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Associations of Dairy Intake with Incident Prediabetes or Diabetes in Middle-Aged Adults Vary by Both Dairy Type and Glycemic Status.
J Nutr 2017; 147(9):1764-1775JN

Abstract

Background:

Inconsistent evidence describes the association between dietary intake of dairy and milk-based products and type 2 diabetes (T2D) risk.

Objective:

Our objective was to assess associations between consumption of milk-based products, incident prediabetes, and progression to T2D in the Framingham Heart Study Offspring Cohort.

Methods:

Total dairy and milk-based product consumption was assessed by ≤4 food-frequency questionnaires across a mean of 12 y of follow-up in 2809 participants [mean ± SD age: 54.0 ± 9.7 y; body mass index (in kg/m2): 27.1 ± 4.7; 54% female]. Prediabetes was defined as the first occurrence of fasting plasma glucose ≥5.6 to <7.0 mmol/L (≥100 to <126 mg/dL), and T2D was defined as the first occurrence of fasting plasma glucose ≥7.0 mmol/L (≥126 mg/dL) or diabetes treatment. Proportional hazards models were used to estimate the risk of incident outcomes relative to dairy product intake in subsets of the cohort who were at risk of developing the outcomes. Spline regressions were used to examine potential nonlinear relations.

Results:

Of 1867 participants free of prediabetes at baseline, 902 (48%) developed prediabetes. Total, low-fat, and high-fat dairy consumptions were associated with a 39%, 32%, and 25% lower risk of incident prediabetes, respectively, in the highest compared with the lowest intakes (≥14 compared with <4 servings/wk). Total, low-fat and skim milk, whole-milk, and yogurt intakes were associated nonlinearly with incident prediabetes; moderate intake was associated with the greatest relative risk reduction. Neither cheese nor cream and butter was associated with prediabetes. Of 925 participants with prediabetes at baseline, 196 (21%) developed T2D. Only high-fat dairy and cheese showed evidence of dose-response, inverse associations with incident T2D, with 70% and 63% lower risk, respectively, of incident T2D between the highest and lowest intake categories (≥14 compared with <1 serving/wk for high-fat dairy, ≥4 compared with <1 serving/wk for cheese).

Conclusion:

Associations of dairy with incident prediabetes or diabetes varied both by dairy product and type and by baseline glycemic status in this middle-aged US population. Baseline glycemic status may partially underlie prior equivocal evidence regarding the role of dairy intake in diabetes.

Authors+Show Affiliations

Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA.Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA. National Heart, Lung, and Blood Institute, Framingham Heart Study, Framingham, MA; and.Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA.Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA; paul.jacques@tufts.edu.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28768835

Citation

Hruby, Adela, et al. "Associations of Dairy Intake With Incident Prediabetes or Diabetes in Middle-Aged Adults Vary By Both Dairy Type and Glycemic Status." The Journal of Nutrition, vol. 147, no. 9, 2017, pp. 1764-1775.
Hruby A, Ma J, Rogers G, et al. Associations of Dairy Intake with Incident Prediabetes or Diabetes in Middle-Aged Adults Vary by Both Dairy Type and Glycemic Status. J Nutr. 2017;147(9):1764-1775.
Hruby, A., Ma, J., Rogers, G., Meigs, J. B., & Jacques, P. F. (2017). Associations of Dairy Intake with Incident Prediabetes or Diabetes in Middle-Aged Adults Vary by Both Dairy Type and Glycemic Status. The Journal of Nutrition, 147(9), pp. 1764-1775. doi:10.3945/jn.117.253401.
Hruby A, et al. Associations of Dairy Intake With Incident Prediabetes or Diabetes in Middle-Aged Adults Vary By Both Dairy Type and Glycemic Status. J Nutr. 2017;147(9):1764-1775. PubMed PMID: 28768835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of Dairy Intake with Incident Prediabetes or Diabetes in Middle-Aged Adults Vary by Both Dairy Type and Glycemic Status. AU - Hruby,Adela, AU - Ma,Jiantao, AU - Rogers,Gail, AU - Meigs,James B, AU - Jacques,Paul F, Y1 - 2017/08/02/ PY - 2017/04/21/received PY - 2017/05/28/revised PY - 2017/07/06/accepted PY - 2017/8/5/pubmed PY - 2017/9/14/medline PY - 2017/8/4/entrez KW - cheese KW - dairy KW - diabetes KW - prediabetes KW - yogurt SP - 1764 EP - 1775 JF - The Journal of nutrition JO - J. Nutr. VL - 147 IS - 9 N2 - Background: Inconsistent evidence describes the association between dietary intake of dairy and milk-based products and type 2 diabetes (T2D) risk.Objective: Our objective was to assess associations between consumption of milk-based products, incident prediabetes, and progression to T2D in the Framingham Heart Study Offspring Cohort.Methods: Total dairy and milk-based product consumption was assessed by ≤4 food-frequency questionnaires across a mean of 12 y of follow-up in 2809 participants [mean ± SD age: 54.0 ± 9.7 y; body mass index (in kg/m2): 27.1 ± 4.7; 54% female]. Prediabetes was defined as the first occurrence of fasting plasma glucose ≥5.6 to <7.0 mmol/L (≥100 to <126 mg/dL), and T2D was defined as the first occurrence of fasting plasma glucose ≥7.0 mmol/L (≥126 mg/dL) or diabetes treatment. Proportional hazards models were used to estimate the risk of incident outcomes relative to dairy product intake in subsets of the cohort who were at risk of developing the outcomes. Spline regressions were used to examine potential nonlinear relations.Results: Of 1867 participants free of prediabetes at baseline, 902 (48%) developed prediabetes. Total, low-fat, and high-fat dairy consumptions were associated with a 39%, 32%, and 25% lower risk of incident prediabetes, respectively, in the highest compared with the lowest intakes (≥14 compared with <4 servings/wk). Total, low-fat and skim milk, whole-milk, and yogurt intakes were associated nonlinearly with incident prediabetes; moderate intake was associated with the greatest relative risk reduction. Neither cheese nor cream and butter was associated with prediabetes. Of 925 participants with prediabetes at baseline, 196 (21%) developed T2D. Only high-fat dairy and cheese showed evidence of dose-response, inverse associations with incident T2D, with 70% and 63% lower risk, respectively, of incident T2D between the highest and lowest intake categories (≥14 compared with <1 serving/wk for high-fat dairy, ≥4 compared with <1 serving/wk for cheese).Conclusion: Associations of dairy with incident prediabetes or diabetes varied both by dairy product and type and by baseline glycemic status in this middle-aged US population. Baseline glycemic status may partially underlie prior equivocal evidence regarding the role of dairy intake in diabetes. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/28768835/Associations_of_Dairy_Intake_with_Incident_Prediabetes_or_Diabetes_in_Middle_Aged_Adults_Vary_by_Both_Dairy_Type_and_Glycemic_Status_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.117.253401 DB - PRIME DP - Unbound Medicine ER -