Dairy Consumption and Cardiometabolic Risk Factors in Patients with Type 2 Diabetes and Obesity During Intensive Lifestyle Intervention: A 6-Month Prospective Cohort Study

Abstract

Abstract Objectives To evaluate the association between dairy consumption and A1C, body weight, and cardiometabolic risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive lifestyle intervention (ILI) program in real-world clinical practice. Methods We evaluated 45 subjects with T2D and obesity enrolled in a 12-week ILI program (mean age 56 ± 9 yrs, 40% female, diabetes duration 10.9 ± 7 yrs, A1C 7.9 ± 1.3%, body weight 106 ± 19 kg, BMI 36 ± 5 kg/m2, and caloric intake 1880 ± 544 kcal/d). We divided the cohort based on weekly average dairy consumption during the 12-week ILI program equally into frequent, less-frequent, and infrequent dairy consumers (1.5 ± 0.6 servings/d, 0.6 ± 0.2 servings/d, and 0.2 ± 0.1 servings/d respectively). High- and low-fat dairy consumption was balanced within the 3 groups. We continued to follow them for additional 12 weeks after the end of the ILI program. Clinical, dietary, and body composition measurements were done at baseline, 12 weeks, and 24 weeks. Results At baseline, there was no significant difference between the 3 groups except for higher caloric intake among frequent compared with infrequent dairy consumers (2106 ± 498 kcal vs 1496 ± 540 kcal, P < 0.01). Frequent dairy consumers increased their %energy from protein from baseline by 5.8 ± 2.3% at 12 weeks and 3.6 ± 2% at 24 weeks (P < 0.05 for both), while the other 2 groups had no changes. There were no significant changes in % energy from fat, saturated fat, carbohydrates, fibers or alcohol consumption between the 3 groups. After the ILI program, the less-frequent group increased their average dairy consumption by 33% to 0.8 ± 0.3 servings/d at 6 months (P < 0.05), while the other 2 groups had no changes. There was a trend towards lower serum HDL-C and higher VLDL-C and insulin with frequent dairy consumption at 12 weeks and 6 months (P trend < 0.05). Changes in A1C, body weight, HOMA-IR, total cholesterol, LDL-C, BP, or body composition parameters showed no association with the frequency of dairy consumption at 12 weeks or 6 months. Conclusions Frequency of dairy consumption during ILI program is not associated with changes in A1C or body weight but with unfavorable trends in serum HDL-C, VLDL-C and Insulin in patients with T2D and obesity. Funding Sources This investigator-initiated study was funded by the National Dairy Council.