Diabetes as a selected risk factor is the 8th leading cause of death in South Africa.

There is now substantial evidence that type 2 diabetes can be prevented or delayed by lifestyle interventions. Therefore diet and exercise should be the first choice in order to avoid weight gain when preventing diabetes.

Facts:

• A higher intake of dairy products, especially low-fat dairy, is associated with lower risk of type 2 diabetes and insulin resistance syndrome (IRS).
• Drinking more milk – a leading source of calcium and vitamin D – may affect the body’s ability to generate or utilize insulin and could help decrease the risk of type 2 diabetes by nearly 15 percent.
• Each serving-per-day increase in dairy intake was associated with a 4% lower risk of type 2 diabetes.

The prevention time line

Pharmacological intervention (medicine) should not be routinely used to prevent diabetes although results of large clinical trails in patients with impaired glucose tolerance are available.

Recommendations for dietary assistance

• Normal weight status in the lower BMI range (BMI 21-23)
• Regular physical activity to be maintained throughout adulthood
• Abdominal obesity (fat round the waist) to be prevented
• Saturated fat (mainly animal fat) intake less than 7% of the total energy intake.

Supporting evidence:

The exact mechanism underlying the inverse association between dairy intake and risk of type 2 diabetes remain unclear, but the following facts have been indicated as significant:

• Components in dairy such as magnesium, calcium, Vitamin D, lactose, and dairy protein may enhance satiety and reduce the risk of overweight and obesity compared with other high-carbohydrate foods and beverages.
• Milk proteins appear to induce rapid release of certain amino acids and hormones, improving insulin sensitivity. Whey proteins appear to be a particularly beneficial for diabetics.
• Higher magnesium intakes were associated with higher insulin sensitivity.  Studies found for every 100 mg increase in magnesium up to the recommended dietary intake, the risk of developing type 2 diabetes decreased by 15 percent.  
• Long-chain omega-3 fatty acids can beneficially modulate glucose metabolism and insulin resistance and it has been reported that fish oil supplementation to diets of dairy cows increases omega-3 fatty acids in milk in a dose-responsive manner.

3 servings-a-day of low-fat dairy may play a vital role

• Low-fat yoghurt – 200g yoghurt will provide 300mg calcium
• Cheese especially Ricotta – 125g Ricotta will provide 300mg calcium
• Low-fat milk – 250ml milk will provide 300mg calcium

References

Lui S, Chai HK, Ford E, SongV, Klevak A, Buriny J & Manson JE. 2006. Diabetes Care (29): 1579 – 1584
Norman R, Bradshaw D, Sschneider M, et al,. 2007. SA Med J (97): 8, part 2
Jermendy G. 2003. Orv Hetil 144 (39): 1909 – 1917
Thorsdottir I, Hill J & Ramel A. 2004. Am J Prev Med (39): 630 - 634
Mayer-Davis EJ. 2008. J Am Diet Assoc (108): S45 – S51
Van Dam RM, Hu FB, Rosenberg L, Krishnan S & Palmer JR. 2006. Diabetes Care (26): 2238 – 2243
Steyn NP, Mann J, Bennett PH, Temple N, Zimmet P, Tuomilehto J, Lindsröm J & Lauherant A. 2004. Publ Health Nutr 7 (1A): 147 – 165
Chai HK, Willett WC, Stampher MJ, Rimm E & Hu FB. 2005. ArchInter Med 165 (9): 997 – 1003
Pereira MA, Jacobs DR, Van Horn L, Dlattery ML, Kartashar AI & Ludwig DS. 2002. J Am Med Assoc (287): 2153 – 2154
Pittas AG, Lau J, HU FB & Dawson-Huges B. 2007. J of Clin Endocrinol & Metabol (92): 2017 – 2029
Schulze MB & Hu FB. 2005. Annu Rev of Public Health (26): 445 – 467
Berry D, Urban A & Grey M. 2006. J Paediatr Health Care (20): 3 – 10
Scheen AJ. 2004. Drugs 64 (22): 2537 – 2565
Holland B, Unwin ID & Buss DH. 1989. Milk products and eggs. The fourth supplement to McCance & Widdowson’s. The Composition of Foods (4th Ed). Xerox Ventura Publisher. UK
Larsson SC & Walk A. 2007. J Intern Med (10): 1111