Milk

Diabetes Prevention And Milk

How milk plays a role in preventing type 2 diabetes

More than 5.7 million Canadians have diabetes and about 90 percent have type 2 diabetes. An additional six million Canadians are living with prediabetes—a condition that can develop into type 2 diabetes if it’s not properly managed.1,2,3

Prediabetes and type 2 diabetes (T2D) can be managed with combination of proper nutrition, physical activity, stress reduction, medication (when needed) and careful blood sugar monitoring.4

The dietary pattern for diabetes prevention and management includes:

  • Choosing healthy proteins.
  • Opting for low-glycemic carbohydrates, such as whole grains, legumes, vegetables and fruit.
  • Choosing more whole foods and fewer ultra-processed foods.
  • Limit sugars and sweets.5

This article will explore the role of milk and dairy foods in the prevention of T2D. It includes the potential mechanisms through which milk and dairy foods may play a role in reducing the risk of developing type 2 diabetes.

Overview of the nutrients in milk

Milk contains protein and 14 essential vitamins and minerals including:

  • Vitamin A
  • B vitamins: B1, B2, B3, B5, B6, B12
  • Vitamin D
  • Calcium
  • Magnesium
  • Phosphorus
  • Zinc
  • Potassium
  • Selenium

Fat in milk

Dairy foods likely protect against T2D due to their combination of calcium, magnesium, vitamin D and protein, which help reduce body fat and insulin resistance.6 There is no evidence that saturated fat from full-fat dairy foods is associated with an increased risk of insulin resistance or T2D.7 In fact, a meta-analysis showed that a high intake of dairy foods was associated with a significant decrease in the risk of T2D.8

Lactose in milk

Milk contains a naturally occurring sugar called lactose. Lactose has a glycemic index (GI) of 46, which is considered low.9 The GI is a scale that ranks carbohydrate-containing foods and beverages by how much they raise blood sugar levels. Diabetes Canada advises choosing foods with a low glycemic index (<55) most often, since low GI diets may decrease risk of type 2 diabetes.

Milk contains a naturally occurring sugar called lactose. Lactose has a glycemic index (GI) of 46, which is considered low.9 The GI is a scale that ranks carbohydrate-containing foods and beverages by how much they raise blood sugar levels. Diabetes Canada advises choosing foods with a low glycemic index (<55) most often, since low GI diets may decrease risk of type 2 diabetes.

Cow’s milk (skim, 1%, 2% and whole) and plain yogurt are low GI.10 What accounts for the low GI status of milk and yogurt? A combination of things, including
  • Lactose is naturally low-GI.
  • A high protein content.
  • The dairy matrix, which helps control gastric emptying.11

Research on the link between milk and T2D

Type 2 diabetes risk reduction:

Many studies have shown a reduced risk of developing type 2 diabetes in people who consume sufficient dairy foods.12,13,14,15

A meta-analysis looked at 21 studies and a total of 44,474 T2D cases. The analysis showed a significant inverse association in developing diabetes in those who consumed more dairy vs. least dairy. Each additional daily 200 g of dairy products was inversely associated with diabetes risk.16 Other studies have shown that 200-400 grams of dairy foods daily are linked to the largest reduction in T2D risk.17,18

A narrative review of cohort studies suggests up to a 15 percent decrease in the risk of developing T2D in people who have three servings of dairy foods per day.19 The benefits are attributed primarily to a low-fat dairy, yogurt and possibly to cheese. Another meta-analysis found high-quality evidence linking intakes of low-fat dairy and yogurt with a reduced risk of T2D.20

Studies also indicate that total intake of dairy foods, including whole-fat dairy foods like milk, cheese and yogurt, is associated with a lower risk of T2D and lower risk of high blood pressure.21,22 Another study found that high-fat dairy was protective against prediabetes, while neutral associations were seen for low-fat dairy types.23

Why do dairy foods help reduce T2D risk?

Some of the main risk factors for developing T2D are hypertension, metabolic syndrome and obesity. Since dairy products can contribute to reducing these risk factors, they also help reduce T2D. Here are some mechanisms at work:

  • Fats: Dairy-derived fatty acids are associated with less insulin resistance. Studies also show that certain fatty acids in dairy, such as pentadecanoic acid and heptadecanoic acid, are associated with lower blood sugar levels (in oral glucose tolerance tests).24 Vitamin K2: Some dairy foods contain vitamin K-2, which can improve insulin sensitivity.25
  • Calcium, magnesium and vitamin D: These nutrients work synergistically by controlling insulin resistance, pancreatic beta-cell function and inflammation.26,27
  • Probiotics and bioactive compounds: Fermented dairy (especially yogurt) is associated with reduced risk of developing T2D due to the presence of probiotic bacteria.28 Fermentation of dairy foods with bacteria generates bioactive peptides, which have a beneficial effect on metabolic health, and may help improve blood cholesterol and fasting blood glucose levels.29
  • Protein: The amino acids and bioactive peptides from milk proteins may help delay gastric emptying and enhance the insulin response, which helps lower postprandial glucose levels.30

Practical tips:

Consuming dairy foods within a balanced diet can help lower risk for T2D. When patients ask for nutrition advice for diabetes prevention, start with these tips.

