The Role of Milk and Dairy Products in the Development of Obesity and Cardiometabolic Disease

Reference work entry


The prevalence of obesity has increased rapidly. Obesity is a key risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD), which are the leading causes of death globally. Dairy products contribute significantly to children’s and adults’ nutrient intake, yet due to relatively high saturated fat content, the health benefits of dairy products have come under question. This chapter provides an overview of the current evidence mainly from systematic reviews and meta-analyses on dairy product consumption and risk of obesity, T2D, and CVD. The data review suggests that milk and certain dairy products are not related or inversely related to obesity in children. In adults, consumption of milk and dairy products improves body composition and enhances weight loss during energy restriction diets, while it has a neutral effect on body weight in maintenance diets. Prospective cohort studies suggest that the consumption of dairy products, with other regular or low-fat content, does not adversely affect the risk of T2D or CVD outcomes and may have a protective effect. The proposed mechanisms underlying the effect of dairy nutrients on obesity and cardiometabolic disease have not been clearly elucidated but include a beneficial role of calcium, dairy fat, and proteins on fat metabolism and excretion, appetite, and the metabolic activity of gut microbiota. There remain many uncertainties, including different effects of different types of dairy products and of different fat content. In conclusion, dairy product consumption, as part of a balanced diet, may protect against the risk of obesity, T2D, and CVD.


Milk Dairy Obesity Cardiovascular diseases Type 2 diabetes Children Adults 


  1. Abargouei, A. S., Janghorbani, M., Salehi-Marzijarani, M., & Esmaillzadeh, A. (2012). Effect of dairy consumption on weight and body composition in adults: A systematic review and meta-analysis of randomized controlled clinical trials. International Journal of Obesity, 36(12), 1485–1493.PubMedCrossRefGoogle Scholar
  2. Alexander, D. D., Bylsma, L. C., Vargas, A. J., Cohen, S. S., et al. (2016). Dairy consumption and CVD: A systematic review and meta-analysis. British Journal of Nutrition, 115(4), 737–750.PubMedCrossRefGoogle Scholar
  3. Alvarez-Bueno, C., Cavero-Redondo, I., Martinez-Vizcaino, V., Sotos-Prieto, M., et al. (2018). Effects of milk and dairy product consumption on type 2 diabetes: Overview of systematic reviews and meta-analyses. Advances in Nutrition, 10(2), S154–S163.Google Scholar
  4. Auestad, N., Hurley, J., Fulgoni, V., Schweitzer, C., et al. (2015). Contribution of food groups to energy and nutrient intakes in five developed countries. Nutrients, 7(6), 4593–4618.PubMedPubMedCentralCrossRefGoogle Scholar
  5. Aune, D., Norat, T., Romundstad, P., & Vatten, L. J. (2013). Dairy products and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis of cohort studies. American Journal of Clinical Nutrition, 98(4), 1066–1083.PubMedCrossRefGoogle Scholar
  6. Benatar, J. R., Sidhu, K., & Stewart, R. A. H. (2013). Effects of high and low fat dairy food on cardio-metabolic risk factors: A meta-analysis of randomized studies. Yu-Kang Tu (ed.). PLoS One, 8(10), e76480.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Boeing, H., Bechthold, A., Hoffmann, G., Schwedhelm, C., et al. (2017). Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies. Critical Reviews in Food Science and Nutrition, 0(0), 1–20.Google Scholar
  8. Booth, A. O., Huggins, C. E., Wattanapenpaiboon, N., & Nowson, C. A. (2015). Effect of increasing dietary calcium through supplements and dairy food on body weight and body composition: A meta-analysis of randomised controlled trials. British Journal of Nutrition, 114(7), 1013–1025.PubMedCrossRefGoogle Scholar
  9. Brouwer-Brolsma, E. M., Sluik, D., Singh-Povel, C. M., & Feskens, E. J. M. (2018). Dairy product consumption is associated with pre-diabetes and newly diagnosed type 2 diabetes in the Lifelines Cohort Study. British Journal of Nutrition119(4), 442–455.Google Scholar
