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18 Nov 2024
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4 min read
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by YINI Editorial team
Diabetes prevention

Probiotic fermented milk holds promise as a new tool in managing Type 2 diabetes

YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
Fermented milk probiotic t2d type 2 diabetes
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Probiotic fermented milk could play a valuable role in helping to tackle Type 2 diabetes. Although yet to be confirmed, early research suggests that consuming fermented milk may be linked to improvements in several key health markers of Type 2 diabetes mellitus (T2DM), including indicators of blood sugar control (1).  

As such, consuming fermented milk products may offer a helping hand in delaying the progression and reducing complications of this chronic disease.

It’s welcome news for scientists as they struggle to stem the tide of the diabetes epidemic that is sweeping across the world and placing a huge burden on individuals and society as a whole.

What is probiotic fermented milk?

Fermented milk products, such as yogurt or kefir, contain live bacteria used in fermentation that may improve gut health. They can also be enriched with probiotics – additional live bacteria that confer further health benefits. Fermented milk products have properties that help the survival and growth of these probiotics in the gut (2).

Scientists have proposed that improving gut health might help manage T2DM by affecting how the body processes sugars and fats. Mounting evidence suggests that composition of the gut bacteria may have a role in the development of T2DM by influencing insulin sensitivity, inflammatory regulation, and lipid metabolism (3). Modulating the composition of the gut microbiota through consumption of probiotics has therefore been proposed as a potential therapy for T2DM.

With this in mind, researchers set out to investigate whether probiotic fermented milk can improve key health indicators in people with T2DM, including measures of glucose and lipid metabolism and inflammatory markers. They analysed the results of ten randomised controlled trials studying the effects of probiotic-enriched fermented milk in over 250 adults with T2DM.

Probiotic fermented milk has potential to benefit the health of people with T2DM

Based on their analysis of randomised controlled trial results, the meta-analysis concluded that probiotic-enhanced fermented milk has the potential to have positive impacts on certain health markers in people with T2DM, when compared with conventional fermented milk products.

  • Blood sugar control: Consuming probiotic fermented milk was associated with significantly reduced markers of blood sugar levels, including a fall in fasting plasma glucose by an average of 17 mg/dL and glycosylated haemoglobin (HbA1c) by 0.5%. These reductions suggest improvements in blood sugar management.
  • Cholesterol levels: in Total cholesterol levels were reduced significantly by 5.15 mg/dL in association with fermented milk consumption, indicating potential cardiovascular health benefits for people with T2DM. The effects on other lipid markers, such as triglycerides, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol, were not significant.
  • Inflammation reduction: The analysis found a significant decrease in levels of the inflammatory marker C-reactive protein (CRP), suggesting a potential anti-inflammatory effect associated with probiotic fermented milk. This could be a valuable finding, since inflammation plays a crucial role in the progression of T2DM and the development of complications (4).

Beneficial effects of probiotic fermented milk in T2DM may be mediated through the gut microbiota

The exact mechanisms behind the beneficial effects of probiotic fermented milk in people with T2DM are not fully understood and probably involve several factors. The authors highlight that one explanation for such benefits might be the change to the composition of the gut microbiota caused by probiotics.

An imbalance in gut microbiota composition is common in people with T2DM, and can lead to increased intestinal permeability, allowing bacterial toxins to enter the circulation, causing inflammation and raising levels of cholesterol and blood sugar (5,6). Probiotics can restore balance to the gut microbiota by promoting the growth of beneficial bacteria and inhibiting the number of harmful bacteria (7,8).

What further research is needed?

While probiotic fermented milk shows promise in helping to manage blood sugar, cholesterol, and inflammation in people with T2DM, further research is needed to confirm these benefits.

The number of studies and participants included in the analysis was relatively small, which limits the strength of the conclusions. The trials included also varied in terms of their study design and duration, as well as the probiotic strains and comparators used, making it difficult to compare results accurately across studies. The researchers propose that larger, more standardized trials are needed to determine whether probiotic fermented milk can become a reliable part of T2DM management.

“The present findings provide a crude indication of the potential benefits of probiotic fermented milk supplementation in improving glucose and lipid metabolism and inflammation in patients with T2DM. However, more robust evidence is needed to determine the clinical significance of probiotic fermented milk in the management of T2DM. “

Zhong H, et al., 2024

References
  1. (1) Zhong H, Wang L, Jia F, et al. Effect of Probiotic Fermented Milk Supplementation on Glucose and Lipid Metabolism Parameters and Inflammatory Markers in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. Biology (Basel). 2024 Aug 21;13(8):641. doi: 10.3390/biology13080641. PMID: 39194579
  2. (2) Khorshidian N., Yousefi M., Mortazavian, A.M. Fermented milk: The most popular probiotic food carrier. Adv. Food Nutr. Res. 2020, 94, 91–114
  3. (3) Gurung M., et al, Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine 2020, 51, 102590
  4. (4) Goldberg R.B., Cytokine and cytokine-like inflammation markers, endothelial dysfunction, and imbalanced coagulation in development of diabetes and its complications. J. Clin. Endocrinol. Metab. 2009, 94, 3171–3182
  5. (5) Zhou Z., Sun B., Yu D., Zhu C., Gut Microbiota: An Important Player in Type 2 Diabetes Mellitus. Front. Cell. Infect. Microbiol. 2022, 12, 834485.
  6. (6) Cani P.D, et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 2007, 56, 1761–1772
  7. (7) Wang Y., Dilidaxi D., Wu Y., Sailike J., Sun X., Nabi X.H,. Composite probiotics alleviate type 2 diabetes by regulating intestinal microbiota and inducing GLP-1 secretion in db/db mice. Biomed. Pharmacother. 2020, 125, 109914
  8. (8) Markowiak-Kopec P., Slizewska K., The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome. Nutrients 2020, 12, 1107.
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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
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11 Nov 2024
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4 min read
Gut Health

New global guidelines unlock the effects of probiotics and prebiotics for gut health

ibd IBS Lactose NAFLD prebiotic probiotic WGO
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New global guidelines on identifying and using probiotics and prebiotics have been drawn up in recognition of their potential benefits in supporting gut health (1).

