LÁCTEOS Y OBESIDAD, DIABETES, HIPERTENSIÓN Y SÍNDROME METABÓLICO:
Estudios epidemiológicos y mecanismos protectores
Jordi Salas-SalvadóCatedrático de Nutrición
Unidad de Nutrición HumanaUniversidad Rovira i Virgili
Conflict of Interest Disclosure
• Relationships with commercial interests:
• Non-paid member of the Scientific Committee of the International Nut and Dried Fruit Foundation.
• Member of the Executive Committee of the Instituto Danone-Spain
• Grants/Research Support: American Pistachio Growers,
International Nut and Dried Fruit Foundation.
• Speakers Bureau/Honoraria: Nuts for Life, Danone, Eroski, Dos
Pinos.
• Consulting Fees: Danone.
Mitigating potential biasThe PREDIMED sponsors had no role in the design and conduct of thestudy: collection, management, analysis, and interpretation of the data:preparation, review or approval of the published manuscripts.
DAIRY PRODUCTS
OBESITY
CANCER
RISK
CARDIOVASCULAR DISEASEDIABETES
METABOLIC
SYNDROME
Minerals
Vitamins
Protein
calcium
magnesium
potassium
phosphate
zinc
Vit. A
Vit. D
Vit. B2, B3, B6, B12
Vit. K2
Probiotic bacteria
“fermented dairy products”
OSTOPOROSIS
HC “lactose”
Fat
DAIRY PRODUCTS
Nutritional concerns:Rich in natural trans fatty acids
Rich in saturated fatty acidsRich in salt (ie. cheese)
Rich in added sugar (some yogurts and processed dairy foods)Irrational beliefs that lead to a decrease in consumption:
“Humans are the unique animals that consume dairy products through the life”
DAIRY PRODUCTS
In the last years some guidelines recommend to consume low-fat dairy
products or to limit them
DAIRY PRODUCTS
Astrup A. Yogurt and dairy product consumption to prevent cardiometabolic diseases: epidemiologic and experimental studies. Am J Clin Nutr. 2014.
“The consumption of yogurt and other dairy products, in observational studies is associated with a reduced risk of weight gain and obesity as well as of CVD, and these findings are, in part, supported by randomized trials”.
Recent published evidences support the idea that dairy products can be beneficial (or not harmful) for several chronic metabolic conditions and CVD.
• Generally the literature agrees that dairy products are neutral or beneficial to human health asevidenced by several meta-analyses and randomised, controlled trials.
• Not all SFA are created equal and that the presence of specific fatty acids (C14:0,C15:0, C17:0 andtrans-palmitoleic) in circulation are associated with a lower incidence of several cardiometabolicdiseases, however some may simply be markers of dairy intake.
• The dairy food matrix also plays a major role in nutritional research.
• Dairy products contain a high SFA content, their consumption induces a positive or neutral effecton human cardiovascular health
Consumers can continue to moderately consume full-fat dairy products as part of a healthy and
balanced lifestyle, however fermented dairy products would be preferential for optimum nutrient
intake and potential cardiovascular health benefits.
DIABETES: THE GLOBAL BURDEN
More than 387 million people in the word have diabetes.By 2030 is expected this will have risen to 592 million people.
• The prevalence of T2DM is increasing in parallel to the obesity epidemics.
• T2DM is a potent risk factor for CVD, blindness, renal failure, and lower limb amputation, decreasing quality of life.
• T2DM is responsible of the 5 % of the total mortality.
• In the next 10 years is expected that mortality by diabetes will increase by 50%.
DIABETES: THE GLOBAL BURDEN
OXIDATION
INFLAMMATION
Endothelialdysfunction
Insulin resistance/secretion
DIABETES
Geneticbackground
Low glycemic index
Fiber
MUFA / PUFA
Magnesium
Antioxidants
(-)
(-)
(-)
(-)
(-)
High glycemic index
SFA
TFA(+)
(+)
(+)
MECHANISMS
Salas-Salvadó et al, NMCD 2011
(-)
Heme iron(+)
“six meta-analysis of prospective studies have shown a decrased
risk of diabetes in those individuals with a higher consumption of
dairy products”.
