New evidence suggests that probiotic yogurt consumption improved body mass index and insulin levels and may be applicable in reducing risk factors of liver diseases.
NAFLD
Non-alcoholic fatty liver disease (NAFLD) is recognized as a common liver disease in many countries and comprises a spectrum of diseases, ranging from simple steatosis of the liver to fibrosis and cirrhosis. The prevalence of this disorder in general population is reported to be 20–30%. A body of evidence suggests that NAFLD is correlated to compositional changes in the intestinal microflora and altered intestinal permeability. Gut microbiota modulation by probiotics could represent a promising therapeutic strategy for this disease and related conditions.
300g of yogurt per day
This study provides evidence of possible beneficial effects of probiotic products in non-alcoholic fatty liver disease (NAFLD). This randomized double-blind controlled clinical trial, was made to 72 NAFLD patients who where divided in two groups. During 8 week one group consumed 300 g/day of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacteriumlactis Bb12. The other group consumed 300 g/day of conventional yogurt.
Probiotics reduce fatty liver disease
Researchers found that patients from the probiotic yogurt had a significant reduction in weight, body mass index, and serum levels of fasting insulin as compared with that in the control group. No significant changes were observed in other parameters in both groups. Further studies are warranted to investigate the possible effects of probiotic products on these adipokines in NAFLD patients.
Figure 1: Yogurt as the signature of a healthy diet
The word signature means “your name written by yourself, always in the same way, usually to show that something has been written or agreed by you” (Cambridge dictionary); or “A person’s name written in a distinctive way as a form of identification in authorizing a cheque or document or concluding a letter” (Oxford dictionary).
For some, the word signature might conjure up notions of a signature dish created by an iconic chef: a unique recipe that identifies that chef. Imagine for a moment getting into the mind of that chef. He carefully considers the vital ingredients that are needed to add just the right balance of flavours, he brings them together in a step-by-step method to create the perfect blend of tastes and textures, and his culinary creation is completed with the presentation of the dish in his unique style. Much of his art stems from his own unique identity, and he infuses an extra something that you might call love, an energy, or simply a touch of finesse, rendering his signature dish a recipe that isn’t easy to replicate.
So, it could be considered that a signature is a print, a label, describing the unique reality surrounding a specific product, service or concept. In the case of yogurt, there are many studies emphasising the positive link specifically between yogurt consumption and metabolic health. Hence, it might be relevant to raise the question: Is there something particular and unique about yogurt that offers a specific advantage or benefit to yogurt consumers?
Building on this concept of a signature dish, you could say that the unique characteristics of yogurt – the nutrient mix, the fermentation process, the active cultures, the texture, the taste, the consistency – are blended together in harmony in such a way that it offers a benefit over and above the value of the inherent calcium, protein, live bacteria, whey, and so on. The whole is certainly greater than the sum of its parts!
This isn’t limited to the nutrients yogurt provides; it possibly has a “symbolic” nature, for example, people who choose to eat yogurt tend not to be high consumers of potato chips, and yogurt eaters might have chosen a lifestyle that promotes good metabolic and overall health (1).
Uniqueness of Yogurt – specific properties of yogurt facilitate improved nutrient intake
What’s in it? Yogurt is generally considered to be a nutritionally dense food, especially for nutrients such as calcium, proteins (Digest 1), and some vitamins. Higher diet quality (for potassium, vitamins B2 and B12, calcium, magnesium and zinc) has been observed with increased dairy consumption (2, 3).
The 2015 Dietary Guidelines for Americans defined “nutrients of concern” as those nutrients that may pose a substantial public health concern. The Committee determined that calcium, potassium, vitamin D, and fibre are under-consumed and may pose a public health concern (4, 5). Dairy foods, including yogurt, are major dietary contributors of three of the four nutrients of concern.
Milk provides nine essential nutrients important for optimal health: calcium, potassium, phosphorus, protein, vitamins A, D and B12, riboflavin, and niacin (niacin equivalents). The nutrient composition of milk and yogurt are similar; however, yogurt represents a more concentrated source of riboflavin, vitamin B12, calcium, magnesium, zinc, and potassium. Hence, the dairy food group is a substantial contributor of many of the above nutrients (e.g., calcium, phosphorus, vitamin A, vitamin D, and protein), all of which should work towards promoting health.
Recent work using the National Health and Nutrition Examination Survey (NHANES 2005-2008) has shown that dairy foods, including full-fat varieties, are key components of the American diet that contribute a significant amount of the essential nutrients calcium, vitamin D and protein, to the diet (6).
