alen

ts (k

cal/k

g an

d ho

ur)

41.3

(5.0

) 41

.2 (4

.8)

41.2

(4.7

) 41

.9 (5

.0)

Cal

cium

supp

lem

ent u

se

704

(9.8

) 64

5 (1

0.2)

11

02 (9

.7)

1989

(9.8

) V

itam

in D

supp

lem

ent u

se

939

(13.

0)

895

(14.

1)

1494

(13.

1)

2725

(13.

4)

Educ

atio

nal l

evel

:

50

89 (7

1.0)

43

15 (6

8.2)

77

61 (6

8.3)

14

197

(69.

8)

10

-12

year

s 97

7 (1

3.6)

93

1 (1

4.7)

16

29 (1

4.3)

27

36 (1

3.5)

>12

year

s 10

54 (1

4.7)

10

51 (1

6.6)

19

29 (1

7.0)

33

34 (1

6.4)

othe

r 43

(0.6

) 28

(0.4

) 43

(0.4

) 66

(0.3

)

Page 6: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Cha

rlson

com

orbi

dity

:

0 58

32 (8

0.9)

52

61 (8

2.8)

94

10 (8

2.5)

17

379

(85.

3)

1

929

(12.

9)

751

(11.

8)

1407

(12.

3)

2115

(10.

4)

2

447

(6.2

) 34

2 (5

.4)

585

(5.1

) 88

1 (4

.3)

Ever

cor

tison

e us

e 30

0 (4

.2)

267

(4.2

) 44

7 (3

.9)

899

(4.4

) Sm

oker

stat

us:

C

urre

nt

1946

(27.

5)

1556

(24.

9)

2587

(23.

0)

5020

(25.

0)

Fo

rmer

27

77 (3

9.2)

24

80 (3

9.6)

44

73 (3

9.7)

76

85 (3

8.2)

Nev

er

2364

(33.

4)

2221

(35.

5)

4197

(37.

3)

7405

(36.

8)

Livi

ng a

lone

16

70 (2

3.2)

11

31 (1

7.8)

18

87 (1

6.5)

34

13 (1

6.8)

*I

nfor

mat

ion

avai

labl

e on

ly in

the

1997

que

stio

nnai

re a

nd v

alue

s are

impu

ted

from

thes

e da

ta

Page 7: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le B

. Bas

elin

e ch

arac

teris

tics o

f the

wom

en in

the

Swed

ish

Mam

mog

raph

y C

ohor

t (19

87-9

0) a

nd o

f the

men

in th

e C

ohor

t of

Swed

ish

Men

(199

7) b

y ca

tego

ries o

f sou

red

milk

and

yog

urt i

ntak

e. V

alue

s are

num

bers

(per

cent

ages

) unl

ess s

tate

d ot

herw

ise

C

ateg

orie

s of d

aily

sour

ed m

ilk a

nd y

ogur

t int

ake

<1

g/d

1-

199

g/d

200-

399

g/d

g/d

T

he S

wed

ish

Mam

mog

raph

y C

ohor

t

N

o 13

543

3377

7 12

921

1192

M

ean

(SD

) age

at e

ntry

(yea

rs)

55.1

(9.9

) 53

.3 (9

.3)

53.4

(10.

4)

53.7

(9.7

) M

ean

(SD

) bod

y m

ass i

ndex

(kg/

m2 )

25.0

(4.0

) 24

.8 (3

.9)

24.5

(3.8

) 24

.7 (3

.8)

Mea

n (S

D) h

eigh

t (cm

) 16

3.6

(5.9

) 16

4.1

(5.7

) 16

4.4

(5.8

) 16

3.5

(6.0

) M

ean

(SD

) nut

rient

inta

ke:

En

ergy

(kca

l/d)

1467

(473

) 15

86 (4

48)

1666

(452

) 19

61 (5

63)

C

alci

um (m

g/d)

80

3 (1

94)

864

(172

) 95

6 (1

67)

1128

(201

)

Phos

phor

us (m

g/d)

13

03 (2

21)

1369

(191

) 14

67 (1

85)

1606

(216

)

Vita

min

D (m

g/d)

4.

3 (1

.5)

4.4

(1.3

) 4.

5 (1

.4)

4.6

(1.7

)

Ret

inol

(mg/

d)

1.02

(0.7

2)

1.04

(0.6

3)

1.00

(0.6

2)

0.98

(0.6

4)

Pr

otei

n (g

/d)

64.4

(9.9

) 66

.5 (8

.6)

69.3

(8.8

) 73

.6 (1

0.3)

Tota

l fat

(g/d

) 47

.4 (1

9.2)

51

.2 (1

8.6)

51

.4 (1

8.6)

61

.3 (2

4.9)

Satu

rate

d fa

t (g/

d)

20.5

(9.4

) 22

.5 (9

.2)

23.0

(9.1

) 28

.9 (1

2.7)

Alc

ohol

(g/d

) 2.

3 (3

.7)

2.6

(3.5

) 2.

7 (3

.5)

2.3

(3.7

) M

ean

(SD

) met

abol

ic e

quiv

alen

ts (k

cal/k

g an

d ho

ur)

42.3

(4.9

) 42

.5 (4

.8)

42.4

(4.8

) 42

.7 (4

.9)

Cal

cium

supp

lem

ent u

se*

3477

(25.

7)

1097

7 (3

2.5)

43

19 (3

3.4)

34

8 (2

9.2)

V

itam

in D

supp

lem

ent u

se*

1348

(10.

0)

4818

(14.

3)

2217

(17.

2)

217

(18.

2)

Ever

oes

troge

n re

plac

emen

t use

* 25

15 (1

8.6)

74

60 (2

2.1)

32

37 (2

5.1)

33

8 (2

8.4)

Ed

ucat

ion

leve

l:

11

273

(83.

2)

2669

8 (7

9.0)

10

036

(77.

7)

955

(80.

1)

10

-12

year

s 85

6 (6

.3)

2498

(7.4

) 10

95 (8

.5)

86 (7

.2)

>1

2 ye

ars

476

(3.5

) 16

25 (4

.8)

788

(6.1

) 54

(4.5

)

othe

r 93

8 (6

.9)

2956

(8.8

) 10

02 (7

.8)

97 (8

.1)

Cha

rlson

com

orbi

dity

:

Page 8: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

0

1191

6 (8

8.0)

30

583

(90.

5)

1159

7 (8

9.8)

10

49 (8

8.0)

1 12

52 (9

.2)

2574

(7.6

) 10

42 (8

.1)

103

(8.6

)

2 37

5 (2

.8)

620

(1.8

) 28

2 (2

.2)

40 (3

.4)

Nul

lipar

ous

1728

(12.

8)

3303

(9.8

) 15

18 (1

1.7)

14

9 (1

2.5)

Ev

er c

ortis

one

use*

61

2 (4

.5)

1651

(4.9

) 70

3 (5

.4)

55 (4

.6)

Smok

er st

atus

:*

C

urre

nt

2902

(21.

4)

6709

(19.

9)

2254

(17.

4)

225

(18.

9)

Fo

rmer

41

12 (3

0.4)

98

92 (2

9.3)

39

72 (3

0.7)

36

9 (3

1.0)

Nev

er

6529

(48.

2)

1717

6 (5

0.9)

66

95 (5

1.8)

59

8 (5

0.2)

Li

ving

alo

ne

3348

(24.

7)

7586

(22.

5)

3191

(24.

7)

343

(28.

8)

T

he C

ohor

t of S

wed

ish

Men

N

o 17

113

1097

6 10

309

6941

M

ean

(SD

) age

at e

ntry

(yea

rs)

60.5

(9.8

) 59

.3 (9

.5)

60.6

(9.7

) 60

.9 (9

.8)

Mea

n (S

D) b

ody

mas

s ind

ex (k

g/m

2 ) 25

.9 (3

.5)

25.9

(3.3

) 25

.6 (3

.2)

25.6

(3.2

) M

ean

(SD

) hei

ght (

cm)

176.

8 (6

.8)

177.

3 (6

.6)

177.

5 (6

.6)

177.

8 (6

.8)

Mea

n (S

D) n

utrie

nt in

take

:

Ener

gy (k

cal/d

) 25

16 (8

30)

2600

(787

) 27

05 (7

83)

3042

(875

)

Cal

cium

(mg/

d)

1373

(501

) 13

86 (4

03)

1509

(403

) 17

61 (4

64)

Ph

osph

orus

(mg/

d)

1990

(363

) 20

16 (2

96)

2111

(291

) 22

92 (3

37)

V

itam

in D

(mg/

d)

6.7

(3.5

) 6.

6 (2

.6)

6.6

(2.8

) 6.

6 (2

.6)

R

etin

ol (m

g/d)

1.

25 (1

.05)

1.

27 (0

.79)

1.

23 (0

.74)

1.

20 (0

.76)

Prot

ein

(g/d

) 10

0.4

(16.

6)

101.

3 (1

3.8)

10

3.2

(13.

8)

107.

5 (1

4.8)

Tota

l fat

(g/d

) 90

.4 (1

6.7)

89

.8 (1

4.1)

88

.7 (1

4.0)

87

.2 (1

4.5)

Satu

rate

d fa

t (g/

d)

41.0

(10.

