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Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk.

Abstract

PURPOSE

The possible effects of dairy consumption on diabetes prevention remain controversial. The aim of this study was to investigate the association between the dairy consumption and type 2 diabetes (T2D) risk in an elderly Mediterranean population at high cardiovascular risk.

METHODS

We prospectively followed 3,454 non-diabetic individuals from the PREDIMED study. Dairy consumption was assessed at baseline and yearly using food frequency questionnaires and categorized into total, low-fat, whole-fat, and subgroups: milk, yogurt, cheeses, fermented dairy, concentrated full fat, and processed dairy. Hazard ratios (HRs) were calculated using Cox proportional hazards regression models.

RESULTS

During a median follow-up of 4.1 years, we documented 270 incident T2D cases. After multivariate adjustment, total dairy product consumption was inversely associated with T2D risk [0.68 (95% CI 0.47-0.98); P-trend = .040]. This association appeared to be mainly attributed to low-fat dairy; the multivariate HRs (95% CIs) comparing the highest versus the lowest tertile consumption were 0.65 (0.45-0.94) for low-fat dairy products and 0.67 (0.46-0.95) for low-fat milk (both P-trend <.05). Total yogurt consumption was associated with a lower T2D risk [HR 0.60 (0.42-0.86); P-trend = .002]. An increased consumption of total low-fat dairy and total yogurt during the follow-up was inversely associated with T2D; HRs were 0.50 (0.29-0.85), 0.44 (0.26-0.75), and 0.55 (0.33-0.93), respectively. Substituting one serving/day of a combination of biscuits and chocolate and whole grain biscuits and homemade pastries for one serving/day of yogurt was associated with a 40 and 45% lower risk of T2D, respectively. No significant associations were found for the other dairy subgroups (cheese, concentrated full fat, and processed dairy products).

CONCLUSIONS

A healthy dietary pattern incorporating a high consumption of dairy products and particularly yogurt may be protective against T2D in older adults at high cardiovascular risk.

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  • Authors+Show Affiliations

    ,

    Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.

    ,

    Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Preventive Medicine and Public Health, University of Navarra Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Cardiovascular Risk and Nutrition Research Group, IMIM, Barcelona, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Preventive Medicine, University of Malaga, Málaga, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Primary Care Division of Sevilla, Department of Family Medicine, San Pablo Health Center, Seville, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Lipid Clinic, Service of Endocrinology and Nutrition, Hospital Clinic, IDIBAPS, Barcelona, Spain.

    ,

    Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Lipids and Vascular Risk Unit, Internal Medicine, Bellvitge University Hospital, Llobregat Hospitalet, Barcelona, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Primary Care Division, Catalan Institute of Health, IDIAP-Jordi Gol, Barcelona, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain.

    ,

    CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. Department of Preventive Medicine and Public Health, University of Navarra Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain.

    Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain. jordi.salas@urv.cat. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. jordi.salas@urv.cat.

    Source

    European journal of nutrition 55:1 2016 Feb pg 349-60

    MeSH

    Aged
    Aged, 80 and over
    Animals
    Body Mass Index
    Cardiovascular Diseases
    Cheese
    Cholesterol, HDL
    Cholesterol, LDL
    Dairy Products
    Diabetes Mellitus, Type 2
    Diet, Fat-Restricted
    Dietary Carbohydrates
    Dietary Fats
    Dietary Proteins
    Energy Intake
    Female
    Follow-Up Studies
    Humans
    Incidence
    Male
    Mediterranean Region
    Middle Aged
    Milk
    Multivariate Analysis
    Nutrition Assessment
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires
    Triglycerides
    Waist Circumference
    Yogurt