  • Refer to a registered dietitian for personalized advice
  • Choose whole foods more often than highly processed foods.
  • Build meals using these proportions: ½ plate vegetables and fruit; ¼ plate whole grains; ¼ plate protein.31
  • Aim for 2-3 servings of milk or dairy products each day.

There’s high-quality scientific evidence to show that dairy foods are associated with a reduced risk of T2D. Patients can be advised to enjoy consuming dairy foods within a balanced diet, and get the benefits of nutrients such as protein, calcium, vitamin D, dairy fat and bioactive compounds. The protective role of dairy in the development of T2D is thought to be largely attributable to the dairy matrix.

CITATIONS

1 https://www.diabetes.ca/media-room/press-releases/diabetes-rates-continue-to-climb-in-canada
2 https://www.diabetes.ca/advocacy—policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada
3 https://www.canada.ca/en/public-health/services/publications/diseases-conditions/framework-diabetes-canada.html
4 https://www.diabetes.ca/about-diabetes/type-2/treatment
5 https://www.diabetes.ca/resources/tools—resources/basic-meal-planning
6 Aune D, et al. (2013). Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr. 98(4):1066-1083. doi:10.3945/ajcn.113.059030
7 Béatrice Morio et al. (2016). Involvement of dietary saturated fats, from all sources or of dairy origin only, in insulin resistance and type 2 diabetes, Nutr Rev, 74(1) Pages 33–47, https://academic.oup.com/nutritionreviews/article/74/1/33/1905672?login=false
8 Aune D, et al. (2013). Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr. 98(4):1066-1083. doi:10.3945/ajcn.113.059030
9 Romero-Velarde E, et al. (2019). The Importance of Lactose in the Human Diet. Nutrients. 12;11(11):2737. doi: 10.3390/nu11112737.
10 https://guidelines.diabetes.ca/docs/patient-resources/glycemic-index-food-guide.pdf
11 Shkembi B, Huppertz T. (2023). Glycemic Responses of Milk and Plant-Based Drinks: Food Matrix Effects. Foods. 12(3):453. doi: 10.3390/foods12030453.
12 Drouin-Chartier JP, et al. (2016). Systematic Review of the Association between Dairy Product Consumption and Risk of Cardiovascular-Related Clinical Outcomes. Adv Nutr. 7(6):1026-1040. doi:10.3945/an.115.011403
13 Schwingshackl L et al, (2017). Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol. 2017 May;32(5):363-375. doi: 10.1007/s10654-017-0246-y.
14 Alvarez-Bueno C, et al. (2019). Effects of Milk and Dairy Product Consumption on Type 2 Diabetes: Overview of Systematic Reviews and Meta-Analyses. Adv Nutr. 1;10(suppl_2):S154-S163. doi: 10.1093/advances/nmy107.
15 Gijsbers L, et al. (2016). Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies. Am J Clin Nutr. 103(4):1111-1124. doi:10.3945/ajcn.115.123216
16 Schwingshackl L et al, (2017). Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol. 2017 May;32(5):363-375. doi: 10.1007/s10654-017-0246-y.
17 Alvarez-Bueno C, et al. (2019). Effects of Milk and Dairy Product Consumption on Type 2 Diabetes: Overview of Systematic Reviews and Meta-Analyses. Adv Nutr. 1;10(suppl_2):S154-S163. doi: 10.1093/advances/nmy107.
18 Gijsbers L, et al. (2016). Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies. Am J Clin Nutr. 103(4):1111-1124. doi:10.3945/ajcn.115.123216
19 Mitri J, et al. (2019). Dairy intake and type 2 diabetes risk factors: A narrative review. Diabetes Metab Syndr. 13(5):2879-2887. doi:10.1016/j.dsx.2019.07.064
20 Drouin-Chartier JP, et al. (2016). Systematic Review of the Association between Dairy Product Consumption and Risk of Cardiovascular-Related Clinical Outcomes. Adv Nutr. 7(6):1026-1040. doi:10.3945/an.115.011403
21 Bhavadharini B, et al (2020). Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries. BMJ Open Diabetes Res Care. 2020;8(1):e000826. 10.1136/bmjdrc-2019-000826
22 Kummer K et al. (2019). Full-Fat Dairy Food Intake is Associated with a Lower Risk of Incident Diabetes Among American Indians with Low Total Dairy Food Intake. J Nutr. 2019 Jul 1;149(7):1238-1244. doi: 10.1093/jn/nxz058.
23 Slurink IA et al (2023). Dairy Product Consumption and Incident Prediabetes in the Australian Diabetes, Obesity, and Lifestyle Study With 12 Years of Follow-Up. J Nutr. 153(6):1742-1752. doi:10.1016/j.tjnut.2023.03.032
24 Mitri J, et al. (2019). Dairy intake and type 2 diabetes risk factors: A narrative review. Diabetes Metab Syndr. 13(5):2879-2887. doi:10.1016/j.dsx.2019.07.064
25 Fernandez MA, et al. (2017). Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms. Adv Nutr. 8(6):812-829. Published 2017 Nov 15. doi:10.3945/an.116.013946
26 Hirahatake KM et al. (2014). Associations between dairy foods, diabetes, and metabolic health: potential mechanisms and future directions. Metabolism. 63(5):618-27. doi: 10.1016/j.metabol.2014.02.009.
27 Aune D et al (2013). Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr. 2013;98(4):1066-1083. doi:10.3945/ajcn.113.059030
28 Companys J et al. (2020). Fermented Dairy Products, Probiotic Supplementation, and Cardiometabolic Diseases: A Systematic Review and Meta-analysis. Adv Nutr. 11(4):834-863. doi:10.1093/advances/nmaa030
29 Fernandez MA, et al. (2017). Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms. Adv Nutr. 8(6):812-829. Published 2017 Nov 15. doi:10.3945/an.116.013946
30 Hidayat K, et al. (2019). Milk in the prevention and management of type 2 diabetes: The potential role of milk proteins. Diabetes Metab Res Rev. 35(8):e3187. doi:10.1002/dmrr.3187
31 Canada’s Food Guide. https://food-guide.canada.ca/en/healthy-eating-recommendations/