DAIRY PRODUCTS AND DIABETES
0.90 0.95 1.05 1.10
Total dairy (n=17) (per 200g/d)
Low-fat dairy (n=13)(per 200g/d)
High-fat dairy (n=13)(per 200g/d)
Total milk (n=12)(per 200g/d)
Low-fat milk (n=7)(per 200g/d)
Cheese (n=13)(per 10g/d)
Number
populationsHeterogenity test
I2 P-vaue
66.4 <0.001
High-fat milk (n=9)(per 200g/d)
68.0 <0.001
51.6 0.016
57.4 0.007
71.6 0.002
84.1 <0.001
61.7 0.002
Consumption of dairy foods and diabetes incidence: a dose-responsemeta-analysis of observational studies
Lieke Gijsbers et al., Am J Clin Nutr 2016
“This dose-response meta-analysis of observational
studies suggest a posible role for dairy foods in the
prevention of type 2 diabetes”
Results should be considered in the context of the
observed heterogeneity
22 cohort studies 579,832 individuals and 43,118 T2D cases)
RR
DAIRY PRODUCTS AND DIABETES
Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies
Lukas Schwingshackl et al, Am J Clin Nutr 2017
21 prospective studies with 44,474 T2D cases
• The inverse association was observed only in Asian and
Australian studies, but not for American and European
studies.
• A significant inverse association was
observed between dairy consumption
and T2D (RR: 0.91; 95% CI 0.85–0.97).
• Each additional daily 200 g of dairy
products was inversely associated with
diabetes risk (RR: 0.97; 95% CI 0.94–0.99)
DAIRY PRODUCTS AND DIABETES
Turner KM, Keogh JB, Clifton PM. Dairy consumption and insulin sensitivity: a systematic review of short- and long-term intervention studies. Nutr Metab Cardiovasc Dis. 2015 Jan;25(1):3-8.
Conclusions (in adults):
• 4 Showed a positive effect on insulin sensitivity as assessed by HOMA.• 1 Showed a negative effect• 5 Showed No effect.
As the number of weight stable intervention studies is very limited and participant numbers small, these findings need to be confirmed by larger trials in order to conclusively determine any relationship between dairy intake and insulin sensitivity.
DAIRY PRODUCTS AND DIABETES
YOGURT AND HEALTH
In epidemiologic prospective studies usually
yogurt consumption
is inversely related to body weight gain, obesity,
metabolic syndrome, diabetes and cardiovascular
disease.
“ONLY YOGURT HAS BEEN ASSOCIATED TO A LOWER RISK OF DIABETES”
YOGURT AND DIABETES
17% lower risk of diabetes incidence in those consuming 3 or more servings of yogurt per week
41,436 men in the Health Professionals Follow-Up Study67,138 women in the Nurses' Health Study85,884 women in the Nurses' Health Study II
3,984,203 person-years of follow-up15,156 incident T2D cases
HRs for a serving yogurt consumption per day and type 2 diabetes
YOGURT AND DIABETES
The Australian Diabetes Obesity and Lifestyle Study
The Whitehall II Prospective Study
EPIC-Interact Study
Women’s Health Initiative
Japan Public Health Center–based Prospective Study
Women’s Health Study
Health Professional Follow-up Study
Nurses Health Study I
Nurses Health Study II
Per 1 serving
18% lower risk
Most of the studies were conducted in apparently healthy young or
middle-aged individuals from different populations.
No study has examined the association between dairy intake and risk
of diabetes in elderly individuals at high cardiovascular risk.
YOGURT AND DIABETES
HRs for type 2 diabetes according to tertiles of total, low-fat and whole-fat dairy
food consumption in the PREDIMED cohort
“Total and low-fat dairy
consumption was inversely
associated to a lower risk of
diabetes”
3.454 non-diabetic participants
270 incident cases of diabetes
(median follow-up of 4.1 years).