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25663611

    Citation

    Díaz-López, Andrés, et al. "Dairy Product Consumption and Risk of Type 2 Diabetes in an Elderly Spanish Mediterranean Population at High Cardiovascular Risk." European Journal of Nutrition, vol. 55, no. 1, 2016, pp. 349-60.
    Díaz-López A, Bulló M, Martínez-González MA, et al. Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. Eur J Nutr. 2016;55(1):349-60.
    Díaz-López, A., Bulló, M., Martínez-González, M. A., Corella, D., Estruch, R., Fitó, M., ... Salas-Salvadó, J. (2016). Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. European Journal of Nutrition, 55(1), pp. 349-60. doi:10.1007/s00394-015-0855-8.
    Díaz-López A, et al. Dairy Product Consumption and Risk of Type 2 Diabetes in an Elderly Spanish Mediterranean Population at High Cardiovascular Risk. Eur J Nutr. 2016;55(1):349-60. PubMed PMID: 25663611.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. AU - Díaz-López,Andrés, AU - Bulló,Mònica, AU - Martínez-González,Miguel A, AU - Corella,Dolores, AU - Estruch,Ramon, AU - Fitó,Montserrat, AU - Gómez-Gracia,Enrique, AU - Fiol,Miquel, AU - García de la Corte,Francisco Javier, AU - Ros,Emilio, AU - Babio,Nancy, AU - Serra-Majem,Lluís, AU - Pintó,Xavier, AU - Muñoz,Miguel Ángel, AU - Francés,Francisco, AU - Buil-Cosiales,Pilar, AU - Salas-Salvadó,Jordi, Y1 - 2015/02/07/ PY - 2014/10/06/received PY - 2015/01/31/accepted PY - 2015/2/10/entrez PY - 2015/2/11/pubmed PY - 2016/11/9/medline KW - Dairy KW - Older adults KW - PREDIMED KW - Type 2 diabetes KW - Yogurt SP - 349 EP - 60 JF - European journal of nutrition JO - Eur J Nutr VL - 55 IS - 1 N2 - PURPOSE: The possible effects of dairy consumption on diabetes prevention remain controversial. The aim of this study was to investigate the association between the dairy consumption and type 2 diabetes (T2D) risk in an elderly Mediterranean population at high cardiovascular risk. METHODS: We prospectively followed 3,454 non-diabetic individuals from the PREDIMED study. Dairy consumption was assessed at baseline and yearly using food frequency questionnaires and categorized into total, low-fat, whole-fat, and subgroups: milk, yogurt, cheeses, fermented dairy, concentrated full fat, and processed dairy. Hazard ratios (HRs) were calculated using Cox proportional hazards regression models. RESULTS: During a median follow-up of 4.1 years, we documented 270 incident T2D cases. After multivariate adjustment, total dairy product consumption was inversely associated with T2D risk [0.68 (95% CI 0.47-0.98); P-trend = .040]. This association appeared to be mainly attributed to low-fat dairy; the multivariate HRs (95% CIs) comparing the highest versus the lowest tertile consumption were 0.65 (0.45-0.94) for low-fat dairy products and 0.67 (0.46-0.95) for low-fat milk (both P-trend <.05). Total yogurt consumption was associated with a lower T2D risk [HR 0.60 (0.42-0.86); P-trend = .002]. An increased consumption of total low-fat dairy and total yogurt during the follow-up was inversely associated with T2D; HRs were 0.50 (0.29-0.85), 0.44 (0.26-0.75), and 0.55 (0.33-0.93), respectively. Substituting one serving/day of a combination of biscuits and chocolate and whole grain biscuits and homemade pastries for one serving/day of yogurt was associated with a 40 and 45% lower risk of T2D, respectively. No significant associations were found for the other dairy subgroups (cheese, concentrated full fat, and processed dairy products). CONCLUSIONS: A healthy dietary pattern incorporating a high consumption of dairy products and particularly yogurt may be protective against T2D in older adults at high cardiovascular risk. SN - 1436-6215 UR - https://www.unboundmedicine.com/medline/citation/25663611/Dairy_product_consumption_and_risk_of_type_2_diabetes_in_an_elderly_Spanish_Mediterranean_population_at_high_cardiovascular_risk_ L2 - https://dx.doi.org/10.1007/s00394-015-0855-8 DB - PRIME DP - Unbound Medicine ER -