Dairy product consumption, calcium intakes, and metabolic syndrome-related factors over 5 years in the STANISLAS study

Levels of Essential and Trace Elements in Mozzarella Available on the Slovak Market with the Estimation of Consumer Exposure

The aim of this study was to determinate the content of some elements in a specific dairy product, mozzarella, in a particular area of western Slovakia and to evaluate the estimation of the risk to the consumers based on the contribution to the provisional tolerable weekly intake. The consumption of mozzarella can contribute to the intake of important elements in the diet, such as calcium and magnesium, along with others. The contents of some toxic and trace elements were low and have not exceeded the permitted limit. In addition, the contribution to PTWI was found to be very low, which means that the consumption of mozzarella possesses no risk to humans. It is concluded that the data obtained in this study can help as a valuable addition to methodological and scientific material in the field of food safety of dairy products and their positive impact on human health.

Comparative analysis of diets in Sioux Falls: Influence of sociodemographic characteristics, alignment to US national diet and healthy diet

Continuous examination of diets and factors that influence dietary patterns is vital to improve diet quality. The objectives of this study are to evaluate the average diet of adults in the Sioux Falls Metropolitan Statistical Area (SFMSA), USA, examining sociodemographic differences in dietary intake and compare the average diet in the SFMSA (SF Diet) to the U.S. national average and USDA healthy dietary guidelines. A cross-sectional population-based study was conducted and 127 individuals were surveyed from August 2020 to August 2021. Dietary intake was assessed using the self-reported single 24-h dietary recall method and sociodemographic questions. Main effects and first order interactions of participant sociodemographic characteristics were considered. Main findings show that men had higher intake of meat, poultry, and eggs (p < 0.05) and alcohol, particularly older men (p < 0.05), than women. Higher alcohol intake was found for participants with lower levels of income and education (p < 0.01). The intake of fish and seafood was higher for older adults with a high level of income (p < 0.01). Differences were found between the SF diet and the national average but both followed a similar trend (e.g., low in fruits and vegetables and high in solid fats) and did not meet dietary guidelines, particularly for nutrient-dense foods. The intake of total vegetables (p < 0.001) and dark green vegetables (p < 0.001) was higher in the SF Diet and the national average was higher in total grains (p < 0.05), refined grains (p < 0.01), oils and fats (p < 0.001), solid fats (p < 0.001), and added sugar (p < 0.001). By not meeting the dietary guidelines, the findings of this study raise public health concerns.

Calcium signalling in hepatic metabolism: Health and diseases

The flexibility between the wide array of hepatic functions relies on calcium (Ca2+) signalling. Indeed, Ca2+ is implicated in the control of many intracellular functions as well as intercellular communication. Thus, hepatocytes adapt their Ca2+ signalling depending on their nutritional and hormonal environment, leading to opposite cellular functions, such as glucose storage or synthesis. Interestingly, hepatic metabolic diseases, such as obesity, type 2 diabetes and non-alcoholic fatty liver diseases, are associated with impaired Ca2+ signalling. Here, we present the hepatocytes' toolkit for Ca2+ signalling, complete with regulation systems and signalling pathways activated by nutrients and hormones. We further discuss the current knowledge on the molecular mechanisms leading to alterations of Ca2+ signalling in hepatic metabolic diseases, and review the literature on the clinical impact of Ca2+-targeting therapeutics.

The relationship between the intake of fruits, vegetables, and dairy products with hypertension: findings from the STEPS study

BACKGROUND

The current research aimed to evaluate the relationship between fruit, vegetable (FV), and dairy consumption with the odds of developing hypertension based on nationwide Stepwise approach to surveillance (STEPS) data in Iran.

METHODS

This cross-sectional study was accomplished by the research center of non-communicable diseases (NCDs) in Tehran. In total, 29,378 individuals' data were analyzed. Participants were classified into normal, elevated BP, stage I, and stage II hypertension according to systolic blood pressure (SBP) and diastolic blood pressure (DBP) examinations. Based on the STEPS questionnaire, the consumption of FVs and dairy products was evaluated. Multinomial logistic regression was applied to assess the relationship between the consumption of FVs and dairy products with hypertension.

RESULTS

The findings revealed that only fruit consumption (≥ 2 servings/day) was negatively related to stage I hypertension (odds ratio (OR) = 0.81; 95% confidence interval (CI): 0.69-0.95) in two servings per day and OR = 0.81; 95% CI: 0.68-0.96 in > two servings per day) in the adjusted model. There was no significant relationship between consuming vegetables and dairy products with elevated BP and hypertension.

CONCLUSION

Our study showed that increasing fruit consumption was related to reducing hypertension odds. Regarding the consumption of dairy products and vegetables, no significant relationship was found with the odds of hypertension. More studies, especially cohorts, are needed to evaluate the impacts of FV and dairy products on the risk of hypertension.

Association between Dietary Diversity Score and Metabolic Syndrome in Korean Adults: A Community-Based Prospective Cohort Study

Dietary diversity is recognized as a key indicator of dietary quality and is known to affect the burden of non-communicable diseases. This study examined the gender-stratified association between dietary diversity score (DDS) and risk of metabolic syndrome (MetS) in 5468 adults aged 40−69 years during a 12-year follow-up of the Korean Genome and Epidemiology Study (KoGES). DDS was calculated according to the consumption of the five food groups based on the Dietary Reference Intakes (DRIs) for Koreans. The Cox proportional hazard model was used to evaluate MetS risk according to DDS. A higher DDS was negatively associated with the consumption of grains but positively associated with the consumption of fruits and non-salted vegetables. Furthermore, participants with a higher DDS showed higher consumption of fish and milk. Prospectively, a higher DDS was significantly associated with a lower risk of MetS in men (HR: 0.76, 95% CI: 0.63−0.92, p < 0.01). In all participants, a higher DDS was inversely associated with the incidence of abdominal obesity (men, HR: 0.76, 95% CI: 0.62−0.93, p < 0.01; women, HR: 0.79, 95% CI: 0.67−0.94, p < 0.01). Furthermore, men with a higher DDS had a lower risk of hypertriglyceridemia (HR: 0.83, 95% CI: 0.71−0.97, p < 0.05). These findings suggested that eating a more varied diet might have favorable effects on preventing MetS in Korean adults.

Association between frequency of dairy product consumption and hypertension: a cross-sectional study in Zhejiang Province, China

BACKGROUND

Hypertension, a well-known risk factor, contributes to millions of deaths from cardiovascular and renal diseases worldwide. However, evidence on the association between frequency of dairy product consumption and hypertension is inconsistent.

METHODS

The data for the present study are from the Tongxiang baseline dataset of the China Kadoorie Biobank prospective study. A total of 53,916 participants aged 30-79 years were included in the final analysis. Multivariable logistic regression was utilized to evaluate the association of dairy product consumption with hypertension, and multiple linear regression was conducted to assess the association of dairy product consumption with systolic and diastolic blood pressure.

RESULTS

Of the 53,916 participants, 2.6% reported consuming dairy products weekly, and 44.4% had prevalent hypertension. After adjusting for socio-demographic status, lifestyle factors, BMI, waist circumference, sleep duration and snoring, when compared with participants who never consumed dairy products, the odds ratios (95% CI) for hypertension among those consuming dairy products less than once per week, and ≥ 1 time per week were 0.85 (0.77-0.95) and 0.74 (0.65-0.84), respectively. The corresponding odds ratios (95% CI) for men were 0.85 (0.71-1.02) and 0.75 (0.61-0.92), respectively (P_trend = 0.001), and for women were 0.88 (0.76-1.01) and 0.77 (0.65-0.91), respectively. (P_trend < 0.001).

CONCLUSIONS

In this large epidemiological study, higher frequency of dairy product consumption is associated with significantly lower odds of hypertension among Chinese adults.

Healthy eating index patterns in adults by sex and age predict cardiometabolic risk factors in a cross-sectional study

BACKGROUND

Associations between diet and cardiometabolic disease (CMD) risk may vary in men and women owing to sex differences in eating habits and physiology. The current secondary analysis sought to determine the ability of sex differences in dietary patterns to discriminate groups with or without CMD risk factors (CMDrf) in the adult population and if this was influenced by age.

