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Back to Cardiovascular Disease

Metabolic Syndrome and Milk Products

Several studies, including meta-analyses, indicate that milk and milk products are associated with a reduction in the risk of developing metabolic syndrome.

Highlights

  • Studies have shown that milk products (such as milk, yogurt and cheese) are inversely associated with the development of metabolic syndrome;
  • Higher-fat dairy products do not appear to increase the risk of developing metabolic syndrome;
  • Several milk nutrients and components appear to be responsible for the potential mechanisms underlying the protective effect of milk products against metabolic syndrome.

There has been an increasing amount of evidence on the role of milk and milk products in preventing metabolic syndrome. In the last few years, several studies have demonstrated that milk products play a role in reducing the risk of developing metabolic syndrome.

Metabolic Syndrome: What are the Facts?

Metabolic syndrome is also known as cardiometabolic syndrome, insulin resistance syndrome or syndrome X. It consists of a cluster of cardiometabolic risk factors that put an individual at increased risk for cardiovascular disease. In fact, metabolic syndrome is considered to be an important contributor to cardiovascular disease and type 2 diabetes.

In Canada, approximately 21% of adults aged 18 to 79 years have metabolic syndrome, according to the 2012-2013 Canadian Health Measures Survey.1

As established by the international consensus guidelines of the International Diabetes Federation (IDF) in collaboration with the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), a diagnosis of metabolic syndrome is made when 3 out of the 5 following risk factors are present:2

Criteria for Clinical Diagnosis of Metabolic Syndrome2

(Diagnosis = 3 or more risk factors)

Risk Factors Categorical Cut Points
Elevated waist circumference

Population- and country-specific definitions (in Canada, established by Health Canada)

≥102 cm (men)
 ≥88 cm (women)

Elevated triglycerides
 (or drug treatment for elevated triglycerides)
≥1.7 mmol/L
Reduced HDL-C
 (or drug treatment for reduced HDL-C)
<1.0 mmol/L (men)
 <1.3 mmol/L (women)
Elevated blood pressure
 (or antihypertensive drug treatment or a history of hypertension)
Systolic ≥130 mm Hg and/or diastolic ≥85 mm Hg
Elevated fasting glucose level
 (or drug treatment for elevated glucose)
≥5.6 mmol/L

The Evidence

A 2015 meta-analysis of observational studies assessed the effect of dairy consumption on the risk of developing metabolic syndrome. The analyses included 8 prospective cohort studies with a total of 31,944 participants.3

  • The highest category of dairy consumption compared to the lowest was associated with a 15% reduced risk of metabolic syndrome;
  • Higher consumption of milk and cheese was found to significantly reduce the risk of metabolic syndrome by 24% and 19%, respectively;
  • Every additional serving of dairy products per day was associated with a 12% reduced risk of metabolic syndrome.

In another meta-analysis of 7 prospective cohort studies, the authors found that:4

  • A higher intake of dairy products was associated with a 14% lower risk of developing metabolic syndrome;
  • Milk was associated with a 25% decreased risk of metabolic syndrome;
  • Every additional serving of dairy products per day was associated with a 6% decreased risk of metabolic syndrome.

Drehmer et al. investigated the association between different types of dairy products with varying fat content and metabolic syndrome. The analysis consisted of 9,835 subjects aged 35 to 74 years from the Brazilian Longitudinal Study of Adult Health, a prospective cohort study.5

  • Dairy products, particularly full-fat dairy products, butter and yogurt, were associated with a reduced risk of metabolic syndrome for each additional serving per day;
  • Low-fat dairy products were not associated with metabolic syndrome risk.

Using data from the SUN (Seguimiento Universidad de Navarra) project, a prospective cohort study in Spain, the association between yogurt consumption and the incidence of metabolic syndrome was examined among 8,063 participants who had a minimum of 6 years of follow-up.6

  • Non-significant inverse associations were observed between higher yogurt consumption (≥7 servings/week vs. <2 servings/week), including whole-fat and low-fat yogurt, and the incidence of metabolic syndrome;
  • Higher yogurt consumption, particularly whole-fat, was associated with a 15% reduced risk of developing central adiposity;
  • The combination of yogurt and fruit was associated with a reduced risk of developing metabolic syndrome.

