TY - JOUR
T1 - Associations of dairy intake with glycemia and insulinemia, independent of obesity, in Brazilian adults
T2 - The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
AU - Drehmer, Michele
AU - Pereira, Mark A.
AU - Schmidt, Maria Inês
AU - Molina, Maria Del Carmen B.
AU - Alvim, Sheila
AU - Lotufo, Paulo A.
AU - Duncan, Bruce B.
N1 - Publisher Copyright:
© 2015 American Society for Nutrition.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background: Inverse associations between dairy intake and the risk of type 2 diabetes have been shown, but more studies are needed, especially from low- and middle-income countries. Objective: The objective was to describe the association between dairy products and direct measures of glycemic status in adults without known diabetes. Design: The Brazilian Longitudinal Study of Adult Health (ELSABrasil) includes 15,105 adults, aged 35-74 y, enrolled from universities and research institutions in 6 Brazilian capital cities. We excluded participants with a known diabetes diagnosis, cardiovascular diseases, and cancer. Dairy consumption was assessed by a food-frequency questionnaire, and we computed servings per day for total and subgroups of dairy. Associations with fasting blood glucose (FG) and fasting insulin, 2-h postload glucose (PG), 2-h postload insulin (PI), glycated hemoglobin (Hb A1c), and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed through multivariable linear regression analysis with adjustment for demographic characteristics, behavioral risk factors, other dietary factors, and anthropometric measurements. Results: The sample size after exclusions was 10,010. The intake of total dairy was inversely associated with FG (linear β for dairy servings/d = -0.46 ± 0.2 mg/dL), PG (-1.25 ± 0.5 mg/dL), PI (-1.52 ± 0.6 mg/dL), Hb A1c (-0.02 ± 0.0%), and HOMA-IR (-0.04 ± 0.0) after adjustment for all covariates (P < 0.05 for all). The findings were consistent across categories of sex, race, obesity status, and dairy fat amount (reduced-fat vs. full-fat dairy). Fermented dairy products showed particularly strong inverse associations with the outcomes, with adjusted differences for a 1-serving/ d increment of -0.24 (95% CI: -0.46, -0.02) mg/dL for FG, -0.86 (-1.42, -0.30) mg/dL for PG, and -0.01% (-0.02%, 0.00%) for Hb A1c. Myristic acid was the only nutrient that appeared to mediate the association between dairy intake and glycemia. Conclusion: Dairy intake, especially fermented dairy, was inversely associated with measures of glycemia and insulinemia in Brazilian adults without diagnosed diabetes.
AB - Background: Inverse associations between dairy intake and the risk of type 2 diabetes have been shown, but more studies are needed, especially from low- and middle-income countries. Objective: The objective was to describe the association between dairy products and direct measures of glycemic status in adults without known diabetes. Design: The Brazilian Longitudinal Study of Adult Health (ELSABrasil) includes 15,105 adults, aged 35-74 y, enrolled from universities and research institutions in 6 Brazilian capital cities. We excluded participants with a known diabetes diagnosis, cardiovascular diseases, and cancer. Dairy consumption was assessed by a food-frequency questionnaire, and we computed servings per day for total and subgroups of dairy. Associations with fasting blood glucose (FG) and fasting insulin, 2-h postload glucose (PG), 2-h postload insulin (PI), glycated hemoglobin (Hb A1c), and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed through multivariable linear regression analysis with adjustment for demographic characteristics, behavioral risk factors, other dietary factors, and anthropometric measurements. Results: The sample size after exclusions was 10,010. The intake of total dairy was inversely associated with FG (linear β for dairy servings/d = -0.46 ± 0.2 mg/dL), PG (-1.25 ± 0.5 mg/dL), PI (-1.52 ± 0.6 mg/dL), Hb A1c (-0.02 ± 0.0%), and HOMA-IR (-0.04 ± 0.0) after adjustment for all covariates (P < 0.05 for all). The findings were consistent across categories of sex, race, obesity status, and dairy fat amount (reduced-fat vs. full-fat dairy). Fermented dairy products showed particularly strong inverse associations with the outcomes, with adjusted differences for a 1-serving/ d increment of -0.24 (95% CI: -0.46, -0.02) mg/dL for FG, -0.86 (-1.42, -0.30) mg/dL for PG, and -0.01% (-0.02%, 0.00%) for Hb A1c. Myristic acid was the only nutrient that appeared to mediate the association between dairy intake and glycemia. Conclusion: Dairy intake, especially fermented dairy, was inversely associated with measures of glycemia and insulinemia in Brazilian adults without diagnosed diabetes.
KW - Cohort studies
KW - Dairy products
KW - Glycemia
KW - Insulinemia
KW - Obesity
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U2 - 10.3945/ajcn.114.102152
DO - 10.3945/ajcn.114.102152
M3 - Article
C2 - 25833975
AN - SCOPUS:84929658357
VL - 101
SP - 775
EP - 782
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 4
ER -