Data from the French dietary survey (Etude Individuelle Nationale sur les Consommations Alimentaires, INCA 2006 (7)) was analysed by using computerized modelling, which enabled the researchers to examine theoretical dietary patterns that would meet nutrient needs within calorie needs. The diet optimization model suggested that French individuals should choose more nutrient-dense foods, including more fruits, vegetables, whole grains, and dairy foods. For the dairy foods, the model suggested replacing some cheese consumption with additional yogurt to help reduce the energy density of the diet and to ensure nutrient adequacy (8). While this study was focused on the French population, the premise of selecting a healthy diet pattern that includes nutrient-rich yogurt can help individuals meet nutrient needs.
6. Keast DR, Hill Gallant KM, Albertson AM, Gugger CK, Holschuh NM. Associations between yogurt, dairy, calcium, and vitamin D intake and obesity among U.S. children aged 8–18 years: NHANES, 2005–2008. Nutrients 2015; 7:1577-1593.
7. AFSSA. Étude Individuelle Nationale des Consommations Alimentaires 2 (INCA 2) (2006-2007) – Rapport, September 2009. https://www.anses.fr/fr/system/files/PASER-Ra-INCA2.pdf
8. Clerfeuille E Maillot M, Verger EO, Lluch A, Darmon N, Rolf-Pedersen N. Dairy products: how they fit in nutritionally adequate diets. J Acad Nutr Diet, 2013; 113: 950-6.
The Dairy Fat Paradox
Fat has, for decades, been considered a “big baddie”. Government guidelines warn us of the dangers of saturated fat, including that from dairy foods. Milk and cheese are substantial contributors of calories and saturated fat to the US diet, but they are also significant nutrient providers (9). For example, the authors state that “Three of the top 10 sources of calories and saturated fats (beef, milk and cheese) contribute 46.3% of the calcium, 49.5% of the vitamin D, 42.3% of the vitamin B12 as well as other essential nutrients to the American diet.” So, the totality of the food should be considered when constructing a healthy diet.
Perhaps surprisingly, total and saturated fat intakes have been negatively related to yogurt and dairy consumption including cheeses (6). This analysis used nationally representative data to examine the associations between yogurt and dairy consumption on macro- and micronutrient intakes and indicators of overweight/obesity in children. The authors showed that yogurt and dairy consumption, regardless of fat contribution, were related to higher intakes of calcium, vitamin D, and protein.
Further, the authors reported that yogurt intake was associated with lower total and saturated fat intakes (represented as percent total daily energy intake) in children 8 – 18 years old. The authors speculate that this result could be due to the fact that low-fat and fat-free yogurts represent a large proportion of the yogurt available for consumption in the U.S. Additionally, yogurts could be displacing other high fat foods in the diet, or yogurt may simply be a marker for a more healthful dietary pattern.
Yogurt intake was also associated with a lower BMI and lower waist circumference in this study.
References:
6. Keast DR, Hill Gallant KM, Albertson AM, Gugger CK, Holschuh NM. Associations between yogurt, dairy, calcium, and vitamin D intake and obesity among U.S. children aged 8–18 years: NHANES, 2005–2008. Nutrients 2015; 7:1577-1593.
Apart from the above evidence on the nutrient contribution of yogurt due to its inherent nature, subjects that consumed yogurt had a higher Dietary Guidelines Adherence Index (DGAI), which is used to assess overall diet quality. Yogurt consumers had higher potassium intakes and were less likely to have inadequate intakes (based on Dietary Reference Intake) of several vitamins, including vitamins B2 and B12, calcium, magnesium, and zinc (2).
Figure 2: Frequent yogurt consumers tend to have more adequate nutrient intakes (1, 2, 6)
6. Keast DR, Hill Gallant KM, Albertson AM, Gugger CK, Holschuh NM. Associations between yogurt, dairy, calcium, and vitamin D intake and obesity among U.S. children aged 8–18 years: NHANES, 2005–2008. Nutrients 2015; 7:1577-1593.
Uniqueness of Yogurt – Yogurt is a vehicle for quality of the whole diet
Beyond its nutrient content, there is evidence suggesting that yogurt consumption might exert a favourable impact on other food choices.
Data from the Framingham Heart Study Offspring indicated that diet quality might be improved in yogurt consumers (2). As well as the data showing that the DGAI score tended to be greater in yogurt consumers compared to non-consumers, fibre intake was significantly greater in yogurt consumers in whom yogurt consumption made up 2% of total energy intake.
These observations might raise the research hypothesis that eating yogurt, for instance at snack time, might orientate food preferences at the subsequent meal.
