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European Journal of Nutrition

, Volume 55, Issue 1, pp 349–360 | Cite as

Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk

  • Andrés Díaz-López
  • Mònica Bulló
  • Miguel A. Martínez-González
  • Dolores Corella
  • Ramon Estruch
  • Montserrat Fitó
  • Enrique Gómez-Gracia
  • Miquel Fiol
  • Francisco Javier García de la Corte
  • Emilio Ros
  • Nancy Babio
  • Lluís Serra-Majem
  • Xavier Pintó
  • Miguel Ángel Muñoz
  • Francisco Francés
  • Pilar Buil-Cosiales
  • Jordi Salas-Salvadó
Original Contribution

Abstract

Purpose

The possible effects of dairy consumption on diabetes prevention remain controversial. The aim of this study was to investigate the association between the dairy consumption and type 2 diabetes (T2D) risk in an elderly Mediterranean population at high cardiovascular risk.

Methods

We prospectively followed 3,454 non-diabetic individuals from the PREDIMED study. Dairy consumption was assessed at baseline and yearly using food frequency questionnaires and categorized into total, low-fat, whole-fat, and subgroups: milk, yogurt, cheeses, fermented dairy, concentrated full fat, and processed dairy. Hazard ratios (HRs) were calculated using Cox proportional hazards regression models.

Results

During a median follow-up of 4.1 years, we documented 270 incident T2D cases. After multivariate adjustment, total dairy product consumption was inversely associated with T2D risk [0.68 (95 % CI 0.47–0.98); P-trend = .040]. This association appeared to be mainly attributed to low-fat dairy; the multivariate HRs (95 % CIs) comparing the highest versus the lowest tertile consumption were 0.65 (0.45–0.94) for low-fat dairy products and 0.67 (0.46–0.95) for low-fat milk (both P-trend <.05). Total yogurt consumption was associated with a lower T2D risk [HR 0.60 (0.42–0.86); P-trend = .002]. An increased consumption of total low-fat dairy and total yogurt during the follow-up was inversely associated with T2D; HRs were 0.50 (0.29–0.85), 0.44 (0.26–0.75), and 0.55 (0.33–0.93), respectively. Substituting one serving/day of a combination of biscuits and chocolate and whole grain biscuits and homemade pastries for one serving/day of yogurt was associated with a 40 and 45 % lower risk of T2D, respectively. No significant associations were found for the other dairy subgroups (cheese, concentrated full fat, and processed dairy products).

Conclusions

A healthy dietary pattern incorporating a high consumption of dairy products and particularly yogurt may be protective against T2D in older adults at high cardiovascular risk.

Keywords

PREDIMED Type 2 diabetes Older adults Dairy Yogurt 

Notes

Acknowledgments

The authors thank the participants for their enthusiastic collaboration, the PREDIMED personnel for excellent assistance, and the personnel of all affiliated primary care centers for their hard work. This study was funded, in part, by the Spanish Ministry of Health (ISCIII), PI1001407, Thematic Network G03/140, RD06/0045, FEDER (Fondo Europeo de Desarrollo Regional), and the Centre Català de la Nutrició de l’Institut d’Estudis Catalans. The Fundación Patrimonio Comunal Olivarero and Hojiblanca SA (Málaga, Spain), California Walnut Commission (Sacramento, CA), Borges SA (Reus, Spain), and Morella Nuts SA (Reus, Spain) donated the olive oil, walnuts, almonds, and hazelnuts, respectively, used in the study. None of the funding sources played a role in the design, collection, analysis or interpretation of the data, or in the decision to submit the manuscript for publication. CIBERobn (Centros de Investigación Biomédica en Red: Obesidad y Nutrición) is an initiative of ISCIII, Madrid, Spain.

