Higher Intake of Dairy Is Associated with Lower Cardiometabolic Risks and Metabolic Syndrome in Asian Indians

There is conflicting evidence about the association between dairy products and cardiometabolic risk (CMR). We aimed to assess the association of total dairy intake with CMR factors and to investigate the association of unfermented and fermented dairy intake with CMR in Asian Indians who are known to have greater susceptibility to type 2 diabetes and cardiovascular diseases compared to white Europeans. The study comprised 1033 Asian Indian adults with normal glucose tolerance chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a validated open-ended semi-quantitative food frequency questionnaire. Metabolic syndrome (MS) was diagnosed based on the new harmonising criteria using central obesity, dyslipidaemia [low high-density lipoprotein cholesterol (HDL) and increased serum triglycerides (TG)], hypertension and glucose intolerance. Increased consumption of dairy (≥5 cups per day of total, ≥4 cups per day of unfermented or ≥2 cups per day of fermented dairy) was associated with a lower risk of high fasting plasma glucose (FPG) [hazards ratio (HR), 95% confidence interval (CI): 0.68, 0.48–0.96 for total dairy; 0.57, 0.34–0.94 for unfermented dairy; and 0.64, 0.46–0.90 for fermented dairy; p < 0.05 for all] compared to a low dairy intake (≤1.4 cups per day of total dairy; ≤1 cup per day of unfermented dairy; and ≤0.1 cup per day of fermented dairy). A total dairy intake of ≥5 cups per day was also protective against high blood pressure (BP) (HR: 0.65, 95% CI: 0.43–0.99, p < 0.05), low HDL (HR: 0.63, 95% CI: 0.43–0.92, p < 0.05) and MS (HR: 0.71, 95% CI: 0.51–0.98, p < 0.05) compared to an intake of ≤1.4 cups per day. A high unfermented dairy intake (≥4 cups per day) was also associated with a lower risk of high body mass index (BMI) (HR: 0.52, 95% CI: 0.31–0.88, p < 0.05) compared to a low intake (≤1 cup per day), while a reduced risk of MS was observed with a fermented dairy intake of ≥2 cups per day (HR: 0.71, 95% CI: 0.51–0.98, p < 0.05) compared to an intake of ≤0.1 cup per day. In summary, increased consumption of dairy was associated with a lower risk of MS and components of CMR.

[1]  T. Spector,et al.  Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome , 2022, BMC microbiology.

[2]  T. Wilsgaard,et al.  Associations Between Intake of Fermented Dairy Products and Blood Lipid Concentrations Are Affected by Fat Content and Dairy Matrix – The Tromsø Study: Tromsø7 , 2021, Frontiers in Nutrition.

[3]  M. Elias,et al.  Higher yogurt intake is associated with lower blood pressure in hypertensive individuals: Cross-sectional findings from the Maine-Syracuse Longitudinal study. , 2021, International dairy journal.

[4]  V. Mohan,et al.  Lower Dietary Intake of Plant Protein Is Associated with Genetic Risk of Diabetes-Related Traits in Urban Asian Indian Adults , 2021, Nutrients.

[5]  K. Lim,et al.  Association of metabolic syndrome with risk of cardiovascular disease mortality and all-cause mortality among Malaysian adults: a retrospective cohort study , 2021, BMJ Open.

[6]  Yue Liu,et al.  Impact of Metabolic Syndrome and It's Components on Prognosis in Patients With Cardiovascular Diseases: A Meta-Analysis , 2021, Frontiers in Cardiovascular Medicine.

[7]  E. Hyppönen,et al.  Evidence for a causal association between milk intake and cardiometabolic disease outcomes using a two-sample Mendelian Randomization analysis in up to 1,904,220 individuals , 2021, International Journal of Obesity.

[8]  S. Rajaa,et al.  Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis , 2020, PloS one.

[9]  J. Lovegrove,et al.  Interaction between the genetic risk score and dietary protein intake on cardiometabolic traits in Southeast Asian , 2020, Genes & nutrition.