METHODS

Diet patterns and quality were evaluated using 24 h recall-based Healthy Eating Index (HEI-2015) in free-living apparently healthy men (n = 184) and women (n = 209) 18-65 y of age with BMIs of 18-44 kg/m2. Participants were stratified into low- and high-CMDrf groups based on the presence/absence of at least one CMDrf: BMI > 25 kg/m2; fasting triglycerides > 150 mg/dL; HDL cholesterol < 50 mg/dL-women or < 40 mg/dL-men; HOMA > 2; HbA1c > 5.7. Sex by age dietary patterns were stratified by multivariate analyses, with metabolic variable associations established by stepwise discriminant analysis.

RESULTS

Diet quality increased with age in both sexes (P < 0.01), while women showed higher fruit, vegetable and saturated fat intake as a percentage of total energy (P < 0.05). The total-HEI score (i.e. diet quality) was lower in the high-CMDrf group (P = 0.01), however, diet quality parameters predicted CMDrf presence more accurately when separated by sex. Lower 'total vegetable' intake in the high-CMDrf group in both sexes, while high-CMDrf men also had lower 'total vegetables', 'greens and beans' intake, and high-CMDrf women had lower 'total fruits', 'whole-fruits', 'total vegetables', 'seafood and plant-proteins', 'fatty acids', and 'saturated fats' intakes (P < 0.05). Moreover, 'dairy' intake was higher in high-CMDrf women but not in men (sex by 'dairy' interaction P = 0.01). Sex by age diet pattern models predicted CMDrf with a 93 and 89% sensitivity and 84 and 92% specificity in women and men, respectively.

CONCLUSIONS

Sex and age differences in dietary patterns classified participants with and without accepted CMDrfs, supporting an association between specific diet components and CMD risk that differs by sex. Including sex specific dietary patterns into health assessments may provide targeted nutritional guidance to reduce the burden of cardiovascular disease.

TRIAL REGISTRATION

ClinicalTrials.gov : NCT02367287 . ClinicalTrials.gov : NCT02298725 .

Role of dietary calcium and its possible mechanism against metabolic disorders: A concise review

The global prevalence of metabolic disorders including hypertension, dyslipidemia, insulin resistance, nonalcoholic fatty liver, and cardiovascular diseases seemed to affect people of all ages cutting across the national, economic, and demographic barrier. Therefore, the prevention of metabolic disorders is considered of paramount importance. The dietary role of nutrients including vitamins and minerals is one of the recommended preventive measures against metabolic disorders in modern society. Recently, dietary calcium, a common nutrient not only showed a beneficial effect against obesity through weight management, but also gained great attention against the risk of metabolic disorders. Though dietary calcium shows several beneficial effects against metabolic disorders but some inconsistent results were also reported. So, the present review aims to extract recent knowledge as well as their possible underlying mechanisms regarding the role of dietary calcium against metabolic disorders. The present review also discusses the negative impact as well as prospect of calcium intake on health issues. In summary, high calcium diet prevents the harmful consequences of metabolic disorders by regulating hormonal actions, alteration in intracellular calcium level, renin-angiotensin system, intestinal fat absorption, fecal fat excretion, lipid metabolism, carbohydrate metabolism, inflammation, and oxidative stress which together improve the metabolic health of an individual. PRACTICAL APPLICATIONS: Metabolic disorder is a global health issue across all sections of society and is growing rapidly in spite of several attempts by the scientific community to prevent it. Recently dietary calcium gained great attention in the last few years for its role in the management and treatment of metabolic disorders. The current review highlights the beneficial role of dietary calcium against several metabolic complications by exploring their underlying mechanisms at cellular level. This study will provide valuable information regarding the recommendation of dietary calcium in health policy as well as its inclusion in the dietary chart through calcium-rich foods and/or taking calcium supplements which can be a useful approach in preventing the risk of metabolic disorder depending on the health status of an individual.

Role of Fluid Milk in Attenuating Postprandial Hyperglycemia and Hypertriglyceridemia

Postprandial plasma glucose and triglyceride concentrations are predictive of relative cardiovascular disease (CVD) risk, and the pathogenesis of both insulin resistance and atherosclerosis has been attributed to acute states of hyperglycemia and hypertriglyceridemia. Postprandial lipemia and hyperglycemia suppress vascular reactivity and induce endothelial dysfunction. Epidemiological studies suggest that chronically-high consumption of milk and milk products is associated with a reduced risk of type 2 diabetes, metabolic syndrome, and CVD. The addition of dairy products to meals high in carbohydrates and fat may lessen these risks through reductions in postprandial glucose and triglyceride responses. Purported mechanisms include dairy proteins and bioactive compounds, which may explain the inverse relationship between dairy consumption and cardiometabolic diseases. The current review evaluates the available literature describing the relationships between metabolic dysfunction, postprandial metabolism, and vascular dysfunction and discusses the potential role of milk and dairy products in attenuating these impairments.

Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis

The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative effectiveness is not well established. Here, we performed a systematic review together with trial sequential analysis to determine the effect of a vegetarian diet on the reduction of blood pressure. We searched the randomized controlled trial (RCT) through Medline, PubMed and Cochrane Central Register. Fifteen eligible RCTs with 856 subjects were entered into the analysis. The pooled results demonstrated that vegetarian diet consumption significantly lowered the systolic blood pressure (weighted mean difference (WMD), −2.66 mmHg (95% confidence interval (CI) = −3.76, −1.55, p < 0.001) and diastolic BP was WMD, −1.69 95% CI = −2.97, −0.41, p < 0.001) as compared to an omnivorous diet. In subgroup analysis, a vegan diet demonstrated a greater reduction in systolic BP (WMD, −3.12 mmHg; 95% CI = −4.54, −1.70, p < 0.001) as compared with a lacto-ovo-vegetarian diet (WMD, −1.75 mmHg, 95% CI −5.38, 1.88, p = 0.05). The vegan diet has showed a similar trend in terms of diastolic blood pressure reduction (WMD, −1.92 mmHg (95% CI = −3.18, −0.66, p < 0.001) but those with a lacto-ovo-vegetarian diet showed no changes in diastolic BP reduction (WMD, 0.00, 95% CI = 0.00, 0.00), p = 0.432). In conclusion, vegetarian diets are associated with significant reductions in BP compared with omnivorous diets, suggesting that they may play a key role in the primary prevention and overall management of hypertension.

Association of cardiovascular diseases with milk intake among general Chinese adults

BACKGROUND

The association of milk intake with cardiovascular disease (CVD) and cause-specific mortality remained controversial and evidence among the Chinese population was limited. We aimed to study the relationship between milk intake and CVDs among general Chinese adults.

METHODS

A total of 104,957 participants received questionnaire survey. Results of physical examination such as anthropometric measurements and biochemical tests during 2007 to 2008, demographic data and their information on milk intake were collected through standardized questionnaires. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) of CVD incidence, cause-specific mortality and all-cause mortality related to milk intake. Restricted cubic splines (RCSs) were applied to examine dose-response associations.

RESULTS

Among the 91,757 participants with a median follow-up period of 5.8 years, we documented 3877 CVD cases and 4091 all-cause deaths. Compared with participants who never consumed milk, the multivariate-adjusted HRs (95% CIs) of CVD incidence for 1 to 150 g/day, 151 to 299 g/day, and ≥300 g/day were 0.94 (0.86-1.03) (P > 0.05), 0.77 (0.66-0.89) (P < 0.05), and 0.59 (0.40-0.89) (P < 0.05), respectively; each 100 g increase of daily milk intake was associated with 11% lower risk of CVD incidence (HR, 0.89; 95% CI: 0.85-0.94; P < 0.001), and 11% lower risk of CVD mortality (HR, 0.89; 95% CI: 0.82-0.97; P = 0.008) after adjustment for age, sex, residential area, geographic region, education level, family history of CVD, smoking, alcohol drinking, physical activity level, body mass index, and healthy diet status (ideal or not). RCS analyses also showed a linear dose-response relationship with CVD (P for overall significance of the curve <0.001; P for non-linearity = 0.979; P for linearity <0.001) and stroke (P for overall significance of the curve = 0.010; P for non-linearity = 0.998; P for linearity = 0.002) incidence, and CVD mortality (P for overall significance of the curve = 0.045; P for non-linearity = 0.768; P for linearity = 0.014) within the current range of daily milk intake.

