Abstract
Population-based studies suggest a role for dairy, especially yogurt, in the prevention of type 2 diabetes (T2D). Whether dairy affects T2D risk after myocardial infarction (MI) is unknown. We examined associations of (types of) dairy with T2D incidence in drug-treated, post-MI patients from the Alpha Omega Cohort. The analysis included 3401 patients (80% men) aged 60–80 y who were free of T2D at baseline (2002–2006). Dairy intakes were assessed using a validated food-frequency questionnaire. Incident T2D was ascertained through self-reported physician diagnosis and/or medication use. Multivariable Cox models were used to calculate Hazard ratios (HRs) and 95% confidence intervals (CI) for T2D with dairy intake in categories and per 1-standard deviation (SD) increment. Most patients consumed dairy, and median intakes were 264 g/d for total dairy, 82 g/d for milk and 41 g/d for yogurt. During 40 months of follow-up (10,714 person-years), 186 patients developed T2D. After adjustment for confounders, including diet, HRs per 1-SD were 1.06 (95% CI 0.91–1.22) for total dairy, 1.02 (0.88–1.18) for milk and 1.04 (0.90–1.20) for yogurt. Associations were also absent for other dairy types and in dairy categories (all p-trend > 0.05). Our findings suggest no major role for dairy consumption in T2D prevention after MI.
Highlights
Type 2 diabetes (T2D) is a major public health problem, especially in aging populations [1,2], with a global prevalence in the elderly of approximately 20% (135.6 million) in 2019 [1]
Results for cheese and T2D risk differ depending on the studies included in the meta-analyses [14,15,16,17,18,19], while milk and other dairy products are generally neutrally associated with T2D risk
After adjustment for demographics, lifestyle, body mass index (BMI), family history of diabetes and dietary variables, total dairy was not associated with T2D risk (HR: 1.32, 95% confidence intervals (CI): 0.88 to 1.99, highest vs. lowest category, p-trend = 0.18)
Summary
Type 2 diabetes (T2D) is a major public health problem, especially in aging populations [1,2], with a global prevalence in the elderly of approximately 20% (135.6 million) in 2019 [1]. The identification of modifiable dietary factors for the prevention of T2D is of public health importance, in the general population and in patients with CHD. Previous meta-analyses and systematic reviews of prospective cohort studies in generally healthy populations have shown that consumption of total dairy, low-fat dairy and especially yogurt, has been neutrally or weakly inversely associated with T2D incidence [15,16,17]. Results for cheese and T2D risk differ depending on the studies included in the meta-analyses [14,15,16,17,18,19], while milk and other dairy products are generally neutrally associated with T2D risk. We examined total dairy intake and a wide range of dairy products in relation to incident T2D during 40 months of follow-up in our cohort of post-MI patients of the Alpha Omega Cohort
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