Table 3. Summary of prospective cohort studies examining associations between dairy fat intake and T2DM (n=10).

Study / Location / Study population / Follow-up / Dairy Fat Intake Measures (Definitions) / Outcomes / Dietary Assessment Methods / Adjustments / Significant Findings / Conclusions
Duffey et al, 201028 / USA / 2,774 men and women (18-30 y old) / 20y / Whole milk and low-fat milk (skim/1%/2%) / Metabolic syndrome, central adiposity (waist circumference), hypertension, high triglycerides, high LDL, and low HDL / Semi-quantitative, interviewer-administered, validated FFQ / Age, sex, race, exam center, weight, smoking status, energy from food, total physical activity, intakes of energy from: fruit juice, sugar sweetened beverages, milk and alcohol / The relative risk of high triglycerides was 0.91 for each quartile increase in whole-fat milk consumption with an overall inversely correlated trend (p<.05) / Whole-fat milk intake was associated with reduced incidence of high triglycerides. There were no other significant relationships between milk intake and outcomes of interest.
Grantham et al, 201329 / Australia / 5,582 men and women (≥25 years old) / 5y / Full-fat milk and low-fat milk / T2DM / 121 item FFQ / Age, sex, total energy intake, family history of diabetes, education, physical activity, smoking status, fasting serum triglycerides, HDL, SBP, waist circumference and hip circumference / The odds of T2DM was .65 times lower for adults who consumed the highest tertile of low-fat milk compared to the lowest (95% Cl: .44, .94) / High intakes of low-fat milk were associated with reduced risk of T2DM.
Louie et al, 201332 / Australia / 1,824 men and women (≥49 y old) / 10y / High-fat dairy (regular milk/cheese, medium-fat dairy dessert) and low-fat dairy (reduced-fat/skim milk, reduced-fat dairy dessert, low-fat cheese) / T2DM, metabolic syndrome / 145 item, semi-qualitative FFQ / Age, sex, smoking status, physical activity, dietary glycemic load, fiber from vegetables, total energy and calcium intake, and family history of diabetes / The odds of metabolic syndrome were 2.01 times higher for those in the highest quartile of low-fat dairy intake compared to those in the lowest with an overall positively correlated trend (p<.05), conversely, those in the highest quartile of high-fat dairy intake had .41 times the odds of metabolic syndrome compared to those in the lowest quartile with an overall negatively correlated trend (p<.001) / High fat dairy intake was inversely associated with metabolic syndrome while low fat dairy was positively associated with metabolic syndrome. No associations were found between either low-fat or full-fat dairy intake and T2DM.
Malik et al, 201133 / USA / 37,038 women (24–42 y old) / 10y / High-fat dairy (whole milk/chocolate milk, cream/other cheese, ice cream, milkshakes, butter) and low-fat dairy (skim milk/chocolate milk, sherbet, yogurt, instant breakfast, cottage/ricotta cheese) / T2DM / 124-item FFQ / Age, BMI, total energy intake, family history of diabetes, smoking status, physical activity, alcohol consumption, oral contraceptive use, hormone replacement therapy, PUFA: SFA ratio, glycemic load, cereal fiber, coffee intake, trans fat intake, processed meat intake, carbonated soft drinks intake, fruit drinks intake, mutual adjustment: high- and low-fat dairy products / The relative risk of T2DM in women who were in the highest quartile of high-fat dairy intake was .72 compared to those in the lowest quartile with an overall inversely correlated trend (p<.05),there was a similar overall trend between higher intakes of low-fat dairy and T2DM (p<.05) / High intakes of both high-fat and low-fat dairy reduced the risk of T2DM.
Margolis et al, 201134 / USA / 82,076 women (50-79 y old) / 8y / High-fat dairy (whole/2% milk, regular cheese/cottage cheese/yogurt, cream soups, ice cream, pudding, custard, flan) and low-fat dairy (skim/1% milk, low-fat cottage cheese, part-skim/reduced-fat cheese, nonfat yogurt, low-fat/nonfat frozen desserts) / T2DM / 122 item FFQ / Age, ethnicity, energy, income, education, smoking status, alcohol use, family history of diabetes, hormone replacement therapy, SBP, DBP, BMI, physical activity, glycemic load, fiber, magnesium, calcium, vitamin D, fruit juice, sugar-sweetened beverages, BMI x low-fat dairy intake / The relative risk of T2DM for women in the highest quintile of low-fat dairy intake was .65 with an overall inversely related trend (p<.01) and a significant interaction between BMI and dairy intake. / Greater low-fat dairy intake was associated with reduced risk of T2DM, especially among women with higher BMI.