CONCLUSIONS

Daily milk intake was associated with lower risk of CVD incidence and mortality in a linear inverse relationship. The findings provide new evidence for dietary recommendations in CVD prevention among Chinese adults and people with similar dietary pattern in other countries.

Diet-derived nutrient patterns and components of metabolic syndrome: a cross-sectional community- based study

BACKGROUND

Metabolic syndrome (MetS) is one of the main public health problems worldwide. Although some relations between dietary intakes and MetS have been found, few studies have focused on association between dietary nutrients interactions and the risk of the MetS and its components. The aim of the present study was to examine the association between nutrient patterns and MetS and its components among Iranian adult population.

METHODS

A total of 588 subjects (aged 18-64 years, 271 males and 317 females) enrolled in the cross sectional study. Dietary consumption was evaluated using an 80-item food frequency questionnaire (FFQ). Biochemical assessments including fasting blood sugar (FBS), aspartate aminotransferase (AST), alanine amino transferase (ALT) and serum lipids were performed by enzymatic methods. Nutrient patterns were obtained by factor analysis procedure using principal component method. Multinational logistic regression analysis was used to evaluate the association between nutrient patterns and MetS and its components.

RESULTS

Three nutrient patterns explaining 53.66% of the variance in dietary nutrients intake, were recognized in the current study. Animal-sourced nutrient pattern was significantly associated with the higher odds of MetS and high triglyceride (TG) levels. Plant-sourced nutrient pattern (high intake of fiber, carbohydrate, vitamins B₆, B₃, C, B₁, E, D, magnesium, potassium, and linoleic acid) was significantly associated with lower risk of MetS and lower blood pressure (p < 0.05). Third nutrient pattern (mixed-source) was significantly related to higher risk of MetS, high waist circumference (WC) and high systolic blood pressure (SBP).

CONCLUSION

This present study confirms the important effect of nutrients and their patterns on MetS risk. Our results suggest that adherence to the nutrient pattern rich in fiber, carbohydrate, vitamins D, B₆, B₃, C, B₁, E, magnesium, potassium, linoleic acid, and docosahexaenoic acid (DHA) is associated with a lower risk of MetS, while animal- and mixed-sourced nutrient patterns are positively associated with greater odds of MetS; However, further longitudinal and interventional studies are required to make a clear conclusion.

The associations of longitudinal changes in consumption of total and types of dairy products and markers of metabolic risk and adiposity: findings from the European Investigation into Cancer and Nutrition (EPIC)-Norfolk study, United Kingdom

BACKGROUND

The consumption of some types of dairy products has been associated with lower cardiometabolic disease incidence. Knowledge remains limited about habitual dairy consumption and the pathways to cardiometabolic risk.

OBJECTIVE

We aimed to investigate associations of habitual consumption of total and types of dairy products with markers of metabolic risk and adiposity among adults in the United Kingdom.

METHODS

We examined associations of changes in dairy consumption (assessed with a food-frequency questionnaire) with parallel changes in cardiometabolic markers using multiple linear regression among 15,612 adults aged 40-78 y at baseline (1993-1997) and followed up over 1998-2000 (mean ± SD: 3.7±0.7 y) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study.

RESULTS

For adiposity, an increase in fermented dairy products [yogurt (total or low-fat) or low-fat cheese] consumption was associated with a lower increase in body weight and body mass index (BMI). For example, over 3.7 y, increasing yogurt consumption by 1 serving/d was associated with a smaller increase in body weight by 0.23 kg (95% CI: -0.46, -0.01 kg). An increase in full-fat milk, high-fat cheese, and total high-fat dairy was associated with greater increases in body weight and BMI [e.g., for high-fat dairy: β = 0.13 (0.05, 0.21) kg and 0.04 (0.01, 0.07) kg/m2, respectively]. For lipids, an increase in milk (total and low-fat) or yogurt consumption was positively associated with HDL cholesterol. An increase in total low-fat dairy was negatively associated with LDL cholesterol (-0.03 mmol/L; -0.05, -0.01 mmol/L), whereas high-fat dairy (total, butter, and high-fat cheese) consumption was positively associated [e.g., 0.04 (0.02, 0.06) mmol/L for total high-fat dairy]. For glycemia, increasing full-fat milk consumption was associated with a higher increase in glycated hemoglobin (P = 0.027).

CONCLUSIONS

The habitual consumption of different dairy subtypes may differently influence cardiometabolic risk through adiposity and lipid pathways.

Prospective associations between total, animal, and vegetable calcium intake and metabolic syndrome in adults aged 40 years and older

BACKGROUND & AIMS

Calcium (Ca) consumption may contribute to a decreased risk of developing metabolic syndrome (MetS). However, epidemiologic evidence on the association between Ca intake and MetS is limited. This study aimed to evaluate the association between dietary Ca intake (animal-based Ca and vegetable-based Ca separately, as well as total Ca intake) and the incidence risk of MetS and its components in the Korean Multi-Rural Communities Cohort (MRCohort).

METHODS

A total of 5509 participants who did not have MetS were enrolled. Dietary Ca intake was calculated using a food frequency questionnaire composed of 106 items.

RESULTS

After 18,880 person-years of follow-up, 876 participants had developed de novo MetS. A significant inverse association between dietary total Ca intake and MetS were observed (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI) = 0.48-0.81, P for trend = 0.002 for the highest quartile of total Ca intake compared with the lowest quartile). Trends for animal Ca (IRR = 0.77, 95% CI = 0.62-0.97, P for trend = 0.039) and vegetable Ca (IRR = 0.54, 95% CI = 0.40-0.73, P for trend <0.001) were similar. The individual components of overall MetS were also inversely related to total, animal, and vegetable Ca. The tendency for an inverse association was more evident in the group with two of any of the metabolic abnormalities of MetS at baseline than in the group with no more than one MetS component.

CONCLUSIONS

Our findings indicate that a relatively high dietary intake of Ca is associated with lower risk of MetS.

Metabolomics reveals plausible interactive effects between dairy product consumption and metabolic syndrome in humans

BACKGROUND & AIMS

Metabolic syndrome (MetS) induces major disturbances in plasma metabolome, reflecting abnormalities of several metabolic pathways. Recent evidences have demonstrated that the consumption of dairy products may protect from MetS, but the mechanisms remains unknown. The present study aimed at identify how the consumption of different types of dairy products could modify the changes in plasma metabolome during MetS.

METHODS

In this observational study, we analyzed how the consumption of dairy products could modify the perturbations in the plasma metabolome induced by MetS in a sample of 298 participants (61 with MetS) from the French MONA LISA survey. Metabolomic profiling was analyzed with UPLC-MS/MS.

RESULTS

Subjects with MetS exhibited major changes in plasma metabolome. Significant differences in plasma levels of branched chain amino acids, gamma-glutamyl amino acids, and metabolites from arginine and proline metabolism were observed between healthy control and Mets subjects. Plasma levels of many lipid species were increased with MetS (mono- and diacylglycerols, eicosanoids, lysophospholipids and lysoplasmalogens), with corresponding decreases in short chain fatty acids and plasmalogens. The consumption of dairy products, notably with a low fat content (milk and fresh dairy products), altered metabolite profiles in plasma from MetS subjects. Specifically, increasing consumption of dairy products promoted accumulation of plasma C15:0 fatty acid and was inversely associated to some circulating lysophospholipids, sphingolipids, gamma-glutamyl amino acids, leukotriene B4 and lysoplasmalogens.

CONCLUSIONS

the consumption of low fat dairy products could mitigate some of the variations induced by MetS.

