Close Send this page to a friend

Your link and message have been sent!

Close Send this page to a friend
* required
Oops! You forgot to fill in some required information.
Loading...

Back to Roles on Certain Health Conditions

Milk Products and Type 2 Diabetes

The relationship between milk product consumption and type 2 diabetes has been examined in a number of studies including several meta-analyses. The totality of the evidence to date indicates that milk products, including higher fat milk products, as well as yogurt and cheese specifically, are associated with a reduced risk of developing type 2 diabetes.

Highlights

  • Milk product consumption is associated with a decreased risk of developing type 2 diabetes;
  • Total dairy and low-fat milk products are associated with a reduced risk of type 2 diabetes;
  • Yogurt and cheese are associated with a reduced risk of type 2 diabetes;
  • High-fat dairy/dairy fat is either neutral or associated with a decreased risk of developing type 2 diabetes;
  • Recent evidence suggests that higher fat milk products, including cheese, may be especially protective in those who have pre-diabetes.

Synopsis

A number of meta-analyses of prospective cohort studies have concluded that higher milk product consumption is associated with a reduced risk of type 2 diabetes. Yogurt and cheese appear to be particularly beneficial. The evidence also suggests that higher fat dairy foods, including cheese, may decrease the risk of developing type 2 diabetes. Potential mechanisms may involve multiple dairy food components including calcium, vitamin-D, dairy-derived fatty acids and amino acids, as well as probiotic and prebiotic effects on the gut microbiome.1,2

The Evidence

A meta-analysis published by Tian et al. in 2017 helps to clarify the relationships between different types of protein-rich foods and the development of type 2 diabetes. Findings from the 11 prospective cohort studies included in this meta-analysis indicate that higher intakes of dairy foods, including yogurt and whole milk in particular, are associated with a lower risk of type 2 diabetes (N=483,174).3

  • Total dairy product consumption was associated with an 11% lower risk of type 2 diabetes, comparing high to low intakes (relative risk of 0.89, 95% CI: 0.84–0.94).
  • Yogurt consumption was associated with a 17% reduced risk of type 2 diabetes, comparing high to low yogurt intakes (relative risk of 0.83, 95% CI: 0.70–0.98).
  • Whole milk consumption was associated with a 13% decreased risk of type 2 diabetes, compared to low dairy fat intake (relative risk of 0.87, 95% CI: 0.78–0.96).

A dose-response meta-analysis published by Gijsbers et al. in 2016 examined the associations between dairy foods and the development of type 2 diabetes. This comprehensive analysis included data from 22 prospective cohort studies involving adults who were healthy at baseline (N=579,832).4

  • Each added 200 g/day serving of total dairy foods was associated with a 3% reduced risk of type 2 diabetes (relative risk of 0.97, 95% CI: 0.95-1.0).
  • Yogurt consumption of 80 g/day was associated with a 14% decreased risk of type 2 diabetes, compared to 0g/day (relative risk of 0.86, 95% CI: 0.83-0.90).

A systematic review of 21 meta-analyses of prospective cohort studies published by Drouin-Chartier et al. in 2016 examined the relationship between dairy product consumption and cardiovascular health outcomes, including type 2 diabetes. This extensive in-depth review, encompassing all of the available epidemiological evidence on this topic, concluded that:5

  • Low-fat dairy and yogurt are associated with a decreased risk of type 2 diabetes (based on high-quality evidence).
  • Total dairy and cheese are also associated with a decreased risk of type 2 diabetes (based on moderate-quality evidence).
  • There is no evidence that the consumption of dairy fat or regular and high-fat dairy is detrimental to any cardiovascular health outcomes, including type 2 diabetes.
  • The recommendation to focus on low-fat dairy instead of regular- and high-fat dairy is currently not evidence-based.

In 2017, Hruby et al. published findings from their investigation of the associations between dairy food intakes and the development of prediabetes and type 2 diabetes. This study included 2,809 adults from the Framingham Heart Study Offspring Cohort who were followed for 12 years.6
Among those with normal glucose status at baseline:

  • Total, low-fat, and high-fat dairy were associated with a 39%, 32%, and 25% lower risk of developing prediabetes, respectively, (comparing ≥14 compared with <4 servings/week).

Among those with pre-diabetes at baseline:

  • High-fat dairy was associated with a 70% reduced risk of developing diabetes (≥14 compared with <1 serving/week for high-fat dairy)
  • Cheese was associated a 63% lower risk of developing type 2 diabetes (≥4 compared with <1 serving/week for cheese).

In a prospective cohort study, the association between dairy fatty acids and incident type 2 diabetes was investigated. A triethnic cohort of 1,625 Hispanic, African American and non-Hispanic white adults aged 40 to 60 years who were followed for 5 years was included in the study.7

  • Serum pentadecanoic acid (15:0) was found to be an independent biomarker for total dairy intake;
  • Serum pentadecanoic acid was associated with a 27% decreased risk for incident type 2 diabetes;
  • The highest tertile of serum pentadecanoic acid was associated with a significantly lower risk of type 2 diabetes after 5 years, with an odds ratio of 0.47 (95% CI: 0.26-0.86).

