The role of dairy consumption in the relationship between wealth and early life physical growth in India: evidence from multiple national surveys

INTRODUCTION

Prevalence of undernutrition continues to be high in India and low household wealth is consistently associated with undernutrition. This association could be modified through improved dietary intake, including dairy consumption in young children. The beneficial effect of dairy on child growth has not been explored at a national level in India. The present analyses aimed to evaluate the direct and indirect (modifying association of household level per adult female equivalent milk and milk product consumption) associations between household wealth index on height for age (HAZ) and weight for age (WAZ) in 6-59 months old Indian children using data from of nationally representative surveys.

METHODS

Two triangulated datasets of two rounds of National Family Health Survey, (NFHS-3 and 4) and food expenditure (National Sample Survey, NSS61 and 68) surveys, were produced by statistical matching of households using Non-Iterative Bayesian Approach to Statistical Matching technique. A Directed Acyclic Graph was constructed to map the pathways in the relationship of household wealth with HAZ and WAZ based on literature. The direct association of wealth index and its indirect association through per adult female equivalent dairy consumption on HAZ and WAZ were estimated using separate path models for each round of the surveys.

RESULTS

Wealth index was directly associated with HAZ and WAZ in both the rounds, but the association decreased from NFHS-3 (βHAZ: 0.145; 95% CI: 0.129, 0.16) to NFHS-4 (βHAZ: 0.102; 95%CI: 0.093, 0.11). Adult female equivalent milk intake (increase of 10gm/day) was associated with higher HAZ (β_NFHS-3=0.001;95% CI: 0, 0.002; β_NFHS-4=0.002;95% CI: 0.002, 0.003) but had no association with WAZ. The indirect association of wealth with HAZ through dairy consumption was 2-fold higher in NFHS-4 compared to NFHS-3.

CONCLUSIONS

The analysis of triangulated survey data shows that household level per- adult female equivalent dairy consumption positively modified the association between wealth index and HAZ, suggesting that regular inclusion of milk and milk products in the diets of children from households across all wealth quintiles could improve linear growth in this population.

Feeling morally troubled about meat, dairy, egg, and fish consumption: Dissonance reduction strategies among different dietary groups

A largescale shift towards plant-based diets is considered a critical requirement for tackling ethical, environmental, and global health issues associated with animal food production and consumption. Although previous research has identified psychological strategies that enable meat-eaters to justify and continue meat consumption and feel less morally conflicted about it, research on the psychological strategies that enable consumers to continue dairy, egg, and fish consumption is scarce. We conducted an online survey study using an adjusted version of the Meat-Eating Justification Scale to investigate the use of psychological strategies to cope with cognitive dissonance related to meat, dairy, egg, and fish consumption in omnivores (n = 186), pescatarians (n = 106), vegetarians (n = 143), vegans (n = 203), and flexitarians (n = 63). Results indicated greater use of meat-related dissonance reduction strategies among omnivores as compared to other dietary groups, greater use of fish-related dissonance reduction strategies among fish consumers (omnivores, flexitarians and pescatarians) compared to vegetarians and vegans, and greater use of dairy and egg-related dissonance reduction strategies among dairy and egg consumers (omnivores, flexitarians, pescatarians, and vegetarians) as compared to vegans. This pattern was particularly clear for justifications used to defend animal product consumption, denial of animal suffering, and use of dichotomization when considering meat and fish consumption. These findings highlight the importance of extending the research on dissonance reduction strategies beyond meat consumption and studying the consumption of a range of animal products. This can help in identifying the psychological barriers to adopting a plant-based diet and informing interventions for behaviour change.

Household dairy production, dairy intake, and anthropometric outcomes in rural Bangladesh

We assess whether ownership of dairy cows is associated with a greater likelihood of consuming dairy products and with child anthropometric status in rural Bangladesh. Consistent with the assumption of imperfectly functioning markets for dairy products, ownership of dairy cows increases the likelihood that a child 6-59 months consumes milk by 7.7 percentage points with no difference in this association between boys and girls. This association nearly doubles in magnitude when we consider households that own a dairy cow that produced milk in the last year. This result is robust to the controls we use and the way in which we measure dairy cow ownership. Even when we saturate our model with child, maternal, household, wealth, as well as village fixed effects, we retain an association between dairy cow ownership and height-for-age z scores (HAZ) that is meaningful in magnitude - 0.13 standard deviations - and statistically significant at the one percent level. For children in the 12-23.9 month age group, ownership of a dairy cow is associated with a 0.37 SD increase in HAZ and a reduction of 11.3 percentage points in stunting. There is no statistically significant association with weight-for-height or wasting. These associations do not differ between boys and girls.