The guidelines, published by the World Gastroenterology Organisation, reflect the growing evidence for the efficacy of specific probiotic strains or prebiotics in a variety of gastrointestinal conditions. Developed by a worldwide team of gastroenterology experts, they represent a shift in the way health professionals view these popular food ingredients.

How do we define probiotics?

Over a century ago, scientists proposed that lactic acid bacteria – commonly used for food fermentation, e.g. such as for the fermentation of milk in yogurt by the strains Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus – can provide health benefits to consumers by modifying their gut microbiota. Today, over 1,500 clinical trials have studied the effects of numerous strains of potentially probiotic bacteria on various human health outcomes. But how do we know which strains of bacteria are probiotic?

According to the World Gastroenterology Organisation, probiotics are defined as live microorganisms that confer a health benefit to humans when consumed in adequate amounts (2). Common probiotics include several strains of Lactobacillus and Bifidobacterium lactic acid bacteria, along with some strains of other bacteria and yeasts. In general, the term “probiotic” should be reserved for live microbial strains that have demonstrated health benefits in controlled human studies.

For more information on the health benefits of probiotics, see Scientists unravel the healthy secrets of probiotics.

How do we define prebiotics?

The concept of prebiotics – compounds that are not digested by humans but lead to health benefits by influencing the gut microbiome – is more recent (3,4). Most prebiotics are either used as food ingredients or found naturally in many foods – common examples include lactulose and oligofructose.

The World Gastroenterology Organisation defines prebiotics as selectively fermented ingredients that result in specific changes to the composition and/or activity of gut microbiota, conferring health benefits. However, the extent to which we may experience these benefits varies due to several factors, including an individual’s gut microbiota and diet.

How do probiotics and prebiotics work?

The consumption of prebiotics or probiotics is intended to influence the gut environment, which is inhabited by trillions of microbes, for the benefit of human health.

Prebiotics affect intestinal bacteria by enhancing the numbers or activities of beneficial bacteria. This may result in decreasing the population of potentially pathogenic microorganisms or reducing potentially deleterious metabolic activities of host microbiota. Prebiotics may also have an impact on immune function.

Probiotic strains may mediate health effects through one or more of several mechanisms:

  • Probiotic strains can lead to immune benefits by activating local macrophages, modulating cytokine profiles, and raising tolerance to food antigens.
  • Probiotics can also lead to improved gut health and reduced inflammation though mechanisms including food digestion, altered acidity, pathogen inhibition, and intestinal barrier enhancement.

What are the potential health benefits of probiotics or prebiotics?

Both probiotics and prebiotics have been shown to have beneficial effects on gut health. Their effects are strain- and dose-specific for probiotics and based on a particular formulation for prebiotics. Based on current evidence, the World Gastroenterology Organisation has summarized several potential health benefits:

  • Diarrhoea treatment and prevention – some probiotic strains can reduce the severity and duration of acute infectious diarrhoea in children, as well as preventing of adult and childhood diarrhoea in certain settings (5).
  • Immune response – several probiotic strains and the prebiotic oligofructose are useful in improving the immune response to infectious diseases.
  • Lactose malabsorption – Probiotic strains of Streptococcus and Lactobacillus – commonly found in yogurt – improve lactose digestion and reduce symptoms related to lactose intolerance (6).
  • Irritable bowel syndrome (IBS) – some strains of probiotics may alleviate symptoms and provide pain relief from IBS.
  • Inflammatory bowel disease – certain probiotics may be effective in preventing pouchitis, inflammation in the lining of a pouch created during surgery to treat treatment of some ulcerative colitis (7).
  • Non-alcoholic fatty liver disease (NAFLD) – certain probiotics can improve markers of liver function in adults and children with NAFLD.
  • Hepatic encephalopathy prevention and treatment – prebiotics such as lactulose are commonly used for the prevention and treatment of hepatic encephalopathy (8).

Probiotics and prebiotics have also been shown to have effects beyond gut health, including allergy prevention and benefits for skin, dental, and respiratory health.

So, what does this mean for clinical practice?

Probiotic- and prebiotic-containing products are available in many forms, most commonly as foods or supplements. Recommendations for probiotic and prebiotic use should tie specific strains or formulations to potential health benefits based on clinical studies.

Different probiotics strains have unique properties that may account for their particular health benefits. However, scientists are increasingly recognising that some mechanisms of probiotic activity may be shared among strains.

“‘The administration or use of prebiotics or probiotics is intended to influence the gut environment, which is inhabited by trillions of microbes, for the benefit of human health. Both probiotics and prebiotics have been shown to have beneficial effects that extend beyond the gut.’”

Guarner F, et al. 2024

References
  1. (1) Source: Guarner F, Sanders ME, Szajewska H, et al. World Gastroenterology Organisation Global Guidelines: Probiotics and Prebiotics. J Clin Gastroenterol. 2024 Jul 1;58(6):533-553. doi: 10.1097/MCG.0000000000002002. PMID: 38885083.
  2. (2) Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506–14.
  3. (3) Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995 Jun;125(6):1401–12
  4. (4) Roberfroid MB et al Prebiotic effects: metabolic and health benefits; Br J Nutr . 2010 Aug:104 Suppl 2:S1-63
  5. (5) Collinson S, Deans A, Padua-Zamora A, Gregorio GV, Li C, Dans LF, et al. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2020 Dec 8;12(12):CD003048
  6. (6) Savaiano DA, Hutkins RW. Yogurt, cultured fermented milk, and health: a systematic review. Nutr Rev. 2021 Apr 7;79(5):599–614.
  7. (7) Su GL, Ko CW, Bercik P, Falck-Ytter Y, Sultan S, Weizman AV, et al. AGA Clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology. 2020 Aug;159(2):697–705
  8. (8) Dalal R, McGee RG, Riordan SM, Webster AC. Probiotics for people with hepatic encephalopathy. Cochrane Database Syst Rev. 2017 Feb 23;2(2):CD008716.
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04 Nov 2024
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2 min read
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by YINI Editorial team
Q&A

Focus on vitamin B2

YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
nutrient riboflavin vitamin B2
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Riboflavin known as vitamin B2 is essential to health. Let’s focus on its effects and its presence in the diet.