Milk and Dairy Product Consumption and Cardiovascular Diseases: An Overview of Systematic Reviews and Meta-Analyses

Milk and dairy products containing milk fat are major food sources of saturated fatty acids, which have been linked to increased risk of cardiovascular-related clinical outcomes such as cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Therefore, current recommendations by health authorities advise consumption of low-fat or fat-free milk. Today, these recommendations are seriously questioned by meta-analyses of both prospective cohort studies and randomized controlled trials (RCTs) reporting inconsistent results. The present study includes an overview of systematic reviews and meta-analyses of follow-up studies, an overview of meta-analyses involving RCTs, and an update on meta-analyses of RCTs (2013-2018) aiming to synthesize the evidence regarding the influence of dairy product consumption on the risk of major cardiovascular-related outcomes and how various doses of different dairy products affect the responses, as well as on selected biomarkers of cardiovascular disease risk, i.e., blood pressure and blood lipids. The search strategies for both designs were conducted in the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception to April 2018. From the 31 full-text articles retrieved for cohort studies, 17 met the eligibility criteria. The pooled risk ratio estimated for the association between the consumption of different dairy products at different dose-responses and cardiovascular outcomes (CVD, CHD, and stroke) showed a statistically significant negative association with RR values <1, or did not find evidence of significant association. The overview of 12 meta-analyses involving RCTs as well as the updated meta-analyses of RCTs did not result in significant changes on risk biomarkers such as systolic and diastolic blood pressure and total cholesterol and LDL cholesterol. Therefore, the present study states that the consumption of total dairy products, with either regular or low fat content, does not adversely affect the risk of CVD.

Dairy Foods and Body Mass Index over 10-Year: Evidence from the Caerphilly Prospective Cohort Study

The association between dairy product consumption and body mass index (BMI) remains controversial. The aim of the present study was to investigate the association between total dairy, milk, cheese, cream and butter consumption and BMI change over a 10-year follow-up by using long-term follow-up cohort data from the Caerphilly Prospective Cohort Study (CAPS). The CAPS included 2512 men aged 45⁻59 years at baseline, who were followed up at 5-year intervals for over 20-year. A semi-quantitative food frequency questionnaire estimated the intake of dairy consumption, including milk, cheese, cream and butter at baseline, 5-year and 10-year follow-up. In total, men free of cardiovascular disease, diabetes and cancer (n = 1690) were included in current analysis. General linear regression and logistic regression were used for data analysis. The results showed higher cheese consumption was associated with lower BMI at the 5-year follow-up (p = 0.013). There was no evidence that higher consumption of total dairy, milk, cream and butter were significantly associated with BMI during the over the 10-year following-up. This study suggest that cheese consumption have beneficial effects on lowering BMI, which needs further investigation.

Dietary total, animal, vegetable calcium and type 2 diabetes incidence among Korean adults: The Korean Multi-Rural Communities Cohort (MRCohort)

BACKGROUND AND AIMS

Although a possible mechanism for developing type 2 diabetes in relation to calcium intake has been suggested, there is currently little epidemiological evidence on the association between dietary calcium and type 2 diabetes (T2D). This study aimed to evaluate the prospective association between dietary calcium and T2D incidence among adults 40 years of age or over, from the Multi-rural Communities Cohort (MRCohort), South Korea.

METHODS AND RESULTS

In total, 8313 participants (3033 men and 5280 women) who did not have diabetes at baseline were recruited between 2005 and 2013. The incidence rate ratio (IRR) was estimated using a modified Poisson regression model with a robust error estimator. During follow-up (31,570 person-years), 322 T2D cases were newly diagnosed. Dietary calcium (total and vegetable calcium) were inversely associated with the risk of T2D incidence among women (IRR = 0.61, 95% CI = 0.43-0.86, P for trend = 0.007 in third tertile of baseline total calcium intake comparing to the first tertile; IRR = 0.57, 95% CI = 0.39-0.84, P for trend = 0.006 for baseline vegetable calcium intake), not for men. The tendency of those inverse associations remained in both the normal fasting blood glucose group and the impaired fasting blood glucose group and were independent of obesity, smoking, and magnesium intake.

CONCLUSIONS

Total and vegetable calcium may be inversely associated with T2D incidence among women, regardless of impaired fasting blood glucose group or normal group. The associations may be potentially dose-responsive. Moderate dietary calcium may be related to lower risk of T2D incidence comparing to low intake group among women.

Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms

Associations between yogurt intake and risk of diet-related cardiometabolic diseases (CMDs) have been the subject of recent research in epidemiologic nutrition. A healthy dietary pattern has been identified as a pillar for the prevention of weight gain and CMDs. Epidemiologic studies suggest that yogurt consumption is linked to healthy dietary patterns, lifestyles, and reduced risk of CMDs, particularly type 2 diabetes. However, to our knowledge, few to no randomized controlled trials have investigated yogurt intake in relation to cardiometabolic clinical outcomes. Furthermore, there has been little attempt to clarify the mechanisms that underlie the potential beneficial effects of yogurt consumption on CMDs. Yogurt is a nutrient-dense dairy food and has been suggested to reduce weight gain and prevent CMDs by contributing to intakes of protein, calcium, bioactive lipids, and several other micronutrients. In addition, fermentation with bacterial strains generates bioactive peptides, resulting in a potentially greater beneficial effect of yogurt on metabolic health than nonfermented dairy products such as milk. To date, there is little concrete evidence that the mechanisms proposed in observational studies to explain positive results of yogurt on CMDs or parameters are valid. Many proposed mechanisms are based on assumptions that commercial yogurts contain strain-specific probiotics, that viable yogurt cultures are present in adequate quantities, and that yogurt provides a minimum threshold dose of nutrients or bioactive components capable of exerting a physiologic effect. Therefore, the primary objective of this review is to investigate the plausibility of potential mechanisms commonly cited in the literature in order to shed light on the inverse associations reported between yogurt intake and various cardiometabolic health parameters that are related to its nutrient profile, bacterial constituents, and food matrix. This article reviews current gaps and challenges in identifying such mechanisms and provides a perspective on the research agenda to validate the proposed role of yogurt in protecting against CMDs.

Biomarkers of the metabolic syndrome: Influence of minerals, oligo- and trace elements

Influences of minerals, oligo- and trace elements on the concentration of biomarkers of the metabolic syndrome (MetS) are reviewed. Since food is a complex mixture of caloric compounds and essential non-caloric food components with multiple interactions and varying bioavailability, it is hard to separate or identify the effect of one single component in a total meal or diet. Moreover the diet contains various non-nutritive biologically active components, which may add some beneficial characteristics. Therefore, conclusions on the effect of components on various biomarkers of MetS are sometimes quite contradictory. Reasons therefore are mentioned. Literature data should be studied in detail to conclude whether a component is related to a reduction of MetS-related symptoms or whether its influence is merely affecting a biomarker.

Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study

Objective To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal.Design Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable.Setting CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium.Participants Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis.Main outcome measures The instrumental variable estimation was conducted using the ratio of coefficients approach. Using meta-analysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized.Results Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P<0.001) and was not associated with systolic blood pressure (0.31, 95% confidence interval -0.05 to 0.68 mm Hg; P=0.09) or risk of hypertension (odds ratio 1.01, 95% confidence interval 0.97 to 1.05; P=0.27). Using LCT-13910 rs4988235 as the instrumental variable, genetically determined dairy consumption was not associated with systolic blood pressure (β=1.35, 95% confidence interval -0.28 to 2.97 mm Hg for each serving/day) or risk of hypertension (odds ratio 1.04, 0.88 to 1.24). Moreover, meta-analysis of the published clinical trials showed that higher dairy intake has no significant effect on change in systolic blood pressure for interventions over one month to 12 months (intervention compared with control groups: β=-0.21, 95% confidence interval -0.98 to 0.57 mm Hg). In observational analysis, each serving/day increase in dairy consumption was associated with -0.11 (95% confidence interval -0.20 to -0.02 mm Hg; P=0.02) lower systolic blood pressure but not risk of hypertension (odds ratio 0.98, 0.97 to 1.00; P=0.11).Conclusion The weak inverse association between dairy intake and systolic blood pressure in observational studies was not supported by a comprehensive instrumental variable analysis and systematic review of existing clinical trials.