Díaz-López et al, Eur J Nutr 2015
DAIRY AND DIABETES
aTertile cut-offs are based on energy-adjusted cumulative average dairy food intake and values are medians
(interquartile range).
Cox regression models were used to assess the RR (95% CI) of diabetes according to tertiles of dairy food intake.
Model 1: Adjusted for age, sex and BMI.
Model 2: Additionally adjusted for dietary intervention group,
physical activity, educational level, smoking, hypertension,
dyslipidemia, and fasting glucose, HDL-cholesterol and
triglyceride levels.
Model 3: Additionally adjusted for cumulative average dietary
intakes in energy-adjusted quintiles (vegetables, legumes,
fruits, cereals, meat, fish, olive oil, nuts) and alcohol and
alcohol squared in g/day.
All models were stratified by recruitment center.
Total dairy, median (g/day): T1: 200; T2: 342; T3: 539Low-fat dairy, median (g/day): T1: 85; T2: 256; T3: 462Whole-fat dairy, median (g/day): T1: 0; T2: 20; T3: 97
HRs for type 2 diabetes according to tertiles of specific yogurt consumption in
the PREDIMED cohort
“Independently of the fat
content, a higher consumption
of yogurt has associated to a
lower risk of diabetes”
3.454 non-diabetic participants
270 incident cases of diabetes
(median follow-up of 4.1 years).
Díaz-López et al, Eur J Nutr 2015
YOGURT AND DIABETES
aTertile cut-offs are based on energy-adjusted cumulative average dairy food intake and values are medians (Interquartil R).
Cox regression models were used to assess the RR (95% CI) of diabetes according to tertiles of dairy food intake.
Total yogurt, median (g/day):T1: 13; T2: 71; T3: 128 Low-fat yogurt, median (g/day): T1: 3; T2: 44; T3: 120 Whole-fat yogurt, median (g/day): T1: 0; T2: 7; T3: 45
Model 1: Adjusted for age, sex and BMI.
Model 2: Additionally adjusted for dietary intervention group,
physical activity, educational level, smoking, hypertension,
dyslipidemia, and fasting glucose, HDL-cholesterol and
triglyceride levels.
Model 3: Additionally adjusted for cumulative average dietary
intakes in energy-adjusted quintiles (vegetables, legumes,
fruits, cereals, meat, fish, olive oil, nuts) and alcohol and
alcohol squared in g/day.
All models were stratified by recruitment center.
HRs for type 2 diabetes according to tertiles of specific yogurt consumption in
the PREDIMED cohort
“Independently of the fat
content, a higher consumption
of yogurt has associated to a
lower risk of diabetes”
3.454 non-diabetic participants
270 incident cases of diabetes
(median follow-up of 4.1 years).
Díaz-López et al, Eur J Nutr 2015
YOGURT AND DIABETES
aTertile cut-offs are based on energy-adjusted cumulative average dairy food intake and values are medians (interquartile
range). Cox regression models were used to assess the RR (95% CI) of diabetes according to tertiles of dairy food intake.
Total yogurt, median (g/day): T1: 13; T2: 71; T3: 128 Low-fat yogurt, median (g/day): T1: 3; T2: 44; T3: 120 Whole-fat yogurt, median (g/day): T1: 0; T2: 7; T3: 45
An average increment of one
serving/day of the standard serving of
yogurt (125 g) was associated with a
33% lower risk of T2D.
Model 1: Adjusted for age, sex and BMI.
Model 2: Additionally adjusted for dietary intervention group,
physical activity, educational level, smoking, hypertension,
dyslipidemia, and fasting glucose, HDL-cholesterol and
triglyceride levels.
Model 3: Additionally adjusted for cumulative average dietary
intakes in energy-adjusted quintiles (vegetables, legumes,
fruits, cereals, meat, fish, olive oil, nuts) and alcohol and
alcohol squared in g/day.
All models were stratified by recruitment center.