Dairy consumption in adults in China: a systematic review

BACKGROUND

Research on dairy consumption in China is lacking, however, some evidence has demonstrated significant changes in recent years, with a reported increase in the overall consumption of dairy products. To fully understand these changes, a systematic review was conducted to examine reported dairy intakes and differences between dairy consumption in different population groups in China.

METHODS

Web of Science, Embase, and PubMed databases were searched for studies published from January 2000 to September 2022. The China National Knowledge Infrastructure (CNKI) was used to retrieve papers available in Chinese. Papers reporting dietary intakes of dairy consumption across age, sex, and geographical location sub-groups were considered for inclusion in this review. In addition, this review includes the consumption of different types of dairy foods and changes in dairy intake over time.

RESULTS

Forty-seven papers were included in the present study. Twelve papers examined dairy consumption across age groups, showing that middle-aged adults tend to consume less dairy than other age groups. Studies comparing across location-specific cohorts reported dairy intakes among urban populations were higher than rural, as well as being higher than the national average. Coastal, Northern and Eastern residents consumed more dairy products than those living in other regions of China, and people in larger cities had higher reported intakes than smaller cities. Milk was the primary dairy product reportedly consumed by Chinese population, followed by yogurt. Concerning sex, evidence showed that females generally reported a greater daily dairy intake than males.

CONCLUSIONS

This review shows that, in China, several different population groups displayed significant differences in the amount and type of dairy consumed. When considering the incorporation of dairy products into healthy eating guidelines or positioning specific dairy products on the market, it is important to consider the differences and variations in consumption patterns within population groups.

Habitual dairy consumption is inversely associated with depressive and social anxiety symptoms among children and adolescents aged 7-17 years: Findings from a cross-sectional study in Beijing, China

BACKGROUND

Knowledge remains limited about dairy consumption and childhood depression and social anxiety, which is our purpose.

METHODS

A cross-sectional study including children and adolescents aged 7-17 years was conducted in 2020 in Beijing. Depression and social anxiety were assessed using the Children's Depression Inventory and the social anxiety scale for children. Habitual dairy consumption was defined as ≥6 days/week. Multivariate linear and logistic regression models were employed to analyze the associations between dairy consumption and depression and social anxiety. Subgroup analyses were conducted to test the robustness of the main results.

RESULTS

A total of 1353 participants were included, with a mean age of 12.06 (SD = 3.10) years old. There were 53.58 % habitual dairy consumers and nearly 11.01 % consumed of ≤1 day/week. The prevalence of depression and social anxiety was 14.04 % and 29.64 %. Compared to participants with less dairy intake, the scores of depression and social anxiety in habitual dairy consumers decreased by 1.725 (95 % CI: -2.939, -0.512) and 1.083 (95 % CI: -1.821, -0.345). Correspondingly, habitual dairy consumption was inversely correlated with depression (OR = 0.602, 95%CI: 0.369-0.982) and social anxiety (OR = 0.622, 95%CI: 0.418-0.923). Such inverse associations were more pronounced in younger participants, those without siblings, with higher parental education and higher consumption of fruits or vegetables.

LIMITATIONS

Conclusions about causality remain speculative due to the cross-sectional design.

CONCLUSIONS

Habitual dairy consumption is inversely associated with childhood depression and social anxiety. A potential attempt could be implemented when recommending dairy products as an adjuvant therapy for childhood mental disorders.

Gestational Health Outcomes Among Pregnant Women in the United States by Level of Dairy Consumption and Quality of Diet, NHANES 2003-2016

Objectives

Diet is an important factor in gestational health. Many pregnant women have suboptimal diets and dairy foods are an excellent source of key nutrients. The aim of this work was to investigate the relationships between dairy consumption (cup equivalents/day) or diet quality assessed using the Healthy Eating Index-2015 and gestational diabetes mellitus (GDM) or gestational weight gain (GWG) among pregnant women in the United States (US).

Methods

Study populations were subsets of pregnant, non-lactating women (20–44 years) in the National Health and Nutrition Examination Surveys 2003–2016, which was approved by the National Center for Health Statistics Research Ethics Review Board. GDM and GWG were classified according to national guidelines. General characteristics were compared across categories of dietary variables. Adjusted regression models estimated associations between diet and GDM and GWG.

