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Healthy Weight: Results from Epidemiological Studies

Data from the first National Health and Nutrition Examination Survey (NHANES I), a cross-sectional study of the dietary intakes of 10,372 US adults aged 18 to 74 years demonstrated an association between increased calcium intake and lower body mass index.

Since the time these study results were published, several epidemiological studies have looked at the role of milk products or components, such as calcium, in body weight regulation in both adults and children.

Prospective cohort studies have been conducted in adults2-9 and in children and adolescents.10-17 The majority of the studies in adults demonstrated the beneficial role of dietary calcium or milk product intake in body weight management. Because growth and optimal development are critical parameters for children and adolescents, avoiding excess weight gain is the goal in this life stage, whereas weight loss is not necessarily the desired outcome for this group. In this context, most studies conducted in children and adolescents also found either a beneficial impact on body weight or no negative impact with respect to weight gain, which is common during this critical period of development.

Several large landmark population studies support an inverse relationship between dietary calcium and milk product intake and body fat, body mass index and the incidence of obesity. These studies include:1

  • NHANES I,1
  • NHANES III,18
  • The Coronary Artery Risk Development in Young Adults (CARDIA) Study,2
  • The Quebec Family Study,19
  • The HERITAGE Family Study,20
  • The Continuing Survey of Food Intakes by Individuals,21
  • The Tehran Lipid and Glucose Study,6
  • The Vitamins and Lifestyle Cohort Study.22

For example, in the CARDIA Study, a 10-year prospective cohort study of 3,157 adults aged 18 to 30 years, increased milk product intake (regardless of whether the products were regular or reduced fat) was associated with a lower incidence of insulin resistance syndrome or metabolic syndrome and each component of this disorder (obesity, hypertension, abnormal glucose and dyslipidemia). The 10-year incidence of metabolic syndrome was 72% lower among overweight individuals consuming 5 or more servings of milk products per day than it was among those consuming fewer than 1.5 servings of milk products per day. Furthermore, the associations were dose-dependent: each daily serving of milk products was associated with a 21% lower risk of developing metabolic syndrome.2

The Quebec Family Study, a cross-sectional study of 235 men and 235 women aged 20 to 65 years, demonstrated that low calcium intakes (< 600 mg/day) were significantly associated with higher body weight and greater adiposity in women but not in men.19

The Heritage Family Study, a cross-sectional study of 362 black and white men and 462 black and white women with a mean age of about 35 years, found that a high calcium intake among black men and white women was strongly associated with leaner body mass and lower body weight as well as less total, visceral and subcutaneous abdominal fat. A low calcium intake was associated with a higher percentage of body fat in men and white women.20

The Tehran Lipid and Glucose Study, a prospective study of 827 adults (357 men and 470 women aged 18 to 74 years) demonstrated that milk product consumption (specifically milk, yogurt and cheese) is significantly inversely associated with the risk of metabolic syndrome. Higher milk product consumption was significantly associated with a lower risk of developing abdominal adiposity and hypertension. Those in the highest compared to the lowest quartile of milk product intake had a 35% reduced risk of developing metabolic syndrome and a 34% reduced risk of developing abdominal obesity and hypertension.6

Three prospective cohort studies have also indicated that a higher intake of lower-fat milk products, in the context of a healthier dietary pattern that also includes increased consumption of fruit, is associated with better body weight and adiposity measures.3,4,23 Although the effect of milk products cannot be isolated per se from these studies, these studies do confirm the importance of adequate milk product intake as part of a healthy diet.

Furthermore, the beneficial impact of milk product intake on body weight and/or fat mass remained significant after adjusting for important potential confounders in several studies.

Overall, the epidemiological evidence, including large landmark studies, suggests a beneficial role for milk products in body weight regulation.

References

  1. McCarron DA et al. Blood pressure and nutrient intake in the United States. Science 1984;224:1392-1398.
  2. Pereira MA et al.Dairy consumption, obesity, and the insulin resistance syndrome in young adults. The CARDIA study. JAMA 2002;287:2081-2089.
  3. Drapeau V et al. Modifications in food group consumption are related to long-term body weight changes. Am J Clin Nutr 2004;80:29-37.
  4. Newby PK et al. Food patterns measured by factor analysis and anthropometric changes in adults. Am J Clin Nutr 2004;80:504-513.
  5. Boon N et al. The relation between calcium intake and body composition in a Dutch population: the Amsterdam Growth and Health Longitudinal study. Am J Epidemiol 2005;162:27-32.
  6. Azadbakht L et al. Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. Am J Clin Nutr 2005;82:523-530.
  7. Rajpathak SN et al. Calcium and dairy intakes in relation to long-term weight gain in US men. Am J Clin Nutr 2006;83:559-566.
  8. Rosell M et al. Association between dairy food consumption and weight change over 9 y in 19 352 perimenopausal women. Am J Clin Nutr 2006;84:1481-1488.
  9. McNaughton SA et al. Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure, and red cell folate. J Nutr 2007;137:99-105.
  10. Carruth BB et Skinner JD. The role of dietary calcium and other nutrients in moderating body fat in preschool children. Int J Obes 2001;25:559-566.
  11. Phillips SM et al. Dairy food consumption and body weight and fatness studied longitudinally over the adolescent period. Int J Obes 2003;27:1106-1113.
  12. Skinner JD et al. Longitudinal calcium intake is negatively related to children’s body fat indexes. J Am Diet Assoc 2003;103:1626-1631.
  13. Newby PK et al. Beverage consumption is not associated with changes in weight and body mass index among low income preschool children in North Dakota. J Am Diet Assoc 2004;104:1086-1094.
  14. Berkey CS et al. Milk, dairy fat, dietary calcium, and weight gain. Arch Pediatr Adolesc Med 2005;159:543-550.
  15. Dixon BL et al. Calcium and dairy intake and measures of obesity in hyper- and normocholesterolemic children. Obes Res 2005;13:1727-1738.
  16. Fiorito LM et al. Girls’ dairy intake, energy intake, and weight status. J Am Diet Assoc 2006;106:1851-1855.
  17. Moore LL et al. Low dairy intake in early childhood predicts excess body fat gain. Obesity 2006;14:1010-1018.
  18. Zemel MB et al. Regulation of adiposity by dietary calcium. FASEB J 2000;14:1132-1138.
  19. Jacqmain M et al. Calcium intake, body composition, and lipoprotein-lipid concentrations in adults. Am J Clin Nutr 2003; 77:1448-1452.
  20. Loos R et al. Calcium intake is associated with adiposity in black and white men and white women of the HERITAGE family study. J Nutr 2004;134:1772-1778.
  21. Albertson AM et al. The relationship between dietary calcium intake and body mass index in adult women from three national dietary databases (abstract). FASEB J 2004;18:6259.
  22. Gonzalez AJ et al. Calcium intake and 10-year weight change in middle-aged adults. J Am Diet Assoc 2006;106:1066-1073.
  23. Newby PK et al. Dietary patterns and changes in body mass index and waist circumference in adults. Am J Clin Nutr 2003;77:1417-1425.

Keywords: healthy weight, health studies

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