Dairy fat intake and risk of type 2 diabetes in 3 cohorts of US men and women.

ABSTRACT

BACKGROUND: Previous studies have examined dairy products with various fat contents in relation to type 2 diabetes (T2D) risk, although data regarding dairy fat intake per se are sparse. OBJECTIVES: We aimed to evaluate the association between dairy fat intake and risk of T2D in 3 prospective cohorts. We also examined associations for isocalorically replacing dairy fat with other macronutrients. METHODS: We prospectively followed 41,808 men in the Health Professionals Follow-Up Study (HPFS; 1986-2012), 65,929 women in the Nurses' Health Study (NHS; 1984-2012), and 89,565 women in the NHS II (1991-2013). Diet was assessed quadrennially using validated FFQs. Fat intake from dairy products and other relevant sources was expressed as percentage of total energy. Self-reported incident T2D cases were confirmed using validated supplementary questionnaires. Time-dependent Cox proportional hazards regression was used to estimate the HR for dairy fat intake and T2D risk. RESULTS: During 4,219,457 person-years of follow-up, we documented 16,511 incident T2D cases. Dairy fat was not associated with risk of T2D when compared with calories from carbohydrates (HR for extreme quintiles 0.98; 95% CI 0.95, 1.02). Replacing 5% of calories from dairy fat with other sources of animal fat or carbohydrate from refined grains was associated with a 17% (HR 1.17; 95% CI 1.13, 1.21) and a 4% (HR 1.04; 95% CI 1.00, 1.08) higher risk of T2D, respectively. Conversely, a 5% calorie replacement with carbohydrate from whole grains was associated with a 7% lower risk of T2D (HR 0.93; 95% CI 0.88, 0.98). CONCLUSIONS: Dairy fat intake was not associated with T2D risk in these cohort studies of US men and women when compared with calories from carbohydrate. Replacing dairy fat with carbohydrates from whole grains was associated with lower risk of T2D. Replacement with other animal fats or refined carbohydrates was associated with higher risk.