Abstract
PurposeOur aim was to investigate prospective associations of consumption of total dairy and dairy types with incident prediabetes in a Dutch population-based study.MethodsTwo enrolment waves of the Hoorn Studies were harmonized, resulting in an analytic sample of 2262 participants without (pre-) diabetes at enrolment (mean age 56 ± 7.3 years; 50% male). Baseline dietary intake was assessed by validated food frequency questionnaires. Relative risks (RRs) were calculated between dairy, fermented dairy, milk, yogurt (all total/high/low fat), cream and ice cream and prediabetes. Additionally, substituting one serving/day of dairy types associated with prediabetes with alternative dairy types was analysed.ResultsDuring a mean 6.4 ± 0.7 years of follow-up, 810 participants (35.9%) developed prediabetes. High fat fermented dairy, cheese and high fat cheese were associated with a 17% (RR 0.83, 95% CI 0.69–0.99, ptrend = 0.04), 14% (RR 0.86, 95% CI 0.73–1.02, ptrend = 0.04) and 21% (RR 0.79, 95% CI 0.66–0.94, ptrend = 0.01) lower risk of incident prediabetes, respectively, in top compared to bottom quartiles, after adjustment for confounders. High fat cheese consumption was continuously associated with lower prediabetes risk (RRservings/day 0.94, 95% CI 0.88–1.00, p = 0.04). Total dairy and other dairy types were not associated with prediabetes risk in adjusted models, irrespective of fat content (RR ~ 1). Replacing high fat cheese with alternative dairy types was not associated with prediabetes risk.ConclusionThe highest intake of high fat fermented dairy, cheese and high fat cheese were associated with a lower risk of prediabetes, whereas other dairy types were not associated. Cheese seems to be inversely associated with type 2 diabetes risk, despite high levels of saturated fatty acids and sodium.
Highlights
Prediabetes is a condition characterized by blood glucose levels that are above the normal range, but still fall below the diagnostic threshold for type 2 diabetes [1].The prevalence of prediabetes is rapidly rising worldwide from 374 million in 2019 to an expected 548 million in 2045 [2]
A high intake of high fat fermented dairy, total cheese and high fat cheese were associated with lower risk of prediabetes in this population-based cohort
Associations were driven by high fat cheese intake, as 52% and 83% of, respectively, high fat fermented dairy and total cheese intake consisted of high fat cheese
Summary
Prediabetes is a condition characterized by blood glucose levels that are above the normal range, but still fall below the diagnostic threshold for type 2 diabetes [1].The prevalence of prediabetes is rapidly rising worldwide from 374 million in 2019 to an expected 548 million in 2045 [2]. People with prediabetes are at increased risk of developing type 2 diabetes (T2D) and cardiovascular diseases (CVD) [3, 4], but may reverse to normoglycaemia with lifestyle adaptation [5]. This emphasizes the need to identify modifiable risk factors that could prevent or reverse this condition. A recent summary of meta-analyses reported dose–response relations of low fat dairy (RRs ranging from 0.88–0.98), yogurt (0.78–0.94) and cheese (0.80–1.00) with T2D, inconsistent results for milk (RRs 0.83–1.27), with considerable heterogeneity present between studies [8]. Studies aiming to elucidate associations between dairy and early-risk stages are warranted
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