Ericson Ulrika, Hellstrand Sophie, Brunkwall Louise, Schulz Christina-Alexandra, Sonestedt Emily, Wallström Peter, Gullberg Bo, Wirfält Elisabet, Orho-Melander Marju
From the Department of Clinical Sciences, Malmö, Diabetes and Cardiovascular Disease, Genetic Epidemiology (UE, SH, LB, C-AS, ES, and MO-M) and the Department of Clinical Sciences, Malmö, Nutritional Epidemiology, Lund University, Lund, Sweden (PW, BG, and EW).
Am J Clin Nutr. 2015 May;101(5):1065-80. doi: 10.3945/ajcn.114.103010. Epub 2015 Apr 1.
Dietary fats could affect glucose metabolism and obesity development and, thereby, may have a crucial role in the cause of type 2 diabetes (T2D). Studies indicated that replacing saturated with unsaturated fats might be favorable, and plant foods might be a better choice than animal foods. Nevertheless, epidemiologic studies suggested that dairy foods are protective.
We hypothesized that, by examining dietary fat and its food sources classified according to fat type and fat content, some clarification regarding the role of dietary fat in T2D incidence could be provided.
A total of 26,930 individuals (61% women), aged 45-74 y, from the Malmö Diet and Cancer cohort were included in the study. Dietary data were collected by using a modified diet-history method. During 14 y of follow-up, 2860 incident T2D cases were identified.
Total intake of high-fat dairy products (regular-fat alternatives) was inversely associated with incident T2D (HR for highest compared with lowest quintiles: 0.77; 95% CI: 0.68, 0.87; P-trend < 0.001). Most robust inverse associations were seen for intakes of cream and high-fat fermented milk (P-trend < 0.01) and for cheese in women (P-trend = 0.02). High intake of low-fat dairy products was associated with increased risk, but this association disappeared when low- and high-fat dairy were mutually adjusted (P-trend = 0.18). Intakes of both high-fat meat (P-trend = 0.04) and low-fat meat (P-trend < 0.001) were associated with increased risk. Finally, we did not observe significant association between total dietary fat content and T2D (P-trend = 0.24), but intakes of saturated fatty acids with 4-10 carbons, lauric acid (12:0), and myristic acid (14:0) were associated with decreased risk (P-trend < 0.01).
Decreased T2D risk at high intake of high- but not of low-fat dairy products suggests that dairy fat partly could have contributed to previously observed protective associations between dairy intake and T2D. Meat intake was associated with increased risk independently of the fat content.
膳食脂肪会影响葡萄糖代谢和肥胖的发展，因此可能在2型糖尿病（T2D）的病因中起关键作用。研究表明，用不饱和脂肪替代饱和脂肪可能有益，植物性食物可能比动物性食物是更好的选择。然而，流行病学研究表明乳制品具有保护作用。
我们假设，通过检查根据脂肪类型和脂肪含量分类的膳食脂肪及其食物来源，可以对膳食脂肪在T2D发病中的作用提供一些明确的认识。
来自马尔默饮食与癌症队列的26930名年龄在45 - 74岁的个体（61%为女性）被纳入研究。通过使用改良的饮食史方法收集膳食数据。在14年的随访期间，确定了2860例新发T2D病例。
高脂肪乳制品（常规脂肪替代品）的总摄入量与新发T2D呈负相关（最高五分位数与最低五分位数相比的HR：0.77；95%CI：0.68，0.87；P趋势<0.001）。对于奶油和高脂肪发酵乳的摄入量（P趋势<0.01）以及女性奶酪的摄入量（P趋势 = 0.02），观察到最强的负相关。低脂肪乳制品的高摄入量与风险增加相关，但当对低脂和高脂乳制品进行相互调整时，这种关联消失（P趋势 = 0.18）。高脂肪肉类（P趋势 = 0.04）和低脂肪肉类（P趋势<0.001）的摄入量均与风险增加相关。最后，我们未观察到膳食总脂肪含量与T2D之间存在显著关联（P趋势 = 0.24），但碳链长度为4 - 10的饱和脂肪酸、月桂酸（12:0）和肉豆蔻酸（14:0）的摄入量与风险降低相关（P趋势<0.01）。
高摄入量的高脂肪而非低脂肪乳制品使T2D风险降低，这表明乳制品脂肪可能部分促成了先前观察到的乳制品摄入量与T2D之间的保护关联。肉类摄入量与风险增加相关，且与脂肪含量无关。
