Abstract

Observational studies provide evidence that a higher intake of protein from plant-based foods and certain animal-based foods is associated with a lower risk for type 2 diabetes (T2DM). However, there are few distinguishable differences between the glucoregulatory qualities of the proteins in plant-based foods, and it is likely their numerous non-protein components (e.g., fibers and phytochemicals) that drive the relationship with T2DM risk reduction. Conversely, the glucoregulatory qualities of the proteins in animal-based foods are extremely divergent, with a higher intake of certain animal-based protein foods showing negative effects, and others showing neutral or positive effects on T2DM risk. Among the various types of animal-based protein foods, a higher intake of dairy products (such as milk, yogurt, cheese and whey protein) consistently shows a beneficial relationship with glucose regulation and/or T2DM risk reduction. Intervention studies provide evidence that dairy proteins have more potent effects on insulin and incretin secretion compared to other commonly consumed animal proteins. In addition to their protein components, such as insulinogenic amino acids and bioactive peptides, dairy products also contain a food matrix rich in calcium, magnesium, potassium, trans-palmitoleic fatty acids, and low-glycemic index sugars—all of which have been shown to have beneficial effects on aspects of glucose control, insulin secretion, insulin sensitivity and/or T2DM risk. Furthermore, fermentation and fortification of dairy products with probiotics and vitamin D may improve a dairy product’s glucoregulatory effects.

Highlights

  • Experts may still argue the science and semantics of whether a “calorie is a calorie” when it comes to effects on body weight; it is abundantly clear that all calorie sources are not created equal when it comes to their effects on metabolic parameters such as glycemia, insulinemia, fat oxidation, and protein synthesis

  • Replacement of one serving of plant protein with one serving of poultry, eggs, fish, or red meat resulted in a 9%–13% increase in type 2 diabetes mellitus (T2DM) risk, while replacement with processed meat resulted in a 21% increased risk

  • While dairy proteins are best known for their ability to potentiate insulin secretion, the data from this review suggests that long-term daily consumption of certain dairy foods may have the potential to improve pathways relating to insulin sensitivity [109]

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Summary

Introduction

Experts may still argue the science and semantics of whether a “calorie is a calorie” when it comes to effects on body weight; it is abundantly clear that all calorie sources are not created equal when it comes to their effects on metabolic parameters such as glycemia, insulinemia, fat oxidation, and protein synthesis. Acute challenge studies regarding protein and fat intake show unique effects of animal protein types (e.g., cheese, egg, beef steak, etc.) on insulin secretion, which differ between healthy and T2DM populations. A study investigating the effects of adding 25 g of various animal proteins to a 50 g glucose meal in subjects with T2DM found that the addition of protein from lean beef, turkey, gelatin, egg white, cottage cheese, and fish all increased plasma insulin concentrations more than consuming glucose alone [11]. In subjects with T2DM, milk intake has been shown to lead to roughly a five-fold greater increase in insulin response than expected, based on its glucose response [85] These findings suggest that beta cells may retain their sensitivity or become more sensitized to specific proteins and nutrient combinations in individuals with compromised glucose sensing and signaling. More RCTs, along with the use of valid biomarkers, are needed to better understand the insulin-potentiating effects of different dairy products, as well as to determine the mechanisms responsible for the insulin-sensitizing and insulin-independent effects of dairy foods and dairy protein supplements on glucoregulatory markers

Gaps in Existing Knowledge and Future Research Directions
Findings
Conclusions
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