Science Dialogue Mapping of Knowledge and Knowledge Gaps Related to the Effects of Dairy Intake on Human Cardiovascular Health and Disease

Authors

Andrew W Brown
Kathryn A Kaiser
Andrew Keitt
Kevin Fontaine
Madeline Gibson
Barbara A Gower
James M Shikany
Colby J Vorland
Donald C Beitz
Dennis M Bier
J Thomas Brenna
David R Jacobs
Penny Kris-Etherton
Kevin Maki
Michael Miller
Marie-Pierre St-Onge
Margarita Teran-Garcia
David B Allison

Publication Date

1-1-2021

Journal

Critical Reviews in Food Science and Nutrition

DOI

10.1080/10408398.2020.1722941

PMID

32072820

PMCID

PMC7434715

PubMedCentral® Posted Date

1-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Cardiovascular Diseases, Cardiovascular System, Dairy Products, Diet, Dietary Fats, Humans, Obesity, Risk Factors, Dairy, dialogue mapping, cardiovascular disease

Abstract

Dairy has been described as everything from a superfood to a poison; yet, arguments, assumptions, and data justifying these labels are not always clear. We used an issue-based information system, “dialogue mapping™,” to summarize scientific points of a live panel discussion on the putative effects of dairy on cardiovascular diseases (CVD) from a day-long session among experts in nutrition and CVD. Dialogue mapping captures relations among ideas to explicitly, logically, and visually connect issues/questions, ideas, pro/con arguments, and agreements, even if discussed at different times. Experts discussed two propositions: for CVD risk, consumption of full-fat dairy products, 1) should be minimized, in part because of their saturated fat content, or 2) need not be minimized, despite their saturated fat content. The panel discussed the dairy-CVD relation through blood lipids, diabetes, obesity, energy balance, blood pressure, dairy bioactives, biobehavioral components, and other putative causal pathways. Associations and effects reported in the literature have varied by fat content of dairy elements considered, study design, intake methods, and biomarker versus disease outcomes. Two conceptual topics emerged from the discussion: 1) individual variability: whether recommendations should be targeted only to those at high CVD risk; 2) quality of evidence: whether data on dairy-CVD relations are strong enough for reliable conclusions – positive, negative, or null. Future procedural improvements for science dialog mapping include using singular rather than competing propositions for discussion.