This is in agreement with the Zhu et al study (10) who used NHANES cohorts to demonstrate that the healthy eating index (HEI, another diet quality score) of frequent yogurt consumers was better than that observed in infrequent consumers. Yogurt consumers (US children) have a greater intake of fruits, whole grains and milk indicating a better compliance to the dietary guidelines.
10. Zhu Y1, Wang H, Hollis JH, Jacques PF. The associations between yogurt consumption, diet quality, and metabolic profiles in children in the USA. Eur J Nutr, 2014.
Can a little sugar in yogurt be a good thing?
Both the 2010 and 2015 Dietary Guidelines for Americans (11,12) state that diets should focus on nutrient-dense foods including fruits and vegetables, whole grains, and dairy foods to meet nutrient needs. Additionally, the 2010 report indicates that added sugars are acceptable to increase the palatability of nutrient-rich foods, such as yogurt (Digest 4).
Hess et al (13) indicated that American children aged 2-11 consume extra energy and sugar in their diet, but insufficient amounts of vitamin D, calcium and potassium. The fat in a whole milk yogurt provides flavour and this may reduce the need for added sugars to increase palatability. A 6 oz pot of plain whole milk yogurt contains a total of 8 g of sugar, as well as vitamin D (if fortified), calcium, and potassium, comparable to that of a low fat, flavoured yogurt (14). Increasing acceptability and availability of whole milk yogurts with low total sugar content may thus be a beneficial way to encourage health-promoting and nutrient-dense snacking among children without raising sugar consumption.
In this context, the authors proposed that swapping current snacks with fruits or vegetables, as well as one serving of low sugar whole milk yogurt, could reduce such imbalances between energy intake and micronutrient intakes. This study shows that increasing palatability and acceptability of yogurt, whether this be raising fat or adding sugar, may be a beneficial way to meet nutrient needs. Another way is to choose whatever yogurt you enjoy, just do it in moderation.
These observations appear to indicate that: • There is a beneficial relationship between yogurt and the intake of nutrients. • This relationship generally favours an increase in nutrient density and has also been associated with a potential decrease of the energy density of the diet.
The Canadian Infogene study (1) examined the relationship between the consumption of specific foods and prudent/western dietary patterns.
As one would expect, the regular consumption of vegetables, fruits, nuts, legumes, fish and yogurt were positively related to a prudent dietary pattern whereas they tended to be negatively related to a western dietary pattern. This is consistent with the fact that yogurt consumers in this study were less prone to overweight and to an unfavourable metabolic profile.
Figure 3: Frequent yogurt eaters tend to make more adequate food choices (1, 2,10)
10. Zhu Y1, Wang H, Hollis JH, Jacques PF. The associations between yogurt consumption, diet quality, and metabolic profiles in children in the USA. Eur J Nutr, 2014.
Uniqueness of Yogurt – could simply eating yogurt promote a healthier lifestyle?
This topic leads us towards a more mysterious issue! It’s possible that the consumption of a specific food (i.e. yogurt) might have a beneficial impact on the global lifestyle of people, because of its symbolic value or undocumented effect…a bit like the chef’s signature dish.
Do yogurt eaters tend not to smoke? This is what we might be inclined to believe when considering the results of the recent Brazilian study suggesting that yogurt consumers are less predisposed to smoking (15). Yogurt consumption was associated with a healthier lifestyle in Brazilian adults. They were less dependent on alcohol, and had a lower smoking status. Non-consumers also showed a higher risk of Type 2 diabetes, hypertension and heart disease.
Are yogurt eaters more active? The Brazilian study also provided evidence suggesting that yogurt consumers are more physically active and tend to be less overweight compared to non-consumers. Recently an Italian study provided concordant results showing that yogurt consumers are more physically active (16, 17).
This issue has also been examined in the Québec family study, for which preliminary data analysis revealed that female yogurt consumers are more physically active, in association with a reduced body weight (18).
Eat yogurt: watch your weight There’s an interesting study reported by Mozaffarian (19) who also used the data of large cohorts to demonstrate that weight gain over time was less pronounced in individuals who reported an increased consumption of some foods including yogurt, as well as nuts, whole grains and fruits. And, not surprisingly, the consumption of foods such as potato chips and processed meats was associated with the opposite effects on weight gain.
Interestingly, when yogurt consumers were followed over a 6-year period (Québec study), they remained less predisposed to overweight and excess body fat.