In a prospective analysis of 1,868 adults aged 55 to 80 years from the PREDIMED (Prevención con Dieta Mediterránea) study, after 3 years of follow-up, the authors observed the following: 7

  • Higher consumption of low-fat dairy was associated with a 23% reduced risk of metabolic syndrome;
  • Yogurt intake (including whole-fat and low-fat) was associated with a 22% to 27% decrease in the risk of developing metabolic syndrome.

Potential Mechanisms

Protein and bioactive peptides
Milk protein, especially whey protein, has been shown to improve body composition and to have a positive impact on muscle protein synthesis. It has been demonstrated that whey protein helps in controlling blood glucose levels.8

Furthermore, bioactive peptides in milk protein may help in reducing blood pressure through their angiotensin-converting-enzyme (ACE)-inhibiting action.8

Vitamin D
Several epidemiological studies have demonstrated that adequate vitamin D intake and status may be protective against metabolic syndrome. Many mechanisms have been proposed to explain how vitamin D may modulate cardiometabolic health. These include:9

-       the reduction of dyslipidemia through the maintenance of calcium homeostasis,

-       the stimulation of insulin production and release,

-       the regulation of the renin-angiotensin-aldosterone system, which helps in blood pressure control.

Calcium, potassium and magnesium
Evidence suggests that calcium may improve the blood lipid profile through the potential mediation of fecal fat excretion.8

Additionally, calcium, potassium and magnesium in milk may help in the management of blood pressure by decreasing sodium retention through various mechanisms. Dietary calcium may help in the hormonal regulation of intracellular calcium, which favourably impacts blood pressure. Potassium also contributes by inhibiting proinflammation in vascular smooth muscle cells, reducing platelet aggregation and decreasing renal vascular resistance. Magnesium may also play a role in modulating intracellular calcium concentrations.8

Milk fat and conjugated linoleic acid (CLA)
Milk fat appears to improve the ratio of HDL-cholesterol to total cholesterol. Saturated fatty acids present in milk fat also have a favourable impact on triglyceride levels.8

CLA has been shown to have many potential benefits on cardiometabolic health, particularly through its effects on plasma lipids and lipoproteins.8

Certain dairy fatty acids (e.g., 15:0 and 17:0), which are biomarkers of dairy intake, have been associated with a reduced risk of cardiovascular disease and type 2 diabetes.10,11,12

Conclusions

Current evidence suggests that milk and milk products are associated with a reduced risk of developing metabolic syndrome.

Further research is needed to provide more evidence on the association between different types of milk products and the prevention of metabolic syndrome.

More studies are also needed to clarify the mechanistic role of milk components in preventing the development of metabolic syndrome.

References

  1. Statistics Canada. 2014. Metabolic syndrome in adults, 2012 to 2013. www.statcan.gc.ca. Accessed December 11, 2015.
  2. Alberti KG et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-1645.
  3. Kim Y and Je Y. Dairy consumption and risk of metabolic syndrome: a meta-analysis. Diabet Med 2015. doi: 10.1111/dme.12970.
  4. Chen GC et al. Dairy products consumption and metabolic syndrome in adults: systematic review and meta-analysis of observational studies. Sci Rep 2015;5:14606.
  5. Drehmer M et al. Total and full-fat, but not low-fat, dairy product intakes are inversely associated with metabolic syndrome in adults. J Nutr 2015. doi: 10.3945/jn.115.220699.
  6. Sayón-Orea C et al. Association between yogurt consumption and the risk of metabolic syndrome over 6 years in the SUN study. BMC Public Health 2015;15:170.
  7. Babio N et al. Consumption of yogurt, low-fat milk, and other low-fat dairy products is associated with lower risk of metabolic syndrome incidence in an elderly Mediterranean population. J Nutr 2015;145:2308-2316.
  8. Rice BH et al. Dairy components and risk factors for cardiometabolic syndrome: recent evidence and opportunities for future research. Adv Nutr 2011;2:396-407.
  9. Muldowney S and Kiely M. Vitamin D and cardiometabolic health: a review of the evidence. Nutr Res Rev 2011;24:1-20.
  10. Santaren ID et al. Serum pentadecanoic acid (15:0), a short-term marker of dairy food intake, is inversely associated with incident type 2 diabetes and its underlying disorders. Am J Clin Nutr 2014;100:1532-1540.
  11. Chowdhury R et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med 2014;160:398-406.
  12. de Oliveira Otto MC et al. Biomarkers of dairy fatty acids and risk of cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc 2013;2:e000092.

Keywords: metabolic syndrome , calcium , bioactive peptides , vitamin D , conjugated linoleic acid


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