HRs (95% CI) for type 2 diabetes associated with the substitution of one serving of yogurt and low-fatmilk for one serving of other alternative foods in the PREDIMED cohort
Substituted foods Yogurt (125 g) Low-fat milk (200 mL)
Dairy desserts (100g)a 0.58 (0.29-1.18) 0.71 (0.35-1.41)
Biscuits and chocolate confectionary (50g) 0.60 (0.38-0.94) 0.69 (0.47-1.03)
Whole-grain biscuits and homemade pastries (50 g) 0.55 (0.32-0.96) 0.63 (0.38-1.05)
aPetit Suisse cheese or custard or ice cream. The servings are based on energy-adjusted cumulative average food intake. Values aregiven as HR (95% CI) from Cox regression models adjusted for age, sex, BMI, dietary intervention, physical activity, educational level,smoking, hypertension, or antihypertensive use (yes/no) and dyslipidemia (yes/no), and fasting glucose, HDL-cholesterol andtriglycerides levels. All models were stratified by recruitment center.
YOGURT SUBSTITUTION AND DIABETES
Díaz-López et al, Eur J Nutr 2015
YOGURT AND DIABETES
0.90 0.95 1.05 1.10
Total dairy (n=17) (per 200g/d)
Low-fat dairy (n=13)(per 200g/d)
High-fat dairy (n=13)(per 200g/d)
Total milk (n=12)(per 200g/d)
Low-fat milk (n=7)(per 200g/d)
Cheese (n=13)(per 10g/d)
Number
publicationsHeterogenity test
I2 P-vaue
66.4 <0.001
High-fat milk (n=9)(per 200g/d)
68.0 <0.001
51.6 0.016
57.4 0.007
71.6 0.002
84.1 <0.001
61.7 0.002
Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observationalstudies
Lieke Gijsbers et al, Am J Clin Nutr 2016
Yogurt (n=12)(per 10g/d)
61.7 0.002
RR
“This dose-response meta-analysis of observational studies suggest a posible role for dairy
foods, PARTICULARLY YOGURT in the prevention of T2D
Results should be considered in the context of the observed heterogeneity
YOGURT AND DIABETES
What are the mechanisms
explaining the beneficial
metabolic effects on
diabetes prevention of dairy
products and yogurt?
DAIRY, YOGURT AND DIABETES - mechanisms
First hypothesis:
The effect of dairy products and yogurt on diabetes
prevention may be explained by their beneficial effects on
satiety, reducing adiposity.
Effects related to the Ca2+ metabolism• An increase in intracellular Ca2+:
• Increases lipogenesis and inhibits lipolysis.
• Calcium present in dairy inhibits fatty acid absorption.
Effects related to the protein or bioactive peptides in dairy products• Inducing satiety.
The probiotic effects of yogurt• Inducing satiety and changing metabolic pathways implicated in lipogenesis and fat deposition.
“Los datos de los estudios observacionales, aunque no del todo consistentes,
indican un efecto protector del consumo de lácteos en general (incluyendo el
yogur) sobre el riesgo de sobrepeso y obesidad en adultos”
Relación entre el consumo lácteos y riesgo de sobrepeso y obesidad en adultos
EVIDENCIA DE ESTUDIOS PROSPECTIVOS
DAIRY AND OBESITY
120,877 U.S. women and men
Free of chronic diseases and not obese
at baseline.
Relationships between changes in food and
beverage consumption and weight changes
every 4 years, according to study cohort.
Mozaffarian et al, N Engl J Med 2011
YOGUR AND OBESITY
Cox Proportional Hazard Ratio (HR) and 95% confidence intervals (CI) of incident overweight/obesity according to
baseline frequency of total, whole-fat, and low-fat yogurt consumption.
Consumo de yogur y riesgo de incidencia de sobrepeso/obesidad:
ESTUDIO PROSPECTIVO sobre 8.516 participantes de la cohorte SUN (1999-2012).