Figure 4: Healthier lifestyle habits
References:
15. Possa G, de Castro MA, Marchioni DM, Fisberg RM, Fisberg M. Probability and amounts of yogurt intake are differently affected by sociodemographic, economic, and lifestyle factors in adults and the elderly-results from a population-based study. Nutr Res, 2015; 35(8):700-6.
16. D’addezio LD, Mistura L, Sette S, Turrini A. Sociodemographic and lifestyle characteristics of yogurt consumers in Italy: Results from the INRAN-SCAI 2005-06 Survey. Med J Nutrition Metab, 2015 ; 8:119–129.
Three top concepts appear to be emerging from the above data:
1. Yogurt consumers seem to have more adequate nutrient intakes.
2. People who eat yogurt tend to make other healthier food choices, helping to improve overall diet quality.
3. Yogurt consumption is linked to other healthy lifestyle habits.
There is no clear explanation that allows us to understand why yogurt consumers are characterized by a healthier lifestyle, but there does seem to be evidence that suggests that we could consider yogurt as a marker of healthy diet & eating habits. It’s relevant to consider that yogurt consumption ultimately appears to be the signature for a healthy diet and lifestyle. Just as the renowned chef painstakingly prepares his signature culinary creation using a blend of ingredients and that extra dose of love and care, yogurt could be seen as a combination of inherent nutrients plus that little something extra that appears to facilitate overall good health.
There appears to be a relationship between yogurt consumption and the health status of the consumer:
YOGURT MIGHT INDEED BE A SIGNATURE OF A HEALTHY DIET & LIFESTYLE
YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
Selected for you this week: Amazing Benefits Of Greek Yogurt, by Elise Moreau of Lifehack.
1. It helps lower blood pressure
Some varieties of yogurt contain twice as much sodium as Greek yogurt, which can contribute to higher blood pressure levels and an increased risk of additional heart-related problems if your sodium intake surpasses the daily recommended value. A 100-gram serving of nonfat Greek yogurt contains just about 36 milligrams of sodium. According to the U.S. Food and Drug Administration, most people should consume no more than 2,300 milligrams of sodium per day.
2. It improves digestive health
When you choose to incorporate Greek yogurt into your diet, you’re also getting the added digestive power of the probiotics it contains. These are live, “good” bacteria that help balance out the bad bacteria in your gut. Probiotics also have anti-inflammatory and anti-pathogenic effects, essentially giving your your immune system a bit of a boost so your body is better equipped to fight off any harmful bacteria.
3. It keeps you fuller for longer
Greek yogurt has twice as much protein per serving as regular yogurt does and cuts the sugar content down by nearly half (when you choose plain over flavored). A typical 100-gram serving of plain, nonfat Greek yogurt has about 10 grams of protein. More protein keeps you full for longer because it takes longer to digest, so you won’t be reaching for other snacks as soon as some other varieties of yogurt might cause you to do.
4. It helps you lose weight
With less than 4 grams of carbohydrates and less than half a gram of fat per 100-gram serving of plain, nonfat Greek yogurt, it’s a perfect choice for people who are watching how many carbs or how much fat they’re consuming. And at only 59 calories, Greek yogurt can help you stick to your daily calorie intake–whether you’re trying to lose or maintain weight.
5. It keeps your brain healthy
Greek yogurt contains Vitamin B12, which is only found in animal products. A 100-gram serving of plain, nonfat Greek yogurt provides about 13 percent of your recommended daily value of this vitamin, which is necessary for a well functioning brain and nervous system. It also helps with cell reproduction and keeps your skin looking healthy.
6. It supports good heart, bone, muscle and nerve health
Dairy products are known to be among the best sources of absorbable calcium, providing some of the highest concentrations of it per serving. Greek yogurt doesn’t contain quite as much calcium as regular yogurt, but a 100-gram nonfat serving still provides around 11 percent of your recommended daily value. Calcium is necessary to keep your teeth strong, your heart rhythm beating at a healthy pace, your blood flowing and all sorts of other parts of your body healthy and functioning properly.
7. It may be an appropriate alternative for people who are sensitive to dairy
People who are lactose intolerant may be able to add small amounts of Greek yogurt to their diet because it doesn’t have as much lactose as other dairy products, due to the fact that it undergoes a different processing method. When Greek yogurt is strained, much of the lactose is removed. Although lactose intolerant people may not be able to eliminate their symptoms entirely by adding Greek yogurt to their diets, they may at least experience less severe symptoms.
8. It gives your metabolism a boost
Humans need trace amounts of iodine to keep their thyroids healthy, and dairy products like Greek yogurt are a good source of this essential mineral. The thyroid gland helps regulate your metabolism–including blood cell production, nerve function and muscle function. Adding more iodine-rich foods in your diet may help you lose weight if you’ve been struggling to shed those extra pounds.
