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Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries

Bhavadharini B 1 , Dehghan M 1 , Mente A 2 , Rangarajan S 1 , Sheridan P 1 , Mohan V 3 Show all authors , Iqbal R 4 , Gupta R 5 , Lear S 6 , Wentzel-Viljoen E 7 , Avezum A 8 , Lopez-Jaramillo P 9 , Mony P 10 , Varma RP 11 , Kumar R 12 , Chifamba J 13 , Alhabib KF 14 , Mohammadifard N 15 , Oguz A 16 , Lanas F 17 , Rozanska D 18 , Bengtsson Bostrom K 19 , Yusoff K 20 , Tsolkile LP 21 , Dans A 22 , Yusufali A 23 , Orlandini A 24 , Poirier P 25 , Khatib R 26 , Hu B 27 , Wei L 28 , Yin L 27 , Deeraili A 29 , Yeates K 30 , Yusuf R 31 , Ismail N 32 , Mozaffarian D 33 , Teo K 1 , Anand SS 1 , Yusuf S 1

Affiliations 

  • 1 Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
  • 2 Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada andrew.mente@phri.ca
  • 3 Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
  • 4 Aga Khan University, Karachi, Pakistan
  • 5 Preventive Cardiology, Eternal Heart Care Centre & Research Institute, Jaipur, Rajasthan, India
  • 6 Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
  • 7 North-West University, Potchefstroom, South Africa
  • 8 Research Division, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
  • 9 University of Santander, Bucaramanga, Colombia
  • 10 St John's Medical College & Research Institute, Bengaluru, Karnataka, India
  • 11 Achutha Menon Centre for Health Science Studies, Thiruvananthapuram, Kerala, India
  • 12 Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • 13 University of Zimbabwe, Harare, Zimbabwe
  • 14 King Saud University, Riyadh, Riyadh Province, Saudi Arabia
  • 15 Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
  • 16 Internal Medicine, Goztepe Training and Research Hospital, Istanbul, Marmara, Turkey
  • 17 Universidad de La Frontera, Temuco, Chile
  • 18 Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland
  • 19 University of Gothenburg, Goteborg, Sweden
  • 20 Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
  • 21 University of the Western Cape, Bellville, South Africa
  • 22 University of the Philippines System, Quezon City, Metro Manila, Philippines
  • 23 Dubai Health Authority, Dubai, UAE
  • 24 Estudios Clinicos Latino America, Rosario, Argentina
  • 25 Cardiology, Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec City, Quebec, Canada
  • 26 Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  • 27 Peking Union Medical College School of Basic Medicine, Beijing, China
  • 28 Medical Research & Biometrics Center, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Xicheng District, Beijing, China
  • 29 Xinjiang Uighur Autonomous Region Center for Disease Control and Prevention, Wulumuqi, Xinjiang, China
  • 30 Queen's University, Kingston, Ontario, Canada
  • 31 Independent University, Dhaka, Bangladesh
  • 32 Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
  • 33 Tufts Friedman School of Nutrition Science & Policy, Boston, Massachusetts, USA
BMJ Open Diabetes Res Care, 2020 04;8(1).
PMID: 32423962 DOI: 10.1136/bmjdrc-2019-000826

Abstract

OBJECTIVE: Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.

METHODS: The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes).

RESULTS: In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake; OR 0.76, 95% CI 0.71 to 0.80, p-trend<0.0001) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone (OR 0.72, 95% CI 0.66 to 0.78, p-trend<0.0001), or consumed jointly with low fat dairy (OR 0.89, 95% CI 0.80 to 0.98, p-trend=0.0005), were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS (OR 1.03, 95% CI 0.77 to 1.38, p-trend=0.13). In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension (HR 0.89, 95% CI 0.82 to 0.97, p-trend=0.02) and diabetes (HR 0.88, 95% CI 0.76 to 1.02, p-trend=0.01). Directionally similar associations were found for whole fat dairy versus each outcome.

CONCLUSIONS: Higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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