[10]  D. Mozaffarian,et al.  Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries , 2020, BMJ Open Diabetes Research & Care.

[11]  Xiyi Wang,et al.  Comparative study on prevalence of metabolic syndrome based on three criteria among adults in Zhejiang province, China: an observational study , 2020, BMJ Open.

[12]  K. S. Vimaleswaran A nutrigenetics approach to study the impact of genetic and lifestyle factors on cardiometabolic traits in various ethnic groups: findings from the GeNuIne Collaboration , 2020, Proceedings of the Nutrition Society.

[13]  J. Tuomilehto,et al.  The metabolic syndrome – What is it and how should it be managed? , 2019, European journal of preventive cardiology.

[14]  M. Melamed,et al.  The Effects of Dairy Intake on Insulin Resistance: A Systematic Review and Meta-Analysis of Randomized Clinical Trials , 2019, Nutrients.

[15]  A. Koulman,et al.  Fermentation of Milk into Yoghurt and Cheese Leads to Contrasting Lipid and Glyceride Profiles , 2019, Nutrients.

[16]  V. Mohan,et al.  Association of whole grains, dairy and dietary fibre with neonatal outcomes in women with gestational diabetes mellitus: The WINGS project (WINGS – 12) , 2019, Journal of Diabetology.

[17]  Jianwen Cai,et al.  Tests of trend between disease outcomes and ordinal covariates discretized from underlying continuous variables: simulation studies and applications to NHANES 2007–2008 , 2019, BMC Medical Research Methodology.

[18]  J. Swinnen,et al.  Technology adoption and value chains in developing countries: Evidence from dairy in India , 2017, Food Policy.

[19]  International Institute for Population Sciences (IIPS) , 2019, The Grants Register 2022.

[20]  A. Marette,et al.  Novel perspectives on fermented milks and cardiometabolic health with a focus on type 2 diabetes. , 2018, Nutrition reviews.

[21]  D. Mozaffarian,et al.  Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study , 2018, The Lancet.

[22]  S. Harikrishnan,et al.  Prevalence of metabolic syndrome and its risk factors in Kerala, South India: Analysis of a community based cross-sectional study , 2018, PloS one.

[23]  F. Hu,et al.  Dairy Products, Dairy Fatty Acids, and the Prevention of Cardiometabolic Disease: a Review of Recent Evidence , 2018, Current Atherosclerosis Reports.

[24]  P. Verma,et al.  Association of Lifestyle Risk Factors with Metabolic Syndrome Components: A Cross-sectional Study in Eastern India , 2018, International journal of preventive medicine.

[25]  A. Lalchandani,et al.  Prevalence of metabolic syndrome crossing 40% in Northern India: Time to act fast before it runs out of proportions , 2018, Journal of family medicine and primary care.

[26]  V. Mohan,et al.  Interaction between TCF7L2 polymorphism and dietary fat intake on high density lipoprotein cholesterol , 2017, PloS one.

[27]  A. Tremblay,et al.  Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms. , 2017, Advances in nutrition.

[28]  Offdan Narvaez-Guerra,et al.  Discordance of metabolic syndrome and abdominal obesity prevalence according to different criteria in Andean highlanders: A community-based study. , 2017, Diabetes & metabolic syndrome.

[29]  V. Mohan,et al.  High fat diet modifies the association of lipoprotein lipase gene polymorphism with high density lipoprotein cholesterol in an Asian Indian population , 2017, Nutrition and Metabolism.

[30]  R. Ohlan Dairy Economy of India , 2016 .

[31]  V. Mohan,et al.  Interaction between FTO gene variants and lifestyle factors on metabolic traits in an Asian Indian population , 2016, Nutrition & Metabolism.

[32]  V. Mohan,et al.  Ethnic variations in diabetes and prediabetes prevalence and the roles of insulin resistance and β-cell function: The CARRS and NHANES studies , 2016, Journal of clinical & translational endocrinology.

[33]  J. Lovegrove,et al.  New perspectives on dairy and cardiovascular health , 2016, Proceedings of the Nutrition Society.