“Una mayor frecuencia de consumo de yogur se asoció inversamente
con el desarrollo de sobrepeso/obesidad”
Martinez-Gonzalez et al, Nutr Metab Cardiovasc Dis. 2014
YOGUR Y OBESIDAD
YOGURT AND HEALTH
Second hypothesis:
The effect of dairy products and yogurt on diabetes
prevention may be explained by other mechanisms increasing
insulin sensitivity or decreasing pancreatic secretion.
Effects related to the Ca2+ metabolism• An increase in intracellular Ca2+ favors insulin secretion and glucose uptake.
Effects related to bioactive peptides in yogurt• Intestinal hormone activation inducing insulin secretion.• Whey protein consumed with a CH-meal increased insulin, and the incretin hormones glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).
Beneficial effects of other components in yogurt• Minerals (phosphor, magnesium, potassium) and vitamins (A, D, B2, B6, B12) and dairy fat.
Effects related to the fat content
Ericson U. Am J Clin Nutr 2015
Total intake of high-fat dairy products was inversely associated with incident T2D (HR for highest compared with lowest quintiles: 0.77; CI 0.68-0.87; P-trend<0.001).
Most robust inverse associations were seen for intakes of high-fat fermented milk (P-trend<0.01) and for cheese in women (P-trend=0.02).
Intakes of saturated fatty acids with 4–10 carbons, lauric acid (12:0), and myristic acid (14:0) were associated with decreased risk (P-trend<0.01).
Conclusions: Decreased T2D risk at high intake of high- but not of low-fat dairy products suggests that dairy fat partly could have contributed to previously observed protective associations between dairy intake and T2D.
DAIRY PRODUCTS AND DIABETES
IS FAT FROM DAIRY UNHEALTHY AND INCREASES
THE RISK OF DIABETES?
Odd chain15:00
Pentadecanoic
Odd chain17:00
Heptadecanoic
Trans 16:1n-7Transpalmitoleic
Even chain14:00; 16:00
18:00
Swedish participants (Krachler 2008)
Erythrocyte membrane (-) (-) (+) palmitoleic
CHS (Mozzafarian 2010)
Circulating(-)
Insulin resistance
EPIC-Norfolk (Patel 2010)
Erythrocyte membrane, circulatingNS (-) NS (+) palmitoleic
EPIC-Postdam (Kröger 2011)
Erythrocyte membrane(-) (-)
NS myristic
NS palmitoleic
(+) stearic
MESA (Mozzafarian 2013)
Circulating(-)
Insulin resistance
EPIC-Interact (Farouhi 2014)
Circulating(-) (-) (+)
IRAS (Santoven 2014)
Circulating
(-)Insulin sensitivity
Β-cell function
NS
CHS: Cardiovascular Health Study; MESA: Multi-Ethnic Study of Atherosclerosis
IRAS: Triethnic Multicenter Insulin Resistance Atherosclerosis Study
Circulating or erythrocyte membrane fatty acid composition and diabetes incidence or glucose and insulin metabolism
Odd chain fatty acids
protect from diabetes
DAIRY PRODUCTS AND DIABETES
Widely distributed in many food
Endogenously
synthesized
Nurses' Health StudyHealth Professionals Follow-Up Study
Astrup A.
A changing view on saturated fatty acids and dairy: from enemy to friendAm J Clin Nutr. 2014;100(6):1407-8.
“The totality of evidence does not support that dairy SFAs increase the risk of coronary artery disease or stroke or CVD mortality”
“In contrast, lean dairy is clearly associated with decreased risk of T2D, and this effect is partly independent of any effect of body fat loss”
“There is no evidence left to support the existing public health advice to limit consumption of dairy to prevent CVD and T2D”
DAIRY PRODUCTS AND DIABETES
Substitutions between dairy product subgroups (per serving/d and risk of type 2 diabetes
Intake of whole-fat yogurt products in place of low-fat yogurt products, low-fat milk,
whole-fat milk and buttermilk are associated with a lower rate of type 2 diabetes
Low-fat yogurt products in place of whole-fat yogurtproducts was associated with a higher rate of type 2diabetes (HR 1·17; 95% CI 1·06, 1·29)
Whole-fat yogurt products in place of low-fat milk (HR0·89; 95% CI 0·83, 0·96), whole-fat milk (HR 0·89; 95% CI0·82, 0·96) or buttermilk (HR 0·89; 95% CI 0·81, 0·97) wereassociated with a lower rate of type 2 diabetes
n= 54 277 Danish Diet, Cancer and Health cohort
What makes the yogurt different?
