Changes in intake of dairy product subgroups and risk of type 2 diabetes: modelling specified food substitutions in the Danish Diet, Cancer and Health cohort

Substituting Potatoes with Other Food Groups and Type 2 Diabetes Risk: Findings from the Diet, Cancer, and Health Study

BACKGROUND

Although potatoes are considered a dietary staple in some cultures, evidence suggests that their impact on type 2 diabetes (T2D) risk is nuanced, with preparation methods and dietary patterns playing crucial roles. Investigating the substitution effects of replacing potatoes with other foods is required to inform dietary recommendations for lowering T2D risk.

OBJECTIVE

The objective of this was to investigate associations between the substitution of potatoes (excluding fries/chips) with other food groups (vegetables, whole grains, refined grains, red meat, processed meat, poultry, fish, and dairy) and the risk of T2D.

METHODS

The diet of participants from the prospective Danish Diet, Cancer, and Health study (DCH) was measured at baseline (1993-1997) by a food frequency questionnaire. Participants were followed up for incident T2D from baseline until 2012. Associations between the substitution of potatoes (total, boiled, and mashed) with other food groups and incident T2D was assessed by multivariable Cox proportional hazards model.

RESULTS

In 54,793 DCH study participants, during a median follow-up of 16.3 y, 7693 incident T2D cases were recorded. A 26% lower risk of T2D was observed when 50 g/d of potatoes were substituted with the same amount of whole grains [hazard ratio and 95% confidence interval (CI): 0.74 (0.70, 0.79)]. Similarly, a lower risk of T2D was observed upon substituting 25 g/d of potatoes with an equivalent amount of green leafy [HR (95% CI): 0.79 (0.74, 0.83)], cruciferous [HR (95% CI): 0.87 (0.83, 0.92)], and yellow/orange/red vegetables [HR (95% CI): 0.97 (0.96, 0.99)]. Conversely, a higher risk of T2D was observed when potatoes were substituted with poultry [HR (95% CI): 1.08 (1.02, 1.15)], red meat [HR (95% CI): 1.06 (1.02, 1.10)], and processed meat [HR (95% CI): 1.17 (1.11, 1.23)]. Replacing boiled potatoes with red meat or poultry was associated with a higher risk of T2D compared with replacing mashed potatoes.

CONCLUSIONS

Substituting potatoes with whole grains and most types of vegetables was associated with a lower risk of T2D, whereas substituting potatoes with poultry, red meat, and processed meat was associated with a higher risk.

Full-fat dairy products and cardiometabolic health outcomes: Does the dairy-fat matrix matter?

Reducing dairy fat intake is a common dietary guideline to limit energy and saturated fatty acid intake for the promotion of cardiometabolic health. However, research utilizing a holistic, food-based approach to assess the consumption of the fat found in dairy, a broad and diverse food group, may provide new insight into these guidelines. Dairy fat is comprised of a diverse assembly of fatty acids, triacylglycerols, sterols, and phospholipids, all uniquely packaged in a milk fat globule. The physical structure of this milk fat globule and its membrane is modified through different processing methods, resulting in distinctive dairy-fat matrices across each dairy product. The objectives of this narrative review were to first define and compare the dairy-fat matrix in terms of its unique composition, physical structure, and fat content across common dairy products (cow's milk, yogurt, cheese, and butter). With this information, we examined observational studies and randomized controlled trials published within the last 10 years (2013-2023) to assess the individual effects of the dairy-fat matrix in milk, yogurt, cheese, and butter on cardiometabolic health and evaluate the implications for nutrition guidance. Searches conducted on Ovid MEDLINE and PubMed® utilizing search terms for cardiometabolic health, both broadly and regarding specific disease outcomes and risk factors, yielded 59 studies that were analyzed and included in this review. Importantly, this review stratifies by both dairy product and fat content. Though the results were heterogeneous, most studies reported no association between intake of these individual regular-fat dairy products and cardiometabolic outcome measures, thus, the current body of evidence suggests that regular-fat dairy product consumption may be incorporated within overall healthy eating patterns. Research suggests that there may be a beneficial effect of regular-fat milk and yogurt intake on outcome measures related to body weight and composition, and an effect of regular-fat cheese intake on outcome measures related to blood lipids, but more research is necessary to define the directionality of this relationship. Lastly, we identify methodological research gaps and propose future research directions to bolster the current evidence base available for ascertaining the role of dairy fat in a healthy diet.

