期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 101, 期 4, 页码 775-782出版社
OXFORD UNIV PRESS
DOI: 10.3945/ajcn.114.102152
关键词
cohort studies; dairy products; glycemia; insulinemia; obesity
资金
- Brazilian Ministries of Health (Department of Science and Technology)
- Ministry of Science, Technology, and Innovation [Financiadora de Estudos e Projetos (FINEP) [01-06-0010.00, 01-06-0212.00, 01-06-0300.00, 01-06-0278.00, 01-06-0115.00, 01-06-0071.00]
- CNPq (the National Council for Scientific and Technological Development) [249320/2013-4]
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 (ELSA-Brasil) 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 A(1c)), 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 0 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 A(1c) (-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 Ale. 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 glycernia and insulinemia in Brazilian adults without diagnosed diabetes.
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