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Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies
Open accessAbstract
Background The association between intake of dairy products and the risk of type 2 diabetes has been investigated in several studies, but the evidence is not conclusive.Objective We conducted an updated systematic review and dose-response meta-analysis of dairy product intake and the risk of type 2 diabetes.Design We searched the PubMed database for prospective cohort and nested case-control studies of dairy product intake and risk of type 2 diabetes up to 5 June 2013. Summary RRs were estimated by use of a random-effects model.Results Seventeen cohort studies were included in the meta-analysis. In the dose-response analysis, the summary RRs (95% CIs) were 0.93 (0.87, 0.99; I(2) = 33%) per 400 g total dairy products/d (n = 12), 0.98 (0.94, 1.03; I(2) = 8%) per 200 g high-fat dairy products/d (n = 9), 0.91 (0.86, 0.96; I(2) = 40%) per 200 g low-fat dairy products/d (n = 9), 0.87 (0.72, 1.04; I(2) = 94%) per 200 g milk/d (n = 7), 0.92 (0.86, 0.99; I(2) = 0%) per 50 g cheese/d (n = 8), and 0.78 (0.60, 1.02; I(2) = 70%) per 200 g yogurt/d (n = 7). Nonlinear inverse associations were observed for total dairy products (P-nonlinearity < 0.0001), low-fat dairy products (P-nonlinearity = 0.06), cheese (P-nonlinearity = 0.05), and yogurt (P-nonlinearity = 0.004), and there was a flattening of the curve at higher intakes.Conclusions This meta-analysis suggests that there is a significant inverse association between intakes of dairy products, low-fat dairy products, and cheese and risk of type 2 diabetes. Any additional studies should assess the association between other specific types of dairy products and the risk of type 2 diabetes and adjust for more confounding factors.
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“These main sources of sucrose have shown beneficial associations (for example, whole grain cereals, fruit, and yogurt) with type 2 diabetes mellitus and cardiovascular disease mortality.87 88 89 90 91 92”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [87]
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“Similarly, a meta-analysis of cohort studies suggested an inverse association between the intake of dairy products, low-fat dairy products and cheese and the risk of type 2 diabetes(117).”
ResultNestel, P. J., Straznicky, N. E., Mellett, N. A., Wong, G., Souza, D. P. D., Tull, D., Barlow, C. K., Grima, M. T., & Meikle, P. J. (2013) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.071712 · Cited by 98
Wolfram, G., Bechthold, A., Boeing, H., Ellinger, S., Hauner, H., Kroke, A., Leschik-Bonnet, E., Linseisen, J., Lorkowski, S., Schulze, M., et al. (2015) · Annals of Nutrition and Metabolism · doi:10.1159/000437243 · Cited by 94
Astrup, A. V., Geiker, N. R. W., & Magkos, F. (2019) · Advances in Nutrition · doi:10.1093/advances/nmz069 · Cited by 91
“A second systematic review and dose-response meta-analysis of 17 cohort studies found a significant inverse, dose-dependent association between intake of total dairy products, lowfat dairy products, and cheese, and risk of T2D (37).”
BackgroundDaniel, N., Nachbar, R. T., Tran, T. T. T., Ouellette, A., Varin, T. V., Cotillard, A., Quinquis, L., Gagné, A., St‐Pierre, P., Trottier, J., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-29005-0 · Cited by 90
Maki, K. C., & Phillips, A. (2014) · Journal of Nutrition · doi:10.3945/jn.114.195149 · Cited by 88
Hirahatake, K. M., Slavin, J. L., Maki, K. C., & Adams, S. H. (2014) · Metabolism · doi:10.1016/j.metabol.2014.02.009 · Cited by 89
“[15] conducted a systematic review and dose-response meta-analysis of 17 cohort studies related to dairy intake and T2D risk.”