Meet Erika Ochoa, a Pediatric Nutritionist and Dietitian from Mexico! She attended the YINI symposium on the Health Effects of Yogurt at the 4th Yogurt Summit in San Diego (US) in April and YINI Mexican Symposium on Health effects of yogurt (Mexico) in May. Discover her key-learnings on the benefits of yogurt: diabetes prevention and contribution to a healthy diet and lifestyle.
Dairy has been subject of multiple health debates in recent years. Although dairy products are present in almost all dietary guidelines, their benefits, including the benefits of yogurt, have been questioned and some claim that they pose risks to our health. As a dietiTian it is my responsibility to review the evidence, draw conclusions (clear and not misleading), and share relevant information in favor of health. Regarding dairy, I can assure you that during the last couple of years more research has come up and the results are quite interesting.
First of all, not all dairy products are the same. The process that milk goes through in order to produce butter, cheese, kefir, or yogurt creates enormous differences in nutrient composition and other organoleptic characteristics that may impact our health. Calcium content, bioactive lipids, satiating and bioactive peptides, and nutrient density have all been related to weight and adiposity control, bone health, and cardiovascular health. Yogurt, a fermented dairy product, has been subject of more research due to its content of live cultures and its impact gut health.
Benefits of Yogurt as part of a healthy diet and lifestyle
It is important to note that yogurt consumers tend to have healthier lifestyles. According to Dr. Angelo Tremblay, several observational cohort studies of Europe and North America describe yogurt consumers to have better diet quality; for example, in the FRAMINGHAM cohort it was associated with higher intake of nutrients like calcium, zinc, magnesium, potassium, protein, and some vitamins. In the Canadian study Infogene, yogurt consumption was associated with a prudent diet (higher intake of vegetables, fruits, and nuts); these results are similar to those described in the most recent (2012) Mexican National Health and Nutrition Survey (ENSNAUT) in which yogurt consumers tend to eat more vegetables and fruits and less sugar-sweetened-beverages.
In the SUN Cohort, according to Dr. Carmen Sayon, yogurt consumption has been associated with less weight gain. It is to note that this effect was enhanced, when yogurt was mixed with fruit—a traditional dessert of the Mediterrean diet—, suggesting that the symbiosis of live cultures in yogurt with prebiotics and other non-nutritional compounds of fruit may boost the benefits.
Dr. Sayon also showed the PREDIMED cohort (which includes elder adults with high cardiovascular risk) findings in which higher yogurt consumption was associated with reduced risk of metabolic syndrome. Dr. Simin Meydani made it clear that there are a few observational studies of yogurt and older adults, however, they tend to suggest that this dairy product may not only improve nutritional status but enhance the immune system, thus, contributing to healthy aging.
Decreased risk of developing Type 2 Diabetes
One the well-known benefits of yogurt is linked to diabetes prevention. Several epidemiological studies have suggested a risk reduction in people with higher yogurt consumption. Dr. Jordi Salas presented evidence that fermented dairy products, like yogurt, were linked to better glucose metabolism; some studies even demonstrated 17% lower diabetes risk with 3 or more servings of yogurt a day.
The mechanisms through which yogurt help prevent type 2 diabetes are not quite clear. Dr. Salas presented two hypothesis:
Yogurt affects satiety and contributes to lower adiposity, thus diabetes risk is lowered: Mechanisms related to this hypothesis are calcium content on yogurt, satiating protein, and live culture effects on health
Yogurt increases insulin sensitivity and/or diminishes pancreatic secretion: Once again, calcium may play an important role (it favors insulin secretion and glucose uptake), bioactive peptides could affect incretin hormones, and bioactive fatty acids (odd chain fatty acids have been related to diabetes protection)
Taking into account the evidence on lower diabetes risk due to the benefits of yogurt and its consumption, Dr. Andrew Prentice simulated what would the impact be on UK’s health care expenditure if yogurt consumption increased from 4 teaspoons to one pot a day. His conservative estimations reached up to £2.3 billion savings over 25 years and, moreover, life quality would increase significantly. Thus, promotion of yogurt consumption might be a target for public health in order to diminish health costs associated to type 2 diabetes.
Finally, but not least, yogurt consumption may become part of our everyday diet. Constance Brown-Riggs RD, Azmina Govinji RD, and Megrette Fletcher helped us understand how yogurt may be a key food towards healthy life-styles and, along with mindful eating, contribute in our fight towards the obesity and diabetes epidemic. Right now, our concern is sugar content on several “healthy” products. Dr. Thomas Wolver proved to us that yogurt is a low glycemic index food, no matter if it is plain or sweetened. Therefore, yogurt benefits can be enjoyed without sacrificing taste.
