Table 3.
Summa ry of prospe ctive cohort studies examin ing associa tions betwee n dairy fat intake and T2DM (n=10).
XStudy Locati on
Study populat
ion Follo
w-up
Dairy Fat Intake Measures
(Definitions) Outcomes
Dietary Assessme nt
Methods Adjustments Significant
Findings Conclusio ns
Duffey et al, 201028
USA 2,774 men and women (18-30 y old)
20y Whole milk and low-fat milk
(skim/1%/2%)
Metabolic syndrome, central adiposity (waist circumfere nce), hypertensi on, high triglyceride s, high LDL, and low HDL
Semi- quantitati ve, interview er-
administe red, validated FFQ
Age, sex, race, exam center, weight, smoking status, energy from food, total physical activity, intakes of energy from:
fruit juice, sugar
The relative risk of high triglycerid es was 0.91 for each quartile increase in whole-fat milk consumpti on with an
Whole-fat milk intake was associate d with reduced incidence of high triglyceri des.
There were no other
sweetened beverages, milk and alcohol
overall inversely correlated trend (p<.05)
significan t
relationsh ips
between milk intake and outcomes of
interest.
Grantha m et al, 201329
Austra
lia 5,582 men and women (≥25 years old)
5y Full-fat milk and low-fat milk
T2DM 121 item
FFQ Age, sex, total energy intake, family history of diabetes, education, physical activity, smoking status,
fasting serum triglycerides, HDL, SBP, waist
circumferenc e and hip circumferenc e
The odds of T2DM was .65 times lower for adults who consumed the
highest tertile of low-fat milk compared to the lowest (95% Cl: . 44, .94)
High intakes of low-fat milk were associate d with reduced risk of T2DM.
Louie et al, 201332
Austra
lia 1,824 men and women (≥49 y old)
10y High-fat dairy (regular milk/cheese, medium-fat dairy dessert) and low-fat dairy
T2DM, metabolic syndrome
145 item, semi- qualitativ e FFQ
Age, sex, smoking status, physical activity, dietary glycemic
The odds of
metabolic syndrome were 2.01 times higher for
High fat dairy intake was inversely associate d with
(reduced- fat/skim milk, reduced-fat dairy dessert, low-fat
cheese)
load, fiber from
vegetables, total energy and calcium intake, and family history of diabetes
those in the highest quartile of low-fat dairy intake compared to those in the lowest with an overall positively correlated trend (p<.05), conversely , those in the highest quartile of high-fat dairy intake had .41 times the odds of
metabolic syndrome compared to those in the lowest quartile with an overall negatively
metabolic syndrome while low fat dairy was positively associate d with metabolic syndrome . No associatio ns were found between either low-fat or full-fat dairy intake and T2DM.
correlated trend (p<.001) Malik et
al, 201133
USA 37,038 women (24–42 y old)
10y High-fat dairy (whole
milk/chocolat e milk, cream/other cheese, ice cream, milkshakes, butter) and low-fat dairy (skim
milk/chocolat e milk, sherbet, yogurt, instant breakfast, cottage/ricott a cheese)
T2DM 124-item
FFQ Age, BMI, total energy intake, family history of diabetes, smoking status, physical activity, alcohol consumption, oral
contraceptive use, hormone replacement therapy, PUFA: SFA ratio, glycemic load, cereal fiber, coffee intake, trans fat intake, processed meat intake, carbonated soft drinks intake, fruit drinks intake, mutual adjustment:
high- and low-fat dairy
The relative risk of T2DM in women who were in the highest quartile of high-fat dairy intake was .72
compared to those in the lowest quartile with an overall inversely correlated trend (p<.05),th ere was a similar overall trend between higher intakes of low-fat dairy and T2DM
High intakes of both high-fat and low- fat dairy reduced the risk of T2DM.
products (p<.05) Margolis
et al, 201134
USA 82,076 women (50-79 y old)
8y High-fat dairy (whole/2%
milk, regular cheese/cottag e
cheese/yogurt , cream
soups, ice cream, pudding, custard, flan) and low-fat dairy
(skim/1%
milk, low-fat cottage cheese, part- skim/reduced- fat cheese, nonfat yogurt, low-fat/nonfat frozen
desserts)
T2DM 122 item
FFQ Age,
ethnicity, energy, income, education, smoking status, alcohol use, family history of diabetes, hormone replacement therapy, SBP, DBP, BMI, physical activity, glycemic load, fiber, magnesium, calcium, vitamin D, fruit juice, sugar- sweetened beverages, BMI x low-fat dairy intake
The relative risk of T2DM for women in the
highest quintile of low-fat dairy intake was .65 with an overall inversely related trend (p<.01) and a significant interaction between BMI and dairy intake.