What is vitamin B2?

Vitamin B2 or Riboflavin is a water-soluble vitamin involved in the maintenance of energy levels. It forms an essential part of co-enzymes Flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) which play major role in energy production, cellular function, growth and development, as well as in the metabolism of fats, drugs and steroids.

FAD is involved in the conversion of the amino acid tryptophan into niacin (vit B3). and FMN in the conversion of vit B6 into a co-enzyme.

Riboflavin helps maintain normal levels of homocysteine in blood.

Dietary recommendations

The daily dietary recommendations are:

  • 1.3mg for men,
  • 1.1mg for women,
  • 1.4mg during pregnancy,
  • 1.6mg during lactation.

When excess vitamin B2 is consumed, it is either not absorbed or is excreted in urine therefore consuming high quantities is relatively harmless and no safe upper limit has been defined.

Deficiency is very rare in developed countries. Symptoms are non-specific and include skin disorders, oedema of mouth and throat, cheilosis (swollen cracked lips), hair loss, reproductive problems, sore throat, itchy and red eyes. Typically, people who have a vitamin B2 deficiency also have deficiencies in other nutrients such as other B vitamins.

Sources of vitamin B2

90% of vitamin B2 found in the diet is in the form of FAD or FMN, only 10% is found in its free form, glycosides or esters. However, the main form found in eggs and milk is free riboflavin.

Vitamin B2 is found in a multitude of foods especially in animal sources such as eggs, organ meats, lean meats, milk and dairy products. It is present in some plant sources such as mushrooms, nuts (ex: almonds) and dark leafy green vegetables. Grains and cereals can be fortified in B2, this is the case in around 56 countries in the world including the USA.

Vitamin B2 in dairy

In the USA, the largest contributor to riboflavin in the diet is milk and milk-based drinks. Milk and dairy products contribute to around 25-27% of riboflavin daily intake in the UK population.

As such, dairy is a great source of vitamin B2. Yogurt is nutrient dense and provides a multitude of vitamins and minerals essential to health. 100g of yogurt contributes to around 15% of vitamin B2 daily intake.

It is recommended to consume about 2-3 portions of dairy per day. Such recommendation varies across countries.

References
  1. (1) Office of Dietary Supplements – Riboflavin
  2. (2) EUFIC – Riboflavin (vitamin B2): foods, functions, how much you need & more
  3. (3) Gliszczyńska-Świgło A, Rybicka I. Minerals and vitamin B2 in flavoured dairy products. Journal of Food Composition and Analysis. 2023;124: 105695.
  4. (4) Yeates AJ, Pourshahidi LK, O’Kane SM, Ward M, Mulhern MS, Lamers Y, et al. Effect of increasing cow’s milk consumption on riboflavin intake and plasma riboflavin measures in women of child-bearing age. Proceedings of the Nutrition Society. 2021;80: E138.
  5. (5) CIQUAL – La table de composition nutritionnelle des aliments. ANSES, France.
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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
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21 Oct 2024
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4 min read
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by YINI Editorial team
Cardiovascular health Healthy Diets & Lifestyle

Could swapping meat with dairy products help protect heart health?

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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
cardiovascular CVD dairy meat saturated fats SFA
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Latest research suggests the type of food saturated fats come from might alter how they affect our heart health. Swapping saturated fats from meat with those from dairy products may help lower cardiovascular risk, the evidence suggests.

Eating too much food high in saturated fats has long been associated with increased risk to the heart and blood vessels. But a recent study highlights that not all saturated fats behave the same way – the type of food they come from can make a big difference in how they affect heart health.

Researchers from the UK investigated whether replacing saturated fatty acids (SFAs) from different meat products with those from individual dairy foods could reduce the risk of cardiovascular events, with intriguing results (1).

Understanding saturated fatty acids and cardiovascular health

Dietary recommendations to reduce risk of cardiovascular disease (CVD) include limiting SFAs to 10% of total energy intake and replacing meat consumption with other plant- and animal-based foods (2,3).

Previous modelling studies have shown a lower incidence of CVD when replacing SFAs from meat products with those from dairy foods (4,5). But scientists haven’t yet unravelled the associations between individual meat products or dairy foods and CVD risk.

With this in mind, researchers from the University of Reading in England looked into how replacing SFAs from meat products (including processed, red, and poultry) with those from individual dairy foods (milk, cheese, and yogurt) was associated with CVD in the UK population.

The researchers analysed data from over 21,000 participants, aged 40–79 years, who were part of the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) study (6). Using food frequency questionnaires, they recorded dietary habits and followed participants for over two decades to track incidence of CVD, coronary artery disease (CAD), and stroke. Here’s what they found…

Swapping from meat to dairy foods may help reduce CVD risk

Results showed that overall, replacing 2.5% of daily energy intake from SFAs in meat with SFAs from dairy foods was associated with a significantly reduced risk of developing CVD. Specifically, replacing total meat SFAs with total dairy SFAs was associated with an 11% lower incidence of CVD and a 12% lower incidence of CAD. These results took other socio-demographic, lifestyle, cardio-metabolic, and dietary factors into account.

Replacing SFAs from red and processed meat may have the greatest CVD benefit

Analyses of individual meat products and dairy foods revealed significantly reduced CVD risks when replacing SFAs from red or processed meat with those from dairy foods.

So, replacing SFAs from processed meat with those from cheese was associated with a 23% lower incidence of CVD and coronary artery disease (CAD) and a 19% lower incidence of stroke, while replacement of SFAs from red meat with those from cheese was associated with a 14% lower incidence of CVD. Similarly, replacing SFAs from processed meat with those from milk was associated with a 16% lower incidence of CVD and a 17% lower incidence of CAD.

Replacing SFAs from poultry with those from dairy products was associated with an increased risk of CVD and stroke. However, the researchers urge caution in interpreting this result. The narrow range of poultry fat intake led to imprecise risk estimates, as indicated by the large confidence intervals, suggesting these findings cannot be generalized. Consequently, the study’s results do not align with previous research, which indicates that the intake of poultry meat and dairy products has a neutral effect on CVD risk.