  10. Buttriss, J. L. (2016). The Eatwell guide refreshed. Nutrition Bulletin, 41(2), 135–141.CrossRefGoogle Scholar
  11. Canfora, E. E., Jocken, J. W., & Blaak, E. E. (2015). Short-chain fatty acids in control of body weight and insulin sensitivity. Nature Reviews Endocrinology, 11(10), 577–591.PubMedCrossRefGoogle Scholar
  12. Chen, M., Pan, A., Malik, V. S., & Hu, F. B. (2012). Effects of dairy intake on body weight and fat: A meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, 96(4), 735–747.PubMedCrossRefGoogle Scholar
  13. Chen, G. C., Wang, Y., Tong, X., Szeto, I. M. Y., et al. (2017). Cheese consumption and risk of cardiovascular disease: A meta-analysis of prospective studies. European Journal of Nutrition, 56(8), 2565–2575.PubMedCrossRefGoogle Scholar
  14. Christensen, R., Lorenzen, J. K., Svith, C. R., Bartels, E. M., et al. (2009). Effect of calcium from dairy and dietary supplements on faecal fat excretion: A meta-analysis of randomized controlled trials. Obesity Reviews, 10(4), 475–486.PubMedCrossRefGoogle Scholar
  15. De Beer, H. (2012). Dairy products and physical stature: A systematic review and meta-analysis of controlled trials. Economics and Human Biology, 10(3), 299–309.PubMedCrossRefGoogle Scholar
  16. de Goede, J., Soedamah-Muthu, S. S., Pan, A., Gijsbers, L., et al. (2016). Dairy consumption and risk of stroke: A systematic review and updated dose-response meta-analysis of prospective cohort studies. Journal of the American Heart Association, 5(5), pii: e002787.Google Scholar
  17. Denke, M. A., Fox, M. M., & Schulte, M. C. (1993). Short-term dietary calcium fortification increases fecal saturated fat content and reduces serum lipids in men. The Journal of nutrition, 123(6), 1047–1053.PubMedGoogle Scholar
  18. Dougkas, A., Reynolds, C. K., Givens, I. D., Elwood, P. C., et al. (2011). Associations between dairy consumption and body weight: A review of the evidence and underlying mechanisms. Nutrition Research Reviews, 24(1), 72–95.PubMedCrossRefGoogle Scholar
  19. Dougkas, A., Barr, S., Reddy, S., & Summerbell, C. D. (2018). A critical review of the role of milk and other dairy products in the development of obesity in children and adolescents. Nutrition Research Reviews, 32(1), 106–127.Google Scholar
  20. Dror, D. K. (2014). Dairy consumption and pre-school, school-age and adolescent obesity in developed countries: A systematic review and meta-analysis. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 15(6), 516–527.CrossRefGoogle Scholar
  21. Drouin-Chartier, J.-P., Brassard, D., Tessier-Grenier, M., Côté, J. A., et al. (2016). Systematic review of the association between dairy product consumption and risk of cardiovascular-related clinical outcomes. Advances in Nutrition, 7(6), 1026–1040.PubMedPubMedCentralCrossRefGoogle Scholar
  22. Eales, J., Lenoir-Wijnkoop, I., King, S., Wood, H., et al. (2016). Is consuming yogurt associated with weight management outcomes? Results from a systematic review. International Journal of Obesity, 40(5), 731–746.PubMedCrossRefGoogle Scholar
  23. EFSA. (2017). European Food Safety Authority. Dietary Reference Values and dietary guidelines. EFSA supporting publications.: Accessed: 2 Aug 2019.
  24. Egan, B. M., Kjeldsen, S. E., Grassi, G., Esler, M., et al. (2019). The global burden of hypertension exceeds 1.4 billion people. Journal of Hypertension, 37(6), 1148–1153.PubMedCrossRefGoogle Scholar
  25. Elwood, P. C., Givens, D. I., Beswick, A. D., Fehily, A. M., et al. (2008). The survival advantage of milk and dairy consumption: An overview of evidence from cohort studies of vascular diseases, diabetes and cancer. Journal of the American College of Nutrition, 27(6), 723S–734S.PubMedCrossRefGoogle Scholar
  26. Fayet-Moore, F. (2015). Flavoured milk consumption among children – What is the evidence? Journal of Nutrition & Intermediary Metabolism., 1, 40.CrossRefGoogle Scholar
  27. Fekete, Á. A., Givens, D. I., & Lovegrove, J. A. (2016). Can milk proteins be a useful tool in the management of cardiometabolic health? An updated review of human intervention trials. Proceedings of the Nutrition Society, 75(3), 328. 2016 p.PubMedCrossRefGoogle Scholar
