Abstract
Dairy consumption has been associated with a modestly lower risk of type 2 diabetes and other components of the metabolic syndrome in few cohort studies. However, confounding by overall diet quality and physical activity levels remains present. We evaluated 4,934 adults who participated in the 2017-2018 National Health and Nutrition Examination Surveys (NHANES) and underwent two 24-hr dietary recalls in addition to general health questionnaires, examinations, and laboratory assessments. Dairy intake data (milk, yogurt, and cheese but not dairy-based desserts) were extracted and transformed into USDA-defined serving sizes then categorized based on number of servings: non-consumers, <1 serving, 1 to <2 servings, and ≥2 servings. We defined diabetes mellites (DM) as physician-diagnosed DM, A1c ≥6.5%, or fasting plasma glucose ≥126 mg/dL. We calculated the Healthy Eating Index-2015 (HEI-2015) , an indicator of overall diet quality. The average age of this cohort was 49.6±18.5 yrs, 51% were female, 73.5% were overweight or obese, and 17% had DM. After multivariate adjustment for age, gender, BMI, smoking, vigorous physical activity, and HEI-2015, intake of ≥2 servings of dairy was associated with lower risk of DM (OR: 0.9, 95% CI 0.81-0.99, p=0.049) compared with non-consumers. In sensitivity analysis, the association between intake of ≥2 servings of dairy and prevalent DM showed directionally dissimilar results when adding dairy type-specific servings to the model (Milk, OR: 0.9, 95% CI 0.77-1.05, p=0.vs. combined cheese and yogurt, OR: 0.87, 95% CI 0.76-0.99, p=0.036) . In conclusion, higher dairy intake is associated with lower risk of DM among US adults while adjusting for diet quality. This association seems to be driven by cheese and yogurt intake rather than by milk. These findings need to be evaluated in randomized prospective intervention trials. Disclosure S.Tomah: None. O.Hamdy: Advisory Panel; L-Nutra Inc., Nestlé, Consultant; Abbott, Sanofi, Research Support; Eli Lilly and Company, Gilead Sciences, Inc., National Dairy Council, Novo Nordisk, Stock/Shareholder; Healthimation. Funding The authors received specific funding for this research
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