Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk

Abstract

Purpose: The possible effects of dairy consumption on diabetes prevention remain controversial. The aim of this study was to investigate the association between the dairy consumption and type 2 diabetes (T2D) risk in an elderly Mediterranean population at high cardiovascular risk. Methods: We prospectively followed 3,454 non-diabetic individuals from the PREDIMED study. Dairy consumption was assessed at baseline and yearly using food frequency questionnaires and categorized into total, low-fat, whole-fat, and subgroups: milk, yogurt, cheeses, fermented dairy, concentrated full fat, and processed dairy. Hazard ratios (HRs) were calculated using Cox proportional hazards regression models. Results: During a median follow-up of 4.1 years, we documented 270 incident T2D cases. After multivariate adjustment, total dairy product consumption was inversely associated with T2D risk [0.68 (95 % CI 0.47–0.98); P-trend = .040]. This association appeared to be mainly attributed to low-fat dairy; the multivariate HRs (95 % CIs) comparing the highest versus the lowest tertile consumption were 0.65 (0.45–0.94) for low-fat dairy products and 0.67 (0.46–0.95) for low-fat milk (both P-trend <.05). Total yogurt consumption was associated with a lower T2D risk [HR 0.60 (0.42–0.86); P-trend = .002]. An increased consumption of total low-fat dairy and total yogurt during the follow-up was inversely associated with T2D; HRs were 0.50 (0.29–0.85), 0.44 (0.26–0.75), and 0.55 (0.33–0.93), respectively. Substituting one serving/day of a combination of biscuits and chocolate and whole grain biscuits and homemade pastries for one serving/day of yogurt was associated with a 40 and 45 % lower risk of T2D, respectively. No significant associations were found for the other dairy subgroups (cheese, concentrated full fat, and processed dairy products). Conclusions: A healthy dietary pattern incorporating a high consumption of dairy products and particularly yogurt may be protective against T2D in older adults at high cardiovascular risk.