Dairy Food Intake Research Articles

Impact of Dairy Food Intake on Glucose Homeostasis: A Randomized Controlled Trial (P08-039-19)

ObjectivesThe consumption of dairy foods, both low-fat and full-fat, tends to be associated with better metabolic health and lower type 2 diabetes risk in most observational studies. We aimed to test the effects of diets rich in either low-fat or full-fat dairy products on glucose tolerance and its key determinants, compared to a diet limited in dairy. We hypothesized that diets rich in dairy, particularly full-fat dairy, would improve glucose homeostasis. MethodsSeventy-two men and women with the metabolic syndrome first completed a 4-week wash-in period during which they limited their dairy intake to no more than 3 servings of skim milk per week. Participants were then randomized to either continue the limited dairy diet or switch to a diet containing 3.3 servings per day of either low-fat or full-fat milk, yogurt, and cheese, for 12 weeks. Glucose tolerance and its key determinants (insulin sensitivity, beta-cell function, liver fat content, low-grade inflammation) were assessed before and after the 12-week intervention period. ResultsIn primary per protocol analyses (n = 67), repeated measures analysis of variance revealed no treatment effect on glucose tolerance, as measured by the area-under-the-curve glucose in a 3-hour oral glucose tolerance test (P = 0.340). However, intervention effects were seen for the homeostasis model assessment insulin resistance index (P = 0.004 overall), and post hoc tests showed a significant increase in insulin resistance in the low-fat dairy group (mean ± SD + 0.8 ± 1.4, adjusted P = 0.03) and the full-fat dairy group (+ 1.3 ± 1.7, adjusted P = 0.003) compared to the limited dairy group (-0.2 ± 1.1). These effects were unchanged in secondary analyses adjusted for moderate changes in fat mass. ConclusionsIn this 12-week dietary intervention study, we detected no evidence for our hypothesis that dairy consumption improves glucose tolerance. Unexpectedly, insulin resistance increased in individuals consuming diets rich in either low-fat or full-fat dairy products, compared to participants who limited their dairy intake. Funding SourcesThis work was supported by the National Dairy Council, Dairy Farmers of Canada, the Dutch Dairy Association (NZO), Dairy Australia, and the French Dairy Interbranch Organization (CNIEL).

Dairy Food Consumption is Inversely Associated with the Prevalence of Periodontal Disease in Korean Adults.

Dairy food consumption is known to be inversely associated with periodontal disease. However, there are conflicting results depending on the type of dairy foods. The aim of this study was to determine the relationship between individual dairy food consumption and periodontal disease. A total of 9798 Korean adults, aged ≥30 years, who participated in the fifth and sixth Korea National Health and Nutrition Examination Survey were included in this study’s analysis. Dairy food consumption was measured by the semi-quantitative food frequency questionnaire. Periodontal disease was defined as Community Periodontal Index score ≥3 in more than one of six sextants. Frequent intake of dairy foods (≥7 servings/week) was associated with a 24% lower prevalence of periodontal disease compared with never consumers after adjustment for age, gender, income, education, smoking, alcohol consumption, body mass index, diabetes mellitus status, calcium intake, tooth brushing frequency, and use of dental floss (Odds ratio (OR)= 0.76, 95% CI = 0.63–0.91, p for trend = 0.052). Also, frequent intake of milk (≥7 servings/week) was associated with a 26% lower prevalence of periodontal disease after adjustment for potential confounders (OR = 0.74, 95% CI = 0.61–0.89, p for trend = 0.022). Frequent consumption of dairy food including milk may have a beneficial effect on periodontal disease in the Korean adult population.

Not a Good Association: Diary Intake and Cardiovascular Disease in the PURE Study

In this comment, I argue that a recent study on dairy food intake and cardiovascular disease published in The Lancet is misleading because the authors fail to account for an important confounder.

Milk and yogurt intake and breast cancer risk: A meta-analysis.