5)

40.5

(8.8

) 40

.6 (8

.8)

41.1

(9.2

)

Alc

ohol

(g/d

) 14

.1 (2

2.0)

13

.9 (2

2.0)

12

.8 (1

8.1)

13

.0 (2

1.7)

M

etab

olic

equ

ival

ents

(kca

l/kg

and

hour

) 41

.6 (5

.1)

41.5

(4.8

) 41

.3 (4

.7)

41.9

(5.0

) C

alci

um su

pple

men

t use

13

21 (7

.7)

1103

(10.

0)

1215

(11.

8)

801

(11.

5)

Vita

min

D su

pple

men

t use

18

17 (1

0.6)

14

86 (1

3.5)

16

47 (1

6.0)

11

03 (1

5.9)

Ed

ucat

iona

l lev

el:

1274

5 (7

4.8)

74

35 (6

7.9)

66

21 (6

4.5)

45

61 (6

5.9)

10-1

2 ye

ars

2103

(12.

3)

1652

(15.

1)

1530

(14.

9)

988

(14.

3)

>1

2 ye

ars

2123

(12.

5)

1820

(16.

6)

2077

(20.

2)

1348

(19.

5)

Page 9: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

ot

her

72 (0

.4)

42 (0

.4)

44 (0

.4)

22 (0

.3)

Cha

rlson

com

orbi

dity

:

0 14

054

(82.

1)

9398

(85.

6)

8650

(83.

9)

5780

(83.

3)

1

2129

(12.

4)

1145

(10.

4)

1112

(10.

8)

816

(11.

8)

2

930

(5.4

) 43

3 (3

.9)

547

(5.3

) 34

5 (5

.0)

Ever

cor

tison

e us

e 71

6 (4

.2)

458

(4.2

) 43

6 (4

.2)

303

(4.4

) Sm

oker

stat

us:

C

urre

nt

5033

(29.

9)

2531

(23.

3)

2109

(20.

7)

1436

(21.

0)

Fo

rmer

65

39 (3

8.9)

42

37 (3

9.0)

40

03 (3

9.3)

26

36 (3

8.6)

Nev

er

5254

(31.

2)

4097

(37.

7)

4071

(40.

0)

2765

(40.

4)

Livi

ng a

lone

35

37 (2

0.7)

16

81 (1

5.3)

16

50 (1

6.0)

12

33 (1

7.8)

*I

nfor

mat

ion

avai

labl

e on

ly in

the

1997

que

stio

nnai

re a

nd v

alue

s are

impu

ted

from

thes

e da

ta

Page 10: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le C

. Che

ese

cons

umpt

ion

and

time

to d

eath

and

frac

ture

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort*

and

the

Coh

ort o

f Sw

edis

h M

en

C

ateg

orie

s of d

aily

che

ese

inta

ke

<2

0 g/

d 20

-39

g/d

40-5

9 g/

d g/

d C

ontin

uous

(p

er 2

0 g)

The

Sw

edis

h M

amm

ogra

phy

Coh

ort

T

otal

mor

talit

y N

umbe

r of d

eath

s 66

02

4689

29

22

1328

15

541

Pers

on-y

ears

of f

ollo

w-u

p 36

9590

45

5595

19

6218

21

0415

12

3181

8 R

ate/

1000

per

son-

year

s†

15.3

11

.0

11.0

10

.2

12.6

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.60

(0.5

8 to

0.6

2)

0.63

(0.6

0 to

0.6

6)

0.51

(0.4

8 to

0.5

4)

0.78

(0.7

7 to

0.7

9)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

70 (0

.68

to 0

.73)

0.

75 (0

.72

to 0

.79)

0.

67 (0

.63

to 0

.72)

0.

86 (0

.85

to 0

.88)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.72

(0.6

9 to

0.7

5)

0.77

(0.7

4 to

0.8

1)

0.70

(0.6

5 to

0.7

5)

0.87

(0.8

5 to

0.8

9)

C

ardi

ovas

cula

r m

orta

lity

Num

ber o

f dea

ths

2311

15

74

1034

35

9 52

78

Pers

on-y

ears

of f

ollo

w-u

p 36

9590

45

5595

19

6218

21

0415

12

3181

8 R

ate/

1000

per

son-

year

s†

5.2

3.7

3.9

3.4

4.3

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

59 (0

.55

to 0

.62)

0.

63 (0

.59

to 0

.68)

0.

48 (0

.43

to 0

.53)

0.

77 (0

.74

to 0

.79)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.69

(0.6

4 to

0.7

3)

0.74

(0.6

8 to

0.8

0)

0.61

(0.5

4 to

0.6

8)

0.83

(0.8

1 to

0.8

6)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

70 (0

.65

to 0

.75)

0.

76 (0

.70

to 0

.82)

0.

63 (0

.55

to 0

.72)

0.

83 (0

.80

to 0

.87)

Can

cer

mor

talit

y N

umbe

r of d

eath

s 10

33

1165

61

3 47

2 32

83

Pers

on-y

ears

of f

ollo

w-u

p 36

9590

45

5595

19

6218

21

0415

12

3181

8 R

ate/

1000

per

son-

year

s†

2.5

2.8

2.4

3.5

2.7

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

82 (0

.76

to 0

.90)

0.

76 (0

.68

to 0

.84)

0.

85 (0

.76

to 0

.95)

0.

94 (0

.91

to 0

.97)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.89

(0.8

2 to

0.9

7)

0.84

(0.7

6 to

0.9

3)

0.96

(0.8

5 to

1.0

9)

0.98

(0.9

5 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

89 (0

.81

to 0

.97)

0.

84 (0

.75

to 0

.94)

0.

95 (0

.83

to 1

.10)

0.

98 (0

.94

to 1

.02)

Any

frac

ture

N

umbe

r of f

ract

ures

56

72

5905

33

54

2321

17

252

Pers

on-y

ears

of f

ollo

w-u

p 33

4019

41

3732

17

2118

19

2968

11

1283

7

Page 11: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Rat

e/10

00 p

erso

n-ye

ars†

15

.6

15.2

17

.9

16.3

15

.5

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

83 (0

.80

to 0

.86)

0.

87 (0

.83

to 0

.91)

0.

79 (0

.76

to 0

.83)

0.

93 (0

.92

to 0

.95)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.86

(0.8

3 to

0.8

9)

0.92

(0.8

8 to

0.9

6)

0.85

(0.8

1 to

0.9

0)

0.96

(0.9

4 to

0.9

7)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

87 (0

.84

to 0

.91)

0.

94 (0

.90

to 0

.99)

0.

89 (0

.83

to 0

.94)

0.

97 (0

.95

to 0

.98)

Hip

frac

ture

N

umbe

r of f

ract

ures

17

22

1290

93

0 31

7 42

59

Pers

on-y

ears

of f

ollo

w-u

p 36

1851

44

9090

19

1694

20

8659

12

1129

5 R

ate/

1000

per

son-

year

s†

4.0

3.1

3.6

2.8

3.5

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

63 (0

.59

to 0

.68)

0.

75 (0

.70

to 0

.82)

0.

50 (0

.44

to 0

.56)

0.

82 (0

.79

to 0

.85)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.69

(0.6

4 to

0.7

4)

0.81

(0.7

5 to

0.8

8)

0.57

(0.5

0 to

0.6

4)

0.86

(0.8

3 to

0.8

9)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

72 (0

.67

to 0

.78)

0.

88 (0

.80

to 0

.97)

0.

64 (0

.55

to 0

.74)

0.

89 (0

.85

to 0

.92)

The

Coh

ort o

f Sw

edis

h M

en

T

otal

mor

talit

y N

umbe

r of d

eath

s 17

54

1484

26

95

4179

10

112

Pers

on-y

ears

of f

ollo

w-u

p 84

070

7426

4 13

3546

24

2214

53

4094

R

ate/

1000

per

son-

year

s†

21.8

19

.7

18.2

18

.2

18.9

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.90

(0.8

4 to

0.9

6)

0.83

(0.7

8 to

0.8

8)

0.82

(0.7

8 to

0.8

7)

0.99

(0.9

8 to

1.0

0)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

97 (0

.91

to 1

.04)

0.

92 (0

.87

to 0

.98)

0.

93 (0

.87

to 0

.98)

0.

99 (0

.98

to 1

.01)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.95

(0.8

9 to

1.0

2)

0.89

(0.8

4 to

0.9

5)

0.86

(0.8

0 to

0.9

2)

0.97

(0.9

6 to

0.9

9)

C

ardi

ovas

cula

r m

orta

lity

Num

ber o

f dea

ths

811

694

1238

18

25

4568

Pe

rson

-yea

rs o

f fol

low

-up

8407

0 74

264

1335

46

2422

14

5340

94

Rat

e/10

00 p

erso

n-ye

ars†

10

.2

9.2

8.2

8.0

8.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

90 (0

.81

to 1

.00)

0.

80 (0

.73

to 0

.88)

0.

78 (0

.71

to 0

.84)

0.

98 (0

.97

to 1

.00)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.99

(0.8

9 to

1.0

9)

0.93

(0.8

5 to

1.0

1)

0.91

(0.8

4 to

1.0

0)

0.99

(0.9

7 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

97 (0

.88

to 1

.08)

0.