Systematic Review of the Association between Dairy Product Consumption and Risk of Cardiovascular-Related Clinical Outcomes

The objective of this systematic review was to determine if dairy product consumption is detrimental, neutral, or beneficial to cardiovascular health and if the recommendation to consume reduced-fat as opposed to regular-fat dairy is evidence-based. A systematic review of meta-analyses of prospective population studies associating dairy consumption with cardiovascular disease (CVD), coronary artery disease (CAD), stroke, hypertension, metabolic syndrome (MetS), and type 2 diabetes (T2D) was conducted on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Quality of evidence was rated by using the Grading of Recommendations Assessment, Development, and Evaluation scale. High-quality evidence supports favorable associations between total dairy intake and hypertension risk and between low-fat dairy and yogurt intake and the risk of T2D. Moderate-quality evidence suggests favorable associations between intakes of total dairy, low-fat dairy, cheese, and fermented dairy and the risk of stroke; intakes of low-fat dairy and milk and the risk of hypertension; total dairy and milk consumption and the risk of MetS; and total dairy and cheese and the risk of T2D. High- to moderate-quality evidence supports neutral associations between the consumption of total dairy, cheese, and yogurt and CVD risk; the consumption of any form of dairy, except for fermented, and CAD risk; the consumption of regular- and high-fat dairy, milk, and yogurt and stroke risk; the consumption of regular- and high-fat dairy, cheese, yogurt, and fermented dairy and hypertension risk; and the consumption of regular- and high-fat dairy, milk, and fermented dairy and T2D risk. Data from this systematic review indicate that the consumption of various forms of dairy products shows either favorable or neutral associations with cardiovascular-related clinical outcomes. The review also emphasizes that further research is urgently needed to compare the impact of low-fat with regular- and high-fat dairy on cardiovascular-related clinical outcomes in light of current recommendations to consume low-fat dairy.

Nutrient patterns and their relationship to metabolic syndrome in Iranian adults

BACKGROUND

The prevalence of metabolic syndrome (MetS) is increasing globally. It is associated with a significant risk of developing type 2 diabetes mellitus and cardiovascular disease.

MATERIALS AND METHODS

The relationship between adherence to several different dietary patterns and the presence of MetS was explored in an Iranian population sample of 5764 subjects.

RESULTS

We observed that the prevalence of MetS was 13% and 18% in men and women, respectively. There were three main dietary patterns: the first pattern was characterized by protein, carbohydrate, starch, glucose, fructose, sucrose, maltose, dietary fibre, potassium, calcium, magnesium, phosphorus, iron, zinc, manganese, thiamine, riboflavin, carotene, vitamin c and lactose; second representative of fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, sodium, calcium, zinc, phosphorus, iodine, vitamin D, chloride, betaine, niacin; third consisting of copper, selenium, vitamin A, riboflavin, vitamin B12. In this dietary pattern, individuals in first quintile had a higher consumption of total fat, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, cholesterol and vitamin A. In the second pattern, individuals in the fifth quintile ate less carbohydrate, dietary fibre, glucose, Fructose, potassium compared to first quintile. We found that individuals in the first quintile in pattern 3 had higher intakes of protein, zinc and calcium compared to other quintiles.

CONCLUSIONS

We have found that a nutrient pattern which mostly characterized by dietary protein, carbohydrate, starch, glucose, fructose, sucrose, maltose was associated with a higher risk of MetS in both genders, while a pattern which was represent of copper, selenium, Vitamin A, riboflavin, vitamin B12 was associated with greater odds of Mets, in women.

High intake of regular-fat cheese compared with reduced-fat cheese does not affect LDL cholesterol or risk markers of the metabolic syndrome: a randomized controlled trial

BACKGROUND

Regular-fat cheese contains a high amount of saturated fat. Therefore, dietary guidelines in many countries recommend the consumption of reduced-fat cheese as opposed to regular-fat cheese. However, the negative effect of regular-fat cheese is still under debate.

OBJECTIVES

The aim was to compare the effects of regular-fat cheese with an equal amount of reduced-fat cheese and an isocaloric amount of carbohydrate-rich foods on LDL cholesterol and risk factors for the metabolic syndrome (MetS).

DESIGN

The study was a 12-wk randomized parallel intervention preceded by a 2-wk run-in period. A total of 164 subjects with ≥2 MetS risk factors were randomly allocated to 1 of 3 intervention groups: regular-fat cheese (REG), reduced-fat cheese (RED), or a no-cheese, carbohydrate control (CHO) group. Subjects in the REG and RED groups replaced part of their daily habitual diet with 80 g cheese/10 MJ, whereas subjects in the CHO group did the same with bread and jam corresponding to 90 g and 25 g/10 MJ, respectively.

RESULTS

A total of 139 subjects completed the intervention. The primary outcome, LDL cholesterol, was not significantly different between the REG and RED diets or between the REG and CHO diets. There was no significant difference in HDL cholesterol between the REG and RED diets, but HDL cholesterol tended to be higher with the REG diet than with the CHO diet (0.06 ± 0.03 mmol/L; P = 0.07). Insulin, glucose, and triacylglycerol concentrations as well as blood pressure and waist circumference did not differ significantly between the 3 diets.

CONCLUSION

A high daily intake of regular-fat cheese for 12 wk did not alter LDL cholesterol or MetS risk factors differently than an equal intake of reduced-fat cheese or an isocaloric amount of carbohydrate-rich foods. This trial was registered at www.clinicaltrials.gov as NCT02616471.

Hypolactasia is associated with insulin resistance in nonalcoholic steatohepatitis

AIM

To assess lactase gene (LCT)-13910C>T polymorphisms in Brazilian non-alcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) patients in comparison with healthy controls.

METHODS

This was a transverse observational clinical study with NAFLD patients who were followed at the Hepatology Outpatient Unit of the Hospital das Clínicas, São Paulo, Brazil. The polymorphism of lactase non-persistence/lactase persistence (LCT-13910C>T) was examined by PCR-restriction fragment length polymorphism technique in 102 liver biopsy-proven NAFLD patients (steatosis in 9 and NASH in 93) and compared to those of 501 unrelated healthy volunteers. Anthropometric, clinical, biochemical and liver histology data were analyzed. Continuous variables were compared using the t or Mann-Whitney tests, and categorical data were compared with the Fisher’s exact test. Univariate logistic regression and multivariate logistic regression adjusted for gender and age were performed.

RESULTS

No differences in the LCT-13910 genotype frequencies were noted between the NAFLD patients (66.67% of the patients with steatosis were CC, 33.33% were CT, and none were TT; 55.91% of the patients with NASH were CC, 39.78% were CT, and 4.3% were TT; P = 0.941) and the healthy controls (59.12% were CC, 35.67% were CT, and 5.21% were TT) or between the steatosis and NASH patients. That is, the distribution of the lactase non-persistence/lactase persistence polymorphism (LCT-13910C>T) in the patients with NAFLD was equal to that in the general population. In the NASH patients, the univariate analysis revealed that the lactase non-persistence (low lactase activity or hypolactasia) phenotype was associated with higher insulin levels (23.47 ± 15.94 μU/mL vs 15.8 ± 8.33 μU/mL, P = 0.027) and a higher frequency of insulin resistance (91.84% vs 72.22%, P = 0.02) compared with the lactase persistence phenotype. There were no associations between the LCT genotypes and diabetes (P = 0.651), dyslipidaemia (P = 0.328), hypertension (P = 0.507) or liver histology in these patients. Moreover, in the NASH patients, hypolactasia was an independent risk factor for insulin resistance even after adjusting for gender and age [OR = 5.0 (95%CI: 1.35-20; P = 0.017)].

CONCLUSION

The LCT-13910 genotype distribution in Brazilian NAFLD patients was the same as that of the general population, but hypolactasia increased the risk of insulin resistance in the NASH patients.

Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies

BACKGROUND

The current state of knowledge regarding the association of dairy products and weight gain, overweight, and obesity is based on studies reporting contradicting and inconclusive results. The aim of the present study was thus to clarify the link between dairy consumption in relation to changes in anthropometric measures/adiposity by a meta-analytical approach.