Different patterns of milk and breast cancer rates across countries suggest that several components of milk could affect breast cancer risk. However, the components of diet are complex including milk that could potentially influence risk. Some milk products such as whole milk and cheese have a high fat content which may increase risk. Moreover, milk products may contain pesticides which have carcinogenic potential. In contrast, some contents of milk such as calcium and vitamin D have been hypothesized to reduce breast cancer risk. Therefore, we performed this meta-analysis to derive a more precise estimation of the association between dairy food intake and breast cancer risk. Using the data from 8 available publications, we examined low-fat/skim milk, whole milk, and yogurt in relation to risk of breast cancer by meta-analysis. Pooled odds ratio (OR) with 95% confidence interval (CI) was used to assess the association. However the results of all milk models and the available epidemiologic evidence do not support a strong association between the consumption of milk or milk products and breast cancer risk. Further studies with larger participants worldwide are needed to validate the relationship of dairy food intake and breast cancer.

Dairy Product Intake and Cardiometabolic Diseases in Northern Sweden: A 33-Year Prospective Cohort Study

Dairy products are important constituents of most diets, and their association with adverse health outcomes remains a focus. We characterized dairy food intake and examined associations with the incidence of type 2 diabetes (T2D), myocardial infarction (MI) or stroke among 108,065 Swedish men and women. Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazards models in a population characterized by high milk tolerance. During a mean follow-up of 14.2 years, 11,641 first-time events occurred. Non-fermented milk intake decreased, whereas butter intake increased over the period. For high intake of non-fermented milk, the HR (95% CI) for developing T2D and MI was 1.17 (1.03, 1.34) and 1.23 (1.10, 1.37), respectively, in men. A greater intake of butter, fermented milk, and cheese tended to be associated with a reduced risk of T2D and/or MI. Non-consumers and those who chose low-fat variants of the targeted dairy products had increased risk for T2D, MI, or stroke compared to those in the non-case group. Generally, effect-sizes were small. This prospective study found that non-fermented milk was associated with an increased risk for developing T2D and MI and that subjects abstaining from dairy products or choosing low-fat variants were at greater risk. However, the overall cardiometabolic risk of non-fermented milk intake was judged as low, since the effect sizes were small.

Dairy food intake, diet patterns, and health: Findings from the Maine-Syracuse Longitudinal Study

This study compared the intake of yogurt and other dairy foods in relation to other dietary habits, and associations with cardiovascular health indicators. Comparative analyses of dietary intakes and cardiometabolic health indicators were conducted in participants from the Maine-Syracuse Longitudinal Study, conducted in 2001-2006 (n = 699). Participants (10.2% of sample) who consumed yogurt more frequently (≥ 5 serves per week) also consumed more fruit, vegetables, nuts, and fish, but fewer sweets, sugar-sweetened soft drinks, and alcohol. The yogurt-healthy food score was significantly inversely associated with fasting plasma glucose (p = 0.044), waist circumference (p = 0.004), and smoking (p = 0.004), and significantly positively associated with physical activity (p < 0.001). In addition, the yogurt-healthy food score was associated with protection against MetS abdominal obesity (OR: 0.80, 95% CI: 0.66-0.07, p = 0.02). The yogurt-healthy dietary pattern was significantly associated with a better cardiometabolic profile.

Higher Dairy Intakes Are Associated with Higher Bone Mineral Density among Adults with Sufficient Vitamin D Status: Results from the Boston Puerto Rican Osteoporosis Study