What to remember?
As a conclusion, dairy products do not pose risk to our health. On the contrary dairy have many benefits, among which benefits of yogurt are being extensively studied. Dietary recommendations should include dairy regularly; yogurt, along with other fermented products, may be needing a special category in the future, due to the beneficial effects of live cultures in our diets. It is a fact that more studies, especially randomized double-blind controlled trials, are needed to deeply understand the mechanisms of yogurt in health and to be able to give more accurate recommendations. Meanwhile, one yogurt a day seems just perfect to everyone.
Optional: Spread a bed of yogurt and/or couscous on the plate underneath the salad, as a bed to catch the dressing (and to make this more of a light main course).
Preparation
Combine the shallot, agave or honey, orange juice, vinegar, and salt in a small bowl, and whisk to thoroughly blend.
Keep whisking as you drizzle in the olive oil, keeping up the action until it is completely incorporated.
Stir/whisk in the yogurt and mix until uniform. Cover and refrigerate until use.
Have the cleaned, dried salad leaves in a large-enough bowl. Break them into bite-sized pieces as desired.
Add about 6 tablespoons of the vinaigrette, tossing as you go, to thoroughly coat all the leaves. Add the orange sections toward the end, mixing them in gently so they don’t break.
Sprinkle in the pistachios with the final toss, and serve pronto.
Plain-yogurt consumers often say they add sweeteners, such as jam or honey to their yogurt. In France, for example, 50% of consumers sweeten plain yogurts prior to consumption. It’s commonly thought that adding sugar or jam oneself is healthier than eating pre-sweetened yogurt. This study calculated also the quantity of added sweetener and showed that on average, it can be greater than in a pre-sweetened yogurt .
These results bring new data on this behavior and demonstrate that for some consumers it might be healthier to eat pre-sweetened commercial yogurts from an energy/sugar intake perspective.
Ad libitum test
This French study measured how much sugar consumers really added under contextualized testing conditions. Participants (199 adults, who regularly consume plain yogurt and add a sweetener) were given a plain yogurt (125 g) at the end of a full meal and were allowed to sweeten it with their usual sweetener (caster sugar, honey, or jam). The added quantities were measured indirectly by weighing the sweetener containers before and after use and converted into equivalent quantities of sucrose, or “added sugar.”
More added sugar with jam
On average, participants added 13.6 g of sugar to their yogurts, which is higher than the 10.2 g of sugar, contained in pre-sweetened commercial pots of yogurts. More sugar was added, when subjects used jam (24.4 g/yogurt), as opposed to caster sugar (11.0 g/yogurt) or honey (12.1 g/yogurt). Age, socio-professional category, and BMI had a significant influence on the added-sugar quantity.
Finally, one other striking result is that consumers may underestimate by half the quantity of added sweeteners. These findings suggest that consumers have a healthy (or healthier) image of their own sweetening behavior. According to them, it is worse to eat pre-sweetened commercial yogurts, but the results show that it’s not necessarily true.
The scientific program was kicked off with an introduction by Chairman Prof. Raanan Shamir (Medicine Faculty, Tel Aviv University, Israel) and Co-Chair Sharon Donovan (PhD, University of Illinois at Urbana-Champaign, IL, US).
Frequent yogurt consumption is associated with a lower risk of diabetes, independent of the fat content.
Substituting 1 daily yogurt serving with 1 serving of other “unhealthy” snack or food alternatives per day, is associated with a reduced risk of T2D incidence.
Several mechanisms (a satiety effect, increased insulin sensitivity…) have been suggested in order to explain these associations, however more mechanistic studies are needed.
Delaying or preventing type 2 diabetes will help to turn the tide on the diabetes epidemic and starts with a healthy pregnancy.
Large clinical trials provided strong evidence that prediabetes can be reversed by almost 60% through weight loss, healthy eating and increased physical activity.
Yogurt can play a positive role in diabetes prevention as part of healthy diets.
Current data suggest that the promoting yogurt consumption could, in the long term, contribute to a reduction in the prevalence of T2D
Reducing the risk of developing T2D through increased yogurt consumption would relieve pressure on the health care infrastructures
Azmina Govindji (RD) and Megrette Fletcher hosted a practical session on ‘Yogurt & Type 2 Diabetes – putting it all into practice’: Azmina presented simulations of yogurt swapping to help saving calories and to incease nutrient density. Megrette introduced the ‘Mindful Eating Cycle’, to use our senses and listen to our body for making the right food choices, at the right time, in the right circumstances, and in the right quantity.
