The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study
Open accessAbstract
Background Dairy product intake may be inversely associated with risk of type 2 diabetes, but the evidence is inconclusive for total dairy products and sparse for types of dairy products.Objective The objective was to investigate the prospective association of total dairy products and different dairy subtypes with incidence of diabetes in populations with marked variation of intake of these food groups.Design A nested case-cohort within 8 European countries of the European Prospective Investigation into Cancer and Nutrition Study (n = 340,234; 3.99 million person-years of follow-up) included a random subcohort (n = 16,835) and incident diabetes cases (n = 12,403). Baseline dairy product intake was assessed by using dietary questionnaires. Country-specific Prentice-weighted Cox regression HRs were calculated and pooled by using a random-effects meta-analysis.Results Intake of total dairy products was not associated with diabetes (HR for the comparison of the highest with the lowest quintile of total dairy products: 1.01; 95% CI: 0.83, 1.34; P-trend = 0.92) in an analysis adjusted for age, sex, BMI, diabetes risk factors, education, and dietary factors. Of the dairy subtypes, cheese intake tended to have an inverse association with diabetes (HR: 0.88; 95% CI: 0.76, 1.02; P-trend = 0.01), and a higher combined intake of fermented dairy products (cheese, yogurt, and thick fermented milk) was inversely associated with diabetes (HR: 0.88; 95% CI: 0.78, 0.99; P-trend = 0.02) in adjusted analyses that compared extreme quintiles.Conclusions This large prospective study found no association between total dairy product intake and diabetes risk. An inverse association of cheese intake and combined fermented dairy product intake with diabetes is suggested, which merits further study.
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Total milk intake is generally unassociated with diabetes, while fermented milk is linked to lower risk.
“While total milk intake is generally unassociated with diabetes, fermented milk is linked to lower risk;57, 227, 229”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [57]
In longitudinal studies evaluating habitual intakes of dairy foods, relationships with CVD and diabetes do not consistently differ by fat content but appear more specific to food type.
“In longitudinal studies evaluating habitual intakes of dairy foods, relationships with CVD and diabetes do not consistently differ by fat content but appear more specific to food type: e.g., cheese, yogurt, milk, butter (Figure 6).57, 221-226”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [57]
Intake of yogurt, but not milk, is consistently associated with lower incidence of diabetes; cheese intake also associates with lower diabetes risk in several although not all studies.
“For example, intake of yogurt, but not milk, is consistently associated with lower incidence of diabetes; while intake of cheese, which has high calorie, fat, and saturated fat content, also associates with lower diabetes risk in several although not all studies.57, 179-184, 224, 226-228”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [57]
Associations have been seen between major food sources of saturated fat, such as red and processed meat, and development of T2DM, though dairy products, notably fermented dairy, may be protective.
“Associations have been seen between major food sources of saturated fat, such as red and processed meat, and development of T2DM (152,153), though dairy products, notably fermented dairy, may be protective (154,155).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [155]
In a large meta-analysis and the EPIC InterAct study, fermented dairy, but not total dairy, was inversely associated with T2DM.
“In a large meta-analysis of cohort studies (13,000 incident cases), and the EPIC InterAct case-cohort study (12,000 incident cases), fermented dairy (i.e., yogurt, cheese, and thick fermented milk), but not total dairy, was inversely associated with T2DM (155,183).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [155]
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References 44 · Cited by 223
- Authors
- Sluijs, I., Forouhi, N. G., Beulens, J. W., van der Schouw, Y. T., Agnoli, C., Arriola, L., Balkau, B., Barricarte, A., Boeing, H., Bueno-de-Mesquita, H. B., Clavel-Chapelon, F., Crowe, F. L., de Lauzon-Guillain, B., Drogan, D., Franks, P. W., Gavrila, D., Gonzalez, C., Halkjær, J., Kaaks, R., Moskal, A., Nilsson, P., Overvad, K., Palli, D., Panico, S., Quirós, J. R., Ricceri, F., Rinaldi, S., Rolandsson, O., Sacerdote, C., Sánchez, M.-J., Slimani, N., Spijkerman, A. M., Teucher, B., Tjonneland, A., Tormo, M.-J., Tumino, R., van der A, D. L., Sharp, S. J., Langenberg, C., Feskens, E. J., Riboli, E., & Wareham, N. J.
- Affiliations
- Utrecht University (NL)
- Addenbrooke's Hospital (GB)
- Inserm (FR)
- German Institute of Human Nutrition (DE)
- University of Oxford (GB)
- Lund University (SE)
- Institut Català d'Oncologia (ES)
- Danish Cancer Society (DK)
- Istituto per lo Studio e la Prevenzione Oncologica (IT)
- University of Naples Federico II (IT)
- Italian institute for Genomic Medicine (IT)
- Centre international de recherche sur le cancer (FR)
- Umeå University (SE)
- Andalusian School of Public Health (ES)
- National Institute for Public Health and the Environment (NL)
- German Cancer Research Center (DE)
- Wageningen University & Research (NL)
- ORCID
- Sluijs, Ivonne
- Forouhi, Nita G
- Beulens, Joline WJ
- Agnoli, Claudia
- Arriola, Larraitz
- Balkau, Beverley
- Barricarte, Aurelio
- Boeing, Heiner
- Crowe, Francesca L
- Franks, Paul W
- Gonzalez, Carlos
- Halkjær, Jytte
- Kaaks, Rudolf
- Nilsson, Peter
- Overvad, Kim
- Palli, Domenico
- Panico, Salvatore
- Quirós, José R
- Ricceri, Fulvio
- Rinaldi, Sabina
- Rolandsson, Olov
- Sacerdote, Carlotta
- Sánchez, María-José
- Slimani, Nadia
- Tumino, Rosario
- Sharp, Stephen J
- Langenberg, Claudia
- Feskens, Edith JM
- Wareham, Nicholas J
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 96
- Issue
- 2
- Pages
- 382-390
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2139021653
- Cited by
- 223
- References
- 44
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 15 · 2023: 12 · 2022: 13 · 2021: 15 · 2020: 16 · 2019: 19 · 2018: 24 · 2017: 26 · 2016: 16 · 2015: 25 · 2014: 18 · 2013: 14 · 2012: 2
- FWCI
- 18.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Socio-Environmental Systems Modeling (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Cancer Research UK
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- dairy consumption, type 2 diabetes, cheese, fermented dairy products, yogurt, diabetes risk, dietary factors
- MeSH terms
- Adult, Energy Intake, Dairy Products, Diabetes Mellitus, Type 2, Diet, Europe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk Factors, Cohort Studies, Incidence, Proportional Hazards Models
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