Why does CVD risk change when replacing SFAs from meat with dairy?

The cause and underlying mechanisms of the changes seen in CVD risk when replacing SFAs from meat products with those from dairy foods remain unclear, but researchers propose several potentially contributing factors:

  • Different proportions of individual SFAs contained within meat and dairy foods may have a differential impact on CVD risk. For example, high concentrations of odd-chain fatty acids found in dairy foods have been linked with lower CVD risk.
  • Other constituents within meat (e.g., sodium, preservatives, and nitrates) and dairy matrices (e.g., protein, calcium, bacteria and the milk fat globule membrane) may also modulate the impact of SFAs on CVD risk.

The authors of this study suggest that future research should focus on the replacement of different types of red meat (unprocessed and processed) with different types of poultry and dairy foods to help specify food-based dietary recommendations for CVD prevention.

“Replacement of SFA from meat products, and especially processed meat, by dairy products may lower incidence of CVD and CAD. Our findings also add to the evidence that different types of meat (…) should be considered separately.”

Vogtschmidt YD, et al., 2024

References
  1. (1) Source: (1) Vogtschmidt YD, Soedamah-Muthu SS, Imamura F, Givens DI, Lovegrove JA. Replacement of Saturated Fatty Acids from Meat by Dairy Sources in Relation to Incident Cardiovascular Disease: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Study. Am J Clin Nutr. 2024 Jun;119(6):1495-1503. doi: 10.1016/j.ajcnut.2024.04.007. PMID: 38608753.
  2. (2) A.H. Lichtenstein, L.J. Appel, M. Vadiveloo, F.B. Hu, P.M. Kris-Etherton, C.M. Rebholz, et al., 2021 Dietary Guidance to improve cardiovascular health: a scientific statement from the American Heart Association, Circulation 144 (23) (2021) e472–e487
  3. (3) Food Standards Agency, The Eatwell Guide: helping you eat a healthy and balanced diet, Food Standards Agency, United Kingdom, 2020
  4. (4) M.C. de Oliveira Otto, D. Mozaffarian, D. Kromhout, A.G. Bertoni, C.T. Sibley, D.R. Jacobs Jr., et al., Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis, Am. J. Clin. Nutr. 96 (2) (2012) 397–404,
  5. (5) L.E.T. Vissers, J. Rijksen, J.M.A. Boer, W.M.M. Verschuren, Y.T. van der Schouw, I. Sluijs, Fatty acids from dairy and meat and their association with risk of coronary heart disease, Eur. J. Nutr. 58 (7) (2019) 2639–2647
  6. (6) N.E. Day, S. Oakes, R.N. Luben, K.T. Khaw, S.A. Bingham, A.A. Welch, et al., EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer, Br. J. Cancer. 80 (Suppl) (1999) 95–103
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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
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14 Oct 2024
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3 min read
Q&A

Focus on vitamin B12

nutrient vitamin vitamin B12
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Cobalamin known as vitamin B12 is essential to health. Let’s focus on its effects and its presence in the diet.

What is vitamin B12?

Vitamin B12 is a water-soluble vitamin part of the vitamin B complex. It is essential for the:

  • function of the nervous system,
  • red blood cell formation
  • DNA synthesis

It is a cofactor of two specific enzymes:

  • Methionine synthase which involved in the conversion of methionine, involved in DNA, RNA, proteins and lipids formation.
  • L-methyl malonyl-CoA mutase, involved in the metabolism of macronutrients.

Dietary recommendations

The dietary recommendation for adults is 4µg per day, it increases to 4.5µg during pregnancy and to 5µg during lactation. No safe upper limit has been determined as B12 has a low potential to become toxic since the body does not absorb or store excessive amounts.

When eating a balanced diet, the body is able to store 1000 to 2000 times more B12 than needed in a day which explains why it might take a while before the deficiency becomes symptomatic.

Symptoms of a deficiency can include megaloblastic anaemia (large abnormally nucleated red blood cells), palpitations, pale skin, dementia, weight loss, infertility, and neurological changes such as numbness and tingling in hands and feet. A deficiency during pregnancy and breastfeeding can lead to neural tube defects, developmental delays, failure to thrive and anaemia in the infant.

Deficiency remains rare in developed countries; it is most commonly caused by diet deficiency. People at risk of B12 inadequacy are mainly:

  • older adults,
  • vegetarians who consume little animal products (eggs, dairy)
  • vegans.
  • people with pernicious anaemia,
  • people with GI disorders, GI surgery which removes part of the stomach,

Sources of vitamin B12

Vitamin B12 is only found in animal sources such as fish, meat, poultry, eggs, and dairy.

Plant foods do not contain B12 naturally, but they can be fortified. For example: breakfast cereal, nutritional yeast, plant-based milk or yogurt alternatives such as fortified soy milk.

People who follow a vegan diet or a vegetarian diet with little to no dairy products should be mindful of their B12 intake and supplement if they do not consume enough fortified plant foods.

Vitamin B12 in dairy

Dairy is a great source of B12. People who consume dairy products are more likely to have adequate B12 levels. Furthermore, people who consume yogurt have a 7.1% higher B12 consumption than those who do not.

Dairy intake recommendations vary across countries. In most cases, it is recommended to consume 2-3 portions of dairy per day. This can help achieve about half of the daily recommended intake of B12.

References
  1. (1) Office of Dietary Supplements – Vitamin B12.
  2. (2) EUFIC – Vitamin B12: foods, functions, how much do you need & more
  3. (3) CIQUAL – La table de composition nutritionnelle des aliments. ANSES, France.
  4. (4) Cifelli CJ, Agarwal S, Fulgoni VL. Association of Yogurt Consumption with Nutrient Intakes, Nutrient Adequacy, and Diet Quality in American Children and Adults. Nutrients. 2020;12: 3435.
  5. (5) Cifelli CJ, Agarwal S, Fulgoni III VL. Association between Intake of Total Dairy and Individual Dairy Foods and Markers of Folate, Vitamin B6 and Vitamin B12 Status in the U.S. Population. Nutrients. 2022;14: 2441. doi:10.3390/nu14122441
  6. (6) Niklewicz A, Smith AD, Smith A, Holzer A, Klein A, McCaddon A, et al. The importance of vitamin B12 for individuals choosing plant-based diets. Eur J Nutr. 2023;62: 1551–1559. doi:10.1007/s00394-022-03025-4
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30 Sep 2024
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6 min read
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by YINI Editorial team
Bone health

Yogurt consumption is associated with stronger bones and reduced fracture risk

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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
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Yogurt (as part of the dairy product group) is recommended in many dietary guidelines because of its nutrient content essential for bone health.