Dairy foods have been shown to improve bone mineral density (BMD) in non-Hispanic whites. Puerto Rican adults have a higher prevalence of osteoporosis and vitamin D deficiency than non-Hispanic whites. However, there is little understanding of lifestyle influences on bone in this population. The aim of this study was to examine associations of dairy intakes with BMD among adults from the Boston Puerto Rican Osteoporosis Study with and without adequate serum vitamin D status. A total of 904 participants in this cross-sectional analysis provided dietary intakes with a culturally tailored food-frequency questionnaire. Dairy food groups were calculated [total dairy, modified dairy (without cream or dairy desserts), fluid dairy (milk+yogurt), cheese, yogurt, and cream and desserts]. BMD (grams per centimeter squared) was measured using dual-energy X-ray absorptiometry. Vitamin D status was defined as sufficient (serum 25-hydroxyvitamin D [25(OH)D]≥20 ng/mL) or insufficient (<20 ng/mL). General linear models were used to examine associations between dairy intake and BMD, stratified by vitamin D status. Of the total sample, 73% were women, of whom 87% were postmenopausal. Mean ± SD age was 60.0±7.6 y and mean ± SD body mass index (kg/m2) was 32.3±6.6. Mean serum 25(OH)D (range: 4-48 ng/mL) was 14.3±3.6 ng/mL in insufficient individuals and 26.0±5.5 ng/mL in sufficient individuals. In the full sample, higher intakes of modified dairy foods (β=0.0015, P=0.02) and milk (β=0.0018, P=0.04) were associated with higher femoral neck (FN) BMD. Among those who were vitamin D sufficient, higher intakes of total dairy (P=0.03-0.07), fluid dairy (P=0.01-0.05), and milk (P=0.02-0.09) were significantly related to higher FN and lumbar spine BMD, respectively. Among vitamin D-insufficient participants, dairy intakes were not associated with BMD (P-range = 0.11-0.94). Dairy food intakes were associated with higher BMD among adults, particularly those with sufficient vitamin D status. Future studies should confirm findings longitudinally and assess culturally acceptable lifestyle interventions to improve bone health among Hispanic adults. This trial was registered at clinicaltrials.gov as NCT01231958.

The relationship between dairy food intake and psychological distress among Iranian adults: results from a large cross-sectional population-based study

Psychological distress is associated with decreased quality of life. The nutritional factor is one of the most important for mental well-being. The aim of the present study was to determine the relationship between dairy food intake and psychological distress. In this cross-sectional study, data on the dietary food intake of 4763 participants were collected using a validated FFQ. Also, the Iranian validated version of the GHQ was used to screen psychological distress. Individuals in the highest tertile of total dairy food intake were less likely to have psychological distress (OR 0.80, 95% CI 0.70–0.91, P = 0.04) in the final adjusted model. At stratified analysis based on sex, the same findings were obtained only among women. Inversely, individuals in the highest category of high-fat dairy intake had greater odds of suffering from psychological distress (OR 1.45, 95% CI 1.07–1.83, P = 0.01). Also, higher intake of high-fat dairy was significantly associated with greater odds of psychological distress among women in models stratified by sex. However, we found a marginally significant inverse association between higher intake of low-fat dairy and psychological distress risk (OR 0.85, 95% CI 0.69–1.01, P = 0.07). This association was not significant among men and women in a stratified analysis based on sex. The result showed dairy intake is associated with psychological distress. Further studies are required to confirm these associations.

Fermented dairy foods intake and risk of cancer.

Fermented dairy foods are known to be nutrient-rich and probiotic content, which gather optimism due to their potential in prevention and management of cancer. We searched the PubMed, Embase and CNKI databases for all available studies through July 2018 on the association between fermented dairy foods intake and cancer risk. The odds ratio (OR) corresponding to the 95% confidence interval (95% CI) was used to assess the association using a random-effect meta-analysis. Finally, 61 studies met the inclusion criteria for our study, with 1,962,774 participants and 38,358 cancer cases. Overall, statistical evidence of significantly decreased cancer risk was found to be associated with fermented dairy foods intake (OR = 0.86, 95% CI = 0.80-0.92) in cohort studies. Yogurt consumption was significantly with decreased cancer risk in the overall comparison (OR = 0.87, 95% CI = 0.80-0.95) and in the cohort studies (OR = 0.81, 95% CI = 0.74-0.88). In terms of subgroup analyses by cancer type, fermented dairy foods intake significantly decreased bladder cancer, colorectal cancer and esophageal cancer risk. In stratified analyses, significantly decreased colorectal cancer risk was found to be associated with cheese intake. Yogurt consumption was significantly decreased bladder cancer and colorectal cancer risk. Our meta-analysis indicated that fermented dairy foods intake was associated with an overall decrease in cancer risk.