METHODS

For the meta-analysis PubMed, EMBASE, Web of Sciences, and google scholar were searched by two independent authors up to May 2016 with no restriction to language or calendar date. Prospective cohort studies reporting about intake of dairy consumption (including milk, yogurt, cheese, butter) and changes in body weight or waist circumference, risk of overweight, obesity, or weight gain were eligible. Pooled effects were calculated using a random effects model, and also a fixed effect model for sensitivity analysis. Due to the heterogeneity of statistical analytical approaches of the studies the analysis were done separately for beta-coefficients of changes in body weight and/or waist circumference per serving of dairy, for differences in weight gain/gain in waist circumference when comparing extreme categories of dairy consumption, and for odds ratios in regard to weight gain, overweight/obesity, or abdominal obesity.

FINDINGS

24 studies (27 reports) met the inclusion criteria for the systematic review, and 22 studies provided sufficient data for inclusion in the meta-analysis. The meta-analysis of the five studies on changes in body weight per serving of dairy no significant results could be found for whole fat dairy and low fat dairy. However, there was inverse association between changes in body weight for each serving's increase of yogurt (beta: -40.99 gram/year, 95% CI, -48.09 to -33.88), whereas each serving's increase of cheese was positively associated (beta: -10.97 gram/year, 95% CI, 2.86 to 19.07). Furthermore, the highest dairy intake category was associated with a reduced risk of abdominal obesity (OR: 0.85; 95% CI, 0.76 to 0.95), and risk of overweight (OR: 0.87; 95% CI, 0.76 to 1.00) compared to the lowest intake category. No significant association could be observed for risk of weight gain.

CONCLUSION

In summary the results of the meta-analysis still reflect that dairy consumption was not positively related to changes in body weight. Yogurt was the only dairy food that showed some evidence for a beneficial effect, where higher intakes were inversely associated a reduced risk of obesity, changes in body weight or waist circumference. Further research is needed, since the overall interpretation of the results is limited by heterogeneous risk estimates.

Yogurt consumption and abdominal obesity reversion in the PREDIMED study

BACKGROUND AND AIMS

Evidence on the association yogurt consumption and obesity is not conclusive. The aim of this study was to prospectively evaluate the association between yogurt consumption, reversion of abdominal obesity status and waist circumference change in elderly.

METHODS AND RESULTS

4545 individuals at high cardiovascular risk were prospectively followed. Total, whole-fat and low-fat yogurt consumption were assessed using food frequency questionnaires. Generalized estimating equations were used to analyze the association between yogurt consumption and waist circumference change (measured at baseline and yearly during the follow-up). Logistic regression models were used to evaluate the odds ratios (ORs) and 95% CIs of the reversion rate of abdominal obesity for each quintile of yogurt consumption compared with the lowest quintile. After multivariable adjustment, the average yearly waist circumference change in the quintiles of whole-fat yogurt consumption was: Q1: 0.00, Q2: 0.00 (-0.23 to 0.23), Q3: -0.15 (-0.42 to 0.13), Q4: 0.10 (-0.21 to 0.42), and Q5: -0.23 (-0.46 to -0.00) cm; p for trend = 0.05. The ORs for the reversion of abdominal obesity for whole-fat yogurt consumption were Q1: 1.00, Q2: 1.40 (1.04-1.90), Q3: 1.33 (0.94-1.89), Q4: 1.21 (0.83-1.77), and Q5: 1.43 (1.06-1.93); p for trend = 0.26.

CONCLUSION

Total yogurt consumption was not significantly associated with reversion of abdominal obesity status and a lower waist circumference. However, consumption of whole-fat yogurt was associated with changes in waist circumference and higher probability for reversion of abdominal obesity. Therefore, it seems that whole-fat yogurt has more beneficial effects in management of abdominal obesity in elderly population at high cardiovascular risk.

History of yogurt and current patterns of consumption

Yogurt has been a part of the human diet for several millennia and goes by many names throughout the world. The word "yogurt" is believed to have come from the Turkish word "yoğurmak," which means to thicken, coagulate, or curdle. While references to the health-promoting properties of yogurt date back to 6000 BC in Indian Ayurvedic scripts, it was not until the 20th century that Stamen Grigorov, a Bulgarian medical student, attributed the benefits to lactic acid bacteria. Today, most yogurt is fermented milk that is acidified with viable and well-defined bacteria (Lactobacillus bulgaricus and Streptococcus thermophiles). While patterns of yogurt consumption vary greatly from country to country, consumption is generally low. In the United States and Brazil, for example, only 6% of the population consume yogurt on a daily basis. Low consumption of yogurt represents a missed opportunity to contribute to a healthy lifestyle, as yogurt provides a good to excellent source of highly bioavailable protein and an excellent source of calcium as well as a source of probiotics that may provide a range of health benefits.

Mechanisms of calcium intake in lowering serum cholesterol levels

Cardiovascular diseases (CVDs), a group of disorders of the heart and blood vessels, are the leading cause of death globally. An estimated 17.1 million people die of CVDs each year, more than 40% of whom die from coronary heart disease (CHD). Hypercholesterolemia is a major risk factor for increasing CHD morbidity and mortality, and serum cholesterol level is a key predictor of CHD development. A number of studies have demonstrated that calcium supplement can lower serum cholesterol levels, which means that calcium might play an important role in preventing the development of CVDs, especially CHD. In this paper, the mechanisms of calcium intake in lowering serum cholesterol levels are summarized, including increasing the excretion of bile acids, interfering with cholesterol absorption, inhibiting the absorption of saturated fatty acids, promoting energy metabolism, regulating plasma 1,25(OH)₂D levels, affecting blood insulin sensibility and controlling appetite.

Dairy Products and Health: Recent Insights

Milk, cheese, yogurt, and other dairy products have long been known to provide good nutrition. Major healthful contributors to the diets of many people include the protein, minerals, vitamins, and fatty acids present in milk. Recent studies have shown that consumption of dairy products appears to be beneficial in muscle building, lowering blood pressure and low-density lipoprotein cholesterol, and preventing tooth decay, diabetes, cancer, and obesity. Additional benefits might be provided by organic milk and by probiotic microorganisms using milk products as a vehicle. New research on dairy products and nutrition will improve our understanding of the connections between these products, the bioactive compounds in them, and their effects on the human body.

Dairy products consumption and metabolic syndrome in adults: systematic review and meta-analysis of observational studies

The association of dairy products consumption with risk of metabolic syndrome (MetS) has been inconsistently reported in observational studies. A systematic review and meta-analysis of published observational studies was conducted to quantitatively evaluate this association. Relevant studies were identified by searching PubMed and EMBASE databases and by carefully checking the bibliographies of retrieved full reports and related reviews. Eligible studies were observational studies that investigated the association between dairy products consumption and risk of MetS in adults, with risk estimates available. Random-effects model was assigned to calculate the summary risk estimates. The final analysis included 15 cross-sectional studies, one case-control study and seven prospective cohort studies. Higher dairy consumption significantly reduced MetS by 17% in the cross-sectional/case-control studies (odds ratio = 0.83, 95% confidence interval [CI], 0.73-0.94), and by 14% (relative risk [RR] = 0.86, 95% CI, 0.79-0.92) in cohort studies. The inverse dairy-MetS association was consistent in subgroup and sensitivity analyses. The dose-response analysis of the cohort studies conferred a significant 6% (RR = 0.94, 95% CI, 0.90-0.98) reduction in the risk of MetS for each increment in dairy consumption of one serving/d. No significant publication bias was observed. Our findings suggest an inverse dose-response relationship between dairy consumption and risk of MetS.

Effect of a high intake of cheese on cholesterol and metabolic syndrome: results of a randomized trial

BACKGROUND

Cheese is generally rich in saturated fat, which is associated with increased risk for cardiovascular diseases. Nevertheless, recent reports suggest that cheese may be antiatherogenic.

OBJECTIVE

The goal of this study was to assess whether intake of two types of Norwegian cheese, with widely varying fat and calcium content, might influence factors of the metabolic syndrome and serum cholesterol levels differently.

DESIGN

A total of 153 participants were randomized to one of three groups: Gamalost(®), a traditional fat- and salt-free Norwegian cheese (50 g/day), Gouda-type cheese with 27% fat (80 g/day), and a control group with a limited cheese intake. Blood samples, anthropometric measurements, blood pressure, and questionnaires about lifestyle and diet were obtained at inclusion and end.