Greater low-fat dairy intake was associate d with reduced risk of T2DM, especially among women with higher BMI.
Mozaffa rian et al, 201335
USA 2,617 men and women (45-84 y old)
14y Serum trans- palmitoleic acid
T2DM, LDL, HDL, triglyceride s,
total:HDL, FPG, fasting insulin,
blood
assay Age, sex, race/ethnicity , adiposity, alcohol intake,
consumption of fruit, vegetables,
The relative risk of T2DM was .52 among those in the
Trans- palmitolei c acid was associate d with reduced risk of
SBP, DBP and whole grains, use of lipid-lowering and
antihypertens ive
medications, field center, education, smoking, physical activity, BMI, waist
circumferenc e,
consumption of whole-fat dairy, low-fat dairy, red meat, and total energy intake
highest quintile of serum trans- palmitoleic acid
compared to those in the lowest quintile with an overall inversely correlated trend (p<.05)
T2DM.
Sluijs et al, 201236*
Weste rn Europ eⱡ
24,475 men and women (35-74 y old)
5y Cheese T2DM semi-
qualitativ e FFQ and 24 hour recall (8% of N)
Age, sex, BMI, diabetes risk factors, education, smoking status, physical activity, alcohol intake, energy intake, energy- adjusted
The relative risk of T2DM was .83 among those in the highest quintile of cheese intake compared to those in
Cheese intake was inversely related to T2DM.
intakes of fruits and vegetables, red meat, processed wheat, sugar- sweetened beverages, coffee, cereal and cereal products, calcium, magnesium, and vitamin D
the lowest quintile with an overall inversely correlated trend (p<.01)
Soedam ah- Muthu et al, 201237
Engla nd
4,526 men and women (33-55 y old)
10y High-fat dairy (full-fat
cheese, yogurt, milk puddings, whole/Channe l Islands milk) and low-fat dairy (cottage cheese, semi- skimmed/skim med milk, milk-based hot drinks)
T2DM, CVD (myocardia l infarction)
114 item FFQ
Age, ethnicity, employment grade,
smoking status, BMI, physical activity, family history, alcohol intake, intakes of:
fruits, vegetables, bread, meat, fish, coffee, tea and total energy
Intakes of total dairy and types of dairy products showed no
consisten t
relationsh ip with incident diabetes or
coronary heart disease Struijk
et al, Denm
ark 5,953
men 5y High-fat dairy
(whole T2DM, FPG,
2hPG, 198 item
FFQ Age, sex,
family history No
associatio There was no
201339 and women (30-60 y old)
milk/milk products ≥2%
fat, cheese
≥20% fat) and low-fat dairy
(milk/milk products <2%
fat, cheese
<20% fat)
HbA1c, HOMA2-B, HOMA2-IR
of diabetes, education level, physical activity, smoking status, alcohol intake, intake of: whole grain cereal, meat, fish, coffee, tea, fruit,
vegetables, energy, changes in baseline diet, and waist circumferenc e
n between risk of T2DM (or biomarker s of risk) and high- fat or low- fat dairy intake.
associatio n
between risk of T2DM (or biomarke rs of risk) and high- fat or low-fat dairy intake.
Von Ruesten et al, 201340
Germ
any 23,531 men and women (35-63 y old)
8y High-fat dairy (milk/yogurt
>1.5% fat, regular curd cheese, cream) and low-fat dairy (milk/yogurt
≤1.5% fat, soured milk, low-fat curd cheese)
CVD
(myocardia l infarction and
stroke), T2DM
148 item
FFQ Age, sex, smoking status, pack- years of smoking, alcohol intake, physical activity, BMI, waist to hip ratio,
hypertension, high blood lipids, education,
No
associatio n between risk of CVD or T2DM and high-fat or low-fat dairy intake.