91 (0

.82

to 0

.99)

0.

87 (0

.79

to 0

.97)

0.

97 (0

.95

to 0

.99)

Page 12: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Can

cer

mor

talit

y N

umbe

r of d

eath

s 43

4 42

4 74

5 12

78

2881

Pe

rson

-yea

rs o

f fol

low

-up

8407

0 74

264

1335

46

2422

14

5340

94

Rat

e/10

00 p

erso

n-ye

ars†

5.

3 5.

6 5.

2 5.

5 5.

4 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.05

(0.9

2 to

1.2

1)

0.96

(0.8

5 to

1.0

8)

1.02

(0.9

2 to

1.1

4)

1.01

(0.9

9 to

1.0

2)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 1.

09 (0

.95

to 1

.24)

1.

01 (0

.90

to 1

.14)

1.

07 (0

.95

to 1

.20)

1.

00 (0

.98

to 1

.02)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.09

(0.9

5 to

1.2

4)

1.01

(0.8

9 to

1.1

4)

1.07

(0.9

3 to

1.2

2)

1.00

(0.9

7 to

1.0

2)

A

ny fr

actu

re

Num

ber o

f fra

ctur

es

859

747

1411

23

62

5379

Pe

rson

-yea

rs o

f fol

low

-up

8026

9 70

808

1272

28

2310

57

5093

61

Rat

e/10

00 p

erso

n-ye

ars†

10

.9

10.5

10

.7

10.4

10

.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

97 (0

.88

to 1

.07)

0.

98 (0

.90

to 1

.07)

0.

96 (0

.88

to 1

.03)

1.

01 (0

.99

to 1

.02)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.98

(0.8

9 to

1.0

8)

1.00

(0.9

2 to

1.0

9)

0.95

(0.8

8 to

1.0

4)

1.00

(0.9

8 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

96 (0

.87

to 1

.06)

0.

97 (0

.88

to 1

.06)

0.

89 (0

.80

to 0

.98)

0.

99 (0

.97

to 1

.01)

Hip

frac

ture

N

umbe

r of h

ip fr

actu

res

227

161

369

509

1266

Pe

rson

-yea

rs o

f fol

low

-up

8339

1 73

732

1323

77

2405

47

5300

47

Rat

e/10

00 p

erso

n-ye

ars†

2.

9 2.

1 2.

5 2.

2 2.

4 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.74

(0.6

1 to

0.9

1)

0.86

(0.7

3 to

1.0

2)

0.77

(0.6

6 to

0.9

0)

1.00

(0.9

7 to

1.0

3)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

77 (0

.63

to 0

.94)

0.

91 (0

.77

to 1

.08)

0.

80 (0

.68

to 0

.95)

1.

00 (0

.97

to 1

.03)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.76

(0.6

2 to

0.9

3)

0.88

(0.7

4 to

1.0

5)

0.75

(0.6

2 to

0.9

2)

0.98

(0.9

4 to

1.0

2)

CI:

conf

iden

ce in

terv

al; H

R: h

azar

d ra

tio

* ha

d ac

cess

to re

peat

exp

osur

e in

form

atio

n; e

xpos

ures

and

cov

aria

tes w

ere

treat

ed a

s cum

ulat

ive

aver

ages

Age

stan

dard

ized

rate

s, nu

mbe

r of c

ases

per

100

0 pe

rson

-yea

rs a

t ris

k M

odel

1: a

ge-a

djus

ted

Mod

el 2

: adj

uste

d fo

r age

, bod

y m

ass i

ndex

, hei

ght,

tota

l ene

rgy

inta

ke, t

otal

alc

ohol

inta

ke, a

hea

lthy

diet

ary

patte

rn, c

alci

um a

nd v

itam

in D

su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s met

abol

ic e

quiv

alen

ts, s

mok

ing

stat

us

and

Cha

rlson

’s c

omor

bidi

ty in

dex;

and

in w

omen

add

ition

ally

for e

ver u

se o

f oes

troge

n re

plac

emen

t the

rapy

and

nul

lipar

ity.

Mod

el 3

: adj

uste

d ac

cord

ing

to m

odel

2 b

ut a

dditi

onal

ly a

djus

ted

for i

ntak

e of

cal

cium

, vita

min

D, p

hosp

horu

s, to

tal f

at, s

atur

ated

fat,

tota

l pr

otei

n an

d re

tinol

Page 13: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le D

. Sou

red

milk

and

yog

urt c

onsu

mpt

ion

and

time

to d

eath

and

frac

ture

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort*

and

the

Coh

ort o

f Sw

edis

h M

en

C

ateg

orie

s of d

aily

sour

ed m

ilk a

nd y

ogur

t int

ake

<1

g/d

1-

199

g/d

200-

399

g/d

g/d

Con

tinuo

us

(per

200

g/d

)

The

Sw

edis

h M

amm

ogra

phy

Coh

ort

T

otal

mor

talit

y N

umbe

r of d

eath

s 35

12

7846

36

92

491

1554

1 Pe

rson

-yea

rs o

f fol

low

-up

2200

64

6991

22

2790

85

3354

7 12

3181

8 R

ate/

1000

per

son-

year

s†

16.1

11

.8

11.7

11

.7

12.6

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.65

(0.6

2 to

0.6

8)

0.65

(0.6

2 to

0.6

9)

0.62

(0.5

6 to

0.6

8)

0.78

(0.7

5 to

0.8

0)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

76 (0

.73

to 0

.80)

0.

84 (0

.80

to 0

.89)

0.

86 (0

.78

to 0

.95)

0.

92 (0

.90

to 0

.95)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.76

(0.7

3 to

0.8

0)

0.84

(0.8

0 to

0.8

8)

0.86

(0.7

8 to

0.9

5)

0.91

(0.8

9 to

0.9

4)

C

ardi

ovas

cula

r m

orta

lity

Num

ber o

f dea

ths

3738

13

39

201

5278

37

38

Pers

on-y

ears

of f

ollo

w-u

p 91

9186

27

9085

33

547

1231

818

9191

86

Rat

e/10

00 p

erso

n-ye

ars†

5.

4 4.

0 4.

0 4.

3 4.

1 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.65

(0.6

0 to

0.6

9)

0.66

(0.6

1 to

0.7

1)

0.68

(0.5

9 to

0.7

9)

0.81

(0.7

8 to

0.8

5)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

75 (0

.70

to 0

.81)

0.

83 (0

.77

to 0

.90)

0.

92 (0

.78

to 1

.07)

0.

95 (0

.91

to 1

.00)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.75

(0.7

0 to

0.8

1)

0.83

(0.7

6 to

0.9

0)

0.93

(0.7

9 to

1.0

9)

0.95

(0.9

0 to

1.0

0)

C

ance

r m

orta

lity

Num

ber o

f dea

ths

2425

75

1 10

7 32

83

2425

Pe

rson

-yea

rs o

f fol

low

-up

9191

86

2790

85

3354

7 12

3181

8 91

9186

R

ate/

1000

per

son-

year

s†

2.7

2.7

2.5

2.7

2.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

83 (0

.76

to 0

.91)

0.

76 (0

.68

to 0

.84)

0.

75 (0

.61

to 0

.92)

0.

88 (0

.83

to 0

.93)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.90

(0.8

2 to

0.9

9)

0.86

(0.7

7 to

0.9

6)

0.85

(0.6

9 to

1.0

5)

0.95

(0.8

9 to

1.0

0)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

89 (0

.81

to 0

.98)

0.

84 (0

.74

to 0

.94)

0.

81 (0

.65

to 1

.01)

0.

93 (0

.87

to 0

.99)

Page 14: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Any

frac

ture

N

umbe

r of f

ract

ures

12

638

4099

51

5 17

252

1263

8 Pe

rson

-yea

rs o

f fol

low

-up

8320

99

2509

76

2976

2 11

1283

7 83

2099

R

ate/

1000

per

son-

year

s†

16.2

15

.2

15.5

15

.4

15.2

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.84

(0.8

0 to

0.8

7)

0.85

(0.8

2 to

0.9

0)

0.80

(0.7

2 to

0.8

7)

0.93

(0.9

0 to

0.9

5)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

88 (0

.85

to 0

.92)

0.

92 (0

.88

to 0

.96)

0.

90 (0

.82

to 0

.99)

0.

97 (0

.95

to 1

.00)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.89

(0.8

5 to

0.9

2)

0.94

(0.8

9 to

0.9

8)

0.93

(0.8

4 to

1.0

3)

0.98

(0.9

6 to

1.0

1)

H

ip fr

actu

re

Num

ber o

f fra

ctur

es

3075

10

69

115

4259

30

75

Pers

on-y

ears

of f

ollo

w-u

p 90

4452

27

3920

32

923

1211

295

9044

52

Rat

e/10

00 p

erso

n-ye

ars†

4.

5 3.

3 3.

4 2.

7 3.

4 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.63

(0.5

9 to

0.6

9)

0.66

(0.6

1 to

0.7

2)

0.49

(0.4

1 to

0.6

0)

0.78

(0.7

4 to

0.8

2)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

72 (0

.66

to 0

.77)

0.

