Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Am J Clin Nutr. 2019 Nov 1;110(5):1201-1212. doi: 10.1093/ajcn/nqz180.
Whether changes in dairy product consumption are related to subsequent risk of type 2 diabetes (T2D) remains unknown.
We evaluated the association of long-term changes in dairy product consumption with subsequent risk of T2D among US men and women.
We followed up 34,224 men in the Health Professionals Follow-Up Study (1986-2012), 76,531 women in the Nurses' Health Study (1986-2012), and 81,597 women in the Nurses' Health Study II (1991-2013). Changes in dairy consumption were calculated from consecutive quadrennial FFQs. Multivariable Cox proportional regression models were used to calculate HRs for T2D associated with changes in dairy product consumption. Results of the 3 cohorts were pooled using an inverse variance-weighted, fixed-effect meta-analysis.
During 2,783,210 person-years, we documented 11,906 incident T2D cases. After adjustment for initial and changes in diet and lifestyle covariates, decreasing total dairy intake by >1.0 serving/d over a 4-y period was associated with an 11% (95% CI: 3%, 19%) higher risk of T2D in the subsequent 4 y compared with maintaining a relatively stable consumption (i.e., change in intake of ±1.0 serving/wk). Increasing yogurt consumption by >0.5 serving/d was associated with an 11% (95% CI: 4%, 18%) lower T2D risk, whereas increasing cheese consumption by >0.5 serving/d was associated with a 9% (95% CI: 2%, 16%) higher risk compared with maintaining stable intakes. Substituting 1 serving/d of yogurt or reduced-fat milk for cheese was associated with a 16% (95% CI: 10%, 22%) or 12% (95% CI: 8%, 16%) lower T2D risk, respectively.
Increasing yogurt consumption was associated with a moderately lower risk of T2D, whereas increasing cheese consumption was associated with a moderately higher risk among US men and women. Our study suggests that substituting yogurt or reduced-fat milk for cheese is associated with a lower risk of T2D.
乳制品消费的变化是否与 2 型糖尿病（T2D）的风险增加有关尚不清楚。
我们评估了美国男性和女性长期乳制品消费变化与 T2D 风险之间的关系。
我们随访了 34224 名男性（1986-2012 年），76531 名女性（1986-2012 年），81597 名女性（1991-2013 年）参加了健康专业人员随访研究。乳制品摄入量的变化是从连续的四年期 FFQ 中计算出来的。使用多变量 Cox 比例风险回归模型计算与乳制品消费变化相关的 T2D 的 HR。使用逆方差加权固定效应荟萃分析汇总了 3 个队列的结果。
在 2783210 人年中，我们记录了 11906 例新发 T2D 病例。在校正初始和饮食及生活方式因素变化后，与保持相对稳定消费相比（即摄入量每周变化±1.0 份），在 4 年内总乳制品摄入量减少>1.0 份/天与随后 4 年内 T2D 风险增加 11%（95%CI：3%，19%）相关。与保持稳定摄入量相比，酸奶摄入量增加>0.5 份/天与 T2D 风险降低 11%（95%CI：4%，18%）相关，而奶酪摄入量增加>0.5 份/天与风险增加 9%（95%CI：2%，16%）相关。用 1 份/天的酸奶或低脂牛奶代替奶酪与 T2D 风险降低 16%（95%CI：10%，22%）或 12%（95%CI：8%，16%）相关。
增加酸奶摄入量与 T2D 风险呈中度降低相关，而增加奶酪摄入量与美国男性和女性的 T2D 风险呈中度增加相关。我们的研究表明，用酸奶或低脂牛奶代替奶酪与 T2D 风险降低有关。
