A recent study sheds light on an intriguing possibility: a daily dairy intake might play a significant role in reversing pre-diabetes, potentially steering those at risk away from developing Type 2 diabetes (T2D).
Researchers tracked the dietary habits and health outcomes of people with pre-diabetes over nearly a decade, providing new insights into how specific types of dairy products could influence their journey toward or away from diabetes. Eating more whole-fat dairy foods such as yogurt may prove to help reverse the progression of pre-diabetes and lower our risk of developing T2D, the research suggests (1).
Pre-diabetes is a pre-cursor to Type 2 diabetes and cardiovascular disease
Pre-diabetes – characterised by higher-than-normal blood sugar levels that aren’t yet high enough to be classified as diabetes – affects over a quarter of middle-aged adults worldwide. Numbers are expected to soar to 470 million people by 2030 (2). Every year, between 5 and 10% of people with pre-diabetes progress to T2D; these people are also at high risk of developing cardiovascular disease and of premature death (3).
While the risk factors for developing T2D are well established, less is known about potential moderators of pre-diabetes progression. Regular consumption of dairy products, especially yogurt, has been associated with a reduced risk of developing T2D.
With this in mind, researchers from the Shahid Beheshti University of Medical Sciences in Iran looked into whether regularly eating dairy products may affect pre-diabetes regression to normal glycaemia or progression to T2D. They followed 334 adults with pre-diabetes for up to nine years, recording the dairy foods they ate using validated Food frequency questionnaires and regularly monitoring their blood sugar levels.
To assess the association between regression to normal glycaemia or progression to T2D, the researchers used several models, taking into account various well-know T2D risk factors:
- Model 1, adjusted for age, sex, post-prandial glycemia, and T2D risk score
- Model 2, additionally adjusted for smoking and physical activity
- Model 3, taking into account all the above risk factors and, additionally adjusted for dietary intakes of fruits, vegetables, legumes, nuts, grains, and meats.
Eating whole-fat dairy foods is associated with reduced risk of pre-diabetes progression
Results showed that eating higher amounts of whole-fat dairy products is significantly associated with pre-diabetes regression. Specifically, each additional 200g of whole-fat dairy per day was associated with a 69% higher likelihood of returning to normal glycaemia, in the model 3 adjusted for the well-established risk factors for T2D development. A higher intake of whole-fat dairy was also linked to lower average blood sugar levels after eating.
Interestingly, the researchers did not find a significant association between the consumption of total (whole-fat and low-fat dairy, or low-fat dairy alone and the chance of pre-diabetes regression or progression, regardless of the model.
These results support previous studies demonstrating a greater protective effect of whole fat dairy consumption against the risk of developing T2D (4,5).
Dairy food choices may vary in their association with pre-diabetes
When looking at the different dairy categories (yogurt, milk, cheese, cream or butter), only yogurt showed a particular beneficial effect and was associated with pre diabetes regression. There was no significant link between the consumption of milk, cheese, cream or butter and changes in pre-diabetes status, regardless of the model:
- Eating a higher daily amount of yogurt was associated with an 82% greater chance of returning to normal blood sugar levels. Once again, this association was only found in model 3 adjusted for most of the well-established risk factors for T2D development. People who returned to normal glycaemia during the follow-up period also ate more yogurt on average than those whose pre-diabetes remained (1.7 vs. 1.1 servings/day).
- Drinking milk was associated with some effect on blood glucose level but did not lead to a significant regression of pre-diabetes. A higher daily intake of milk (0.5 or 1.9 vs. <0.2 servings/day) was related to lower average blood sugar levels after eating, ,this did not lead to a significant regression of pre-diabetes.
- Finally, cheese consumption appeared to negatively affect blood glucose levels, as a higher daily intake of cheese (≥ 1.0 vs. < 0.4 servings/day) was associated with higher average blood sugar levels after eating. People who developed T2D during the follow-up period appeared to eat more cheese than those who did not.
These results support previous findings on the unique role of yogurt in potentially decreasing the risk of developing T2D (6).
What biological mechanisms could be associated with pre-diabetes regression?
The cause and underlying mechanisms of the observed relationships between dairy intake and the risk of developing T2D remain unclear (5). Scientists attribute the protective effects of dairy products against T2D to their fatty acids profiles along with other bioactive components including probiotics, menaquinones, and the milk fat globule membrane (6,7).
The researchers of this study suggest that potential effects of regular dairy intake on the regression or progression of pre-diabetes are mediated through improved glucose tolerance and insulin sensitivity, as dairy intake was associated with changes to blood sugar levels after eating but not fasting levels.
“These findings further support that regular consumption of dairy may attenuate the risk of developing Type 2 diabetes or the chance of returning to normal glycemia, and various dairy products may affect these pathways differently.”