Yogurt is rich in elements essential for bone health

Dairy products including yogurt are rich in protein and several micronutrients important for bone health – phosphorus, potassium, vitamin D (when fortified) and most notably calcium.

In addition, yogurts containing live bacteria and those with added prebiotics – food ingredients that promote the growth or activity of beneficial microorganisms – may benefit bone health by modifying the gut microbiota and increasing calcium absorption.

Yogurt consumption increases children’s intake of vital micronutrients for bone health

Yogurt is linked to healthy growth of bones during childhood and adolescence

  • In a study in China, adding one serving of yogurt to the usual diet of preschool children for 5 days each week over 9 months promoted growth (height and weight gain) and significantly increased bone mineral density compared with children not receiving yogurt supplementation.
  • Consumption of fermented dairy products, such as yogurt, is associated with improved bone health,
    particularly bone mineral density, in children and teenagers.

“For most age groups, it is difficult to meet the nutrient requirements for healthy bones without three servings of dairy products each day.”

Connie Weaver

Professor

Yogurt is associated with stronger bones and better physical function in older people

Increasing yogurt consumption could be a convenient way of improving the nutritional status and health of older adults, including their bone health.
The association between yogurt consumption and bone health was investigated in a study of people aged over 60 years. Results showed:

  • Women who frequently ate yogurt (more than one serving per day) had stronger bones than those who rarely or never ate yogurt (less than one serving per week). Total hip and femoral neck bone mineral density was 3.1–3.9% higher among frequent yogurt consumers.
  • In men, vertebral bone mineral density was 4.1% higher in low-yogurt consumers compared with non-consumers. High-yogurt consumers were found to have 12.9% higher mean vitamin D concentrations than low-/non-consumers. A potential protective effect on bone was supported by changes in levels of the bone biomarker TRAP 5b (tartrate-resistant acid phosphatase 5b), a direct marker of osteoclasts – bone cells involved in the maintenance and repair of bone.
  • Compared with low-/non-consumers, women who often ate yogurt had better scores for daily living activities and physical self-maintenance.

Yogurt may reduce the risk of hip fracture

Available evidence suggests that yogurt is associated with a lower risk of hip fracture in older adults.

  • Improving calcium and protein intakes with dairy foods (milk, yogurt and cheese) reduces the risk of all bone fractures occurring in older care residents by one-third.
  • A meta-analysis reported that a higher intake of yogurt was associated with a 25% reduction in hip fracture risk when compared with low intake.
  • A study in middle-aged and elderly Swedish women showed that low intake of fermented milk products (yogurt and soured milk) was associated with high rates of hip fracture.
  • Hip fracture rates were lowest among women with a high intake of fermented milk products in combination with a high intake of fruit and vegetables.

Yogurt could reduce the risk of osteoporosis

In people over the age of 60 years, statistical modelling of yogurt intake and bone health predicted that each increase of one serving per week of yogurt intake was associated with a 39% lower risk of osteoporosis in women and a 52% lower risk in men.
Encouraging older people to eat yogurt more often, particularly vitamin D- and calcium-fortified yogurt, may be a valuable public health strategy to stave off osteoporosis.

Yogurt is recommended as part of a healthy diet

Many international advisory boards recommend the consumption of dairy products in amounts equivalent to 400–500 mL (~14–17 fluid ounces) milk per day. By consuming three servings of dairy products per day, the recommended daily intakes of nutrients essential for good bone health may be readily achieved.
Several countries include yogurt (as part of dairy products) in their dietary guidelines. These include, among others, the USA, Canada, Japan, the UK, Australia, Switzerland, Sweden, and Portugal.

“Yogurt is rich in protein, calcium, and several micronutrients important for bone health at all ages but particularly during childhood growth phases, and in later life to maintain stronger bones and physical function, and to reduce risk of falls and fractures.”

René Rizzoli

Professor

References:

  • Rozenberg S, Body JJ, Bruyère O, et al. Effects of dairy products consumption on health: Benefits and beliefs – a commentary from the Belgian Bone Club and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. Calcif Tissue Int. 2016;98:1–17.
  • Drewnowski A. Measures and metrics of sustainable diets with a focus on milk, yogurt, and dairy products. Nutr Rev. 2018;76:21–8.
  • Caroli A, Poli A, Ricotta D, et al. Invited review: Dairy intake and bone health: A viewpoint from the state of the art. J Dairy Sci. 2011;94:5249–62.
  • Rizzoli R. Dairy products, yogurts, and bone health. Am J Clin Nutr. 2014;99(5 Suppl):1256S–62S.
  • Rizzoli R, Biver E. Effects of fermented milk products on bone. Calcif Tissue Int. 2018;102:489–500.
  • He M, Yang YX, Han H, et al. Effects of yogurt supplementation on the growth of preschool children in Beijing suburbs. Biomed Environ Sci. 2005;18:192–7.
  • De Lamas C, de Castro MJ, Gil-Campos M, et al. Effects of dairy product consumption on height and bone mineral content in children: a systematic review of controlled trials. Adv Nutr. 2019;10:S88–96.
  • Saviano DA, Hutkins RW. Yogurt, cultured fermented milk, and health: a systematic review. Nutr Rev. 2021;79:599–614.
  • El-Abbadi NH, Dao MC, Meydani SN. Yogurt: role in healthy and active aging. Am J Clin Nutr. 2014;99(5Suppl):1263S–70S.
  • Laird E, Molloy AM, McNulty H, et al. Greater yogurt consumption is associated with increased bone mineral density and physical function in older adults. Osteoporos Int. 2017;28:2409–19.
  • van den Heuvel EGHM, Steijns JMJM. Dairy products and bone health: how strong is the scientific evidence? Nutr Res Rev. 2018;31:164–78.
  • Iuliano S, Poon S, Robbins J, et al. Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomised controlled trial. BMJ. 2021;375:n2364.
  • Bian S, Hu J, Zhang K, et al. Dairy product consumption and risk of hip fracture: a systematic review and metaanalysis. BMC Public Health. 2018;18:165.
  • Michaëlsson K, Wolk A, Lemming EW, et al. Intake of milk or fermented milk combined with fruit and vegetable consumption in relation to hip fracture rates: a cohort study of Swedish women. J Bone Miner Res. 2018;33:449–57.
  • Bonjour JP, Benoit V, Payen F, et al. Consumption of yogurts fortified in vitamin D and calcium reduces serum parathyroid hormone and markers of bone resorption: a double-blind randomized controlled trial in institutionalized elderly women. J Clin Endocrinol Metab. 2013;98:2915–21.
  • Bonjour JP, Benoit V, Atkin S, et al. Fortification of yogurts with vitamin D and calcium enhances the inhibition of serum parathyroid hormone and bone resorption markers: a double blind randomized controlled trial in women over 60 living in a community dwelling home. J Nutr Health Aging. 2015;19:563–9.
  • Sahni S, Mangano KM, Kiel DP, et al. Dairy intake is protective against bone loss in older vitamin D supplement users: the Framingham study. J Nutr. 2017;147:645–52.
  • Prentice AM. Dairy products in global public health. Am J Clin Nutr. 2014;99(5 Suppl):1212S–6S.
  • Bell V, Ferrão J, Fernandes T. Nutritional guidelines and fermented food frameworks. Foods. 2017;6:65.
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23 Sep 2024
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3 min read
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by YINI Editorial team
Q&A

Focus on vitamin A

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Vitamin A is an essential compound to health at every life stage. What are its functions and where to find it?

What is vitamin A?

Vitamin A is essential at every stage of life. It contributes to the mechanism of vision. Vitamin A is present in the light sensitive protein rhodopsin in the retina and helps the differentiation of the membrane and cornea in the eye.

It is also involved in the regulation (activation, repression) of gene expression, and is thus implicated in numerous bodily functions: embryonic development, cell growth, tissue renewal (skin, intestinal mucosa), immune system…

Deficiency can lead to night blindness and in most serious cases permanent blindness. During pregnancy and early childhood, it can cause abnormal lung development and risk of anaemia. However, vitamin A deficiency is quite rare in developed countries, as most people get enough vitamin A in their diet.

Dietary recommendations

In the diet, Vitamin A can be found in two main forms; retinol and carotenoids:

  • Retinol is the form of vitamin A that is best absorbed and metabolised directly by the human body as it is pre-formed vitamin A.
  • Carotenoids (such as beta-caroten) are precursors (pro-vitamin A), absorbed and converted into vitamin A.

Thus, diet recommendations are given in Retinol Equivalent (RE) and 1µg RE is 6µg of beta-carotene and 12µg of other carotenoids.

The recommendation is of 650-750 µg RE for healthy adults, 700µg RE during pregnancy and 1300µg RE during lactation.

It is recommended to consume no more than 3000 µg RE per day for adults including during pregnancy and lactation, as an excess in vitamin A can increase the risk of birth defects, and not more than 1500µg RE per day, in postmenopausal women, as it could increase bone fracture risk.

Dietary sources of Vitamin A

Vitamin A can be found in plant and animal sources.

In vegetables, vitamin A is found in the form of carotenoids. They are responsible for the orange and red pigments of plants and we find it in vegetable or fruits such as carrots, sweet potatoes, pumpkin, mango or melon. They are also present in dark leafy green vegetables (kale, spinach for example).

Animal sourced-food contain vitamin A in the form of retinol. It can be found for example in dairy, eggs, liver meats.

Dietary sources of vitamin A - YINI

Vitamin A in dairy

In dairy, vitamin A is found mostly as retinol and a little bit of beta carotene.

Most dairy products are also a source of lipids which help with the absorption of fat-soluble vitamins, such as vitamin A

Fat free dairy contains much less vitamin A.

That is why when choosing a yogurt, it is best to choose one with some fat (whole milk or semi skimmed milk dairy) to optimize vitamin A intakes.

Vitamin A in dairy - YINI
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16 Sep 2024
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Diabetes prevention Echoes from ASN Nutrition 2024 Expert interviews

Interview with Wendy Reinhardt Kapsak, MS, RDN

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Diabetes is a growing global health crisis, demanding comprehensive and evidence-based strategies to combat its rise. As highlighted during the symposium ‘Yogurt and Reduced Risk of Type 2 Diabetes: Exploring the New FDA Qualified Health Claim and Potential Implications for Improving Public Health’ at ASN Nutrition 2024, incorporating nutrition expertise and food-based approaches, such as yogurt with its unique nutrient profile, is crucial in addressing Type 2 diabetes and related health challenges.

In this interview, Wendy Reinhardt Kapsak, MS, RDN discusses the recent FDA-approved qualified health claim on yogurt’s role in reducing Type 2 diabetes risk and its broader implications for public health and nutrition policies.

Key messages:

  • FDA-qualified health claims, such as the potential link between yogurt consumption and reduced risk of type 2 diabetes, are crucial for providing consumers with science-backed information. These claims help consumers make informed dietary choices that support health and well-being.
  • Regular consumption of yogurt, at least three servings per week, may reduce the risk of developing type 2 diabetes according to limited scientific evidence, contributing to public health efforts in managing and preventing chronic diseases.
  • Yogurt is a nutrient-dense, versatile, and enjoyable food that can provide essential nutrients often under-consumed in the United States, such, calcium, and vitamin D. It can be easily incorporated into various meals and snacks, making it a convenient option for improving dietary habits and supporting health goals like muscle and bone health.
  • Yogurt addresses current consumer trends by being a fresh,  high-quality protein food. Its adaptability to different dietary patterns caters to the diverse needs of younger and older generations thereby encouraging healthier eating habits and lifestyle changes.