Suboptimal diet quality is associated with the incidence of type 2 diabetes mellitus in middle-aged and older populations in China: evidence from a population-based cross-sectional study

The association between dietary quality and type 2 diabetes mellitus (T2DM) based on the Chinese Dietary Balance Index (DBI-16) is seldom reported. We hypothesized that poor dietary quality might increase the risk of T2DM in the middle-aged and older populations. A total of 1816 individuals (≥50 years) were included in the study. Demographic characteristics and dietary intake data were collected. Logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DBI-16 indexes and the risk of T2DM. The insufficient intake of vegetables and dairy might decrease the risk of T2DM (ORVegetable = 0.77, 95% CI = 0.60-0.97; ORDairy = 0.58, 95% CI = 0.35-0.96), but the individuals with insufficient intake of fruit were more likely to have a higher risk of T2DM (ORfruit = 2.26, 95% CI = 1.69-3.06). Compared with the subjects with the lowest quartile of Low Bound Score (LBS) or Diet Quality Distance (DQD), the individuals with Q2 and Q3 level of LBS (ORQ2 = 1.40, 95% CI = 1.03-1.90, P = .033; ORQ3 = 1.52, 95% CI = 1.11-2.08, P < .01) or DQD (ORQ2 = 1.45, 95% CI = 1.06-1.99, P = .021; ORQ3 = 1.64, 95% CI = 1.20-2.24, P < .01) showed increased risk of T2DM with a nonlinear association observed by RCS analysis. We concluded that imbalanced dietary intake, especially insufficient daily fruit intake, might predict an increased risk of T2DM in the middle-aged and elderly Chinese.

Whole milk dairy foods and cardiometabolic health: dairy fat and beyond

Bovine dairy milk is a nutrient-rich matrix, but consumption of full-fat dairy food varieties has been claimed historically to be associated with poorer cardiometabolic health, a notion often attributed to the saturated fat content. However, continued investigation that includes observational studies and randomized controlled trials (RCTs) provide evidence that favorably supports full-fat dairy foods and their bioactive components on cardiometabolic health. This review addresses this controversy by examining the evidence surrounding full-fat dairy foods and their implications for human health. Dairy foods are heterogeneous, not just in their fat content but also in other compositional aspects within and between fermented (e.g., yogurt, cheese) and nonfermented products (e.g., milk) that could differentially influence cardiometabolic health. Drawing from complementary lines of evidence from epidemiological studies and RCTs, this review describes the health effects of dairy foods regarding their fat content, as well as their polar lipids that are concentrated in the milk fat globule fraction. Observational studies have limitedly supported the consumption of full-fat dairy to protect against cardiometabolic disorders. However, this framework has been disputed by RCTs indicating that dairy foods, regardless of their fat content or fermentation, are not detrimental to cardiometabolic health and may instead alleviate certain cardiometabolic risk factors. As dietary recommendations evolve, which currently indicate to avoid full-fat dairy foods, it is essential to consider the totality of evidence, especially from RCTs, while also recognizing that investigation is needed to evaluate the complexity of dairy foods within diverse dietary patterns and their impacts on cardiometabolic health.

Dairy product consumption and type 2 diabetes in an Argentinian population: is there an association?

Introduction

Introduction: dairy products have long been recommended as part of a healthy eating plan, but there is a controversial opinion about whether or not they should be included in the diet of people with type 2 diabetes (T2D). Objective: the aim of this study was to know if there is an association between the intake of total dairy and dairy subgroups and the chance of having T2D, and the status of markers of glucose metabolism. Methods: three hundred and forty-two adult subjects participated in the study. A validated food-frequency questionnaire was applied to establish the dairy intake. Clinical-pathological and anthropometric variables (height, weight, waist circumference and serum concentrations of blood glucose, glycated hemoglobin [HbA1c], high sensitive C-reactive protein [hs-CRP], tumor necrosis factor alpha [TNFα], interleukin [IL] 6 and IL-10) were measured. Consumption tertiles were calculated for each dairy subgroup. Correlation coefficients, multiple linear regression models and logistic regression models were used to assess the relation between dairy product consumption and markers of glucose metabolism. Results: a negative correlation was observed between the consumption of fermented dairy products and IL-10 (r = -0.27, p = 0.0206). Fermented dairy products were inversely associated with blood glucose, and HbA1c. Total dairy intake was positively associated with a lower chance of having diabetes in tertiles 2 and 3 of consumption, in relation to the reference tertile, adjusted for age, smoking habit, and alcohol intake, body mass index (BMI) and dietary variables. Conclusions: with this study, we broaden our understanding of the role of dairy intake in diabetes risk. However, more long-term studies are needed to confirm the associations and explore different confounding factors.