Results

No statistically significant linear associations between dairy consumption or diet quality and GDM or GWG were observed.

Conclusions for Practice

Future research should aim to address the limitations of the current cross-sectional analyses and further elucidate the underlying relationships between diet and gestational health.

Dairy consumption and risk of type-2 diabetes: the untold story

The role of dairy products in human health has been extensively studied for decades; however, evidence regarding dairy consumption and risk of type 2 diabetes (T2D) remains controversial and uncertain. Furthermore, study results are misinterpreted to a remarkable extent. The aim of this review is to critically appraise the association between intake of dairy foods and risk of T2D. A thorough search was conducted using electronic databases of PubMed, Scopus, and Web of Science. Related studies that addressed this research question between 2004 to 2019 were considered. Although most of the existing evidence suggests a beneficial role of dairy consumption on risk of T2D, only low-fat dairy foods and yogurt have shown a significant and consistent role, while other dairy products showed no association with prevention of T2D. Researchers, readers, and the public should maintain caution when reporting and interpreting findings and consider aspects such as heterogeneity, generalizability, and clinical and statistical significance.

Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study

BACKGROUND AND AIM

Physical activity (PA) and sedentary behaviours (SB) are related to obesity and cardiometabolic risk; however, the literature is controversial regarding the effect of dairy consumption on the development of cardiovascular disease (CVD) risk factors. The aim of this study was to assess longitudinally the relationship between specific lifestyle behaviours (PA and SB) and dairy consumption in a sample of European children and adolescents.

METHODS AND RESULTS

Children from the IDEFICS study were included in the analyses. Two measurements, with 2 years' interval, were conducted. A total of 1688 (50.8% boys) children provided information regarding diet, measured by a 24-h dietary recall, PA measured by accelerometers and parent-reported sedentary screen time (SST) at both time points. Different combinations of these behaviours, at each survey and over time, were derived applying specific recommendations. Multilevel ordinal logistic regression and analysis of covariance were used to assess their association with dairy consumption, adjusted for potential confounders. Differences by gender were found regarding dairy product consumption and also adherence to SB and PA recommendations at T0 and T1. Children meeting both lifestyle recommendations, at the two measurement points, had higher probability to consume more milk and yogurt and less cheese than the rest of combinations.

CONCLUSIONS

These results suggest that European children with a healthy lifestyle, especially regarding PA and SB over time, consumed more milk and yogurt. This study suggests that the protective effect of specific dairy products found in literature could be partially due to the association of their consumption with specific healthy lifestyles.

Dairy Consumption and Associations with Nutritional Status of Chinese Children and Adolescents

OBJECTIVE

This study aimed to describe frequency and quantity of total dairy consumption of Chinese children and adolescents and explore the associations between dairy consumption and nutrition status, including stunting, wasting, overweight, and obesity.

METHODS

Participants included 28,250 children and adolescents aged 6-17 years old. A food frequency questionnaire (FFQ) including 100 kinds of food was used to collect information about frequency and quantity of dairy consumption. Determination of stunting was with a height cutoff value for age and gender, and determination for wasting, overweight, and obesity was with BMI for age and gender.

RESULTS

Of the total sample, 36.1% of children aged 6-17 reported consuming dairy food more than once per day (⪖ 1/day). The average total dairy intake of all the participants was 126.7 g/day. For boys, dairy consumption had an inverse correlation with stunting and wasting after controlling for confounders. For girls, dairy consumption was negatively associated with stunting and obesity after controlling for confounders as above.

CONCLUSION

Dairy consumption in Chinese children and adolescents was relatively lower than that in developed countries, and was negatively associated with stunting and wasting for boys and with stunting and obesity for girls.

Strategies for public health initiatives targeting dairy consumption in young children: a qualitative formative investigation of parent perceptions

OBJECTIVE

Dairy products contain essential nutrients to ensure healthy growth and bone development in children. However, a significant proportion of children in developed countries fail to consume the daily recommended intake of dairy products. Parents are the gatekeepers of familial nutritional intake and represent a potential vehicle through which to increase dairy consumption in children. As such, formative research was conducted to gain insight into parents' perceived barriers to and benefits of purchasing and consuming dairy products and to develop innovative message content that could be utilized in future public health campaigns.

DESIGN

Seven in-depth group interviews were conducted in two phases between February and May 2015.

SETTING

Interviews were conducted in local recreational centres and libraries in British Columbia, Canada.