A Prospective Study of Dairy-Food Intake and Early Menopause.

Early natural menopause, the cessation of ovarian function prior to age 45 years, affects approximately 10% of women and increases risk of cardiovascular disease and other adverse conditions. Laboratory evidence suggests a potential role of dairy foods in the ovarian aging process; however, no prior epidemiologic studies have evaluated how dairy-food intake is associated with risk of early menopause. We therefore evaluated how intakes of total, low-fat, high-fat, and individual dairy foods were associated with early menopause in Nurses' Health Study II. Women who were premenopausal at the start of follow-up in 1991 were followed until 2011 for early menopause. Food frequency questionnaires were used to assess dietary intake. In Cox proportional hazards models adjusting for age, smoking, and other factors, total baseline dairy-food intake of ≥4 servings/day versus <4 servings/week was associated with 23% lower risk of early menopause (hazard ratio = 0.77, 95% confidence interval: 0.64, 0.93; P for trend = 0.08). Associations appeared to be limited to low-fat dairy foods (for ≥2 servings/day vs. <3 servings/month, hazard ratio = 0.83, 95% confidence interval: 0.68, 1.01; P for trend = 0.02), whereas high-fat dairy-food intake was not associated with early menopause. Low-fat dairy foods may represent a modifiable risk factor for reducing risk of early menopause among premenopausal women.

Association between Lifestyle Habits Questionnaire and Plasma Free Amino Acid Profile in Japanese Rural Community Dwellers

The plasma free amino acid (PFAA) profiles are demonstrated to be altered by overnutrition and subsequent insulin resistance, and/or protein malnutrition in generally healthy subjects. Although, the measurement of PFAAs to evaluate the risk of overnutrition and protein malnutrition is potentially useful, large scale social implementation present several difficulties. Currently, rigorous measurement of PFAAs using high-performance liquid chromatography–electrospray ionization mass spectrometry, following the collection of fasting blood in the morning in hospitals with strict sample management, is required, which can be a burden for local hospitals. In this study, we designed a simple lifestyle habits questionnaire consisting of 19 questions reported to be associated with overnutrition and protein malnutrition, suitable for Japanese rural communities. And then, we investigated the association between PFAAs and the results of the questionnaire in 1,764 Japanese local community dwellers. The results of questions regarding lifestyles leading to overnutrition and subsequent body weight gain were associated with higher concentrations of most essential amino acids including branched chain amino acids and aromatic amino acids. On the other hand, results of questions related to lifestyles leading to protein malnutrition were associated with lower concentrations of some essential amino acids. The results of questions regarding sleep duration, frequency of dairy food intake, snack habit, gait speed, fruit and vegetable intake had little impact on PFAA profiles. This simple lifestyle habits questionnaire could be a potential screening tool to predict alterations of PFAA profiles. Further validations of the associations with other populations are necessary before large scale social implementation

Associations of Dairy Intake with Arterial Stiffness in Brazilian Adults: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Recent studies have suggested the possible effect of dairy product intake on cardiovascular risk markers, including arterial stiffness. Our aim was to investigate whether dairy food intake is associated with arterial stiffness, which we assessed by carotid-femoral pulse wave velocity (cfPWV) and pulse pressure (PP) in a cross-sectional analysis of baseline data (2008–2010; n = 12,892) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Dairy consumption was evaluated with a validated food-frequency questionnaire (FFQ) by computing servings per day for total and subgroups of dairy products. Dairy consumption was described in four categories (≤1 serving/day to >4 servings/day). Covariance analysis (ANCOVA) was used to compare cfPWV across increasing intake of dairy food, adjusting for confounding factors, including non-dairy food groups. The intake of total dairy was inversely associated with cfPWV and PP (−0.13 m/s and −1.3 mmHg, from the lowest and to the highest category of dairy intake). Low-fat dairy, fermented dairy and cheese showed an inverse relationship with cfPWV and PP. These findings suggest a beneficial effect of dairy consumption to reduce arterial stiffness. However, further evidence from longitudinal studies or long-term intervention is needed to support reduction of cfPWV and PP mediating the beneficial effects of dairy products on cardiovascular health.