Can you introduce yourself and let us know about your work?

I am President, CEO of the International Food Information Council (IFCI). IFIC is a nonprofit organization focused on consumer research and education. Its mission is to effectively communicate science-based information on food safety, nutrition, and sustainable food systems for public benefit.

Could you start by explaining what FDA-regulated claims are and how they differ from health claims or marketing statements?

In the United States, there are several types of claims related to food products. A “Nutrient Content Claim” specifies the nutrient content of a product, such as “This product contains calcium.” A “Structure/Function Claim” suggests the role of a nutrient in supporting normal body functions, like “This product supports bone health.” These two types of claims can be made without submitting extensive scientific evidence to the FDA.

However, two additional claims require FDA engagement. An “Authorized Health Claim” necessitates significant scientific agreement and involves a detailed and lengthy process to establish, indicating a strong link between a nutrient and reduced risk of a disease. A “Qualified Health Claim” allows for claims based on less conclusive scientific evidence reviewed by the FDA. While it doesn’t require significant scientific agreement, it provides a way to discuss the current level of scientific knowledge about the relationship between a nutrient and a disease.

Could you provide examples of FDA-regulated qualified health claims that have been effectively used to communicate health benefits to consumers? What about the FDA qualified health claim on yogurt consumption and the reduction of the risk of type 2 diabetes?

One example of an FDA-regulated qualified health claim involves nuts and the risk reduction of  heart disease, particularly due to the dietary fats contained in nuts. Another claim discussed today is the potential link between regularly consuming yogurt and reducing the risk of type 2 diabetes, specifically at least three servings over the course of a week. These claims contribute to public health goals by promoting dietary patterns that can help reduce the risk of chronic diseases and improve overall health.

In the case of yogurt, consuming at least three servings per week may reduce the risk of developing type 2 diabetes. Type 2 diabetes remains a critical public health issue in the U.S., with an annual increase of 1.2 million new cases since 2004, making it the 8th leading cause of death. Despite efforts, the portion of the population with type 2 diabetes reached 12% in 2023, highlighting the urgent need for preventive measures and better management strategies. Projections indicate that by 2030, 20% of Black females and 12% of White females will have type 2 diabetes, underscoring the ongoing and escalating challenge of this disease.

Incorporating yogurt into a healthy diet not only may lower the risk of type 2 diabetes but can also positively impact other diet-related health outcomes. This demonstrates how specific dietary choices can play a crucial role in improving public health outcomes.

In your presentation you provided a lot of elements regarding consumer trends. What are their main characteristics?

Today’s consumers are more knowledgeable and health-conscious. More than half of Americans are familiar with My Plate*, and nearly half report that it has led them to eat a more balanced diet. This awareness is particularly high among millennials, college graduates, married individuals, those with higher incomes, and families with children under 18.

Consumers are increasingly following specific eating patterns or diets to feel better and have more energy, with younger generations prioritizing energy and weight loss, and older generations focusing on healthy aging. There is also a notable trend towards higher protein consumption, with younger generations seeking protein from supplements and older generations preferring food sources. Additionally, “fresh,” “good source of protein,” and “low in sugar” are the top criteria for defining healthy food, and more Americans are favoring lifestyle changes over medication for health conditions.

Taking these consumer trends into account, could you elaborate on the benefits of yogurt, particularly the part of your presentation where you mentioned its ease of consumption and accessibility?

Yogurt effectively addresses consumer characteristics through its nutrient density and versatility, providing essential nutrients that are often under-consumed in the United States due to the general under-consumption of dairy. It aligns with the health criteria consumers often prioritize, offering a good source of complete protein, calcium, and often vitamin D. Yogurt can be easily incorporated into various meals and snacks, making it a convenient and enjoyable option for those aiming to improve their diet. The FDA-qualified health claim linking yogurt consumption to a reduced risk of type 2 diabetes positions it as a beneficial food for managing and preventing chronic diseases.

Yogurt can also provide many essential nutrients that are typically under-consumed in the United States, primarily because dairy is an under-consumed food group. Nutrients like calcium, and vitamin D are often abundant in dairy, making yogurt a particularly beneficial choice for many consumers. These nutrients are crucial for maintaining overall health, and yogurt serves as an accessible source for those looking to improve their intake.

Additionally, many consumers find yogurt delicious on its own or when paired with other nutrient-rich foods like fruits or vegetables. This versatility makes it not only easy to incorporate into a diet but also enjoyable and fun to consume. The variety of flavor profiles that yogurt offers excites consumers, encouraging them to include it more frequently in their meals.

Finally, yogurt’s adaptability to various dietary patterns makes it suitable for different generational needs, whether for energy, weight loss, or healthy aging. By offering a tasty and easy-to-consume option, yogurt encourages healthier eating habits, supporting the consumer preference for lifestyle changes. With healthcare professionals and dietitians being the most trusted sources of dietary information, yogurt’s health benefits can be effectively communicated to consumers, reinforcing its role in a balanced diet and contributing to overall public health.

*My plate is the current nutrition guide published by the United States Department of Agriculture’s Center for Nutrition Policy and Promotion, and serves as a recommendation based on the Dietary Guidelines for Americans.

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09 Sep 2024
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Diabetes prevention

Can regular consumption of whole-fat dairy foods help reverse pre-diabetes?

dairy Diabetes pre-diabetes t2d yogurt
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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.”