Potential Mechanisms

Milk products may help in weight management and have a protective effect against hypertension and metabolic syndrome, which are major risk factors for type 2 diabetes.

Glucose homeostasis
In a systematic review, results from longer intervention studies indicate that higher dairy intake may help improve insulin sensitivity.8

Calcium and vitamin D
Calcium and vitamin D, as well as magnesium, may reduce the risk of type 2 diabetes through their role in modulating insulin resistance, pancreatic beta-cell function, and inflammation.2,9,10 Evidence from cell culture and animal models also suggests calcium may reduce fat cell lipid accumulation and adiposity.2

Milk proteins

  • Whey protein may promote insulin sensitivity, improve glucose tolerance and lipid profile, and help in weight control;1,8,11 
  • The essential amino acid Leucine may counter mitochondrial dysfunction and increase thermogenesis.2
  • Bioactive peptides may also help to control blood pressure.

Dairy fatty acids

  • Trans-palmitoleic acid (trans-16:1n-7) has been associated with lower insulin resistance, lower blood pressure, a better lipid profile and a reduced risk of type 2 diabetes;12,13,14
  • Pentadecanoic acid (15:0) has been inversely associated with fasting plasma glucose and incident type 2 diabetes;7,14,15 
  • Conjugated linoleic acid may play a role in the prevention of obesity, which is a risk factor for type 2 diabetes.

Other dairy components

  • Probiotic bacteria, found in fermented milk products such as yogurt, have been shown to improve blood lipid profile and antioxidant status of individuals with type 2 diabetes.1,16
  • Milk products, particularly fermented ones, contain menaquinones (vitamin K2), which have been associated with reduced risk of developing type 2 diabetes .9,15
  • A higher fat dairy-based diet has been shown to significantly alter the gut microbiome and reduce liver fat (compared to a soy and sucrose-based diet) in animal studies.2

Conclusion

Current evidence indicates that higher consumption of milk products is associated with a reduced risk of developing type 2 diabetes. Both lower fat and higher fat milk products may play a beneficial role in preventing type 2 diabetes; and emerging evidence suggests that higher fat milk products may be especially protective in those who have pre-diabetes. Yogurt and cheese in particular, appear to be protective against type 2 diabetes.

References

  1. Chen M et al. Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysisBMC Med 2014;12:215.
  2. Hirahatake KM et al. Associations between dairy foods, diabetes, and metabolic health: potential mechanisms and future directions.Metabolism 2014;63:618-627.
  3. Tian et al. Dietary protein consumption and the risk of type 2 diabetes: A systematic review and meta-analysis of cohort studies. Nutrients 2017;9:982.
  4. Gijsbers L et al. Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies. Am J Clin Nutr 2016;103:1111-1124.
  5. Drouin-Chartier JP et coll. Systematic review of the association between dairy product consumption and risk of cardiovascular-related clinical outcomes. Adv Nutr 2016;7:1026-1040.
  6. Hruby A et al. Associations of dairy intake with incident prediabetes or diabetes in middle-aged adults vary by both dairy type and glycemic status. J Nutr 2017;147:1764-1775.
  7. 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 disordersAm J Clin Nutr2014;100:1532-1540.
  8. Turner KM et al. Dairy consumption and insulin sensitivity: a systematic review of short- and long-term intervention studiesNutr Metab Cardiovasc Dis 2015;25:3-8.
  9. Aune D et al. Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studiesAm J Clin Nutr 2013;98:1066-1083.
  10. Pittas AG et al. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysisJ Clin Endocrinol Metab 2007;92:2017-2029.
  11. Bjørnshave A and Hermansen K. Effects of dairy protein and fat on the metabolic syndrome and type 2 diabetesRev Diabet Stud 2014;11:153-166.
  12. Mozaffarian D et al. Trans-palmitoleic acid, metabolic risk factors, and new-onset diabetes in US adults: a cohort studyAnn Intern Med 2010;153:790-799.
  13. Mozaffarian D et al. Trans-palmitoleic acid, other dairy fat biomarkers, and incident diabetes: the Multi-Ethnic Study of Atherosclerosis (MESA)Am J Clin Nutr 2013;97:854-861.
  14. Kratz M et al. Dairy fat intake is associated with glucose tolerance, hepatic and systemic insulin sensitivity, and liver fat but not β-cell function in humansAm J Clin Nutr 2014;99:1385-1396.
  15. Forouhi NG et al. Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort studyLancet Diabetes Endocrinol 2014;2:810-818.
  16. O’Connor LM et al. Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diaryDiabetologia 2014;57:909-917.

Keywords: type 2 diabetes , healthy weight , calcium , vitamin D


  • Educational Material Educational Material Educational Material
    Educational Material

    Need educational resources for your practice? Download copies online, or order print versions free of charge.

    Make a request
  • /newsletter
    NutriNews®

    Every month, articles of interest are featured in our NutriNews Bulletin. Sign up today to stay up to date on the latest scientific evidence and research.

    Sign up