Adherence to the EAT-Lancet diet in midlife and development in weight or waist circumference after five years in a Danish cohort

Purpose

The EAT-Lancet reference diet has been proposed as a healthy dietary pattern to reduce food-related climate impacts, but little is known regarding associations with bodyweight development. This study investigated adherence to the EAT-Lancet diet in midlife and development in weight and waist circumference (WC) after five years.

Design

The Danish Diet, Cancer and Health cohort recruited participants in 1993-1997. At baseline, data on diet, lifestyle, and anthropometry were collected. Participants self-reported weight and WC five years later. In total, 44,194 participants were included in analyses of weight (43,678 for WC). Baseline adherence to the EAT-Lancet diet was scored 0-14 points. Multiple linear regression was used to estimate associations between the EAT-Lancet diet and development in weight and WC after five years. Poisson regression was used to estimate risk ratios (RR) of obesity (≥30 kg/m2) or elevated WC.

Results

Adherence to the EAT-Lancet diet was not associated with follow-up weight, adjusting for baseline weight and confounders (11-14 vs 0-7 points β: -0.08, 95% CI: -0.27, 0.11 kg), but was associated with lower follow-up WC adjusting for baseline WC and confounders (β: -0.38, 95% CI: -0.69, -0.07 cm), and was associated with lower risk of obesity and elevated WC (RR 0.89, 95% CI: 0.82, 0.98, and 0.95, 95% CI: 0.93, 0.96, respectively).

Conclusion

Adherence to the EAT-Lancet diet in midlife was associated with lower WC but not weight after five years follow up, taking baseline into account. Our findings suggest that greater adherence to the EAT-Lancet diet does not contribute to development of obesity.

Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies

BACKGROUND

There is growing evidence that substituting animal-based with plant-based foods is associated with a lower risk of cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality. Our aim was to summarize and evaluate the evidence for the substitution of any animal-based foods with plant-based foods on cardiometabolic health and all-cause mortality in a systematic review and meta-analysis.

METHODS

We systematically searched MEDLINE, Embase, and Web of Science to March 2023 for prospective studies investigating the substitution of animal-based with plant-based foods on CVD, T2D, and all-cause mortality. We calculated summary hazard ratios (SHRs) and 95% confidence intervals (95% CI) using random-effects meta-analyses. We assessed the certainty of evidence (CoE) using the GRADE approach.

RESULTS

In total, 37 publications based on 24 cohorts were included. There was moderate CoE for a lower risk of CVD when substituting processed meat with nuts [SHR (95% CI): 0.73 (0.59, 0.91), n = 8 cohorts], legumes [0.77 (0.68, 0.87), n = 8], and whole grains [0.64 (0.54, 0.75), n = 7], as well as eggs with nuts [0.83 (0.78, 0.89), n = 8] and butter with olive oil [0.96 (0.95, 0.98), n = 3]. Furthermore, we found moderate CoE for an inverse association with T2D incidence when substituting red meat with whole grains/cereals [0.90 (0.84, 0.96), n = 6] and red meat or processed meat with nuts [0.92 (0.90, 0.94), n = 6 or 0.78 (0.69, 0.88), n = 6], as well as for replacing poultry with whole grains [0.87 (0.83, 0.90), n = 2] and eggs with nuts or whole grains [0.82 (0.79, 0.86), n = 2 or 0.79 (0.76, 0.83), n = 2]. Moreover, replacing red meat for nuts [0.93 (0.91, 0.95), n = 9] and whole grains [0.96 (0.95, 0.98), n = 3], processed meat with nuts [0.79 (0.71, 0.88), n = 9] and legumes [0.91 (0.85, 0.98), n = 9], dairy with nuts [0.94 (0.91, 0.97), n = 3], and eggs with nuts [0.85 (0.82, 0.89), n = 8] and legumes [0.90 (0.89, 0.91), n = 7] was associated with a reduced risk of all-cause mortality.

