Slurink Isabel Al, Vogtschmidt Yakima D, Brummel Bo, Smeets Tom, Kupper Nina, Soedamah-Muthu Sabita S
Center of Research on Psychological disorders and Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom.
Curr Dev Nutr. 2024 Sep 29;8(11):104470. doi: 10.1016/j.cdnut.2024.104470. eCollection 2024 Nov.
Modest inverse associations have been found between dairy intake, particularly yogurt, and type 2 diabetes risk. Investigating associations of dairy intake with early onset of type 2 diabetes offers opportunities for effective prevention of this condition.
This study aims to investigate the relationships between the intake of different dairy types, prediabetes risk, and continuous glycemic outcomes.
Systematic literature searches across multiple databases were performed of studies published up to September 2023. Included were prospective cohort studies in healthy adults that examined the association between dairy intake and prediabetes risk according to diagnostic criteria, or continuous glycemic markers. A dose-response random-effects meta-analysis was used to derive incremental relative risks (RRs) for associations of total dairy, fermented dairy, milk, yogurt, cheese (all total, high-fat, and low-fat), cream, and ice cream with prediabetes risk adjusted for sociodemographic, health and cardiometabolic risk factors, and dietary characteristics.
The meta-analyses encompassed 6653 prediabetes cases among 95,844 individuals (age range 45.5-65.5 y) including 6 articles describing 9 cohorts. A quadratic inverse association was observed for total dairy intake and prediabetes risk, with the lowest risk at 3.4 servings/d (RR: 0.75; 95% confidence interval: 0.60, 0.93; = 18%). Similarly, total, and high-fat cheese exhibited nonlinear inverse associations with prediabetes risk, showing the lowest risk at 2.1 servings/d (0.86; 0.78, 0.94; = 0%, and 0.90; 0.81, 0.99; = 12%), but a higher risk at intakes exceeding 4 servings/d. Ice cream intake was linearly associated with prediabetes risk (0.85; 0.73, 0.99; = 0% at the highest median intake of 0.23 servings/d). Other dairy types showed no statistically significant associations. The systematic review on dairy intake and glycemic outcomes showed considerable variabilities in design and results.
The findings suggest an inverse association between moderate dairy and cheese intake in preventing prediabetes. The potential for reverse causation and residual confounding highlights the need for studies with comprehensive repeated measurements.
PROSPERO 2023 CRD42023431251.
已发现乳制品摄入量，尤其是酸奶摄入量与2型糖尿病风险之间存在适度的负相关。研究乳制品摄入量与2型糖尿病早期发病之间的关联为有效预防这种疾病提供了机会。
本研究旨在调查不同类型乳制品的摄入量、糖尿病前期风险和连续血糖结果之间的关系。
对截至2023年9月发表的研究在多个数据库中进行系统文献检索。纳入的是健康成年人的前瞻性队列研究，这些研究根据诊断标准或连续血糖标志物检查了乳制品摄入量与糖尿病前期风险之间的关联。采用剂量反应随机效应荟萃分析，得出总乳制品、发酵乳制品、牛奶、酸奶、奶酪（全脂、高脂和低脂）、奶油和冰淇淋与经社会人口统计学、健康和心血管代谢风险因素以及饮食特征调整后的糖尿病前期风险关联的增量相对风险（RRs）。
荟萃分析纳入了95844名个体（年龄范围45.5 - 65.5岁）中的6653例糖尿病前期病例，包括6篇描述9个队列的文章。观察到总乳制品摄入量与糖尿病前期风险呈二次负相关，每天摄入3.4份时风险最低（RR：0.75；95%置信区间：0.60，0.93；I² = 18%）。同样，全脂和高脂奶酪与糖尿病前期风险呈非线性负相关，每天摄入2.1份时风险最低（0.86；0.78，0.94；I² = 0%，以及0.90；0.81，0.99；I² = 12%），但摄入量超过4份/天时风险更高。冰淇淋摄入量与糖尿病前期风险呈线性相关（在最高中位数摄入量为每天0.23份时，RR为0.85；0.73，0.99；I² = 0%）。其他类型的乳制品未显示出统计学上的显著关联。关于乳制品摄入量和血糖结果的系统评价显示，在设计和结果方面存在相当大的差异。
研究结果表明，适量摄入乳制品和奶酪在预防糖尿病前期方面存在负相关。反向因果关系和残余混杂的可能性凸显了进行全面重复测量研究的必要性。
PROSPERO 2023 CRD42023431251。