Resources

Download useful resources, research studies, and fact sheets on the benefits of dairy

Milk and Mucus

Milk and Mucus The current body of research indicates that milk and other dairy foods do not increase mucus production...

GET THE FACTS

Milk and Hypertension

MILK AND BLOOD PRESSURE Milk plays a role in disease prevention for many chronic conditions, including heart disease and hypertension...

GET THE FACTS

Disease Prevention

Disease Prevention Milk plays a role in disease prevention for many chronic conditions, including heart disease, hypertension, type 2 diabetes..

GET THE FACTS

RESOURCES

Download useful resources, research studies, and fact sheets on the benefits of dairy

Nutrients in Dairy

As a source of complete protein and essential nutrients, drinking milk is a simple way to support optimal health.

GET THE FACTS

Dairy and Disease Prevention

Naturally nutrient dense, milk helps to combat nutrition deficiencies and ward off heart disease, hypertension, and colorectal cancer.

GET THE FACTS

Dairy Milk and Plant Based Beverages

All forms of milk, including lactose-free milk, contain complete protein, vitamins, and minerals.

GET THE FACTS

Heart Health Benefits of Milk

It is estimated that 80% of heart disease cases can be prevented with lifestyle changes that include a nutritious diet, regular exercise, and smoking cessation.

GET THE FACTS

Dairy and Colorectal Cancer

Studies have shown that high consumption of total dairy products and total milk was associated with a lower risk of developing colorectal cancer.

GET THE FACTS

Milk and Hypertension

Milk plays a role in disease prevention for many chronic conditions, including heart disease and hypertension. Learn how adding milk into your patients’ diets can help with blood pressure management.

GET THE FACTS

Milk and Lactose Intolerance

Some people have trouble digesting lactose, but that doesn’t mean giving up dairy! Read on to learn more about lactose intolerance, how it’s formally diagnosed, and how you can provide the best nutrition advice to patients.

GET THE FACTS

Milk and Physical Activity

Milk has a unique combination of nutrients that make it the ideal beverage for post-exercise rehydration and protein
synthesis.

GET THE FACTS

Milk and Pediatric Nutrition

Leading pediatric and health organizations recognize the benefits of milk and dairy foods for early childhood. Just how much milk is recommended for children, and which nutrients will kids get from a tall glass of milk?

GET THE FACTS

Milk and Mucus

When a runny nose or congestion appears, many people believe they need to cut out milk to reduce mucus. It turns out that this is a myth, and studies show that milk does not cause mucus.

GET THE FACTS

Diabetes Prevention and Milk

Take a closer look at the role of milk in the prevention of T2D. There are potential mechanisms through which milk and dairy foods may play a role in reducing the risk of developing type 2 diabetes

GET THE FACTS