Previous studies showed positive associations between milk intake and Parkinson’s disease (PD) in men but not in women, but few studies were available in women. Due to the long prodromal PD phase, reverse causation represents a major threat to investigations of diet in PD; cohort studies with a long follow-up are needed. We investigated associations between intake of milk and other dairy products with PD incidence in women from the E3N cohort study (1993–2018). PD diagnoses were validated using medical records and drug claim databases. Diet was assessed via a dietary questionnaire. Hazard ratios (HR) were estimated using multivariable Cox regression models. Exposures were lagged by 5y in main analyses and longer lags in sensitivity analyses. We examined the impact of adjustment for premotor symptoms (constipation/depression). During a mean follow-up of 18.8y, 845 of 71,542 women developed PD. Main analyses showed a J-shaped association between total milk intake and PD (P-non linearity = 0.045), with a significant linear positive association among drinkers (HR/1-SD = 1.09, 95% CI = 1.01–1.18, P = 0.024), that was explained in secondary analyses by a different pattern of association for plain milk (alone or with cereals) and milk added to drinks (tea/coffee/chicory). PD incidence increased significantly with plain milk consumption (HR/1-SD = 1.08 [1.02–1.14], P = 0.014). A U-shaped relation was observed for milk added to drinks (P-non linearity = 0.038), with lower PD incidence in women with moderate consumption (HR = 0.77 [0.61–0.97], P = 0.030) and no difference between non-drinkers and those with the highest consumption (HR = 0.98 [0.79–1.21], P = 0.848). Findings were similar in analyses using longer lags and adjusted for constipation/depression. Consumption of other dairy products was not associated with PD. A J-shaped association between total milk intake and PD was explained by a different pattern of association for plain milk intake and milk added to drinks. Reverse causation is unlikely to explain a positive association of plain milk with PD incidence in women. The U-shaped relation for milk added to drinks could be explained by an interaction between milk and coffee/tea/chicory. Further studies are warranted to elucidate the underlying mechanisms.

以前的研究表明，男性的牛奶摄入量与帕金森病 （PD） 呈正相关，但女性没有，但很少有女性的研究。由于前驱期 PD 期长，反向因果关系对 PD 饮食研究构成主要威胁;需要进行长期随访的队列研究。我们调查了 E3N 队列研究 （1993-2018） 中女性牛奶和其他乳制品摄入量与 PD 发病率之间的关联。使用病历和药物索赔数据库验证 PD 诊断。通过饮食问卷评估饮食。使用多变量 Cox 回归模型估计风险比 （HR）。暴露在主要分析中滞后 5 年，在敏感性分析中滞后更长时间。我们检查了调整运动前症状 （便秘/抑郁） 的影响。在 18.8 年的平均随访期间，71,542 名妇女中有 845 名发生了 PD。主要分析显示，总牛奶摄入量与 PD 之间存在 J 形关联（P 非线性 = 0.045），饮酒者之间存在显著的线性正相关（HR/1-SD = 1.09,95% CI = 1.01-1.18，P = 0.024），这在二次 分析中可以通过纯牛奶（单独或与谷物一起）和添加到饮料中的牛奶（茶/咖啡/菊苣）的不同关联模式来解释。PD 发生率随着纯牛奶的摄入而显著增加 （HR/1-SD = 1.08 [1.02–1.14]，P = 0.014）。在饮料中添加牛奶时观察到 U 形关系 （P 非线性 = 0.038），适度饮酒女性的 PD 发生率较低 （HR = 0.77 [0.61–0.97]，P = 0.030），不饮酒者与饮酒量最高的女性之间没有差异 （HR = 0.98 [0.79–1.21]，P = 0.848）。 在使用较长滞后并针对便秘/抑郁进行调整的分析中，结果相似。食用其他乳制品与 PD 无关。总牛奶摄入量和 PD 之间的 J 形关联可以通过纯牛奶摄入量和饮料中添加牛奶的不同关联模式来解释。反向因果关系不太可能解释纯牛奶与女性 PD 发病率的正相关。饮料中添加牛奶的 U 形关系可以用牛奶和咖啡/茶/菊苣之间的相互作用来解释。需要进一步的研究来阐明潜在的机制。