CONCLUSIONS

Our findings indicate that a shift from animal-based (e.g., red and processed meat, eggs, dairy, poultry, butter) to plant-based (e.g., nuts, legumes, whole grains, olive oil) foods is beneficially associated with cardiometabolic health and all-cause mortality.

A Mediterranean Diet May Be Protective in the Development of Diabetic Retinopathy

The Mediterranean diet is recognized as one of the healthiest available dietary patterns. This perception results from its beneficial effects on the cardiovascular system and, also, on hypertension, diabetes, and cancer compared with other diets. Its impact on the course of diabetes is assessed in the available scientific literature; however, little information is available about its impact on diabetic retinopathy. The MD is characterized mainly by the consumption of fish, seafood, foods of plant origin, and fresh fruit and vegetables. It is also recommended to consume legumes, which are a source of folic acid, magnesium, iron, and dietary fiber. High consumption of nuts and unrefined grains is also recommended in the MD. Marine fish provide polyunsaturated acids from the omega-3 group. Olive oil plays a very important role, especially olive oil obtained from mechanical pressing. Additionally, olive oil contains vitamins E, K, and polyphenols. Polyphenols, which are present in a diverse range of vegetables, fruits, and seeds, have the ability to decrease oxidative stress, inflammation, and insulin resistance. Resveratrol is naturally found in grape skins and seeds, as well as in peanuts and berries, and is a constituent of red wine. Resveratrol can inhibit increased vascular leakage and loss of pericytes and regulate the level of VEGF protein in the retina, thus inhibiting the development of DR. Consumption of fruits, vegetables, fish, and olive oil may be correlated with a lower risk of diabetic retinopathy. This paper presents the definition of the Mediterranean diet and its influence on the course of diabetes and diabetic retinopathy.

UHPLC-Q-Orbitrap-Based Integrated Lipidomics and Proteomics Reveal Propane-1,2-diol Exposure Accelerating Degradation of Lipids via the Allosteric Effect and Reducing the Nutritional Value of Milk

The scandal of detecting the flavoring solvent propane-1,2-diol (PD) in milk has brought a crisis to the trust of consumers in the dairy industry, while its deposition and transformation are still indistinct. Pseudo-targeted lipidomics revealed that PD accelerated the degradation of glycerolipid (33,638.3 ± 28.9 to 104,54.2 ± 28.4 mg kg^-1), phosphoglyceride (467.4 ± 8.2 to 56.6 ± 4.2 mg kg^-1), and sphingolipids (11.4 ± 0.3 to 0.7 ± 0.2 mg kg^-1), which extremely decreased the milk quality. Recoveries and relative standard deviations (RSDs) of the established method were 85.0-109.9 and 0.1-14.9%, respectively, indicating that the approach was credible. Protein-lipid interactions demonstrated that 10 proteins originating from fat globules were upregulated significantly and the activities of 7 enzymes related to lipid degradation were improved. Diacylglycerol cholinephosphotransferase was the only enzyme with decreased activity, and the molecular docking results indicated that PD adjusted its activity through regulating the conformation of the active center and weakening the hydrogen bond force between the enzyme and substrate. This study firstly revealed the mechanism of deposition and transformation of PD in milk, which contributed to the knowledge on the milk quality control and provided key indicators to evaluate the adverse risks of PD in dairy products.

Dairy matrix: is the whole greater than the sum of the parts?

Dairy foods are a heterogeneous group of products that vary in physical state and structure; profile and amounts of essential nutrients, bioactive ingredients, and other constituents; the extent of alteration of these constituents by processing, whether they are fermented or aged; and addition of constituents during manufacture. The complexity of the dairy matrix is associated with a heterogeneous impact on health outcomes from increased, decreased, or neutral effects for specific dairy products and specific health outcomes. Researchers must become more nuanced and systematic in their study of the role of dairy products in health to develop meaningful dietary recommendations. This review of the evidence for the dairy matrix and health points out the dearth of randomized controlled trials and of mechanistic insights. The variable effects of dairy-product consumption on health suggest possibilities for personalized nutrition advice.