81 (0

.74

to 0

.88)

0.

64 (0

.53

to 0

.78)

0.

89 (0

.84

to 0

.94)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.73

(0.6

8 to

0.7

9)

0.84

(0.7

6 to

0.9

3)

0.70

(0.5

7 to

0.8

6)

0.92

(0.8

7 to

0.9

8)

T

he C

ohor

t of S

wed

ish

Men

T

otal

mor

talit

y N

umbe

r of d

eath

s 42

71

2034

22

56

1551

10

112

Pers

on-y

ears

of f

ollo

w-u

p 19

8527

13

1942

12

1784

81

840

5340

94

Rat

e/10

00 p

erso

n-ye

ars†

21

.2

17.0

17

.9

17.7

18

.9

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

79 (0

.75

to 0

.83)

0.

83 (0

.79

to 0

.88)

0.

83 (0

.78

to 0

.87)

0.

95 (0

.93

to 0

.97)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.88

(0.8

4 to

0.9

3)

0.91

(0.8

6 to

0.9

5)

0.90

(0.8

5 to

0.9

6)

0.97

(0.9

5 to

0.9

9)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

88 (0

.84

to 0

.93)

0.

90 (0

.86

to 0

.95)

0.

90 (0

.84

to 0

.96)

0.

97 (0

.95

to 0

.99)

Car

diov

ascu

lar

mor

talit

y N

umbe

r of d

eath

s 19

38

917

996

717

4568

Pe

rson

-yea

rs o

f fol

low

-up

1985

27

1319

42

1217

84

8184

0 53

4094

R

ate/

1000

per

son-

year

s†

9.6

7.8

7.9

8.1

8.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

80 (0

.74

to 0

.87)

0.

81 (0

.75

to 0

.88)

0.

84 (0

.77

to 0

.91)

0.

95 (0

.93

to 0

.98)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.91

(0.8

4 to

0.9

8)

0.89

(0.8

2 to

0.9

6)

0.93

(0.8

5 to

1.0

1)

0.98

(0.9

5 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

91 (0

.84

to 0

.98)

0.

88 (0

.82

to 0

.95)

0.

90 (0

.82

to 0

.99)

0.

97 (0

.94

to 1

.00)

Page 15: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

C

ance

r m

orta

lity

Num

ber o

f dea

ths

1181

61

9 65

6 42

5 28

81

Pers

on-y

ears

of f

ollo

w-u

p 19

8527

13

1942

12

1784

81

840

5340

94

Rat

e/10

00 p

erso

n-ye

ars†

5.

9 5.

1 5.

2 4.

9 5.

4 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.85

(0.7

7 to

0.9

4)

0.88

(0.8

0 to

0.9

7)

0.83

(0.7

4 to

0.9

2)

0.94

(0.9

0 to

0.9

8)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

90 (0

.81

to 0

.99)

0.

93 (0

.84

to 1

.02)

0.

87 (0

.78

to 0

.98)

0.

95 (0

.92

to 0

.99)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.90

(0.8

2 to

1.0

0)

0.94

(0.8

5 to

1.0

3)

0.89

(0.7

9 to

1.0

1)

0.96

(0.9

2 to

1.0

0)

A

ny fr

actu

re

Num

ber o

f fra

ctur

es

2103

12

35

1199

84

2 53

79

Pers

on-y

ears

of f

ollo

w-u

p 18

9017

12

6054

11

6338

77

952

5093

61

Rat

e/10

00 p

erso

n-ye

ars†

11

.1

10.1

10

.2

10.6

10

.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

90 (0

.84

to 0

.97)

0.

91 (0

.85

to 0

.98)

0.

94 (0

.87

to 1

.02)

1.

00 (0

.97

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.93

(0.8

7 to

1.0

0)

0.92

(0.8

6 to

0.9

9)

0.95

(0.8

7 to

1.0

3)

1.00

(0.9

7 to

1.0

3)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

93 (0

.87

to 1

.00)

0.

92 (0

.86

to 0

.99)

0.

95 (0

.87

to 1

.03)

1.

00 (0

.97

to 1

.03)

H

ip fr

actu

re

Num

ber o

f hip

frac

ture

s 56

5 24

6 26

8 18

7 12

66

Pers

on-y

ears

of f

ollo

w-u

p 19

6838

13

1053

12

0947

81

209

5300

47

Rat

e/10

00 p

erso

n-ye

ars†

2.

8 2.

1 2.

1 2.

1 2.

4 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.73

(0.6

3 to

0.8

5)

0.74

(0.6

4 to

0.8

6)

0.75

(0.6

3 to

0.8

8)

0.96

(0.9

1 to

1.0

2)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

77 (0

.66

to 0

.90)

0.

76 (0

.65

to 0

.88)

0.

77 (0

.65

to 0

.92)

0.

97 (0

.92

to 1

.03)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.78

(0.6

7 to

0.9

0)

0.75

(0.6

5 to

0.8

7)

0.75

(0.6

3 to

0.9

0)

0.97

(0.9

1 to

1.0

4)

CI:

conf

iden

ce in

terv

al; H

R: h

azar

d ra

tio

*had

acc

ess t

o re

peat

exp

osur

e in

form

atio

n, e

xpos

ures

and

cov

aria

tes w

ere

treat

ed a

s cum

ulat

ive

aver

ages

Age

stan

dard

ized

rate

s, nu

mbe

r of c

ases

per

100

0 pe

rson

-yea

rs a

t ris

k M

odel

1: a

ge-a

djus

ted

Mod

el 2

: adj

uste

d fo

r age

, bod

y m

ass i

ndex

, hei

ght,

tota

l ene

rgy

inta

ke, t

otal

alc

ohol

inta

ke, a

hea

lthy

diet

ary

patte

rn, c

alci

um a

nd v

itam

in D

su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s met

abol

ic e

quiv

alen

ts, s

mok

ing

stat

us

and

Cha

rlson

’s c

omor

bidi

ty in

dex;

and

in w

omen

add

ition

ally

for e

ver u

se o

f oes

troge

n re

plac

emen

t the

rapy

and

nul

lipar

ity.

Mod

el 3

: adj

uste

d ac

cord

ing

to m

odel

2 b

ut a

dditi

onal

ly a

djus

ted

for i

ntak

e of

cal

cium

, vita

min

D, p

hosp

horu

s, to

tal f

at, s

atur

ated

fat,

tota

l pr

otei

n an

d re

tinol

.

Page 16: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le E

. Mec

hani

stic

mod

el o

f milk

con

sum

ptio

n in

rela

tion

to m

orta

lity

and

frac

ture

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort*

and

in th

e C

ohor

t of

Sw

edis

h M

en.

C

ateg

orie

s of d

aily

milk

inta

ke

<1 g

lass

1

to 2

gla

sses

2

to 3

gla

sses

Con

tinuo

us

(<

200

g/d)

(2

00 to

399

g/d

) (4

00 to

599

g/d

) g/

d)

(per

200

g/d

)

The

Sw

edis

h M

amm

ogra

phy

Coh

ort

T

otal

mor

talit

y A

djus

ted

HR

(95%

CI)

† 1.

00 (r

efer

ence

) 1.

33 (1

.27

to 1

.38)

1.

90 (1

.80

to 2

.01)

2.

61 (2

.41

to 2

.84)

1.

26 (1

.23

to 1

.29)

Any

frac

ture

A

djus

ted

HR

(95%

CI)

† 1.

00 (r

efer

ence

) 1.

13 (1

.09

to 1

.17)

1.

28 (1

.21

to 1

.35)

1.

37 (1

.26

to 1

.49)

1.

06 (1

.04

to 1

.09)

Hip

frac

ture

A

djus

ted

HR

(95%

CI)

† 1.

00 (r

efer

ence

) 1.

38 (1

.28

to 1

.49)

2.

03 (1

.83

to 2

.25)

2.

54 (2

.15

to 3

.00)

1.

25 (1

.19

to 1

.32)

The

Coh

ort o

f Sw

edis

h M

en

T

otal

mor

talit

y A

djus

ted

HR

(95%

CI)

† 1.

00 (r

efer

ence

) 1.

01 (0

.96

to 1

.07)

1.

09 (1

.02

to 1

.15)

1.

16 (1

.07

to 1

.25)

1.

05 (1

.03

to 1

.06)

Any

frac

ture

A

djus

ted

HR

(95%

CI)

† 1.

00 (r

efer

ence

) 1.

03 (0

.96

to 1

.11)

1.

02 (0

.94

to 1

.11)

1.

05 (0

.94

to 1

.16)

1.

02 (1

.00

to 1

.05)

Hip

frac

ture

A

djus

ted

HR

(95%

CI)

† 1.

00 (r

efer

ence

) 0.

98 (0

.84

to 1

.14)

1.

19 (1

.01

to 1

.40)

1.

10 (0

.89

to 1

.37)

1.