RESULTS

At baseline, there were no differences between the groups in relevant baseline characteristics, mean age 43, 52.3% female. After 8 weeks' intervention, there were no changes in any of the metabolic syndrome factors between the intervention groups compared with the control group. There were no increases in total- or LDL cholesterol in the cheese groups compared with the control. Stratified analysis showed that those in the Gouda group with metabolic syndrome at baseline had significant reductions in total cholesterol at the end of the trial compared with control (-0.70 mmol/L, p=0.013), and a significantly higher reduction in mean triglycerides. In the Gamalost group, those who had high total cholesterol at baseline had a significant reduction in total cholesterol compared with control (-0.40 mmol/L, p=0.035).

CONCLUSIONS

In conclusion, cholesterol levels did not increase after high intake of 27% fat Gouda-type cheese over 8 weeks' intervention, and stratified analysis showed that participants with metabolic syndrome had reduced cholesterol at the end of the trial.

Cheddar Cheese Ripening Affects Plasma Nonesterified Fatty Acid and Serum Insulin Concentrations in Growing Pigs

BACKGROUND

Meta-analyses of observational studies found cheese consumption to be inversely associated with risk of type 2 diabetes and metabolic syndrome. This may be attributed to the bioactive compounds produced during cheese ripening.

OBJECTIVE

The objective of this study was to investigate by means of a porcine model how cheeses with different ripening times affect blood glucose, insulin, and lipid concentrations and fecal-fat excretion.

METHODS

A parallel-arm randomized intervention study with 36 Landrace × Yorkshire × Duroc crossbred 3-mo-old female pigs was conducted. The pigs were fed a 21-d butter-rich run-in diet (143 g of butter/kg diet), followed by a 14-d intervention with 1 of 3 isocaloric diets: 4-mo ripened cheddar (4-MRC) diet, 14-mo ripened cheddar (14-MRC) diet, or 24-mo ripened cheddar (24-MRC) diet (350 g of cheese/kg diet). Serum cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and insulin; plasma nonesterified fatty acids (NEFAs) and glucose; fecal-fat excretion; and body weight were measured.

RESULTS

Plasma NEFAs were lower in the 24-MRC (201 ± 26 μEq/L) and in the 14-MRC (171 ± 19 μEq/L) diet groups than in the 4-MRC diet group (260 ± 27 μEq/L; P = 0.044 and P = 0.001). Serum insulin was lower in the 24-MRC diet group (1.04 ± 0.09 mmol/L) than in the 4-MRC diet group (1.44 ± 0.14 mmol/L; P = 0.002), but intermediate and not different from either in the 14-MRC diet group (1.25 ± 0.11 mmol/L). Likewise, homeostasis model assessment of insulin resistance was lower in the 24-MRC diet group (0.030 ± 0.003) than in the 4-MRC diet group (0.041 ± 0.005; P < 0.01), but intermediate and not different from either in the 14-MRC group (0.036 ± 0.004).

CONCLUSIONS

Intake of long-term ripened cheddar improved indicators of insulin sensitivity in growing pigs compared with short-term ripened cheddar. This may also be important for human health.

The cross-sectional relationship between dietary calcium intake and metabolic syndrome among men and women aged 40 or older in rural areas of Korea

BACKGROUND/OBJECTIVES

Studies conducted in Western populations have suggested that dietary calcium may protect against metabolic abnormalities, but there is little evidence of this effect in Asians, who have relatively low calcium intake. We evaluated the cross-sectional relationship between dietary calcium and metabolic syndrome among Korean men and women aged 40 years and over.

SUBJECTS/METHODS

A total of 6,375 subjects aged 40 years and over and were recruited between January 2005 and February 2010 from the baseline study of the Multi-Rural Communities Cohort Study in Rural Communities (MRCohort). A food frequency questionnaire was used to collect dietary information. Metabolic syndrome was defined using the modified criteria published in the Third Report of the National Cholesterol Education Program Adult Treatment Panel.

RESULTS

Calcium intake was related inversely to metabolic syndrome in women (P-value = 0.0091), but not in men (P = 0.1842). Among metabolic components, high waist circumference (WC) (P = 0.0426) and high blood glucose (P = 0.0027) in women and hypertriglyceridemia (P = 0.0017) in men were inversely correlated with calcium intake. Excluding those who used calcium or multinutrient supplements did not attenuate the relationship between dietary calcium and metabolic abnormalities.

CONCLUSION

Dietary calcium intake from foods may be inversely related to metabolic syndrome, WC, and blood glucose among women in rural areas of Korea.

Anti-obesogenic effects of calcium prevent changes in the GLP-1 profile in adult rats primed by early weaning

SCOPE

Gut peptides regulate appetite and adipogenesis. Early weaning (EW) leads to later development of obesity that can be prevented by calcium supplementation. We evaluated gut peptides that may have a role in the establishment of this dysfunction.

METHODS AND RESULTS

At birth, lactating Wistar rats were separated in: EW, lactating rats involved with a bandage interrupting the lactation during the last 4 days of standard lactation, and C (control) dams whose pups had free access to milk during throughout lactation. At 120 days old, half of EW group received calcium supplementation (EWCa); EW and C received standard diet. At 21 days old, EW presented higher glucagon-like peptide 1 (GLP-1) in plasma and glucagon-like peptide 1 receptor (GLP1-R) in adipose tissue and hypothalamus, but lower GLP-1 and GLP1-R in the gut. At 180 days old, GLP-1 response to food intake was blunted in EW and restored by calcium. GLP-1 in the gut was lower in EW and its receptor was lower in adipose tissue, and GLP1-R was higher in the gut of calcium EW group.

CONCLUSION

Thus, EW had short- and long-term effects upon GLP-1 profile, which may have contributed to obesity development, hyperphagia, and insulin resistance due to its adipogenic and appetite control roles. Calcium supplementation was able to prevent most of the changes in GLP-1 caused by EW.

Association between yogurt consumption and the risk of metabolic syndrome over 6 years in the SUN study

BACKGROUND

The role of yogurt consumption in the development of metabolic syndrome (MetS) is not fully understood and the available epidemiologic evidence is scarce. The aim of our study was to assess the association between total, whole-fat, or low-fat yogurt consumption and the risk of developing MetS.

METHODS

Yogurt consumption was assessed at baseline through a 136-item validated FFQ. MetS was defined following the harmonized definition for MetS according to the AHA and the IDF criteria. Logistic regression models were used.

RESULTS

During the first 6-y of follow-up of the SUN cohort, 306 incident cases of MetS were identified. Frequent consumption [≥875 g/week (≥7 servings/week) versus ≤ 250 g/week (2 servings/week)] of total, whole-fat and low-fat yogurt consumption showed non-significant inverse associations with MetS [OR = 0.84 (95% CI: 0.60-1.18); 0.98 (95% CI: 0.68-1.41); and 0.63 (95% CI: 0.39-1.02) respectively]. Only one component of the MetS, central adiposity, was inversely associated with total and whole-fat yogurt consumption [OR = 0.85 (95% CI: 0.74-0.98) and 0.85 (95% CI: 0.73-0.99) respectively]. In the joint assessment of exposure to total yogurt consumption and fruit consumption, those in the highest category of total yogurt consumption, and having a high fruit consumption (above the median ≥264.5 g/day) exhibited a significantly lower risk of developing MetS [OR = 0.61 (95% CI: 0.38-0.99)] compared with those in the lowest category of total yogurt consumption and had fruit consumption below the study median.

CONCLUSION

No significant association between yogurt consumption and MetS was apparent. Only one component out of the 5 MetS criteria, central adiposity, was inversely associated with high yogurt consumption. The combination of high consumption of both yogurt and fruit was inversely associated with the development of MetS.

Dairy consumption is associated with a lower prevalence of metabolic syndrome among young adults from Ribeirão Preto, Brazil

OBJECTIVE

It has been suggested that a greater dairy consumption is a contributing factor to a lower prevalence of metabolic syndrome (MetS) as a result of the possible actions of some milk nutrients. However, results remain controversial. The aim of this study was to examine the association between dairy consumption and MetS and its components.