There was no associatio n
between risk of T2DM or CVD and high-fat or low-fat dairy intake.
vitamin supplementat ion, total energy intake, other food groups
ⱡNetherlands, Greece, Germany, Sweden, Denmark, Norway, United Kingdom, Spain, Italy
Abbreviations: CVD, cardiovascular disease; T2DM, type II diabetes mellitus; LDL, low-density lipoprotein
cholesterol; HDL, high-density lipoprotein cholesterol; total:HDL, ratio total cholesterol to HDL; FPG, fasting plasma glucose; 2hPG, 2-hour plasma glucose; HbA1c, hemoglobin A1c; HOMA2-B, homeostatic model assessment of beta- cell function; HOMA2-IR, homeostatic model assessment of insulin resistance; SBP, systolic blood pressure; DBP, diastolic blood pressure; FFQ, food frequency questionnaire; BMI, body mass index; PUFA:SFA ratio, ratio of polyunsaturated fatty acids to saturated fatty acids.
27Bernstein AM, Sun Q, Hu FB, Stampfer MJ, Manson JE, Willett WC. Major dietary protein sources and risk of coronary heart disease in women.
Circulation. 2010;122(9):876-883 Medline. doi:10.1161/CIRCULATIONAHA.109.915165
28Duffey KJ, Gordon-Larsen P, Steffen LM, Jacobs DR Jr, Popkin BM. Drinking caloric beverages increases the risk of adverse cardiometabolic outcomes in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. 2010;92(4):954-959 Medline.
doi:10.3945/ajcn.2010.29478
29Grantham NM, Magliano DJ, Hodge A, Jowett J, Meikle P, Shaw JE. The association between dairy food intake and the incidence of diabetes in Australia: the Australian Diabetes Obesity and Lifestyle Study (AusDiab). Public Health Nutr. 2013;16(02):339-345 Medline.
doi:10.1017/S1368980012001310
32Louie JC, Flood VM, Rangan AM, et al. Higher regular fat dairy consumption is associated with lower incidence of metabolic syndrome but not type 2 diabetes. Nutr Metab Cardiovasc Dis. 2013;23(9):816-821 Medline. doi:10.1016/j.numecd.2012.08.004
33Malik VS, Sun Q, van Dam RM, et al. Adolescent dairy product consumption and risk of type 2 diabetes in middle-aged women. Am J Clin Nutr.
2011;94(3):854-861 Medline. doi:10.3945/ajcn.110.009621
34Margolis KL, Wei F, de Boer IH, et al. A diet high in low-fat dairy products lowers diabetes risk in postmenopausal women. J Nutr.
2011;141(11):1969-1974 Medline. doi:10.3945/jn.111.143339
35Mozaffarian D, de Oliveira Otto MC, Lemaitre RN, et al. Trans-palmitoleic acid, other dairy fat biomarkers, and incident diabetes: the Multi- Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2013;97(4):854-861 Medline. doi:10.3945/ajcn.112.045468
36Sluijs I, Forouhi NG, Beulens JW, et al. The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin Nutr. 2012;96(2):382-390 Medline. doi:10.3945/ajcn.111.021907
37Soedamah-Muthu SS, Masset G, Verberne L, Geleijnse JM, Brunner EJ. Consumption of dairy products and associations with incident diabetes, CHD and mortality in the Whitehall II study. Br J Nutr. 2013;109(04):718-726 Medline. doi:10.1017/S0007114512001845
39Struijk EA, Heraclides A, Witte DR, et al. Dairy product intake in relation to glucose regulation indices and risk of type 2 diabetes. Nutr Metab Cardiovasc Dis. 2013;23(9):822-828 Medline. doi:10.1016/j.numecd.2012.05.011
40von Ruesten A, Feller S, Bergmann MM, Boeing H. Diet and risk of chronic diseases: results from the first 8 years of follow-up in the EPIC- Potsdam study. Eur J Clin Nutr. 2013;67(4):412-419 Medline. doi:10.1038/ejcn.2013.7