Mozaffarian et al, 201335 / USA / 2,617 men and women (45-84 y old) / 14y / Serum trans-palmitoleic acid / T2DM, LDL, HDL, triglycerides, total:HDL, FPG, fasting insulin, SBP, DBP / blood assay / Age, sex, race/ethnicity, adiposity, alcohol intake, consumption of fruit, vegetables, and whole grains, use of lipid-lowering and antihypertensive medications, field center, education, smoking, physical activity, BMI, waist circumference, consumption of whole-fat dairy, low-fat dairy, red meat, and total energy intake / The relative risk of T2DM was .52 among those in the highest quintile of serum trans-palmitoleic acid compared to those in the lowest quintile with an overall inversely correlated trend (p<.05) / Trans-palmitoleic acid was associated with reduced risk of T2DM.
Sluijs et al, 201236* / Western Europeⱡ / 24,475 men and women (35-74 y old) / 5y / Cheese / T2DM / semi-qualitative FFQ and 24 hour recall (8% of N) / Age, sex, BMI, diabetes risk factors, education, smoking status, physical activity, alcohol intake, energy intake, energy-adjusted intakes of fruits and vegetables, red meat, processed wheat, sugar-sweetened beverages, coffee, cereal and cereal products, calcium, magnesium, and vitamin D / The relative risk of T2DM was .83 among those in the highest quintile of cheese intake compared to those in the lowest quintile with an overall inversely correlated trend (p<.01) / Cheese intake was inversely related to T2DM.
Soedamah-Muthu et al, 201237 / England / 4,526 men and women (33-55 y old) / 10y / High-fat dairy (full-fat cheese, yogurt, milk puddings, whole/Channel Islands milk) and low-fat dairy (cottage cheese, semi-skimmed/skimmed milk, milk-based hot drinks) / T2DM, CVD (myocardial infarction) / 114 item FFQ / Age, ethnicity, employment grade, smoking status, BMI, physical activity, family history, alcohol intake, intakes of: fruits, vegetables, bread, meat, fish, coffee, tea and total energy / Intakes of total dairy and types of dairy products showed no consistent relationship with incident diabetes or coronary heart disease
Struijk et al, 201339 / Denmark / 5,953 men and women (30-60 y old) / 5y / High-fat dairy (whole milk/milk products ≥2% fat, cheese ≥20% fat) and low-fat dairy (milk/milk products <2% fat, cheese <20% fat) / T2DM, FPG, 2hPG, HbA1c, HOMA2-B, HOMA2-IR / 198 item FFQ / Age, sex, family history of diabetes, education level, physical activity, smoking status, alcohol intake, intake of: whole grain cereal, meat, fish, coffee, tea, fruit, vegetables, energy, changes in baseline diet, and waist circumference / No association between risk of T2DM (or biomarkers of risk) and high-fat or low-fat dairy intake. / There was no association between risk of T2DM (or biomarkers of risk) and high-fat or low-fat dairy intake.
Von Ruesten et al, 201340 / Germany / 23,531 men and women (35-63 y old) / 8y / High-fat dairy (milk/yogurt >1.5% fat, regular curd cheese, cream) and low-fat dairy (milk/yogurt ≤1.5% fat, soured milk, low-fat curd cheese) / CVD (myocardial infarction and stroke), T2DM / 148 item FFQ / Age, sex, smoking status, pack-years of smoking, alcohol intake, physical activity, BMI, waist to hip ratio, hypertension, high blood lipids, education, vitamin supplementation, total energy intake, other food groups / No association between risk of CVD or T2DM and high-fat or low-fat dairy intake. / There was no association between risk of T2DM or CVD and high-fat or low-fat dairy intake.
ⱡNetherlands, Greece, Germany, Sweden, Denmark, Norway, United Kingdom, Spain, Italy
Abbreviations: CVD, cardiovascular disease; T2DM, type II diabetes mellitus; LDL, low-density lipoprotein cholesterol; HDL, high-density lipoprotein cholesterol; total:HDL, ratio total cholesterol to HDL; FPG, fasting plasma glucose; 2hPG, 2-hour plasma glucose; HbA1c, hemoglobin A1c; HOMA2-B, homeostatic model assessment of beta-cell function; HOMA2-IR, homeostatic model assessment of insulin resistance; SBP, systolic blood pressure; DBP, diastolic blood pressure; FFQ, food frequency questionnaire; BMI, body mass index; PUFA:SFA ratio, ratio of polyunsaturated fatty acids to saturated fatty acids.

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