07 (1

.02

to 1

.13)

H

R: H

azar

d ra

tio, C

I: co

nfid

ence

inte

rval

*h

ad a

cces

s to

repe

at e

xpos

ure

info

rmat

ion,

exp

osur

es a

nd c

ovar

iate

s wer

e tre

ated

as c

umul

ativ

e av

erag

es

†The

haz

ard

ratio

s wer

e ad

just

ed fo

r age

, bod

y m

ass i

ndex

, hei

ght,

tota

l ene

rgy

inta

ke, t

otal

alc

ohol

inta

ke, a

hea

lthy

diet

ary

patte

rn, c

alci

um a

nd

vita

min

D su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s met

abol

ic e

quiv

alen

ts,

smok

ing

stat

us a

nd C

harls

on’s

com

orbi

dity

inde

x an

d in

add

ition

inta

ke o

f cal

cium

, vita

min

D, p

hosp

horu

s, to

tal f

at, s

atur

ated

fat,

tota

l pro

tein

an

d re

tinol

; and

in w

omen

add

ition

ally

for e

ver u

se o

f oes

troge

n re

plac

emen

t the

rapy

and

nul

lipar

ity.

Page 17: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le F

. Dai

ly c

onsu

mpt

ion

of m

ilk, c

hees

e an

d fe

rmen

ted

milk

or y

ogur

t in

rela

tion

to m

orta

lity

and

frac

ture

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort*

; mut

ually

adj

uste

d fo

r int

akes

of t

he o

ther

dai

ry c

ateg

orie

s

Tot

al m

orta

lity

Milk

inta

ke

<200

g/d

20

0 to

399

g/d

40

0 to

599

g/d

g/

d pe

r 200

g/d

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.29

(1.2

4 to

1.3

3)

1.75

(1.6

7 to

1.8

3)

2.05

(1.9

2 to

2.1

9)

1.18

(1.1

6 to

1.2

0)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 1.

19 (1

.15

to 1

.24)

1.

53 (1

.46

to 1

.61)

1.

78 (1

.66

to 1

.91)

1.

13 (1

.11

to 1

.15)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.33

(1.2

8 to

1.3

9)

1.91

(1.8

0 to

2.0

3)

2.62

(2.3

8 to

2.8

9)

1.19

(1.1

5 to

1.2

4)

Che

ese

inta

ke

<20

g/d

20 to

39

g/d

40 to

59

g/d

g/d

per 2

0 g/

d H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.64

(0.6

1 to

0.6

6)

0.65

(0.6

2 to

0.6

8)

0.54

(0.5

0 to

0.5

7)

0.79

(0.7

8 to

0.8

1)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

74 (0

.71

to 0

.77)

0.

78 (0

.75

to 0

.82)

0.

72 (0

.67

to 0

.76)

0.

87 (0

.86

to 0

.89)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.82

(0.7

9 to

0.8

6)

0.96

(0.9

1 to

1.0

1)

0.98

(0.9

1 to

1.0

6)

0.93

(0.9

0 to

0.9

5)

Ferm

ente

d m

ilk/y

ogur

t int

ake

<1 g

/d

1 to

199

g/d

20

0 to

399

g/d

g/

d pe

r 200

g/d

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.70

(0.6

7 to

0.7

3)

0.73

(0.6

9 to

0.7

6)

0.67

(0.6

1 to

0.7

4)

0.82

(0.8

0 to

0.8

4)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

79 (0

.76

to 0

.83)

0.

88 (0

.84

to 0

.93)

0.

90 (0

.81

to 0

.99)

0.

94 (0

.91

to 0

.96)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.85

(0.8

2 to

0.8

9)

1.03

(0.9

8 to

1.0

9)

1.20

(1.0

8 to

1.3

3)

0.98

(0.9

5 to

1.0

2)

C

ardi

ovas

cula

r m

orta

lity

Milk

inta

ke

<200

g/d

20

0 to

399

g/d

40

0 to

599

g/d

g/

d pe

r 200

g/d

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.25

(1.1

7 to

1.3

3)

1.76

(1.6

3 to

1.9

0)

2.04

(1.8

2 to

2.2

9)

1.20

(1.1

6 to

1.2

3)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 1.

14 (1

.07

to 1

.22)

1.

51 (1

.40

to 1

.64)

1.

73 (1

.54

to 1

.96)

1.

13 (1

.10

to 1

.17)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.25

(1.1

6 to

1.3

4)

1.80

(1.6

2 to

1.9

9)

2.35

(2.0

0 to

2.7

7)

1.18

(1.1

1 to

1.2

6)

Che

ese

inta

ke

<20

g/d

20 to

39

g/d

40 to

59

g/d

g/d

per 2

0 g/

d H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.62

(0.5

8 to

0.6

6)

0.65

(0.6

1 to

0.7

0)

0.50

(0.4

5 to

0.5

6)

0.78

(0.7

5 to

0.8

0)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

72 (0

.67

to 0

.77)

0.

77 (0

.71

to 0

.83)

0.

64 (0

.57

to 0

.73)

0.

84 (0

.82

to 0

.87)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

0.79

(0.7

3 to

0.8

5)

0.91

(0.8

3 to

0.9

9)

0.84

(0.7

3 to

0.9

7)

0.89

(0.8

5 to

0.9

3)

Ferm

ente

d m

ilk/y

ogur

t int

ake

<1 g

/d

1 to

199

g/d

20

0 to

399

g/d

g/

d pe

r 200

g/d

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

0.70

(0.6

5 to

0.7

5)

0.73

(0.6

7 to

0.7

9)

0.74

(0.6

4 to

0.8

6)

0.86

(0.8

2 to

0.9

0)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

78 (0

.73

to 0

.84)

0.

87 (0

.80

to 0

.95)

0.

95 (0

.82

to 1

.11)

0.

96 (0

.92

to 1

.01)

Page 18: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

83 (0

.77

to 0

.89)

0.

98 (0

.90

to 1

.08)

1.

20 (1

.01

to 1

.42)

1.

00 (0

.94

to 1

.06)

Can

cer

mor

talit

y M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

10 (1

.02

to 1

.19)

1.

22 (1

.10

to 1

.35)

1.

49 (1

.28

to 1

.74)

1.

08 (1

.04

to 1

.13)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.06

(0.9

8 to

1.1

5)

1.15

(1.0

3 to

1.2

8)

1.40

(1.1

9 to

1.6

5)

1.06

(1.0

2 to

1.1

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

08 (0

.99

to 1

.18)

1.

18 (1

.03

to 1

.35)

1.

48 (1

.19

to 1

.83)

1.

08 (0

.99

to 1

.17)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

85 (0

.78

to 0

.93)

0.

78 (0

.70

to 0

.86)

0.

88 (0

.79

to 0

.99)

0.

95 (0

.92

to 0

.98)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.91

(0.8

3 to

0.9

9)

0.86

(0.7

7 to

0.9

5)

0.99

(0.8

8 to

1.1

2)

0.98

(0.9

5 to

1.0

2)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

92 (0

.84

to 1

.01)

0.

88 (0

.78

to 1

.00)

1.

04 (0

.89

to 1

.21)

1.

00 (0

.94

to 1

.05)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

86 (0

.78

to 0

.95)

0.

79 (0

.71

to 0

.88)

0.

77 (0

.62

to 0

.94)

0.

89 (0

.84

to 0

.95)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.92

(0.8

4 to

1.0

1)

0.88

(0.7

8 to

0.9

8)

0.86

(0.6

9 to

1.0

6)

0.95

(0.9

0 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

93 (0

.84

to 1

.03)

0.

90 (0

.79

to 1

.02)

0.

89 (0

.71

to 1

.13)

0.

96 (0

.89

to 1

.04)

Any

frac

ture

M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

07 (1

.04

to 1

.11)

1.

15 (1

.10

to 1

.20)

1.

13 (1

.06

to 1

.21)

1.

01 (1

.00

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.07

(1.0

3 to

1.1

1)

1.14

(1.0

9 to

1.2

0)

1.13

(1.0

5 to

1.2

1)

1.01

(0.9

9 to

1.0

3)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

15 (1

.10

to 1

.19)

1.

31 (1

.23

to 1

.39)

1.

42 (1

.29

to 1

.57)

1.

06 (1

.02

to 1

.10)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

84 (0

.81

to 0

.87)

0.

88 (0

.85

to 0

.92)

0.

81 (0

.77

to 0

.85)

0.

94 (0

.93

to 0

.95)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.87

(0.8

4 to

0.9

0)

0.93

(0.8

9 to

0.9

7)

0.87

(0.8

2 to

0.9

1)

0.96

(0.9

4 to

0.9

7)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

91 (0

.88

to 0

.95)

1.

03 (0

.98

to 1

.09)

1.

01 (0

.94

to 1

.09)

0.

99 (0

.96

to 1

.01)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

85 (0

.82

to 0

.89)

0.

88 (0

.84

to 0

.92)

0.

82 (0

.74

to 0

.90)

0.

94 (0

.91

to 0

.96)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.89

(0.8

5 to

0.9

3)

0.93

(0.8

9 to

0.9

8)

0.90

(0.8

2 to

1.0

0)

0.97

(0.9

5 to

1.0

0)

Page 19: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

93 (0

.89

to 0

.97)

1.

02 (0

.97

to 1

.08)

1.

08 (0

.97

to 1

.20)

1.

01 (0

.97

to 1

.05)

Hip

frac

ture

M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

23 (1

.15

to 1

.32)

1.