  28. Fontecha, J., Calvo, M. V., Juarez, M., Gil, A., et al. (2018). Milk and dairy product consumption and cardiovascular diseases: An overview of systematic reviews and meta-analyses. Advances in nutrition (Bethesda, Md.)., 10(2), S164–S189.Google Scholar
  29. Frayn, K., & Stanner, S. (2008). The aetiology and epidemiology of cardiovascular disease. In: Cardiovascular disease: nutrition and emerging risk factors: The report of a British Nutrition Foundation Task Force. pp. 1–21.Google Scholar
  30. Gao, D., Ning, N., Wang, C., Wang, Y., et al. (2013). Dairy products consumption and risk of type 2 diabetes: Systematic review and dose-response meta-analysis. PLoS One, 8(9).PubMedPubMedCentralCrossRefGoogle Scholar
  31. Garrido-Chamorro, R. P., Sirvent-Belando, J. E., Gonzalez-Lorenzo, M., Martin-Carratala, M. L., et al. (2009). Correlation between body mass index and body composition in elite athletes. The Journal of Sports Medicine and Physical Fitness, 49(3), 278–284.PubMedGoogle Scholar
  32. Geng, T., Qi, L., & Huang, T. (2018). Effects of dairy products consumption on body weight and body composition among adults: An updated meta-analysis of 37 randomized control trials. Molecular Nutrition & Food Research, 62(1), 1700410.CrossRefGoogle Scholar
  33. Gijsbers, L., Ding, E. L., Malik, V. S., De Goede, J., et al. (2016). Consumption of dairy foods and diabetes incidence: A dose-response meta-analysis of observational studies. American Journal of Clinical Nutrition,103(4), 1111–24. PubMedCrossRefGoogle Scholar
  34. Gille, D., Schmid, A., Walther, B., & Vergères, G. (2018). Fermented food and non-communicable chronic diseases: A review. Nutrients, 10(4), e448.Google Scholar
  35. Golden, N. H., & Abrams, S. A. (2014). Optimizing bone health in children and adolescents. Pediatrics, 134(4), e1229–e1243.PubMedCrossRefGoogle Scholar
  36. Gonzalez, J. T., Rumbold, P. L. S., & Stevenson, E. J. (2012). Effect of calcium intake on fat oxidation in adults: A meta-analysis of randomized, controlled trials. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 13(10), 848–857.CrossRefGoogle Scholar
  37. Guo, J., Astrup, A., Lovegrove, J. A., Gijsbers, L., et al. (2017). Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: Dose – response meta-analysis of prospective cohort studies. European Journal of Epidemiology, 32(4), 269–287.PubMedPubMedCentralCrossRefGoogle Scholar
  38. Ing, S. W., & Belury, M. A. (2011). Impact of conjugated linoleic acid on bone physiology: Proposed mechanism involving inhibition of adipogenesis. Nutrition Reviews, 69(3), 123–131.PubMedCrossRefGoogle Scholar
  39. Iodine Global Network. (2017). Global scorecard of iodine nutrition in 2017 in the general population and in pregnant women (PW). Zurich: IGN. (2015).Google Scholar
  40. Jandacek, R. J. (1991). The solubilization of calcium soaps by fatty acids. Lipids, 26(3), 250–253.CrossRefGoogle Scholar
  41. Khoramdad, M., Rahimi, M., Cheraghi, Z., Izadi, N., et al. (2016). The effect of dairy products subgroups consumption on the risk of diabetes: A systematic review and meta-analysis. Iranian Red Crescent Medical Journal, 19(3).Google Scholar
  42. Kjølbæk, L., Lorenzen, J. K., Larsen, L. H., & Astrup, A. (2017). Calcium intake and the associations with faecal fat and energy excretion, and lipid profile in a free-living population. Journal of Nutritional Science, 6, e50.PubMedPubMedCentralCrossRefGoogle Scholar
  43. Kouvelioti, R., Josse, A. R., & Klentrou, P. (2017). Effects of dairy consumption on body composition and bone properties in youth: A systematic review. Current developments in nutrition, 1(8), e001214.PubMedPubMedCentralCrossRefGoogle Scholar
  44. Kratz, M., Baars, T., & Guyenet, S. (2013). The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. European Journal of Nutrition, 52(1), 1–24.PubMedCrossRefGoogle Scholar
  45. Lanou, A. J., & Barnard, N. D. (2008). Dairy and weight loss hypothesis: An evaluation of the clinical trials. Nutrition Reviews, 66(5), 272–279.PubMedCrossRefGoogle Scholar
  46. Laursen, A. S. D., Sluijs, I., Boer, J. M. A., Verschuren, W. M. M., et al. (2019). Substitutions between dairy products and risk of stroke: Results from the EPIC-NL cohort. British Journal of Nutrition, 121(12), 1–21.PubMedCrossRefGoogle Scholar