Bahadoran Z, et al., 2024

References
  1. (1) Source: Bahadoran Z, Mirmiran P, Azizi F. Usual intake of dairy products and the chance of pre-diabetes regression to normal glycemia or progression to type 2 diabetes: a 9-year follow-up. Nutr Diabetes. 2024 Apr 9;14(1):15. doi: 10.1038/s41387-024-00257-7. PMID: 38594262.
  2. (2) Makaroff LE. The need for international consensus on prediabetes. Lancet Diabetes Endocrinology 2017;5:5–7
  3. (3) Cai X, Zhang Y, Li M, Wu JH, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ; 2020;370:m2297.
  4. (4) Hruby A, Ma J, Rogers G, Meigs JB, Jacques PF. Associations of dairy intake with incident prediabetes or diabetes in middle-aged adults vary by both dairy type and glycemic status. J Nutr. 2017;147:1764–7
  5. (5) Bhavadharini B, Dehghan M, Mente A, Rangarajan S, Sheridan P, Mohan V, et al. Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries. BMJ Open Diabetes Res Care. 2020;8:e000826
  6. (6) Zhang K, Bai P, Deng Z. Dose-dependent effect of intake of fermented dairy foods on the risk of diabetes: results from a meta-analysis. Can J Diabetes. 2022;46:307–12.
  7. (7) Mozaffarian D. Dairy foods and type 2 diabetes: profiling our metabolites and health. Am J Clin Nutr. 2021;114:5–6.
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02 Sep 2024
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7 min read
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Cardiovascular health Publications

Eating yogurt is associated with reduced risk of cardiovascular disease

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Dairy products such as yogurt have consistently been linked with either neutral or beneficial effects on risk of cardiovascular disease (CVD), a finding highlighted by multiple literature reviews and a metaanalysis.

Yogurt may reduce the risk of high blood pressure

Among adults included in the USA NHANES (1999–2014) survey, the prevalence of hypertension was 20% lower for those that consumed yogurt, compared with non-consumers, and blood pressure levels were significantly lower.
Another study of adults in the USA found that greater intakes of dairy, low-fat/fat-free dairy, low-fat/skimmed milk and yogurt were associated with a lower risk of developing high blood pressure per year.
Eating one extra serving of yogurt per week was related to a 6% lower risk of developing high blood pressure.

Yogurt may reduce risk of CVD

Yogurt consumption is associated with lower CVD risk.

A meta-analysis of 10 cohort studies from the USA, Sweden, The Netherlands, Finland, Australia and the UK, including 385,122 participants found a 17% decreased risk of CVD with fermented dairy food intake. Sub-group analysis found that yogurt consumption was associated with a 22% fall in CVD risk.

A study of 7,679 Australian women found that high yogurt intake (>70 g or ~2 ounces/day) was associated with 16% lower CVD risk over 15 years compared with no intake.

Among a Greek population (N=3042), a 20–30% lower CVD risk over 10 years was found per 200 g or ~7 ounces/day yogurt consumption, with the greater effect seen in women.

A French study of 104,805 adults from the NutriNet-Santé cohort (2009–2019) found no association between overall dairy intake and CVD risk over 5 years but did find that eating at least 160 g or ~6 ounces/day of fermented dairy (yogurt and cheese) was associated with 19% lower risk of cerebrovascular disease compared with intakes of less than 57 g/day (~2 ounces/day).

In people with high blood pressure:

  • Consuming two or more servings of yogurt per week, especially when part of a healthy diet, was associated with a reduced risk of heart attack or stroke compared with eating less than one serving per month.
  • Among those eating two or more servings of yogurt per week, women had a 17% lower CVD risk and men had a 21% lower risk compared with those who ate less than one serving per month.

Children and teenagers could benefit too

In European adolescents, consumption of milk and yogurt was inversely associated with being overweight and positively associated with cardiorespiratory fitness.

Dairy consumption was inversely associated with CVD risk score in European girls aged 12.5–17.5
years.

Yogurt may reduce mortality risk

Yogurt consumption is associated with reduced risk of all-cause and CVD mortality across population-based studies.

A meta-analysis of 17 cohort studies of 896,871 participants, with 75,791 deaths, found the highest intake of yogurt was associated with a 7% lower risk of death from all causes and 11% lower risk of death from CVD than the lowest intake. Each additional serving of yogurt per day (244 g or ~8 ounces) was associated with a 7% reduced risk of all-cause mortality and 14% reduced risk of CVD mortality.

While the association between yogurt consumption and all-cause mortality has met with mixed results from large cohort studies in the past,152,162 more recent studies show an association with reduced risk of mortality.

A meta-analysis of 235,676 participants in eight cohort studies found that yogurt intake of at least 200 g/day (~7 ounces/day) was associated with12% lower all-cause mortality and 13% lower risk of CVD mortality compared with lower yogurt intake.

In the Prospective Urban Rural Epidemiology (PURE) study (2003–2018) of 136,384 people aged 35–70 years from 21 countries in five continents, higher intake of yogurt (>1 serving/ day) was associated with a 14% lower risk of death or major cardiovascular event, 17% lower risk of total mortality and 10% lower risk of major CVD compared with no intake.

A large population survey of adults (N=32,625) in the USA NHANES (1999–2014) study found a
17% reduced risk for all-cause mortality with yogurt intake over 8 years. The health benefits of yogurt were more pronounced among women, people aged ≥60 years, and non-Hispanic Black people.

A Japanese population study (N=14,264) showed a 28–30% reduction in mortality over 9 years with
increasing yogurt intake among people aged 40–74 years.

How might yogurt reduce CVD risk?

Blood pressure modulation following the consumption of yogurt may be linked to an association with
improved lipid profiles, reduced BMI, or the ability to produce anti-hypertensive peptides that inhibit angiotensin-converting enzyme, which plays a crucial role in blood pressure regulation.
The association between yogurt consumption and reduced risk of CVD may be due to the protective properties of some components.

Yogurt and other dairy products are rich in micronutrients and proteins, some of which have
been shown to lower blood pressure.

Low-grade inflammation underlies the pathology of CVD, and some saturated fatty acids found in dairy products (e.g., lauric acid) may have antiinflammatory effects.

Calcium, potassium and magnesium found in yogurt have been linked to a reduced risk of stroke.

The dairy matrix may contribute to the beneficial effects of yogurt and other dairy products and determine the fat bioavailability.

Fermented milk products such as probioticcontaining yogurts have a high antioxidant potential and could play a part in healthy and active ageing.

“Yogurt consumption is associated with reduced risk of cardiovascular disease – and large population-based studies reveal a link between yogurt consumption and reduced risk of death from cardiovascular and all causes”

Professor Luis Moreno

References :

  • Melini F, Melini V, Luziatelli F, et al. Health-promoting components in fermented foods: an up-to-date systematic review. Nutrients. 2019;11:1189.
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YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
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