Lori Shemek, Nutrition and Weight Loss expert, attended the YINI symposium at the EB congress in San Diego and interviewed Prof. Donovan on gut microbiota, yogurt and our optimal health. Read more about her key-learnings!
Discover our Storify with more updates on the event and follow the updates on Twitter!
Mindful eating is eating with intention and attention. Azmina Govindji, RD (AG), reviewed with Megrette Fletcher (MF) the six decision points regarding food and eating, and saw that mindful eating counseling is a fun and interactive way to connect with individuals with at risk for diabetes. Here is a summary of their live session of questions and answers.
AG: Megrette, let’s explore the “WHY?” first. Why do I eat?
MF : There are two reasons. The first is because I am hungry. The second is I am eating because of non-food triggers. Three good examples are proximity to food, emotions or habits. Mindful Eating asks, “Am I aware of situations or emotions (stress, boredom, socializing, events…) that trigger me to want to eat when I’m not hungry?” We have created a handout that explains the concept of pausing and “check in” and notice your physical sensation. It is called The Body, Mind, Heart Scan, that is described in Eat What You Love, Love What You Eat with Diabetes. It can help a person pause and observe all the information that is present before making a food choice.
AG: WHEN we eat can also have an important impact on food choice.
MF : Many people struggle to identify physical hunger. Having a fast paced life and being over scheduled are usual reasons not to check in. This is why mindful eating talks about having a pause or ‘check in’ to rate physical hunger. If I am not physically hungry, (because I checked in with my hunger) then WHEN I want to eat is WHEN I AM mentally, emotionally stressed, or triggered by habit (mindless eating). The part about mindful eating that many people misunderstand is thinking you “shouldn’t eat” when you are not hungry. The more effective question is “What can I do to cope better with my mental, emotional or environmental triggers instead of eating?”
AG: The next part of the Mindful Eating Cycle : WHAT do I eat?
MF : If a person is eating because he is physically hungry, there is a huge opportunity to learn about nutrition and expand our education. Mindful Eating encourages each person to reflect on the overall balance, variety, and moderation of their food choices. Even if a person is reaching for food due to emotional triggers, helping him choose food he enjoys that is nutrient dense or foods that have less glycemic impact can have a huge effect on the prevention of diabetes and overall blood sugar control. Foods such as yogurt are a good choice in that context.
AG: Can you talk about distracted eating? HOW do I eat ?
MF : As a society, distracted eating is often the norm. Distraction often leads to eating quickly – so you can get back to the task. You might notice the speed of your eating by asking “Do I eat fast?” If you think, “Yes, I do eat fast!” You might consider what is the outcome of rapid eating. Eating is a huge source of pleasure and when a person eats in a distracted way, they seem to miss the pleasure of eating. Therefore, bringing back pleasure and enjoyment while eating is an important part of creating a sustainable behavioral change.
AG: Can you talk about portions? HOW MUCH do I eat ?
MF : Each choice a person makes regarding food is two choices – what to eat and how much. In nutrition, we know that portion choices are key. In mindful eating, there is a huge shift from “a serving size” to “How much food is needed to ease my current level of hunger?” Brian Wansink, Ph.D. in his book Mindless Eating, explained that people eat what is served them, even if the food tastes bad! When mindless eating is the concern, having environmental controls (like prepackaged foods) is a great place to start. Choosing single servings products like yogurt can help thus a person better manage portions!
AG: I think we are at the final step in the mindful eating cycle — the WHERE? Where do I invest my energy?
MF : It is easy to forget that the purpose of choosing nutrient dense foods is to help us live life to the fullest. Health messages can get twisted around in my head, and I think I should eat healthy because someone told me to, instead, realizing I am eating healthy, nutritious foods because it gives me the energy to live my life well. This desire to “Be good” can create the conditions for emotional eating. Set a clear intention is part mindful eating! Eating mindfully offers you a chance to pause and gain perspective before you eat but you can pause at any point and ask “Why am I eating?” Again, questions help a person see choices. They replace the more parental internal voice of what you SHOULD do.
Key learnings:
Although it is a deceptively simple title, the question “Am I hungry?” opens the door to understanding why, when, what, how, and how much you eat, and where you invest your energy. These are the questions the ‘Am I Hungry? Mindful Eating Cycle’ helps you to answer :
Why do I eat? Or in other words, what is driving my eating cycle at any given time?