  47. Layman, D. K., & Walker, D. A. (2006). Potential importance of leucine in treatment of obesity and the metabolic syndrome. The Journal of Nutrition, 136(1), 319S–323S.PubMedCrossRefGoogle Scholar
  48. Louie, J. C. Y., Flood, V. M., Hector, D. J., Rangan, A. M., et al. (2011). Dairy consumption and overweight and obesity: A systematic review of prospective cohort studies. Obesity Reviews, 12(7), e582–e592.PubMedCrossRefGoogle Scholar
  49. Lu, L., Xun, P., Wan, Y., He, K., et al. (2016). Long-term association between dairy consumption and risk of childhood obesity: A systematic review and meta-analysis of prospective cohort studies. European Journal of Clinical Nutrition, 70(4), 414–423.PubMedCrossRefGoogle Scholar
  50. Marette, A., & Picard-Deland, E. (2014). Yogurt consumption and impact on health: Focus on children and cardiometabolic risk. American Journal of Clinical Nutrition, 99(5),1243–7.Google Scholar
  51. Michaëlsson, K., Wolk, A., Langenskiöld, S., Basu, S., et al. (2014). Milk intake and risk of mortality and fractures in women and men: Cohort studies. BMJ (Online), 349, g6015Google Scholar
  52. Mozaffarian, D. (2016). Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: A comprehensive review. Circulation, 133(2), 187–225.PubMedPubMedCentralCrossRefGoogle Scholar
  53. National Research Council (U.S.). Committee on Technological Options to Improve the Nutritional Attributes of Animal Products. (1988). Designing foods : Animal product options in the marketplace. Washington, DC: National Academy Press.Google Scholar
  54. Onvani, S., Haghighatdoost, F., Surkan, P. J., & Azadbakht, L. (2017). Dairy products, satiety and food intake: A meta-analysis of clinical trials. Clinical Nutrition, 36(2), 389–398.PubMedCrossRefGoogle Scholar
  55. Patel, A. I., Moghadam, S. D., Freedman, M., Hazari, A., et al. (2018). The association of flavored milk consumption with milk and energy intake, and obesity: A systematic review. Preventive Medicine, 111, 151–162.PubMedCrossRefGoogle Scholar
  56. Pei, R., Martin, D. A., DiMarco, D. M., & Bolling, B. W. (2017). Evidence for the effects of yogurt on gut health and obesity. Critical Reviews in Food Science and Nutrition, 57(8), 1569–1583.PubMedCrossRefGoogle Scholar
  57. Pimpin, L., Wu, J. H. Y., Haskelberg, H., Del Gobbo, L., et al. (2016). Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality. PLoS One, 11(6).PubMedPubMedCentralCrossRefGoogle Scholar
  58. Pi-Sunyer, X. (2009). The medical risks of obesity. Postgraduate Medicine121(6), 21–33.PubMedPubMedCentralCrossRefGoogle Scholar
  59. Pittas, A. G., Lau, J., Hu, F. B., & Dawson-Hughes, B. (2007). Review: The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. Journal of Clinical Endocrinology and Metabolism, 92(6), 2017–2029.PubMedCrossRefGoogle Scholar
  60. Qin, L.-Q., Xu, J.-Y., Han, S.-F., Zhang, Z.-L., et al. (2015). Dairy consumption and risk of cardiovascular disease: An updated meta-analysis of prospective cohort studies. Asia Pacific Journal of Clinical Nutrition, 24(1), 90–100.PubMedGoogle Scholar
  61. Roe, M., Pinchen, H., Church, S., & Finglas, P. (2015). McCance and Widdowson’s the composition of foods seventh summary edition and updated composition of foods integrated dataset. Nutrition Bulletin, 40(1), 36–39.CrossRefGoogle Scholar
  62. Sayon-orea, C., Martínez-gonzález, M. A., Ruiz-canela, M., & Bes-rastrollo, M. (2017). Associations between yogurt consumption and weight gain and risk of obesity and metabolic syndrome: A systematic review. Advances in Nutrition, 8(1), 146–154.Google Scholar
  63. Schwingshackl, L., Hoffmann, G., Schwedhelm, C., Kalle-, T., et al. (2016). Consumption of dairy products in relation to changes in anthropometric variables in adult populations: A systematic review and Meta- analysis of cohort Studies. PloS One, 11(6), 1–15.PubMedPubMedCentralCrossRefGoogle Scholar
  64. Schwingshackl, L., Bogensberger, B., & Hoffmann, G. (2018). Diet quality as assessed by the healthy eating index, alternate healthy eating index, dietary approaches to stop hypertension score, and health outcomes: An updated systematic review and Meta-analysis of cohort studies. Journal of the Academy of Nutrition and Dietetics118(1), 74–100.Google Scholar
