Consumption of total dairy and dairy subtypes with incident prediabetes in the Lifelines study population

Prediabetes is a condition characterized by blood glucose levels that are above the normal range, but still fall below the diagnostic threshold for type 2 diabetes mellitus. People with prediabetes are at increased risk for progressing to type 2 diabetes mellitus and cardiovascular diseases, emphasizing the need to identify modifiable risk factors that could prevent or reverse this condition. Dairy products are widely consumed and due to a wide variety of nutrients interesting for research on cardio-metabolic health. The most recent meta-analysis show a modest lowering in DM risk between the highest vs lowest dairy intake level of 3-4% for total and low fat dairy (per 200 g/day). Only one prospective cohort study reported associations of dairy products with incident prediabetes. In 1867 participants of The Framingham Heart Study Offspring cohort with 12 years of follow-up, both consumption of total, low fat and high fat dairy was associated with 39%, 32%, and 25% lower prediabetes incidence respectively, in highest compared to lowest quartiles. Strong inverse associations were also found for consumption of fermented dairy products and prediabetes in the Maastricht Study and the Lifelines Cohort, but a cross-sectional design was used with limitations regarding assessment of causal relationships. The precise time point along the etiological pathway at which specific dairy products modify type 2 diabetes risk remains largely unknown, and potential early phase effects of dairy consumption may imply a potential role of dairy in prediabetes prevention. Questions remain regarding which dose and type of dairy products are associated with incident prediabetes. Therefore, we would like to explore prospective associations of dairy and prediabetes in the Lifelines Cohort using longitudinal data. Repeated assessment of dairy intake in the Lifelines cohort provides up-to-date consumption level data and enables assessment of within-person variability. Furthermore, we will explore substitutions of dairy types associated with prediabetes for other dairy types to dissociate the impact of increases or decreases in intake with concomitant changes in intake of other dairy foods.