The role of yogurt in food-based dietary guidelines
Gómez-Gallego, C., Gueimonde, M., & Salminen, S. (2018) · Nutrition Reviews · doi:10.1093/nutrit/nuy059 · Cited by 92
“association between the risk of type 2 diabetes and intake of whole-fat dairy products, low-fat dairy products, and cheese.(87) The mechanism behind this effect is not clear and could be related to multiple factors such as nutritional composition,(58) the negative association with weight gain as mentioned previously,…”
BackgroundZhang, M., Dong, X., Huang, Z., Li, X., Zhao, Y., Wang, Y., Zhu, H., Fang, A., & Giovannucci, E. L. (2023) · Advances in Nutrition · doi:10.1016/j.advnut.2023.06.007 · Cited by 87
“Inconsistently, a meta-analysis published in 2013 showed that per 50-g cheese/d was associated with 8% reduced risk of T2D, and there was a marginal nonlinear association between cheese consumption and T2D risk, with a reduction (cid:4) 50 g/d [15].”
BackgroundJain, S. K., Micinski, D., Huning, L., Kahlon, G., Bass, P. F., & Levine, S. N. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.114 · Cited by 84
Mechanisms Preserving Insulin Action during High Dietary Fat Intake
Lundsgaard, A., Holm, J. B., Sjøberg, K. A., Bojsen-Møller, K. N., Myrmel, L. S., Fjære, E., Jensen, B. A. H., Nicolaisen, T. S., Hingst, J. R., Hansen, S. L., et al. (2018) · Cell Metabolism · doi:10.1016/j.cmet.2018.08.022 · Cited by 85
Moore, J. B., Horti, A., & Fielding, B. A. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-021387 · Cited by 86
Szilagyi, A. (2015) · Nutrients · doi:10.3390/nu7085309 · Cited by 86
“A meta-analysis of dairy foods in T2D is supportive of a protective effect before the onset of disease [158].”
BackgroundYogurt and Diabetes: Overview of Recent Observational Studies
Salas‐Salvadó, J., Guasch‐Ferré, M., Díaz‐López, A., & Babió, N. (2017) · Journal of Nutrition · doi:10.3945/jn.117.248229 · Cited by 83
“The intake of 30 (16) and 50 (17) g cheese/d was inversely associated with type 2 diabetes, but no associations were reported for the intake of 10 g cheese/d (5).”
BackgroundMilk A1 β-casein and health-related outcomes in humans: a systematic review
de Gaudry, D. K., Lohner, S., Schmucker, C. M., Kapp, P., Motschall, E., Hoerrlein, S., Röger, C., & Meerpohl, J. J. (2018) · Nutrition Reviews · doi:10.1093/nutrit/nuy063 · Cited by 81
Our extended microbiome: The human-relevant metabolites and biology of fermented foods
Caffrey, E. B., Sonnenburg, J. L., & Devkota, S. (2024) · Cell Metabolism · doi:10.1016/j.cmet.2024.03.007 · Cited by 87
Chen, G., Szeto, I. M. Y., Chen, L., Han, S.-F., Li, Y., van Hekezen, R., & Qin, L. (2015) · Scientific Reports · doi:10.1038/srep14606 · Cited by 79
Huang, L., Lin, J.-S., Aris, I. M., Yang, G., Chen, W., & Li, L. (2019) · Nutrients · doi:10.3390/nu11050998 · Cited by 79
“However, new evidence has shown that there is an inverse cross-sectional association between SFA-rich dairy products and T2D [16].”
BackgroundLiu, Q., Ayoub‐Charette, S., Khan, T. A., Au‐Yeung, F., Blanco Mejia, S., de Souza, R. J., Wolever, T. M. S., Leiter, L. A., Kendall, C. W. C., & Sievenpiper, J. L. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.118.010977 · Cited by 65
“93,94 The link between dairy and hypertension is unclear.”
Vitamin D Status, Calcium Intake and Risk of Developing Type 2 Diabetes: An Unresolved Issue
Muñoz‐Garach, A., García-Fontana, B., & Muñoz‐Torres, M. (2019) · Nutrients · doi:10.3390/nu11030642 · Cited by 77
“However, it is important to notice possible confounding factors such as fat content in some dairy products, which can influence the protective effects of calcium [74,83].”
BackgroundLiang, J., Zhou, Q., Amakye, W. K., Su, Y., & Zhang, Z. (2016) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2016.1242114 · Cited by 77
“Moreover, by pooling seventeen cohort studies Aune et al have found that a high intake of total dairy and low-fat dairy but not high-fat dairy products were associated with a significant decrease in the risk of type 2 diabetes (Aune et al., 2013), a condition which may be linked to increased risk of CVD (Grundy et al.”