SUBJECTS

Mothers (n 21, mean age 38 (sd 5) years) and fathers (n 9, mean age 38 (sd 3) years) of children aged 4-10 years.

RESULTS

Parents perceived both positive and negative physical outcomes associated with consuming dairy. Lack of trustworthy information was a frequently discussed barrier theme to purchasing and consuming dairy products. Mothers were concerned about the cost of dairy products. Differences in purchasing and consumption strategies were reported between parents of children who consumed adequate dairy and those who did not. Parents believed the most appropriate communication channel was through print material.

CONCLUSIONS

Messages targeting parents, as a means of increasing dairy consumption in children, should address barriers identified by parents. In addition, practical tips should be provided to promote purchasing and consumption of dairy products.

Dairy consumption is associated with a lower incidence of the metabolic syndrome in middle-aged and older Korean adults: the Korean Genome and Epidemiology Study (KoGES)

This cohort study examined the association between total and individual dairy products and the risk of developing the metabolic syndrome (MetS) and its components in Korean adults from the Korean Genome and Epidemiology Study. We prospectively analysed 5510 participants aged 40-69 years without the MetS at baseline during a 10-year follow-up period. Dairy consumption was assessed with a semi-quantitative FFQ at baseline and after 4 years. The MetS was defined according to the criteria by the National Cholesterol Education Program Adult Treatment Panel III. The Cox's proportional hazard model was used to examine the association between consumption of total dairy products, milk and yogurt in servings per week and the risk of incident MetS or individual components. A total of 2103 subjects developed the MetS (38·2 %) during an average follow-up of 67·4 months (range 17-104 months). Frequent dairy consumption (>7 servings of total dairy and milk/week, ≥4 servings of yogurt/week) was associated with a reduced risk of incident MetS and its components. In the multivariable adjusted model, hazard ratios for the MetS were 0·51 (95 % CI 0·43, 0·61) for total dairy products, 0·50 (95 % CI 0·38, 0·66) for milk and 0·67 (95 % CI 0·57, 0·78) for yogurt in frequent consumers compared with non-consumers. An inverse association between milk/yogurt and low HDL-cholesterol was shown only in women. In conclusion, high consumption of individual dairy products including milk and yogurt as well as total dairy were associated with a reduced risk of incident MetS and individual components in Korean adults.

Dairy product consumption and the metabolic syndrome

AIMS

To briefly summarize findings from epidemiological studies on the relationship between dairy product consumption and the metabolic syndrome(MetS).

MATERIALS AND METHODS

A search for relevant literature was undertaken on Web of Science, Google scholar, Pubmed (2000 to July 2013), to identify observational studies which examined the association between dairy intake and MetS (prevalence or incidence), and for any randomized controlled trials investigating the effect of dairy intake on MetS.

RESULTS

Here we review the physiological effects and possible mechanisms involved of three main dairy constituents (calcium (Ca), protein, fat) on important components of the MetS. Effects of Ca may be related to intestinal binding to fatty acids or bile acids, or to changes in intracellular Ca metabolism by suppressing calciotropic hormones. Dietary proteins may increase satiety in both the short and longer term, which may result in a reduced energy intake. Dairy proteins are precursors of angiotensin-I converting enzyme-inhibitory peptides, which may lower blood pressure. To reduce the intake of saturated fatty acids (SFA), the consumption of low-fat instead of high-fat dairy products is recommended.

CONCLUSION

More research is warranted to better understand the physiological effects and the mechanisms involved of dairy products in the prevention and treatment of the MetS.

In utero preeclampsia exposure, milk intake and pubertal development

Cord blood insulin-like growth factor-1 (IGF-1) concentrations are lower in preeclamptic (PE) than normotensive (NT) pregnancies. PE offspring have increased risk of cardiovascular disease and decreased risk of some cancers including breast. We examined the effects of PE exposure in utero, infant feeding and childhood diet at 3-5 years on IGF-1 and breast development in 194 female offspring who were followed from birth until follow-ups at 10.8 and 12.9 years. Diet was not associated with serum IGF-1 levels at 10.8 years. PE exposure was associated with reduced odds of thelarche at 10.8 years only among exclusively breastfed girls. Milk, butter and ice cream consumption at 3-5 years was inversely related to the OR of breast development at 10.8 years. Child's weight and maternal overweight were positively associated with breast development at 10.8 years; child's height and weight were positively associated with breast development at 12.9 years.