title: Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk.
abstract: OBJECTIVE
  The possible effects of dairy consumption on diabetes prevention remain controversial. The aim of this study was to investigate the association between the dairy consumption and type 2 diabetes (T2D) risk in an elderly Mediterranean population at high cardiovascular risk.
  
  
  METHODS
  We prospectively followed 3,454 non-diabetic individuals from the PREDIMED study. Dairy consumption was assessed at baseline and yearly using food frequency questionnaires and categorized into total, low-fat, whole-fat, and subgroups: milk, yogurt, cheeses, fermented dairy, concentrated full fat, and processed dairy. Hazard ratios (HRs) were calculated using Cox proportional hazards regression models.
  
  
  RESULTS
  During a median follow-up of 4.1 years, we documented 270 incident T2D cases. After multivariate adjustment, total dairy product consumption was inversely associated with T2D risk [0.68 (95% CI 0.47-0.98); P-trend = .040]. This association appeared to be mainly attributed to low-fat dairy; the multivariate HRs (95% CIs) comparing the highest versus the lowest tertile consumption were 0.65 (0.45-0.94) for low-fat dairy products and 0.67 (0.46-0.95) for low-fat milk (both P-trend <.05). Total yogurt consumption was associated with a lower T2D risk [HR 0.60 (0.42-0.86); P-trend = .002]. An increased consumption of total low-fat dairy and total yogurt during the follow-up was inversely associated with T2D; HRs were 0.50 (0.29-0.85), 0.44 (0.26-0.75), and 0.55 (0.33-0.93), respectively. Substituting one serving/day of a combination of biscuits and chocolate and whole grain biscuits and homemade pastries for one serving/day of yogurt was associated with a 40 and 45% lower risk of T2D, respectively. No significant associations were found for the other dairy subgroups (cheese, concentrated full fat, and processed dairy products).
  
  
  CONCLUSIONS
  A healthy dietary pattern incorporating a high consumption of dairy products and particularly yogurt may be protective against T2D in older adults at high cardiovascular risk.
authors: Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain.|CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
authors: Andrés
authors: A
authors: Díaz-López
authors: Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain.|CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
authors: Mònica
authors: M
authors: Bulló
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Preventive Medicine and Public Health, University of Navarra Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain.
authors: Miguel A
authors: MA
authors: Martínez-González
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain.
authors: Dolores
authors: D
authors: Corella
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors: Ramon
authors: R
authors: Estruch
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Cardiovascular Risk and Nutrition Research Group, IMIM, Barcelona, Spain.
authors: Montserrat
authors: M
authors: Fitó
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Preventive Medicine, University of Malaga, Málaga, Spain.
authors: Enrique
authors: E
authors: Gómez-Gracia
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain.
authors: Miquel
authors: M
authors: Fiol
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Primary Care Division of Sevilla, Department of Family Medicine, San Pablo Health Center, Seville, Spain.
authors: Francisco Javier
authors: FJ
authors: García de la Corte
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Lipid Clinic, Service of Endocrinology and Nutrition, Hospital Clinic, IDIBAPS, Barcelona, Spain.
authors: Emilio
authors: E
authors: Ros
authors: Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain.|CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
authors: Nancy
authors: N
authors: Babio
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors: Lluís
authors: L
authors: Serra-Majem
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Lipids and Vascular Risk Unit, Internal Medicine, Bellvitge University Hospital, Llobregat Hospitalet, Barcelona, Spain.
authors: Xavier
authors: X
authors: Pintó
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Primary Care Division, Catalan Institute of Health, IDIAP-Jordi Gol, Barcelona, Spain.
authors: Miguel Ángel
authors: MÁ
authors: Muñoz
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain.
authors: Francisco
authors: F
authors: Francés
authors: CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Department of Preventive Medicine and Public Health, University of Navarra Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain.
authors: Pilar
authors: P
authors: Buil-Cosiales
authors: Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Tarragona, Spain. jordi.salas@urv.cat.|CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. jordi.salas@urv.cat.
authors: Jordi
authors: J
authors: Salas-Salvadó
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002611:Cheese; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003611:Dairy Products; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D018752:Diet, Fat-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D008892:Milk; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D015014:Yogurt
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D014280:Triglycerides
keywords: Dairy; Older adults; PREDIMED; Type 2 diabetes; Yogurt