METHODS

Dairy consumption and biochemical and anthropometric parameters were determined in 2031 young adults ages 23 to 25 y. Food consumption was assessed using a food frequency questionnaire. The estimated habitual portion of dairy products consumed daily was divided into quintiles. The criteria of the International Diabetes Federation (IDF) and of the Joint Interim Statement (JIS) were used for the classification of MetS. Nonadjusted and adjusted odds ratios (ORs) were estimated by logistic regression.

RESULTS

The prevalence of MetS was 11.9% by the IDF criteria and 9% by the JIS criteria. A greater dairy consumption was associated with a lower prevalence of MetS according to both IDF (OR, 0.61; 95% confidence interval [CI], 0.38-0.97) and JIS (OR, 0.62; 95% CI, 0.39-0.98) criteria when the last quintile was compared with the first. The association persisted in the model adjusted for demographic, socioeconomic, dietary, and lifestyle variables according to the IDF (OR, 0.53; 95% CI, 0.30-0.93) and was borderline according to the JIS (OR, 0.59; 95% CI, 0.34-1.00), but lost significance when data were adjusted for calcium in both models.

CONCLUSIONS

A greater dairy consumption is associated with a lower prevalence of MetS, with calcium probably being the nutrient responsible for this association.

Smoking and dietary factors associated with moderate-to-severe acne in French adolescents and young adults: results of a survey using a representative sample

BACKGROUND

Dietary factors and smoking play a role in acne.

METHODS

CSA Santé conducted a survey in France in 2012. Each individual answered a questionnaire to report acne, with associated epidemiological variables. Data on subjects between 15 and 24 years of age were extracted. The characteristics of subjects reporting acne were compared to subjects reporting no acne, using univariate and multivariate analysis.

RESULTS

The daily consumption of chocolate and sweets was independently and highly associated with acne, with an odds ratio of 2.38 (95% CI: 1.31-4.31). Smoking more than 10 cigarettes a day was highly associated with no acne, with an odds ratio of 0.44 (95% CI: 0.30-0.66). The regular use of cannabis was associated with acne, with an odds ratio of 2.88 (95% CI: 1.55-5.37).

CONCLUSION

Chocolate, sweets and cannabis smoking are associated with acne. We found tobacco to be protective. We failed to investigate the respective roles of sugar, lipids and milk.

Dairy consumption, type 2 diabetes, and changes in cardiometabolic traits: a prospective cohort study of middle-aged and older Chinese in Beijing and Shanghai

OBJECTIVE To prospectively investigate associations of dairy consumption with risk of type 2 diabetes and changes of cardiometabolic traits. RESEARCH DESIGN AND METHODS In 2005, 2,091 middle-aged and older Chinese men and women were recruited and followed for 6 years. Baseline dairy consumption was assessed by a 74-item food frequency questionnaire. Erythrocyte fatty acids were analyzed by gas chromatography coupled with flame ion detector. Cardiometabolic traits were measured at both baseline and follow-up visits. RESULTS Only 1,202 (57.5%) participants reported any dairy consumption, with a median intake of 0.89 (interquartile range 0.19-1.03) serving/day. Compared with nonconsumers, the relative risks (RRs) of type 2 diabetes among those having 0.5-1 serving/day and >1 serving/day were 0.70 (95% CI 0.55-0.88) and 0.65 (0.49-0.85), respectively, after multivariate adjustment (Ptrend < 0.001), which were attenuated by further adjusting for changes in glucose during follow-up (Ptrend = 0.07). Total dairy consumption was associated with favorable changes in glucose, waist circumference, BMI, diastolic blood pressure (all Ptrend < 0.05), and systolic blood pressure (Ptrend = 0.05) after multivariate adjustment, including baseline values of dependent variables. Erythrocyte trans-18:1 isomers were significantly correlated with total dairy consumption (rs = 0.37, Ptrend < 0.001), and these dairy food biomarkers were associated with a lower risk of type 2 diabetes. The RR of type 2 diabetes comparing extreme quartiles of trans-18:1 isomers was 0.82 (0.65-1.04, Ptrend = 0.02), which was attenuated after adjustment for dairy consumption (Ptrend = 0.15). CONCLUSIONS Dairy consumption was associated with a significantly lower risk of type 2 diabetes and favorable changes of cardiometabolic traits in Chinese.

Dairy foods and dairy protein consumption is inversely related to markers of adiposity in obese men and women

A number of intervention studies have reported that the prevalence of obesity may be in part inversely related to dairy food consumption while others report no association. We sought to examine relationships between energy, protein and calcium consumption from dairy foods (milk, yoghurt, cheese, dairy spreads, ice-cream) and adiposity including body mass index (BMI), waist (WC) and hip circumference (HC), and direct measures of body composition using dual energy X-ray absorptiometry (% body fat and abdominal fat) in an opportunistic sample of 720 overweight/obese Australian men and women. Mean (SD) age, weight and BMI of the population were 51 ± 10 year, 94 ± 18 kg and 32.4 ± 5.7 kg/m², respectively. Reduced fat milk was the most commonly consumed dairy product (235 ± 200 g/day), followed by whole milk (63 ± 128 g/day) and yoghurt (53 ± 66 g/day). Overall dairy food consumption (g/day) was inversely associated with BMI, % body fat and WC (all p < 0.05). Dairy protein and dairy calcium (g/day) were both inversely associated with all adiposity measures (all p < 0.05). Yoghurt consumption (g/day) was inversely associated with % body fat, abdominal fat, WC and HC (all p < 0.05), while reduced fat milk consumption was inversely associated with BMI, WC, HC and % body fat (all p < 0.05). Within a sample of obese adults, consumption of dairy products, dairy protein, and calcium was associated with more favourable body composition.

Dietary strategies to reduce metabolic syndrome

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, dyslipidemias, hypertension, high fasting glucose, chronic low-grade inflammation and oxidative stress. This condition has become an increasing problem in our society where about 34 % of adults are diagnosed with MetS. In parallel with the adult situation, a significant number of children present lipid abnormalities and insulin resistance, which can be used as markers of MetS in the pediatric population. Changes in lifestyle including healthy dietary regimens and increased physical activity should be the first lines of therapy to decrease MetS. In this article, we present the most recent information on successful dietary modifications that can reduce the parameters associated with MetS. Successful dietary strategies include energy restriction and weight loss, manipulation of dietary macronutrients--either through restriction of carbohydrates, fat, or enrichment in beneficial fatty acids, incorporation of functional foods and bioactive nutrients, and adherence to dietary and lifestyle patterns such the Mediterranean diet and diet/exercise regimens. Together, the recent findings presented in this review serve as evidence to support the therapeutic treatment of MetS through diet.

Dietary nutrient intake and metabolic syndrome risk in Chinese adults: a case-control study

Background

Because human diets are composed of a wide variety of nutrients that may work synergistically to prevent or promote disease, assessing dietary nutrient intake status may be informative. The purpose of this study was to assess the dietary nutrient intake status of Chinese adults with metabolic syndrome (MetS) and to evaluate its possible role in MetS.

Methods

This case–control study was conducted from March 2010 to January 2011. A total of 123 patients with MetS and 135 controls participated in this study at the Health Examination Center of Heping District in Tianjin, China. Dietary intake was estimated by 24-h dietary recalls. We used principal component factor analysis to derive nutrient groups from 17 major nutrients. We examined the odds ratios and 95% confidence intervals using logistic regression models to test the relationship between tertiles of dietary nutrient pattern and MetS.

Results

There were 4 major dietary nutrient patterns in this study: “vitamin B group”, “protein and lipids”, “vitamin E and minerals”, and “antioxidant vitamins”. After adjustment for potential confounders, the highest tertile of the nutrient pattern factor score for the “vitamin B group” (odds ratio: 0.16; 95% confidence interval: 0.05–0.47) was negatively associated with MetS compared with the lowest tertiles. No relationships were found between other dietary nutrient patterns and MetS.

Conclusions

The “vitamin B group” pattern was inversely associated with MetS in Chinese adults. This finding supports the hypothesis that the “vitamin B group” pattern may have a potentially beneficial effect on the prevention of MetS.