62 (1

.49

to 1

.77)

1.

66 (1

.45

to 1

.90)

1.

11 (1

.07

to 1

.15)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.17

(1.0

9 to

1.2

6)

1.47

(1.3

4 to

1.6

0)

1.45

(1.2

6 to

1.6

8)

1.06

(1.0

3 to

1.1

0)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

38 (1

.28

to 1

.50)

2.

02 (1

.80

to 2

.28)

2.

53 (2

.09

to 3

.06)

1.

22 (1

.14

to 1

.31)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

66 (0

.62

to 0

.72)

0.

78 (0

.72

to 0

.85)

0.

53 (0

.47

to 0

.60)

0.

83 (0

.81

to 0

.86)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.71

(0.6

6 to

0.7

7)

0.84

(0.7

7 to

0.9

1)

0.59

(0.5

2 to

0.6

8)

0.86

(0.8

3 to

0.8

9)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

82 (0

.76

to 0

.89)

1.

08 (0

.98

to 1

.20)

0.

89 (0

.76

to 1

.04)

0.

96 (0

.91

to 1

.01)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

67 (0

.62

to 0

.73)

0.

72 (0

.66

to 0

.78)

0.

53 (0

.43

to 0

.64)

0.

81 (0

.77

to 0

.86)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.74

(0.6

8 to

0.8

0)

0.83

(0.7

6 to

0.9

1)

0.66

(0.5

4 to

0.8

1)

0.90

(0.8

5 to

0.9

5)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

82 (0

.75

to 0

.89)

1.

04 (0

.93

to 1

.15)

0.

97 (0

.78

to 1

.21)

1.

01 (0

.94

to 1

.08)

H

R: H

azar

d ra

tio, C

I: co

nfid

ence

inte

rval

*h

ad a

cces

s to

repe

at e

xpos

ure

info

rmat

ion,

exp

osur

es a

nd c

ovar

iate

s wer

e tre

ated

as c

umul

ativ

e av

erag

es

Mod

el 1

adj

uste

d fo

r age

, milk

, che

ese,

ferm

ente

d m

ilk/y

ogur

t M

odel

2 a

djus

ted

for a

ge, m

ilk, c

hees

e, fe

rmen

ted

milk

/yog

urt,

body

mas

s ind

ex, h

eigh

t, to

tal e

nerg

y in

take

, tot

al a

lcoh

ol in

take

, a h

ealth

y di

etar

y pa

ttern

, cal

cium

and

vita

min

D su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s m

etab

olic

equ

ival

ents

, sm

okin

g st

atus

, Cha

rlson

’s c

omor

bidi

ty in

dex,

eve

r use

of o

estro

gen

repl

acem

ent t

hera

py, a

nd n

ullip

arity

. M

odel

3, a

djus

ted

acco

rdin

g to

mod

el 2

but

in a

dditi

on in

clud

ed in

take

of c

alci

um, v

itam

in D

, pho

spho

rus,

tota

l fat

, sat

urat

ed fa

t, to

tal p

rote

in,

and

retin

ol

Page 20: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le G

. Dai

ly c

onsu

mpt

ion

of m

ilk, c

hees

e an

d fe

rmen

ted

milk

or y

ogur

t in

rela

tion

to m

orta

lity

and

frac

ture

in th

e C

ohor

t of S

wed

ish

Men

; m

utua

lly a

djus

ted

for i

ntak

es o

f the

oth

er d

airy

cat

egor

ies

T

otal

mor

talit

y M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

01 (0

.96

to 1

.06)

1.

08 (1

.03

to 1

.14)

1.

14 (1

.08

to 1

.21)

1.

04 (1

.02

to 1

.05)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.00

(0.9

5 to

1.0

5)

1.05

(1.0

0 to

1.1

1)

1.09

(1.0

3 to

1.1

6)

1.03

(1.0

1 to

1.0

4)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

00 (0

.95

to 1

.05)

1.

06 (0

.99

to 1

.12)

1.

09 (1

.00

to 1

.18)

1.

01 (0

.98

to 1

.03)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

91 (0

.85

to 0

.97)

0.

83 (0

.78

to 0

.88)

0.

82 (0

.78

to 0

.87)

0.

99 (0

.98

to 1

.00)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.98

(0.9

1 to

1.0

5)

0.93

(0.8

7 to

0.9

9)

0.93

(0.8

7 to

0.9

9)

0.99

(0.9

8 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

96 (0

.89

to 1

.03)

0.

90 (0

.84

to 0

.96)

0.

87 (0

.81

to 0

.94)

0.

97 (0

.95

to 0

.99)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

92 (0

.88

to 0

.97)

0.

89 (0

.83

to 0

.95)

0.

95 (0

.86

to 1

.06)

0.

96 (0

.93

to 0

.98)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.95

(0.9

1 to

1.0

0)

0.94

(0.8

8 to

1.0

0)

0.95

(0.8

5 to

1.0

5)

0.97

(0.9

5 to

0.9

9)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

96 (0

.91

to 1

.01)

0.

94 (0

.88

to 1

.01)

0.

94 (0

.84

to 1

.06)

0.

96 (0

.93

to 0

.99)

Car

diov

ascu

lar

mor

talit

y M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

07 (0

.99

to 1

.16)

1.

16 (1

.07

to 1

.25)

1.

24 (1

.14

to 1

.35)

1.

06 (1

.04

to 1

.08)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.04

(0.9

6 to

1.1

2)

1.10

(1.0

1 to

1.1

9)

1.15

(1.0

6 to

1.2

6)

1.05

(1.0

3 to

1.0

7)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

03 (0

.95

to 1

.12)

1.

09 (0

.99

to 1

.19)

1.

12 (0

.99

to 1

.27)

1.

03 (0

.99

to 1

.07)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

91 (0

.82

to 1

.01)

0.

80 (0

.74

to 0

.88)

0.

77 (0

.71

to 0

.84)

0.

98 (0

.96

to 0

.99)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.99

(0.9

0 to

1.1

0)

0.93

(0.8

5 to

1.0

2)

0.92

(0.8

4 to

1.0

0)

0.99

(0.9

7 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

98 (0

.89

to 1

.09)

0.

92 (0

.83

to 1

.01)

0.

89 (0

.80

to 0

.99)

0.

97 (0

.95

to 1

.00)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

90 (0

.84

to 0

.97)

0.

90 (0

.82

to 0

.99)

0.

97 (0

.83

to 1

.12)

0.

96 (0

.93

to 0

.99)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.93

(0.8

6 to

1.0

0)

0.96

(0.8

7 to

1.0

5)

0.96

(0.8

2 to

1.1

2)

0.98

(0.9

5 to

1.0

1)

Page 21: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

93 (0

.86

to 1

.00)

0.

95 (0

.86

to 1

.05)

0.

94 (0

.79

to 1

.12)

0.

96 (0

.92

to 1

.01)

Can

cer

mor

talit

y M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

95 (0

.86

to 1

.05)

0.

97 (0

.88

to 1

.07)

1.

03 (0

.92

to 1

.14)

1.

00 (0

.98

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.97

(0.8

8 to

1.0

7)

0.97

(0.8

7 to

1.0

7)

1.01

(0.9

0 to

1.1

3)

0.99

(0.9

7 to

1.0

2)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

00 (0

.90

to 1

.10)

1.

02 (0

.91

to 1

.15)

1.

11 (0

.95

to 1

.30)

1.

00 (0

.95

to 1

.05)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

06 (0

.93

to 1

.21)

0.

97 (0

.86

to 1

.09)

1.

03 (0

.93

to 1

.15)

1.

01 (0

.99

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.09

(0.9

5 to

1.2

4)

1.01

(0.9

0 to

1.1

4)

1.07

(0.9

5 to

1.2

0)

1.00

(0.9

8 to

1.0

2)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

09 (0

.95

to 1

.25)

1.

02 (0

.89

to 1

.16)

1.

08 (0

.93

to 1

.25)

0.

99 (0

.96

to 1

.03)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

94 (0

.85

to 1

.02)

0.

89 (0

.79

to 1

.00)

0.

83 (0

.67

to 1

.02)

0.

95 (0

.91

to 0

.99)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.97

(0.8

8 to

1.0

6)

0.93

(0.8

2 to

1.0

5)

0.84

(0.6

8 to

1.0

4)

0.96

(0.9

2 to

1.0

0)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

99 (0

.90

to 1

.09)

0.

97 (0

.85

to 1

.11)

0.

90 (0

.71

to 1

.14)

0.

96 (0

.91

to 1

.02)

Any

frac

ture

M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

02 (0

.96

to 1

.10)

1.

01 (0

.94

to 1

.09)

1.

03 (0

.95

to 1

.12)

1.

01 (1

.00

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.02

(0.9

6 to

1.1

0)

1.01

(0.9

3 to

1.0

8)

1.02

(0.9

4 to

1.1

1)

1.01

(0.9

9 to

1.0

3)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

02 (0

.95

to 1

.10)

0.

99 (0

.91

to 1

.08)

0.

99 (0

.88

to 1

.11)

1.

01 (0

.98

to 1

.05)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

97 (0

.88

to 1

.07)

0.

99 (0

.91

to 1

.07)

0.