Higher Dairy Food Intake Is Associated With Higher Spine Quantitative Computed Tomography (QCT) Bone Measures in the Framingham Study for Men But Not Women.

Previous studies found that dairy foods were associated with higher areal bone mineral density (BMD). However, data on bone geometry or compartment-specific bone density is lacking. In this cross-sectional study, the association of milk, yogurt, cheese, cream, milk+yogurt, and milk+yogurt+cheese intakes with quantitative computed tomography (QCT) measures of bone were examined, and we determined if associations were modified by serum vitamin D (25-OH D, tertiles) or age (<50 versus ≥50 years). Participants were 1522 men and 1104 women (aged 32 to 81 years, mean 50 years [men]; 55 years [women]) from the Framingham Heart Study with measures of dairy food intake (servings/wk) from a food-frequency questionnaire, volumetric BMD (vBMD, integral and trabecular, g/cm3 ), cross-sectional area (CSA, cm2 ), and estimated vertebral compressive strength (VCS, N) and 25-OH D (radioimmunoassay). Sex-specific multivariable linear regression was used to calculate the association of dairy food intake (energy adjusted) with each QCT measure, adjusting for covariates. Mean milk intake ±SD was 6 ± 7 servings/week in both men and women. In men, higher intake of milk, milk+yogurt, and milk+yogurt+cheese was associated with higher integral (p = 0.001 to 0.006) and trabecular vBMD (p = 0.006 to 0.057) and VCS (p = 0.001 to 0.010). Further, a higher cheese intake was related with higher CSA (p = 0.049). In women, no significant results were observed for the dairy foods, except for a positive association of cream intake with CSA (p = 0.016). The associations appeared to be stronger in older men. Across 25-OH D tertiles, dairy was positively associated with bone health. In summary, men with higher intakes of milk, milk+yogurt, and milk+yogurt+cheese had higher trabecular and integral vBMD and VCS but not CSA. Dairy intake seems to be most beneficial for older men, and dairy continued to have positive associations among all 25-OH D levels. © 2018 American Society for Bone and Mineral Research.

Complex Interactions of Obesity, Dairy Food Intake and Genetics of Lactase

Complex Interactions of Obesity, Dairy Food Intake and Genetics of Lactase

Genome-Wide Interactions with Dairy Intake for Body Mass Index in Adults of European Descent.

Body weight responds variably to the intake of dairy foods. Genetic variation may contribute to inter-individual variability in associations between body weight and dairy consumption. A genome-wide interaction study to discover genetic variants that account for variation in BMI in the context of low-fat, high-fat and total dairy intake in cross-sectional analysis was conducted. Data from nine discovery studies (up to 25 513 European descent individuals) were meta-analyzed. Twenty-six genetic variants reached the selected significance threshold (p-interaction <10-7) , and six independent variants (LINC01512-rs7751666, PALM2/AKAP2-rs914359, ACTA2-rs1388, PPP1R12A-rs7961195, LINC00333-rs9635058, AC098847.1-rs1791355) were evaluated meta-analytically for replication of interaction in up to 17 675 individuals. Variant rs9635058 (128 kb 3' of LINC00333) was replicated (p-interaction = 0.004). In the discovery cohorts, rs9635058 interacted with dairy (p-interaction = 7.36 × 10-8) such that each serving of low-fat dairy was associated with 0.225 kg m-2 lower BMI per each additional copy of the effect allele (A). A second genetic variant (ACTA2-rs1388) approached interaction replication significance for low-fat dairy exposure. Body weight responses to dairy intake may be modified by genotype, in that greater dairy intake may protect a genetic subgroup from higher body weight.