Is a marker of a healthy lifestyle?
Replace other unhealthy or healthy
foods when consumed?
Possible probiotic effects: changing
gut microbiota and body metabolism
• New active metabolites decreasing insulin resistance.
• Insulin secretion induced by menaquinones (Vit K2) synthetized by the gut microbiota.
YOGURT AND HEALTH
In epidemiologic prospective studies usually yogurt consumption is
inversely related to body weight gain, obesity, metabolic syndrome,
diabetes and cardiovascular disease.
CVDCAD Stroke Hypertension
Total dairy Neutral Neutral Favorable
Moderate High Moderate
Regular- orhigh-fat dairy
Uncertain Neutral Neutral
Very low High Moderate
Low-fat dairy Uncertain Neutral Favorable
Very low High Moderate
Milk Uncertain Neutral Neutral
Very low Moderate Moderate
Cheese Neutral Neutral Favorable
High Moderate Moderate
Yogurt Neutral Neutral Neutral
Moderate Moderate Moderate
Fermented dairy Uncertain Uncertain Favorable
Very low Very low Moderate
YOGUR AND CARDIOVASCULAR DISEASE
Systematic Review of the Association between Dairy Product Consumption and
Risk of Cardiovascular-Related Clinical Outcomes Drouin-Chartier et al., 2016
CARDIOVASCULAR DISEASE
Classical Risk Factors Novel Risk Factors
Major Unmet Clinical Need
Metabolic syndrome
Abdominal
Obesity
HDL-C
TG
TNF IL-6
PAI-1
Glu
Insulin
T2DM
Smoking LDL-C BP
YOGUR AND METABOLIC SYNDROME
Prevalence of Metabolic Syndrome in Catalonia, Spain in 1992-1993 and 2002-2003 using two different definitions
0
10
20
30
40
50
60
18-24 25-34 35-44 45-54 55-64 65-74 Total
Grupo de edad (años)
Pre
va
len
cia
de
SM
et
(%)
SMet 1992 ATPIII
SMet 2002 ATPIII
Muestra representativa de
la población de Catalunya
Buckland et al, Nutrition Reviews, 2009
YOGUR Y SÍNDROME METABÓLICO
Prevalencia de Síndrome Metabólico
Dairy consumption and the incidence of MetS: PROSPECTIVE STUDIES
“Higher total dairy consumption
(including yogurt and chesses)
was associated with lower
incidence MetS”
YOGURT AND METABOLIC SYNDROME
Pérez-Martínez et al, 2017
Evidence: There is no evidence to support the existing public health advice to limit consumption of dairy products to prevent MetSRecommendation: Dairy products and particularly yogurt consumption may be useful in preventing MetS
Cox regression models adjusted for intervention group, sex, age, physical activity and BMI and baseline current smoker, and hypoglycemic, hypolipidemic,
antihypertensive and insulin treatment, cumulative average consumption of vegetables, fruit, legumes, cereals, fish, red meat, alcohol, biscuits, olive oil and nuts.
