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

• Published in: BMJ open diabetes research & care Vol. 8; no. 1; p. e000826
• Main Authors: Bhavadharini, Balaji, Dehghan, Mahshid, Mente, Andrew, Rangarajan, Sumathy, Sheridan, Patrick, Mohan, Viswanathan, Iqbal, Romaina, Gupta, Rajeev, Lear, Scott, Wentzel-Viljoen, Edelweiss, Avezum, Alvaro, Lopez-Jaramillo, Patricio, Mony, Prem, Varma, Ravi Prasad, Kumar, Rajesh, Chifamba, Jephat, Alhabib, Khalid F, Mohammadifard, Noushin, Oguz, Aytekin, Lanas, Fernando, Rozanska, Dorota, Bengtsson Bostrom, Kristina, Yusoff, Khalid, Tsolkile, Lungiswa P, Dans, Antonio, Yusufali, Afzalhussein, Orlandini, Andres, Poirier, Paul, Khatib, Rasha, Hu, Bo, Wei, Li, Yin, Lu, Deeraili, Ai, Yeates, Karen, Yusuf, Rita, Ismail, Noorhassim, Mozaffarian, Dariush, Teo, Koon, Anand, Sonia S, Yusuf, Salim
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2020; BMJ Publishing Group
• Subjects: adult diabetes; Antihypertensives; Apolipoproteins; Blood pressure; Butter; Cardiovascular disease; Cholesterol; Dairy products; Diabetes; diet; dose-response metaanalysis; endocrinology; Endocrinology & Metabolism; Endocrinology and Diabetes; Endokrinologi och diabetes; Epidemiology/Health Services Research; Fasting; Glucose; Hypertension; Laboratories; life-style; low-income countries; Metabolic syndrome; Milk; nutrients; nutrition; prevention; pure; Questionnaires; risk; Triglycerides; Yogurt; South America; Canada; Sweden; Turkey; Europe; China; Africa; Malaysia; North America; India; nutrition; hypertension; adult diabetes; endocrinology
• ISSN: 2052-4897; 2052-4897
• DOI: 10.1136/bmjdrc-2019-000826

ObjectiveOur 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.MethodsThe 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).ResultsIn 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.ConclusionsHigher 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.