[34]  Mark A Pereira,et al.  Total and Full-Fat, but Not Low-Fat, Dairy Product Intakes are Inversely Associated with Metabolic Syndrome in Adults. , 2016, The Journal of nutrition.

[35]  J. Stamler,et al.  Association of Dietary MUFA Intake with HDL Profile Measurements in Japanese Men and Women Living in Japan and Hawaii: INTERLIPID Study. , 2015 .

[36]  Albert Koulman,et al.  Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study , 2014, The lancet. Diabetes & endocrinology.

[37]  Y. Yoon,et al.  Dairy Product Intake Is Inversely Associated with Metabolic Syndrome in Korean Adults: Anseong and Ansan Cohort of the Korean Genome and Epidemiology Study , 2013, Journal of Korean medical science.

[38]  J. Kim,et al.  Dairy food consumption is inversely associated with the risk of the metabolic syndrome in Korean adults. , 2013, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[39]  D. I. Givens,et al.  Does Dairy Food Intake Predict Arterial Stiffness and Blood Pressure in Men? Evidence from the Caerphilly Prospective Study , 2012, Proceedings of the Nutrition Society.

[40]  J. Spahn,et al.  Dairy Consumption, Blood Pressure, and Risk of Hypertension: An Evidence-Based Review of Recent Literature , 2011, Current cardiovascular risk reports.

[41]  B. Balkau,et al.  Dairy Consumption and the Incidence of Hyperglycemia and the Metabolic Syndrome , 2011, Diabetes Care.

[42]  V. Mohan,et al.  Dietary profile of urban adult population in South India in the context of chronic disease epidemiology (CURES – 68) , 2010, Public Health Nutrition.

[43]  D. Schoeller,et al.  Metabolic fate of saturated and monounsaturated dietary fats: the Mediterranean diet revisited from epidemiological evidence to cellular mechanisms. , 2009, Progress in lipid research.

[44]  F. Sacks,et al.  Dietary monounsaturated fat activates metabolic pathways for triglyceride-rich lipoproteins that involve apolipoproteins E and C-III. , 2008, The American journal of clinical nutrition.

[45]  V. Mohan,et al.  Adipocytokines and the expanding 'Asian Indian Phenotype'. , 2006, The Journal of the Association of Physicians of India.

[46]  R. Eckel,et al.  Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. , 2006, Circulation.

[47]  V. Mohan,et al.  Obesity and abdominal obesity in Asian Indians. , 2006, The Indian journal of medical research.

[48]  Lawrence A Leiter,et al.  Metabolic syndrome under fire: weighing in on the truth. , 2006, The Canadian journal of cardiology.

[49]  V. Sudha,et al.  Reproducibility and validity of an interviewer-administered semi-quantitative food frequency questionnaire to assess dietary intake of urban adults in southern India , 2006, International journal of food sciences and nutrition.

[50]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[51]  D. Lawlor,et al.  Avoiding milk is associated with a reduced risk of insulin resistance and the metabolic syndrome: findings from the British Women's Heart and Health Study , 2005, Diabetic medicine : a journal of the British Diabetic Association.

[52]  A. Hamsten,et al.  Milk-derived fatty acids are associated with a more favorable LDL particle size distribution in healthy men. , 2004, The Journal of nutrition.

[53]  V. Mohan,et al.  The Chennai Urban Rural Epidemiology Study (CURES)--study design and methodology (urban component) (CURES-I). , 2003, The Journal of the Association of Physicians of India.

[54]  P. Koskinen,et al.  Angiotensin I-converting enzyme inhibitory properties of whey protein digests: concentration and characterization of active peptides. , 2000, The Journal of dairy research.

[55]  W C Willett,et al.  Adjustment for total energy intake in epidemiologic studies. , 1997, The American journal of clinical nutrition.

[56]  E M Mathus-Vliegen,et al.  [Healthy diet]. , 1995, Nederlands tijdschrift voor tandheelkunde.

[57]  K. Ghosh,et al.  India , 1988, The Lancet.