Eating yogurt is linked to reductions in obesity, metabolic syndrome, type 2 diabetes and heart disease. Now research is needed to validate the potential role of yogurt in protecting against these cardiometabolic disease (CMD) risks and find out how yogurt may be achieving this positive effect.
Most of the data suggesting that yogurt may reduce the risk of CMDs come from epidemiological studies. In this review, the authors discuss the possible mechanisms underlying the association found by these studies, and highlight the need for randomised controlled trials to provide concrete evidence in support of these mechanisms.
Yogurt may reduce risk of obesity and type 2 diabetes
Observational studies suggest that yogurt is linked to reduced risk of obesity and type 2 diabetes, and accumulating evidence supports the role of yogurt consumption in weight management. Yogurt appears to have a neutral effect on the risk of heart and vascular disease.
The yogurt matrix plays an important role
The yogurt matrix may play an important role in boosting the health benefits of its nutrients. The gel structure of the matrix may protect its nutrients and bioactive compounds against degradation and allow improved nutrient interactions.
The yogurt matrix may be responsible for the reduced incidence of type 2 diabetes in people who eat yogurt compared with milk and other dairy products.
Yogurt may have positive effects on the gut microbiota
Yogurt is believed to have positive effects on the gut microbiota and intestinal barrier function – these effects may contribute to its cardiometabolic health benefits.
Disruption of the microbial balance in the gut (dysbiosis) and impaired intestinal barrier function can contribute to obesity, inflammation and type 2 diabetes. Consuming yogurts with live cultures may have important beneficial effects on maintaining a healthy and balanced gut microbiota.
Yogurt also provides an ideal vehicle for probiotics. Commercial probiotic yogurts have been shown to improve blood sugar control and cholesterol in people with diabetes. However, the effects of commercially available probiotic yogurts are strain-specific, and we need to find out more about both classic (containing S. thermophilus and L. bulgaricus) and alternative cultures to establish potential effects on CMD risks.
Fermentation releases beneficial bioactive peptides
Bioactive peptides released during yogurt fermentation have been shown to have cardiometabolic health properties. These include blood pressure-lowering, cholesterol-lowering, anti-thrombotic, anti-oxidant, mucin-stimulating, and immune modulating activities. Bioactive peptides may also help to improve insulin sensitivity.
Proteins in yogurt may help control appetite
Positive effects of yogurt on CMDs have often been attributed to the potential for yogurt to increase satiety – the person feels full and so eats less food afterwards. This may be due in part to its protein content.
Fats in yogurt may protect against CMDs
Eating high-fat yogurt has been associated with a reduced risk of CMDs. Yogurt contains several bioactive fats.
Medium-chain fatty acids (MCFAs) in yogurt are a source of rapid energy and not likely to be deposited as fat in the body. MCFAs have been associated with anti-diabetes effects, including improved glucose tolerance, protection against insulin resistance and preserved insulin action.
Conjugated linoleic acid (CLA) has been linked with anti-obesity effects, and improved metabolic parameters associated with type 2 diabetes.
Calcium in yogurt may regulate glucose and insulin
Yogurt is a good source of calcium. Insulin secretion depends on calcium, and calcium in yogurt may help to regulate glucose and insulin. Calcium may also help to prevent type 2 diabetes through mechanisms that reduce nutrient deficiencies, control high blood pressure, prevent obesity and reduce inflammation.
The authors conclude that further evidence is needed to justify official recommendations for eating yogurt to prevent CMDs. Research needs to validate the benefits of yogurt in particular health parameters, identify the mechanisms, and decide on how much yogurt we should eat to achieve greatest benefits.
It is likely that the calcium, protein, bioactive nutrients and live cultures contained in yogurt are largely responsible for its beneficial effects of yogurt on CMD risk. However, further research is needed to discover the individual roles of these nutrients and how they work together in the food matrix.
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Source: Fernandez MA, Panahi S, Daniel N, et al. Yogurt and cardiometabolic diseases: a critical review of potential mechanisms. Adv Nutr 2017;8(6):812-829.