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Dairy intake, plasma metabolome, and risk of type 2 diabetes in a population-based cohort

Zhang, Shunming LU ; Janzi, Suzanne LU ; Du, Yufeng LU ; Smith, J. Gustav LU orcid ; Qi, Lu ; Borné, Yan LU and Sonestedt, Emily LU orcid (2025) In American Journal of Clinical Nutrition 121(5). p.1137-1148
Abstract

Background: Whether dairy intake is related to type 2 diabetes (T2D) remains unclear, as does potential metabolic mechanisms for this association. Objectives: We aimed to examine the association between high dairy intake and risk of T2D and identify plasma metabolites reflecting dairy intake. Methods: This prospective cohort study included 26,461 Swedish individuals recruited between 1991 and 1996 and followed up until 31 December, 2020, with available data on dairy intake at baseline and linked registers. Plasma metabolites were measured in a subsample (n = 893) using mass spectrometry. Associations of dairy intake with risk of T2D were assessed using Cox proportional hazards models, with results presented as hazard ratios (HRs) and... (More)

Background: Whether dairy intake is related to type 2 diabetes (T2D) remains unclear, as does potential metabolic mechanisms for this association. Objectives: We aimed to examine the association between high dairy intake and risk of T2D and identify plasma metabolites reflecting dairy intake. Methods: This prospective cohort study included 26,461 Swedish individuals recruited between 1991 and 1996 and followed up until 31 December, 2020, with available data on dairy intake at baseline and linked registers. Plasma metabolites were measured in a subsample (n = 893) using mass spectrometry. Associations of dairy intake with risk of T2D were assessed using Cox proportional hazards models, with results presented as hazard ratios (HRs) and 95% confidence intervals (CIs). Results: A total of 4552 new-onset incident T2D cases were documented during a median follow-up of 24.3 y. Increased risk of T2D was observed among participants consuming high nonfermented milk (>1000 g/d compared with <200 g/d; HR: 1.40; 95% CI: 1.12, 1.74) and cheese (>100 g/d compared with <20 g/d; HR: 1.23; 95% CI: 1.07, 1.41), although decreased risk of T2D was observed among those with high fermented milk (>300 g/d compared with 0 g/d; HR: 0.88; 95% CI: 0.74, 1.03), cream (>50 g/d compared with <10 g/d; HR: 0.77; 95% CI: 0.64, 0.92), and butter (>50 g/d compared with 0 g/d; HR: 0.82; 95% CI: 0.71, 0.94). Such associations were slightly attenuated after additional adjustment for BMI. In addition, we identified metabolite profiles for nonfermented milk (n = 45), fermented milk (n = 48), cheese (n = 12), cream (n = 27), and butter (n = 46); no overlap between metabolites was found. Conclusions: In this cohort of Swedish adults, high intakes of nonfermented milk and cheese are positively associated with risk of T2D, although high intakes of fermented milk, cream, and butter are inversely associated. Metabolomics provides novel insights into understanding the metabolic pathways of these associations.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
butter, cheese, cream, dairy, metabolites, metabolomics, milk, type 2 diabetes, yogurt
in
American Journal of Clinical Nutrition
volume
121
issue
5
pages
12 pages
publisher
Elsevier
external identifiers
  • scopus:105003252215
  • pmid:40318879
ISSN
0002-9165
DOI
10.1016/j.ajcnut.2025.02.023
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s)
id
b5aeb7e6-dc83-49ab-b51f-127637b32620
date added to LUP
2025-05-07 13:36:32
date last changed
2025-05-08 03:00:02
@article{b5aeb7e6-dc83-49ab-b51f-127637b32620,
  abstract     = {{<p>Background: Whether dairy intake is related to type 2 diabetes (T2D) remains unclear, as does potential metabolic mechanisms for this association. Objectives: We aimed to examine the association between high dairy intake and risk of T2D and identify plasma metabolites reflecting dairy intake. Methods: This prospective cohort study included 26,461 Swedish individuals recruited between 1991 and 1996 and followed up until 31 December, 2020, with available data on dairy intake at baseline and linked registers. Plasma metabolites were measured in a subsample (n = 893) using mass spectrometry. Associations of dairy intake with risk of T2D were assessed using Cox proportional hazards models, with results presented as hazard ratios (HRs) and 95% confidence intervals (CIs). Results: A total of 4552 new-onset incident T2D cases were documented during a median follow-up of 24.3 y. Increased risk of T2D was observed among participants consuming high nonfermented milk (&gt;1000 g/d compared with &lt;200 g/d; HR: 1.40; 95% CI: 1.12, 1.74) and cheese (&gt;100 g/d compared with &lt;20 g/d; HR: 1.23; 95% CI: 1.07, 1.41), although decreased risk of T2D was observed among those with high fermented milk (&gt;300 g/d compared with 0 g/d; HR: 0.88; 95% CI: 0.74, 1.03), cream (&gt;50 g/d compared with &lt;10 g/d; HR: 0.77; 95% CI: 0.64, 0.92), and butter (&gt;50 g/d compared with 0 g/d; HR: 0.82; 95% CI: 0.71, 0.94). Such associations were slightly attenuated after additional adjustment for BMI. In addition, we identified metabolite profiles for nonfermented milk (n = 45), fermented milk (n = 48), cheese (n = 12), cream (n = 27), and butter (n = 46); no overlap between metabolites was found. Conclusions: In this cohort of Swedish adults, high intakes of nonfermented milk and cheese are positively associated with risk of T2D, although high intakes of fermented milk, cream, and butter are inversely associated. Metabolomics provides novel insights into understanding the metabolic pathways of these associations.</p>}},
  author       = {{Zhang, Shunming and Janzi, Suzanne and Du, Yufeng and Smith, J. Gustav and Qi, Lu and Borné, Yan and Sonestedt, Emily}},
  issn         = {{0002-9165}},
  keywords     = {{butter; cheese; cream; dairy; metabolites; metabolomics; milk; type 2 diabetes; yogurt}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1137--1148}},
  publisher    = {{Elsevier}},
  series       = {{American Journal of Clinical Nutrition}},
  title        = {{Dairy intake, plasma metabolome, and risk of type 2 diabetes in a population-based cohort}},
  url          = {{http://dx.doi.org/10.1016/j.ajcnut.2025.02.023}},
  doi          = {{10.1016/j.ajcnut.2025.02.023}},
  volume       = {{121}},
  year         = {{2025}},
}