96 (0

.88

to 1

.04)

1.

00 (0

.99

to 1

.02)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.98

(0.8

9 to

1.0

9)

1.01

(0.9

2 to

1.1

0)

0.96

(0.8

8 to

1.0

4)

1.00

(0.9

8 to

1.0

1)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

96 (0

.87

to 1

.06)

0.

96 (0

.88

to 1

.06)

0.

88 (0

.79

to 0

.98)

0.

99 (0

.97

to 1

.02)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

95 (0

.89

to 1

.01)

0.

95 (0

.88

to 1

.04)

1.

07 (0

.93

to 1

.23)

1.

00 (0

.98

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.95

(0.8

9 to

1.0

1)

0.95

(0.8

7 to

1.0

4)

1.04

(0.9

0 to

1.2

0)

1.00

(0.9

7 to

1.0

3)

Page 22: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

94 (0

.88

to 1

.01)

0.

94 (0

.86

to 1

.04)

1.

00 (0

.86

to 1

.17)

1.

01 (0

.97

to 1

.05)

Hip

frac

ture

M

ilk in

take

<2

00 g

/d

200

to 3

99 g

/d

400

to 5

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

96 (0

.83

to 1

.11)

1.

13 (0

.97

to 1

.30)

0.

97 (0

.82

to 1

.15)

1.

03 (0

.99

to 1

.07)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.96

(0.8

3 to

1.1

1)

1.13

(0.9

7 to

1.3

1)

0.98

(0.8

2 to

1.1

7)

1.04

(1.0

0 to

1.0

8)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

95 (0

.82

to 1

.11)

1.

10 (0

.93

to 1

.31)

0.

94 (0

.74

to 1

.19)

1.

06 (0

.99

to 1

.14)

C

hees

e in

take

<2

0 g/

d 20

to 3

9 g/

d 40

to 5

9 g/

d g/

d pe

r 20

g/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

75 (0

.61

to 0

.92)

0.

87 (0

.74

to 1

.03)

0.

79 (0

.67

to 0

.92)

1.

00 (0

.97

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.78

(0.6

3 to

0.9

5)

0.92

(0.7

8 to

1.0

9)

0.81

(0.6

9 to

0.9

7)

1.00

(0.9

7 to

1.0

3)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

76 (0

.62

to 0

.94)

0.

88 (0

.74

to 1

.06)

0.

74 (0

.60

to 0

.92)

1.

00 (0

.95

to 1

.05)

Fe

rmen

ted

milk

/yog

urt i

ntak

e <1

g/d

1

to 1

99 g

/d

200

to 3

99 g

/d

g/d

per 2

00 g

/d

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

84 (0

.73

to 0

.96)

0.

73 (0

.60

to 0

.88)

1.

19 (0

.92

to 1

.54)

0.

97 (0

.91

to 1

.03)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.83

(0.7

2 to

0.9

6)

0.74

(0.6

1 to

0.8

9)

1.18

(0.9

0 to

1.5

3)

0.98

(0.9

2 to

1.0

4)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

82 (0

.71

to 0

.95)

0.

71 (0

.58

to 0

.88)

1.

09 (0

.81

to 1

.47)

1.

00 (0

.92

to 1

.09)

H

R: H

azar

d ra

tio, C

I: co

nfid

ence

inte

rval

*h

ad a

cces

s to

repe

at e

xpos

ure

info

rmat

ion,

exp

osur

es a

nd c

ovar

iate

s wer

e tre

ated

as c

umul

ativ

e av

erag

es

Mod

el 1

adj

uste

d fo

r age

, milk

, che

ese,

ferm

ente

d m

ilk/y

ogur

t M

odel

2 a

djus

ted

for a

ge, m

ilk, c

hees

e, fe

rmen

ted

milk

/yog

urt,

body

mas

s ind

ex, h

eigh

t, to

tal e

nerg

y in

take

, tot

al a

lcoh

ol in

take

, a h

ealth

y di

etar

y pa

ttern

, cal

cium

and

vita

min

D su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s m

etab

olic

equ

ival

ents

, sm

okin

g st

atus

and

Cha

rlson

’s c

omor

bidi

ty in

dex

Mod

el 3

, adj

uste

d ac

cord

ing

to m

odel

2 b

ut in

add

ition

incl

uded

inta

ke o

f cal

cium

, vita

min

D, p

hosp

horu

s, to

tal f

at, s

atur

ated

fat,

tota

l pro

tein

, an

d re

tinol

Page 23: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le H

. Sen

sitiv

ity a

naly

sis u

sing

bas

elin

e da

ta fr

om 1

987-

1990

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort t

o st

udy

the

asso

ciat

ion

betw

een

milk

in

take

and

mor

talit

y an

d fr

actu

re

C

ateg

orie

s of d

aily

milk

inta

ke

<1 g

lass

1

to 2

gla

sses

2

to 3

gla

sses

Con

tinuo

us

(<

200

g/d)

(2

00 to

399

g/d

) (4

00 to

599

g/d

) g/

d)

(per

200

g/d

)

Tot

al m

orta

lity

N c

ases

39

08

5946

43

45

1557

15

756

Pers

on-y

ears

of f

ollo

w-u

p 34

5082

47

2600

30

8015

11

2094

12

3779

1 R

ate/

1000

per

son-

year

s*

11.9

12

.2

13.5

15

.3

12.7

H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.02

(0.9

8 to

1.0

7)

1.16

(1.1

1 to

1.2

1)

1.33

(1.2

5 to

1.4

1)

1.10

(1.0

8 to

1.1

1)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 1.

01 (0

.97

to 1

.05)

1.

10 (1

.05

to 1

.15)

1.

21 (1

.14

to 1

.29)

1.

07 (1

.05

to 1

.08)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.03

(0.9

8 to

1.0

7)

1.14

(1.0

8 to

1.2

1)

1.29

(1.1

9 to

1.4

1)

1.10

(1.0

7 to

1.1

3)

C

ardi

ovas

cula

r m

orta

lity

N c

ases

13

11

1999

15

24

545

5379

Pe

rson

-yea

rs o

f fol

low

-up

3450

82

4726

00

3080

15

1120

94

1237

791

Rat

e/10

00 p

erso

n-ye

ars*

4.

1 4.

1 4.

7 5.

5 4.

3 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.01

(0.9

4 to

1.0

8)

1.18

(1.1

0 to

1.2

7)

1.42

(1.2

8 to

1.5

7)

1.12

(1.0

9 to

1.1

5)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 0.

99 (0

.92

to 1

.06)

1.

12 (1

.04

to 1

.21)

1.

27 (1

.14

to 1

.41)

1.

08 (1

.05

to 1

.12)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.01

(0.9

4 to

1.1

0)

1.19

(1.0

8 to

1.3

1)

1.41

(1.2

2 to

1.6

3)

1.14

(1.0

9 to

1.1

9)

C

ance

r m

orta

lity

N c

ases

87

0 12

85

874

298

3327

Pe

rson

-yea

rs o

f fol

low

-up

3450

82

4726

00

3080

15

1120

94

1237

791

Rat

e/10

00 p

erso

n-ye

ars*

2.

6 2.

7 2.

8 2.

8 2.

7 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.03

(0.9

5 to

1.1

2)

1.09

(0.9

9 to

1.2

0)

1.11

(0.9

8 to

1.2

7)

1.04

(1.0

0 to

1.0

7)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 1.

04 (0

.95

to 1

.13)

1.

09 (0

.99

to 1

.20)

1.

11 (0

.96

to 1

.28)

1.

03 (1

.00

to 1

.07)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.04

(0.9

5 to

1.1

5)

1.10

(0.9

7 to

1.2

5)

1.13

(0.9

4 to

1.3

6)

1.04

(0.9

8 to

1.0

9)

Page 24: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Any

frac

ture

N

cas

es

4853

66

63

4388

15

03

1740

7 Pe

rson

-yea

rs o

f fol

low

-up

3114

54

4262

72

2777

47

1022

32

1117

705

Rat

e/10

00 p

erso

n-ye

ars*

15

.9

15.4

15

.5

15.4

15

.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

97 (0

.93

to 1

.00)

0.

99 (0

.95

to 1

.03)

0.

98 (0

.92

to 1

.04)

1.

00 (0

.98

to 1

.01)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.98

(0.9

4 to

1.0

2)

1.00

(0.9

6 to

1.0

5)

0.99

(0.9

3 to

1.0

6)

1.00

(0.9

9 to

1.0

2)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 0.

99 (0

.95

to 1

.03)

1.

02 (0

.97

to 1

.08)

1.

03 (0

.95

to 1

.11)

1.

02 (0

.99

to 1

.04)

Hip

frac

ture

N

cas

es

1136

16

73

1141

37

1 43

21

Pers

on-y

ears

of f

ollo

w-u

p 33

9753

46

4390

30

2452

11

0381

12

1697

7 R

ate/

1000

per

son-

year

s*

3.5

3.5

3.6

3.8

3.6

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

98 (0

.91

to 1

.06)

1.

04 (0

.96

to 1

.13)

1.

10 (0

.98

to 1

.24)

1.