  65. Seidell, J. C., & Halberstadt, J. (2015). The global burden of obesity and the challenges of prevention. Annals of Nutrition & Metabolism, 66(Suppl 2), 7–12.CrossRefGoogle Scholar
  66. Soedamah-Muthu, S. S., & de Goede, J. (2018). Dairy consumption and Cardiometabolic diseases: Systematic review and updated meta-analyses of prospective cohort studies. Current Nutrition Reports, 7(4), 171.PubMedPubMedCentralCrossRefGoogle Scholar
  67. Stonehouse, W., Wycherley, T., Luscombe-Marsh, N., Taylor, P., et al. (2016). Dairy intake enhances body weight and composition changes during energy restriction in 18–50-year-old adults – A meta-analysis of randomized controlled trials. Nutrients, 8(7), 394.PubMedCentralCrossRefGoogle Scholar
  68. Thorning, T. K., Raben, A., Tholstrup, T., Soedamah-Muthu, S. S., et al. (2016). Milk and dairy products: Good or bad for human health? An assessment of the totality of scientific evidence. Food & Nutrition Research, 60(1), 32527.CrossRefGoogle Scholar
  69. Thorning, T. K., Bertram, H. C., Bonjour, J.-P., de Groot, L., et al. (2017). Whole dairy matrix or single nutrients in assessment of health effects: Current evidence and knowledge gaps. The American Journal of Clinical Nutrition., 105(5), 1033–1045.PubMedCrossRefGoogle Scholar
  70. Tong, X., Dong, J. Y., Wu, Z. W., Li, W., et al. (2011). Dairy consumption and risk of type 2 diabetes mellitus: A meta-analysis of cohort studies. European Journal of Clinical Nutrition, 65(9), 1027–1031.PubMedCrossRefGoogle Scholar
  71. Tordoff, M. G. (2001). Calcium: Taste, intake, and appetite. Physiological Reviews, 81(4), 1567–1597.PubMedCrossRefGoogle Scholar
  72. Tordoff, M. G., Hughes, R. L., & Pilchak, D. M. (1998). Calcium intake by rats: Influence of parathyroid hormone, calcitonin, and 1,25-dihydroxyvitamin D. The American journal of physiology, 274(1 Pt 2), R214–R231.PubMedGoogle Scholar
  73. United States Department of Agriculture (2015). 2015–2020 Dietary Guidelines for Americans: 8th edition. Accessed Oct 2018.
  74. Visioli, F., & Strata, A. (2014). Milk, dairy products, and their functional effects in humans: A narrative review of recent evidence. Advances in Nutrition, 5(2), 131–143.PubMedPubMedCentralCrossRefGoogle Scholar
  75. Wang, W., Wu, Y., & Zhang, D. (2016). Association of dairy products consumption with risk of obesity in children and adults: A meta-analysis of mainly cross-sectional studies. Annals of Epidemiology, 26(12), 870–882.e2.PubMedCrossRefGoogle Scholar
  76. WHO. (2003). Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. WHO. Accessed 2 Aug 2019.
  77. WHO. (2018a). Obesity and overweight factsheet. Accessed 11 Dec 2018.
  78. WHO. (2018b). World Health Organisation Diabetes Fact Sheets. WHO. Accessed 2 Aug 2019.
  79. WHO. (2018c). World Health Organisation Cardiovascular Fact Sheets. WHO. Accessed 2 Aug 2019.
  80. WHO 2008. (n.d.) Waist circumference and waist-hip ratio: Report of a WHO expert consultation. Accessed 11 Dec 2018.
  81. World Health Organization. (2013). WHO | Cardiovascular diseases (CVDs) factsheet.
  82. Xue, B., Greenberg, A. G., Kraemer, F. B., & Zemel, M. B. (2001). Mechanism of intracellular calcium ([Ca2+]i) inhibition of lipolysis in human adipocytes. The FASEB Journal, 15(13), 2527–2529.PubMedCrossRefGoogle Scholar
  83. Yu, E., & Hu, F. B. (2018). Dairy products, dairy fatty acids, and the prevention of cardiometabolic disease: A review of recent evidence. Current Atherosclerosis Reports, 20(5).Google Scholar
  84. Zemel, M. B. (2002). Regulation of adiposity and obesity risk by dietary calcium: Mechanisms and implications. Journal of the American College of Nutrition, 21(2), 146S–151S.PubMedCrossRefGoogle Scholar

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Authors and Affiliations

  1. 1.The Institut Paul Bocuse Research CentreInstitut Paul BocuseEcullyFrance
  2. 2.Centre of Excellence for Sustainable Food Systems, Department of Epidemiology and Population HealthUniversity of LiverpoolLiverpoolUK

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