Conflict of interest

Dr. Estruch reports serving on the board of and receiving lecture fees from the Research Foundation on Wine and Nutrition (FIVIN); serving on the boards of the Beer and Health Foundation and the European Foundation for Alcohol Research (ERAB); receiving lecture fees from Cerveceros de España and Sanofi-Aventis; and receiving grant support through his institution from Novartis. Dr. Ros reports grants from RTIC G03/140, ISCIII, Spain, grants from CIBERobn, ISCIII, Spain; serving on the board of and receiving grant support through his institution from the California Walnut Commission, Sacramento CA, USA, non-financial support from Patrimonio Comunal Olivarero, Spain, nonfinancial support from La Morella Nuts, Spain, non-financial support from Borges S.A., Spain, during the conduct of the study; serving on the board and receiving personal fees and other from Flora Foundation, Unilever; personal fees, non-financial support and other from La Asturiana S.A., non-financial support from International Nut Council, outside the submitted work. Dr. Serra-Majem reports serving on the boards of the Mediterranean Diet Foundation and the Beer and Health Foundation. Dr. Pintó reports serving on the board of and receiving grant support through his institution from the Residual Risk Reduction Initiative (R3i) Foundation; serving on the board of Omegafort; serving on the board of and receiving payment for the development of educational presentations, as well as grant support through his institution, from Ferrer; receiving consulting fees from Abbott Laboratories; receiving lecture fees, as well as grant support through his institution, from Merck and Roche; receiving lecture fees from Danone and Esteve; receiving payment for the development of educational presentations from Menarini; and receiving grant support through his institution from Sanofi-Aventis, Kowa, Unilever, Boehringer Ingelheim, and Karo Bio. Dr. Salas-Salvadó reports serving on the board of and receiving grant support through his institution from the International Nut and Dried Fruit Council; serving on the scientific board of the Institute Danone, Spain; receiving consulting fees from Danone; and receiving grant support through his institution from Eroski and Nestlé. No other potential conflict of interest relevant to this article was reported.

Supplementary material

394_2015_855_MOESM1_ESM.docx (55 kb)
Supplementary material 1 (DOCX 55 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Andrés Díaz-López
    • 1
    • 2
  • Mònica Bulló
    • 1
    • 2
  • Miguel A. Martínez-González
    • 2
    • 3
  • Dolores Corella
    • 2
    • 4
  • Ramon Estruch
    • 2
    • 5
  • Montserrat Fitó
    • 2
    • 6
  • Enrique Gómez-Gracia
    • 2
    • 7
  • Miquel Fiol
    • 2
    • 8
  • Francisco Javier García de la Corte
    • 2
    • 9
  • Emilio Ros
    • 2
    • 10
  • Nancy Babio
    • 1
    • 2
  • Lluís Serra-Majem
    • 2
    • 11
  • Xavier Pintó
    • 2
    • 12
  • Miguel Ángel Muñoz
    • 2
    • 13
  • Francisco Francés
    • 2
    • 4
  • Pilar Buil-Cosiales
    • 2
    • 3
  • Jordi Salas-Salvadó
    • 1
    • 2
  1. 1.Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPVUniversitat Rovira i VirgiliReusSpain
  2. 2.CIBERobn Physiopathology of Obesity and NutritionInstitute of Health Carlos IIIMadridSpain
  3. 3.Department of Preventive Medicine and Public HealthUniversity of Navarra Osasunbidea-Servicio Navarro de SaludPamplonaSpain
  4. 4.Department of Preventive Medicine and Public Health, School of MedicineUniversity of ValenciaValenciaSpain
  5. 5.Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS)University of BarcelonaBarcelonaSpain
  6. 6.Cardiovascular Risk and Nutrition Research GroupIMIMBarcelonaSpain
  7. 7.Department of Preventive MedicineUniversity of MalagaMálagaSpain
  8. 8.Institute of Health SciencesUniversity of Balearic Islands and Son Espases HospitalPalma de MallorcaSpain
  9. 9.Primary Care Division of Sevilla, Department of Family MedicineSan Pablo Health CenterSevilleSpain
  10. 10.Lipid Clinic, Service of Endocrinology and NutritionHospital Clinic, IDIBAPSBarcelonaSpain
  11. 11.Department of Clinical SciencesUniversity of Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain
  12. 12.Lipids and Vascular Risk Unit, Internal Medicine, Bellvitge University HospitalLlobregat HospitaletBarcelonaSpain
  13. 13.Primary Care Division, Catalan Institute of HealthIDIAP-Jordi GolBarcelonaSpain

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