When do I feel like eating? When do I think about eating? When do I decide to eat?
What do I eat? What do I choose from all the available options?
How do I eat? How, specifically, do I get the food I’ve chosen into my body?
How much do I eat? How much fuel do I consume?
Where do I invest the energy I consume? Where does the fuel I’ve consumed go?
Prevention of Type 2 Diabetes (T2D) requires positive lifestyle and dietary changes to maintain a healthy weight and improve glycaemic control. In such a context, yogurt is an ideal snack to eat trough lifecycle. It’s a convenient and tasty way to help growing children and to meet their calcium needs. Low in energy density, but nutrient –dense , yogurt is also an ideal alternative, also for people watching their weight.
Yogurt is a nutrient dense food
Nutrient density is the measure of nutrient’s richness, provided per calorie of food. It is a way of evaluating the nutritional quality of a food. Nutrient-dense food choices can help people to meet their nutritional requirements without consuming excess calories, and eating yogurt. One of the key dietary recommendations of the recent US Dietary Guidelines is a shift towards more nutrient dense food choices. According to Azmina Govindji, most individuals in the United States would benefit from an increased dairy intake in fat-free or low-fat forms, whether from milk, yogurt, and cheese.
Yogurt swappings
Yogurt may help to reduce energy intakes and glycaemic impact by using food swaps, such as substituting a granola bar or a dessert for a fruit yogurt, a can of sugared drink for a yogurt smoothie, yogurt smoothie for fruit juice, or enjoying frozen yogurt instead of an ice cream bar. These types of swappings can also promote normalization of blood glucose; for example, high protein foods like yogurt and nuts promote satiety, and protein and fat can help to slow down post-prandial blood glucose levels.
The versatility of yogurt
Today, yogurt plays an important role in many different world cuisines and yogurt consumers generally adopt healthier nutrition and lifestyle behaviour. With its protein content and nutrient density, yogurt, including sweetened yogurt, can be a nutritious and potentially satisfying snack for people of all ages and activity levels. The versatility of yogurt, as well as the texture and mode of eating (with a spoon, in savory or sweet preparations), lends also itself well to the enjoyment of foods and mindful eating. Therefore, yogurt is nowadays deeply rooted in our eating behaviour and is an integral part of a healthy diet.
Key learnings:
Yogurt is a nutritious food throughout the whole lifecycle
Swapping out foods and eating yogurt instead could help:
saving calories
increasing the volume/weight of food consumed, without increasing calories
Significantly improving nutrient profile without contributing excess calories
National and global health organizations recognize factors, such as poor diet and physical inactivity, as key contributors to the epidemics of overweight, obesity and several diet-related chronic diseases, including Type 2 Diabetes. In US, the 2010 Dietary Guidelines Advisory Committee evaluated emerging evidence about the effect of dairy food consumption on key chronic. Their review led to the following statement in the 2010 DGA: “Moderate evidence…indicates that intake of milk and milk products is associated with a reduced risk of cardiovascular disease and type 2 diabetes and with lower blood pressure in adults”. This new meta-analysis on dairy products and incident diabetes funded by Wageningen University reinforces this association.
14% less diabetes risk with yogurt
The authors performed a meta-analysis to quantify the associations of incident T2D with dairy foods at different levels of intake. Their literature search included the PubMed, Scopus, and Embase databases (from inception to 14 April 2015) and focused on international prospective cohort studies (22 studies comprised of 579,832 individuals and 43,118 T2D cases) that examined the association between dairy and incident T2D in healthy adults.
Results showed the importance of the subtype of dairy message in the T2D prevention. Indeed, total dairy and low-fat dairy were inversely associated with T2D risk (RR: 0.97 & 0.96 per 200-g/d increment). A much stronger inverse association was found for yogurt intake (at 80 g/d, RR: 0.86 compared with no consumption) and… surprisingly ice cream intake (by the way, at very low intake ∼10 g/d, RR: 0.81). But no added incremental benefits were found at a higher intake for total dairy, while other dairy types were not associated with T2D risk.
A specific effect of yogurt
The main conclusion of this paper confirms previously published meta-analysis suggesting an inverse association of dairy food, in particular yogurt, with incident T2D. However it is important to highlight the fact that, as observed in previous meta-analysis, the global trend on dairy products and T2D is positive but there is high heterogeneity between types of dairy products and study populations. According to the authors, a strong emerging evidence linking higher yogurt intake with lower risk for T2D indicates nowadays that the process of milk fermentation that produces yogurt may modify milk in a beneficial way. Research is needed to better understand this observed association.
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