Independent of the fat content,
Yogurt consumption was
inversely associated with the
incidence of MetS and its
components
Yogurt consumption and incidence of MetS or its components: PREDIMED study
1.868 participants without MetS at
baseline; 930 incident cases of
MetS (mean follow-up: 3.2 y)
P for trend=0.230
P for trend=0.004
P for trend=0.689
P for trend=0.348
P for trend=0.183
P for trend=0.048
P for trend=0.005
P for trend=0.001
P for trend<0.001
P for trend<0.001
P for trend=0.095
P for trend=0.126
P for trend=0.864
P for trend=0.011
P for trend=0.001
Central obesity
High fasting plasma glucose
High blood pressure
Low HDL-c
High triglicerides
Metabolic Syndrome P for trend=0.144
TOTAL YOGURT
Central obesity
High fasting plasma glucose
High blood pressure
Low HDL-c
High triglicerides
Metabolic Syndrome P for trend=0.003
WHOLE-FAT YOGURT
Central obesity
High fasting plasma glucose
High blood pressure
Low HDL-c
High triglicerides
Metabolic Syndrome P for trend=0.004
LOW-FAT YOGURT
0.5 1.0 2.0
HAZARD RATIO (95% CI)
Hazard ratios (95% CI) of metabolic syndrome and its components across energy-
adjusted tertiles of yogurt consumption (Tertile 3 vs Tertile 1).
↓23%
↓22%
↓27%
“Low-fat dairy products were inversely associated with MetS incidence”
“The consumption of cheese was associated with an increased risk of MetS incidence”
YOGURT AND METABOLIC SYNDROME
Babio et al, 2015
TOTAL DAIRY AND METS
There was an inverse association between total dairy intake and incidence of MetS (RR= 0.73, 95%CI= 0.64–0,83).
Dairy products consumption in the prevention of metabolic syndrome: a systematic review and
meta-analysis of prospective cohort studies.
Mena-Sánchez G et al, 2018 (Working paper –under review- )
MILK AND METS
An inverse association was observed between total milk intake and incidence of MetS (RR= 0.79, 95%CI= 0.64–0,97).
Dairy products consumption in the prevention of metabolic syndrome: a systematic review and
meta-analysis of prospective cohort studies.
Mena-Sánchez G et al, 2018 (Working paper –under review- )
YOGURT AND METS
There was an inverse association between total yogurt intake and incidence of MetS (RR= 0.74, 95%CI= 0.66–0,82).
Dairy products consumption in the prevention of metabolic syndrome: a systematic review and
meta-analysis of prospective cohort studies.
Mena-Sánchez G et al, 2018 (Working paper –under review- )
YOGURT AND METS
The pooled risk showed a linear association between one serving of total yogurt consumption/day and the risk of MetS [0.77 (95% CI, 0.60–1.00); P = 0.046]
Dairy products consumption in the prevention of metabolic syndrome: a systematic review and
meta-analysis of prospective cohort studies.
Mena-Sánchez G et al, XXXX 2018 (Working paper –under review- )
Three studies were included in the dose–response analysis of
total yogurt consumption and the
risk of MetS.
CONCLUSIONS
▪ A high intake of total dairy products was associated with decreased risk of Obesity, Hypertension, T2D and MetS in several prospective studies (in children and adults).
▪ A high intake of low-fat dairy products was associated with decreased risk of T2D, HT and MetS, but not with body weight.
▪ Total milk was associated with decreased risk of Obesity and MetS in cross-sectional and prospective studies but not with HT.
▪ Frequent yogurt consumption was consistently associated to a lower risk of obesity, diabetes and MetS and this association was independent of the fat content.
▪ Substitutions of one serving of yogurt per day for one serving of other “unhealthy” snacks or food alternatives per day was associated with a reduced risk of T2D incidence.
CONCLUSIONS
▪ Any type of dairy product was associated to an increased risk of Obesity, T2D, Hypertension or MetS.
▪ In general, full-fat dairy products do not have demonstrated deleterious effects on Obesity, T2D, Hypetension or MetS.
▪ Several mechanisms have been suggested in order to explain these associations, however more mechanistic studies are needed.
▪ Large clinical trials with an appropriate design are warranted to definitively demonstrate that yogurt consumption protects from diabetes.
▪ Consumers can continue to moderately consume full-fat dairy products as part of a healthy and balanced lifestyle, however yogurt products would be preferential for potential cardiovascular health benefits.
Hospital Universitario de Sant Joan de Reus
Universitat Rovira i Virgili
Unidad de Nutrición Humana
Investigadores estudio PREDIMED