Hruby, A., Ma, J., Rogers, G. T., Meigs, J. B., & Jacques, P. F. (2017) · Journal of Nutrition · doi:10.3945/jn.117.253401 · Cited by 75
Milenković, T., Bozhinovska, N., Μacut, D., Bjekić-Macut, J., Rahelić, D., Velija-Ašimi, Z., & Bureković, A. (2021) · Nutrients · doi:10.3390/nu13041307 · Cited by 97
Lucan, S. C., & DiNicolantonio, J. J. (2014) · Public Health Nutrition · doi:10.1017/s1368980014002559 · Cited by 76
Zhu, Y., Wang, H., Hollis, J., & Jacques, P. F. (2014) · European Journal of Nutrition · doi:10.1007/s00394-014-0735-7 · Cited by 73
Guo, J., Givens, D. I., Astrup, A., Bakker, S. J. L., Goossens, G. H., Kratz, M., Marette, A., Pijl, H., & Soedamah‐Muthu, S. S. (2019) · Advances in Nutrition · doi:10.1093/advances/nmz050 · Cited by 69
“(34), which both also reported low-fat but not high-fat dairy to be inversely associated with T2D risk.”
BackgroundMethodResultInfluentialEussen, S. J. P. M., DONGEN, M. C. J. M. V., Wijckmans, N. E. G., den Biggelaar, L. J. C. J., Elferink, S. J. W. H. O., Singh‐Povel, C. M., Schram, M. T., Sep, S. J. S., Kallen, C., Koster, A., et al. (2016) · British Journal Of Nutrition · doi:10.1017/s0007114516000313 · Cited by 72
“Meta-analyses and a recent study have shown that milk consumption was inversely (8) or not associated with the risk of T2DM in fully adjusted models (10 – 12 , 20) .”
Milk fat biomarkers and cardiometabolic disease
Risérus, U., & Marklund, M. (2016) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000381 · Cited by 72
The Potential Role of Yogurt in Weight Management and Prevention of Type 2 Diabetes
Panahi, S., & Tremblay, A. (2016) · Journal of the American College of Nutrition · doi:10.1080/07315724.2015.1102103 · Cited by 69
“In another meta-analysis evaluating various types of dairy products including low-fat dairy and cheese, a nonlinear association was observed between consumption of yogurt and risk of type 2 diabetes [8].”
BackgroundEngel, S., & Tholstrup, T. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.112227 · Cited by 71
Meta-Analysis of Milk Consumption and the Risk of Cognitive Disorders
Wu, L., & Sun, D. (2016) · Nutrients · doi:10.3390/nu8120824 · Cited by 69
Is consuming yoghurt associated with weight management outcomes? Results from a systematic review
Eales, J. F., Lenoir‐Wijnkoop, I., King, S., Wood, H., Kok, F. J., Shamir, R., Prentice, A. M., Edwards, M., Glanville, J., & Atkinson, R. L. (2015) · International Journal of Obesity · doi:10.1038/ijo.2015.202 · Cited by 64
Metadata
- Authors
- Aune, D., Norat, T., Romundstad, P., & Vatten, L. J.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 98
- Issue
- 4
- Pages
- 1066-1083
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2108208530
- Cited by
- 434
- References
- 59
- Citations by year
- 2026: 8 · 2025: 21 · 2024: 25 · 2023: 23 · 2022: 22 · 2021: 32 · 2020: 36 · 2019: 50 · 2018: 42 · 2017: 52 · 2016: 48 · 2015: 42 · 2014: 30 · 2013: 3
- FWCI
- 5.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- 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
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Keywords
- dairy products, type 2 diabetes, low-fat dairy, cheese, yogurt, milk, high-fat dairy, dose-response relationship, inverse association, nonlinear relationship, dietary intake, diabetes risk, confounding adjustment
- MeSH terms
- Animals, Cheese, Dairy Products, Diabetes Mellitus, Type 2, Diet, Dietary Fats, Humans, Milk, Prospective Studies, Risk Factors, Yogurt, Cohort Studies, Case-Control Studies
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