Milk and other dairy foods and risk of hip fracture in men and women.

The purpose of this study was to examine whether higher milk and dairy food consumption are associated with risk of hip fracture in older adults following a report of an increased risk for milk in Swedish women. In two US cohorts, 80,600 postmenopausal women and 43,306 men over 50years of age were followed for up to 32years. Cox proportional hazards models were used to calculate the relative risks (RR) of hip fracture per daily serving of milk (240mL) and other dairy foods that were assessed every 4years, controlling for other dietary intakes, BMI, height, smoking, activity, medications, and disease diagnoses. Two thousand one hundred thirty-eight incident hip fractures were identified in women and 694 in men. Each serving of milk per day was associated with a significant 8% lower risk of hip fracture in men and women combined (RR=0.92, 95% confidence interval (CI) 0.87 to 0.97). A suggestive inverse association was found for cheese in women only (RR=0.91, CI 0.81 to 1.02). Yogurt consumption was low and not associated with risk. Total dairy food intake, of which milk contributed about half, was associated with a significant 6% lower risk of hip fracture per daily serving in men and women (RR=0.94, CI 0.90 to 0.98). Calcium, vitamin D, and protein from non-dairy sources did not modify the association between milk and hip fracture, nor was it explained by contributions of these nutrients from milk. In this group of older US adults, higher milk consumption was associated with a lower risk of hip fracture.

Discrepancy in socioeconomic status does not fully explain the variation in diet quality between consumers of different coffee types.

Habitual consumers of different coffee types may vary in socioeconomic status (SES), which is an important determinant of diet quality. Nonetheless, research on diet quality among coffee consumers was scarce. We aimed to compare the diet quality of coffee consumers with different preferences towards coffee type and additive usage. In this cross-sectional analysis, intake data of food, coffee, and additive usage from the adult respondents of the 2011-2012 Australian Health Survey were used. Participants were grouped according to the type of coffee (espresso and ground coffee, E&G; coffee made from coffee mixes and instant coffee, M&I; non-consumers, NC) and additives (milk, sugar, and intense sweetener) consumed. Adjusted food group intake was compared between consumption groups using general linear model. E&G drinkers had better SES than M&I and NC. After adjusting for covariates, the mean dairy intake of E&G drinkers was 22.2% higher than M&I drinkers (p<0.001) and 33.1% higher than NC (p<0.001). Mean discretionary food intake of E&G drinkers was 12.1% lower than M&I (p=0.003) and 12.3% lower than NC (p=0.001). In terms of additive usage, non-users of coffee additive had the lowest dairy food intake and the highest discretionary food intake. Coffee consumers' different preferences towards coffee type and additive usages reflected significant variations in their diet quality, even after adjustment of SES. Therefore, future epidemiological studies should consider separating coffee drinkers according to their habitual consumption of different types of coffee.

Intake of dairy foods and risk of Parkinson disease.

To prospectively examine the association between commonly consumed dairy products and the risk of Parkinson disease (PD) in women and men. Analyses were based on data from 2 large prospective cohort studies, the Nurses' Health Study (n = 80,736) and the Health Professionals Follow-up Study (n = 48,610), with a total of 26 and 24 years of follow-up, respectively. Both US-based studies were conducted via mailed biennial questionnaires. Dietary intake was assessed with food frequency questionnaires administered repeatedly over the follow-up period. Incident cases of PD (n = 1,036) were identified via questionnaires and subsequently confirmed by reviewing medical records. We also conducted a meta-analysis to combine our study with 3 previously published prospective studies on total milk intake and PD risk and 1 study on total dairy intake and PD risk. While total dairy intake was not significantly associated with PD risk in our cohorts, intake of low-fat dairy foods was associated with PD risk. The pooled, multivariable-adjusted hazard ratio (HR) comparing people who consumed at least 3 servings of low-fat dairy per day to those who consumed none was 1.34 (95% confidence interval [CI] 1.01-1.79, p trend = 0.04). This association appeared to be driven by an increased risk of PD associated with skim and low-fat milk (HR 1.39, 95% CI 1.12-1.73, p trend <0.01). Results were similar in women and men (p for heterogeneity >0.05). In the meta-analysis, the pooled relative risk comparing extreme categories of total milk intake was 1.56 (95% CI 1.30-1.88), and the association between total dairy and PD became significant (HR 1.27, 95% CI 1.04-1.55). Frequent consumption of dairy products appears to be associated with a modest increased risk of PD in women and men.

