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Effect of Milk and Cultured Milk Products on Type 2 Diabetes: A Global Systematic Review and Meta-analysis of Prospective Cohort Studies

  • Review Article
  • Published:
Journal of the Indian Institute of Science Aims and scope

A Correction to this article was published on 17 October 2023

This article has been updated

Abstract

Background

Dairy products have been used for centuries and were generally believed to be healthy. Recently, dairy products have been implicated in the rise of non-communicable diseases especially new onset type 2 diabetes (T2D). However, the available data have been inconsistent.

Objective

To perform a systematic review and meta-analysis of all the available prospective studies on the effect of dairy products with incident (new onset) T2D.

Methods

A total of 3009 articles were retrieved from PubMed, Scopus, Medline and Science Direct from January 2000 to March 2022 from which 27 prospective cohort studies were included. We classified dairy products as ‘total dairy’ and ‘total milk’ and further stratified them based on their fat content and fermentation. A subgroup analysis was conducted in people of Asian and Western ethnicity.

Results

Globally, total dairy products [Relative risk (RR) − 0.14; 95% Confidence Interval (CI) − 0.23; − 0.05; I2 = 30%], total fermented dairy [RR − 0.08; 95% CI − 0.16; − 0.00; I2 = 41%], and plain yogurt [RR − 0.08; 95% CI − 0.15; − 0.01; I2 = 34%] were inversely associated with incident T2D. Other dairy products including low and high fat total dairy products, low and high fat milk and cheese had a neutral effect with no significant association with T2D. Subgroup analysis by ethnicity suggested that intake of total dairy confers protective effects against incident T2D among the Asian population. The plain yogurt, in particular, showed protection against new onset T2D across both ethnicities and across age groups. Further, the subgroup analysis by age showed that the consumption of high fat dairy predisposed younger adults to new onset of T2D.

Conclusion

Total and fermented dairy products, particularly plain yogurt, are protective against new onset T2D while milk, cheese and other dairy products have no significant effect on incident T2D.

Study Registration Number

This protocol was registered on the International Prospective Register of Systematic Reviews, PROSPERO (CRD42021249202).

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

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Funding

We thank International Life Sciences Institute India (ILSI India) for funding this study.

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Authors and Affiliations

  1. Department of Diabetology, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research On Diabetes and Dr. Mohan’s Diabetes Specialities Centre, International Diabetes Federation (IDF) Centre of Excellence in Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, Tamil Nadu, 600 086, India

    Viswanathan Mohan, Ranjit Mohan Anjana & Ranjit Unnikrishnan

  2. Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India

    Kuzhandhaivelu Abirami, Valangaiman Sriram Manasa, Rinky Rajput, Nagarajan Lakshmipriya, Chowdary Sruthi, Vasudevan Sudha & Kamala Krishnaswamy

  3. Childhood and Youth Onset Diabetes, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India

    Anandakumar Amutha

  4. Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India

    Balaji Bhavadharini

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  1. Viswanathan Mohan
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Contributions

SV and KK designed the research. VSM, BB, AA and RR carried out screening of abstract and full texts and the quality assessment of articles. BB provided the databases to extract articles pertinent to the research question. VSM and SC were involved in data extraction of study characteristics. KA and NL analysed and performed statistical analysis of selected studies. VSM, RR, BB and NL wrote the manuscript. VM, RMA, KK, RU and SV has the primary responsibility for the final content. VM, KK, RMA and SV critically reviewed the manuscript and provided constructive feedback on the preparation of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Viswanathan Mohan.

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Conflict of interest

We have undertaken a trial to understand the insulin index and glycaemic index of milk and curd funded by the Institute of Rural Management Anand (IRMA), Anand.

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Mohan, V., Abirami, K., Manasa, V.S. et al. Effect of Milk and Cultured Milk Products on Type 2 Diabetes: A Global Systematic Review and Meta-analysis of Prospective Cohort Studies. J Indian Inst Sci 103, 167–190 (2023). https://doi.org/10.1007/s41745-023-00396-3

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