04 (1

.00

to 1

.07)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.98

(0.9

1 to

1.0

6)

1.01

(0.9

2 to

1.1

0)

1.03

(0.9

0 to

1.1

6)

1.01

(0.9

8 to

1.0

5)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

00 (0

.92

to 1

.08)

1.

04 (0

.93

to 1

.16)

1.

08 (0

.91

to 1

.27)

1.

04 (0

.99

to 1

.09)

C

I: co

nfid

ence

inte

rval

; HR

: haz

ard

ratio

*

Age

stan

dard

ized

rate

s, nu

mbe

r of c

ases

per

100

0 pe

rson

-yea

rs a

t ris

k M

odel

1 a

djus

ted

for a

ge

Mod

el 2

adj

uste

d fo

r age

, bod

y m

ass i

ndex

, hei

ght,

tota

l ene

rgy

inta

ke, t

otal

alc

ohol

inta

ke, a

hea

lthy

diet

ary

patte

rn, c

alci

um a

nd v

itam

in D

su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s met

abol

ic e

quiv

alen

ts, s

mok

ing

stat

us,

Cha

rlson

’s c

omor

bidi

ty in

dex,

eve

r use

of o

estro

gen

repl

acem

ent t

hera

py, a

nd n

ullip

arity

. M

odel

3, a

djus

ted

acco

rdin

g to

mod

el 2

but

in a

dditi

on in

clud

ed in

take

of c

alci

um, v

itam

in D

, pho

spho

rus,

tota

l fat

, sat

urat

ed fa

t, to

tal p

rote

in,

and

retin

ol

Page 25: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Tab

le I.

Sen

sitiv

ity a

naly

sis u

sing

dat

a fr

om 1

997

as b

asel

ine

in th

e Sw

edis

h M

amm

ogra

phy

Coh

ort t

o st

udy

the

asso

ciat

ion

betw

een

milk

inta

ke a

nd m

orta

lity

and

frac

ture

Cat

egor

ies o

f dai

ly m

ilk in

take

<1

gla

ss

1-2

glas

ses

2-3

glas

ses

C

ontin

uous

(<20

0 g/

d)

(200

to 3

99 g

/d)

(400

to 5

99 g

/d)

g/d)

(p

er 2

00 g

/d)

T

otal

mor

talit

y N

cas

es

2327

16

71

374

107

4479

Pe

rson

-yea

rs o

f fol

low

-up

2354

75

1307

27

3074

7 73

97

4043

45

Rat

e/10

00 p

erso

n-ye

ars*

10

.4

11.8

12

.2

14.2

11

.1

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

05 (0

.98

to 1

.13)

1.

05 (0

.93

to 1

.18)

1.

27 (1

.05

to 1

.54)

1.

04 (1

.00

to 1

.07)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.07

(0.9

9 to

1.1

5)

1.01

(0.8

9 to

1.1

4)

1.29

(1.0

6 to

1.5

7)

1.04

(1.0

1 to

1.0

8)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

08 (1

.00

to 1

.16)

1.

03 (0

.90

to 1

.17)

1.

34 (1

.08

to 1

.67)

1.

05 (1

.01

to 1

.10)

Car

diov

ascu

lar

mor

talit

y N

cas

es

928

674

163

44

1809

Pe

rson

-yea

rs o

f fol

low

-up

2354

75

1307

27

3074

7 73

97

4043

45

Rat

e/10

00 p

erso

n-ye

ars*

4.

2 4.

7 5.

3 5.

7 4.

5 H

R (9

5% C

I), m

odel

1

1.00

(ref

eren

ce)

1.04

(0.9

3 to

1.1

6)

1.06

(0.8

9 to

1.2

8)

1.21

(0.8

9 to

1.6

4)

1.03

(0.9

8 to

1.0

8)

HR

(95%

CI),

mod

el 2

1.

00 (r

efer

ence

) 1.

05 (0

.94

to 1

.18)

1.

03 (0

.85

to 1

.24)

1.

26 (0

.92

to 1

.73)

1.

04 (0

.98

to 1

.09)

H

R (9

5% C

I), m

odel

3

1.00

(ref

eren

ce)

1.04

(0.9

3 to

1.1

8)

1.02

(0.8

3 to

1.2

5)

1.26

(0.8

9 to

1.7

7)

1.03

(0.9

7 to

1.1

0)

C

ance

r m

orta

lity

N c

ases

85

9 56

6 11

8 39

15

82

Pers

on-y

ears

of f

ollo

w-u

p 23

5475

13

0727

30

747

7397

40

4345

R

ate/

1000

per

son-

year

s*

3.8

4.1

3.8

5.4

3.9

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

03 (0

.91

to 1

.16)

1.

03 (0

.84

to 1

.26)

1.

34 (0

.98

to 1

.85)

1.

05 (1

.00

to 1

.11)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.02

(0.9

0 to

1.1

6)

0.95

(0.7

7 to

1.1

7)

1.31

(0.9

4 to

1.8

1)

1.04

(0.9

8 to

1.1

0)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

04 (0

.91

to 1

.19)

0.

98 (0

.79

to 1

.23)

1.

39 (0

.97

to 1

.99)

1.

07 (0

.99

to 1

.15)

Page 26: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Any

frac

ture

N

cas

es

5395

31

97

713

173

9478

Pe

rson

-yea

rs o

f fol

low

-up

2196

72

1216

11

2874

6 69

36

3769

65

Rat

e/10

00 p

erso

n-ye

ars*

25

.0

25.5

24

.8

24.9

25

.1

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 0.

98 (0

.93

to 1

.03)

0.

97 (0

.89

to 1

.06)

1.

03 (0

.89

to 1

.20)

1.

05 (1

.01

to 1

.11)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

0.98

(0.9

3 to

1.0

3)

0.96

(0.8

8 to

1.0

5)

0.99

(0.8

5 to

1.1

6)

1.03

(0.9

8 to

1.0

8)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

00 (0

.94

to 1

.05)

0.

99 (0

.90

to 1

.09)

1.

05 (0

.89

to 1

.24)

1.

07 (1

.01

to 1

.14)

Hip

frac

ture

N

cas

es

1112

78

1 18

1 37

21

11

Pers

on-y

ears

of f

ollo

w-u

p 23

3280

12

9337

30

417

7335

40

0369

R

ate/

1000

per

son-

year

s*

5.0

5.5

6.0

4.9

5.3

HR

(95%

CI),

mod

el 1

1.

00 (r

efer

ence

) 1.

07 (0

.96

to 1

.18)

1.

21 (1

.03

to 1

.43)

1.

15 (0

.85

to 1

.54)

1.

05 (1

.01

to 1

.11)

H

R (9

5% C

I), m

odel

2

1.00

(ref

eren

ce)

1.05

(0.9

4 to

1.1

6)

1.18

(1.0

0 to

1.4

0)

1.00

(0.7

4 to

1.3

6)

1.03

(0.9

8 to

1.0

8)

HR

(95%

CI),

mod

el 3

1.

00 (r

efer

ence

) 1.

09 (0

.97

to 1

.22)

1.

26 (1

.05

to 1

.52)

1.

15 (0

.83

to 1

.60)

1.

07 (1

.01

to 1

.14)

C

I: co

nfid

ence

inte

rval

; HR

: haz

ard

ratio

*

Age

stan

dard

ized

rate

s, nu

mbe

r of c

ases

per

100

0 pe

rson

-yea

rs a

t ris

k M

odel

1 a

djus

ted

for a

ge

Mod

el 2

adj

uste

d fo

r age

, bod

y m

ass i

ndex

, hei

ght,

tota

l ene

rgy

inta

ke, t

otal

alc

ohol

inta

ke, a

hea

lthy

diet

ary

patte

rn, c

alci

um a

nd v

itam

in D

su

pple

men

tatio

n, e

ver u

se o

f cor

tison

e, e

duca

tiona

l lev

el, l

ivin

g al

one,

phy

sica

l act

ivity

leve

l est

imat

ed a

s met

abol

ic e

quiv

alen

ts, s

mok

ing

stat

us

and

Cha

rlson

’s c

omor

bidi

ty in

dex,

eve

r use

of o

estro

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Page 27: Appendix Figure A. Directed Acyclic Graph (DAG) for milk ...Oct 30, 2014  · 0.1.2.3 0 5 10 15 20 25 Follow − up (years) Kaplan −

Table J. Change in daily milk and fermented milk consumption between the first and the second food frequency questionnaire within the Swedish Mammography Cohort by change in comorbidity and fracture status between the first and the second food frequency questionnaire Change in reported intake Milk

(g/d; 95% CI) Soured milk and

yogurt (g/d; 95% CI)

Cheese (g/d; 95% CI)

No new comorbidity -87 (-85- to -90) 106 (103 to 108) -24 (-23 to -24) One new comorbidity -75 (-64 to -85) 121 (108 to 134) -19 (-18 to -21) Two or more new comorbidities -81 (-71 to -90) 112 (101 to 122) -20 (-19 to -22)

No fracture -86 (-84 to -89) 107 (105 to 110) -23 (-23 to -24) One new fracture -76 (-67 to -86) 111 (99 to 124) -24 (-22 to -26) One new hip fracture -101 (-78 to -126) 116 (87 to 145) -20 (-16 to -24) CI: confidence interval