IDENTIFICATION OF RISK FACTORS FOR SELECTED NON COMMUNICABLE DISEASES AMONG PUBLIC SECTOR OFFICE EMPLOYEES, SRI LANKA

The increasing prevalence of Non communicable diseases has been observed in many low income countries during the last decades. Occupational health plays a major role as it is the stem of the country. Documented scientific proven quantity and quality based descriptive evidence on the nutritional, physical activity and other risk factors among office employees are lacking in Sri Lanka. A descriptive cross sectional study was conducted with 380 public sector office employees in Sri Lanka. Socio demographic and behavioral risk factor data (smoking, alcoholism)- using self-administered questionnaire, anthropometry data (weigh, height, waist and hip circumference), blood pressure dietary data using semi quantitative Food Frequency Questionnaire, Physical activity data using International Physical Activity Questionnaire - long form and fasting blood glucose level were assessed. Data was analyzed using SPSS version 16. Mean age of the study population was 38 years (± 9.22). There 38.7% were obese and 20.6% were overweight. Mean waist circumference was 86.75 (± 9.83) cm. 55.2% of them were centrally obese, average waist to hip ratio was 0.92 (± 0.07) and 62.1% of them were having higher waist to hip ratio according to the WHO (Asian) cut off. 39.9% population was under the pre-hypertensive stage. There 4.8% were diabetes and 7.7% were pre-diabetes. 17.2% of male were currently smoking and 52.6% of male were using alcohol. There 31% were inactive while majority of them (61.7%) were moderately physically active. Median Total PA score was 963 MET-min/weeks. Highest PA score was at Domestic and garden domain (420 MET-min/week), and lowest PA score was at work domain (33 MET-min/week). Daily intake of fruit, vegetable and dairy foods were well below national recommendations. Overweight, obesity, central obesity and pre-hypertension, unhealthy eating habits and sedentary during working were identified as risk factors. Article DOI: https://dx.doi.org/10.20319/lijhls.2015.12.1224 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

The Perception of School Milk Program and Consumption of Calcium Source of Middle School Students in Gyeonggi, Korea

In order to develop the strategies to increase the participation of school milk program (SMP), 300 middle school students were surveyed. The information regarding the perception of SMP and intakes of milk and other calcium sources as well as general characteristics was obtained by self‐administered questionnaire. The data were compared between the subjects who wanted the SMP (wanting‐SMP) and those who did not (not‐wanting‐SMP). More of not‐wanting‐SMP group graduated from the elementary schools without SMP (10.9% vs. 4.5%, p&lt;0.05) and drank milk usually along with other foods such as cereals (32.4% vs. 26.1%) or snacks (26.1% vs. 19.8%), while less of them drank milk alone (33.3% vs. 42.3%, p&lt;0.05), compared to wanting‐SMP group. Compared to wanting‐SMP group, more of not‐wanting‐SMP group drank milk less often than once a week (19.6% vs. 52.2%, p&lt;0.05), while the intakes of dairy foods and calcium supplements were not different between groups. Without significant differences between groups, 65.6% of subjects drank the flavored milks when they had a choice to purchase, while 82.6% drank unflavored milk when they did not have a choice home. Conclusively, the results suggested that the adolescents who are reluctant to participate school milk program may have inadequate calcium intake and provided the rationale to urge them to participate SMP not only for the adequate calcium intakes currently, but also for the good dietary habits regarding drinking milk regularly from healthier type, which will favor their health in the future.