TABLE 3.
Risk of incident diabetes (n = 196 cases) among those with prediabetes (n = 925) at exam 5 (baseline, 1991–1995) in the Framingham Heart Study Offspring Cohort, by mean total dairy and milk-based product intakes1
| HR (95% CI) |
||||||||
| Intake by category2 | Median intake2 | Respondents/cases, n | Person-years, n | Crude rate | Model 1 | Model 2 | Model 3 | Model 4 |
| Total dairy | ||||||||
| 0 to <4 | 2.8 | 117/30 | 1280.9 | 2.3 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 4 to <7 | 5.6 | 206/33 | 2389.9 | 1.4 | 0.56 (0.34, 0.92) | 0.57 (0.35, 0.95) | 0.58 (0.35, 0.97) | 0.60 (0.36, 0.99) |
| 7 to <14 | 10 | 385/94 | 4431.9 | 2.1 | 0.92 (0.60, 1.41) | 0.93 (0.60, 1.43) | 0.93 (0.59, 1.46) | 0.84 (0.54, 1.33) |
| ≥14 | 18.5 | 217/39 | 2554.8 | 1.5 | 0.67 (0.40, 1.13) | 0.70 (0.41, 1.19) | 0.68 (0.37, 1.25) | 0.63 (0.34, 1.15) |
| P-trend | 0.59 | 0.69 | 0.65 | 0.39 | ||||
| High-fat dairy | ||||||||
| 0 to <1 | 0.7 | 73/22 | 751.1 | 2.9 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 to <4 | 2.6 | 433/96 | 4965.7 | 1.9 | 0.63 (0.39, 1.00) | 0.63 (0.39, 1.01) | 0.57 (0.36, 0.92) | 0.56 (0.34, 0.90) |
| 4 to <7 | 5.1 | 274/53 | 3213.9 | 1.6 | 0.51 (0.30, 0.85) | 0.53 (0.32, 0.90) | 0.45 (0.26, 0.77) | 0.40 (0.23, 0.69) |
| 7 to <14 | 9 | 114/18 | 1357.8 | 1.3 | 0.41 (0.22, 0.79) | 0.45 (0.23, 0.86) | 0.39 (0.20, 0.78) | 0.36 (0.18, 0.72) |
| ≥14 | 18 | 31/7 | 369.1 | 1.9 | 0.58 (0.23, 1.47) | 0.53 (0.21, 1.36) | 0.29 (0.10, 0.86) | 0.30 (0.10, 0.92) |
| P-trend | 0.12 | 0.14 | 0.03 | 0.03 | ||||
| Low-fat dairy | ||||||||
| 0 to <1 | 0.3 | 182/46 | 1950.1 | 2.4 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 to <4 | 2.5 | 257/47 | 3090.0 | 1.5 | 0.61 (0.41, 0.92) | 0.60 (0.40, 0.90) | 0.59 (0.39, 0.90) | 0.60 (0.39, 0.91) |
| 4 to <7 | 5.4 | 195/42 | 2294.4 | 1.8 | 0.81 (0.53, 1.23) | 0.79 (0.52, 1.21) | 0.80 (0.51, 1.24) | 0.73 (0.47, 1.14) |
| 7 to <14 | 9.4 | 196/42 | 2246.8 | 1.9 | 0.84 (0.55, 1.29) | 0.88 (0.57, 1.36) | 0.85 (0.53, 1.37) | 0.78 (0.48, 1.27) |
| ≥14 | 17.6 | 95/19 | 1076.3 | 1.8 | 0.74 (0.43, 1.28) | 0.73 (0.42, 1.28) | 0.72 (0.39, 1.35) | 0.75 (0.39, 1.41) |
| P-trend | 0.85 | 0.97 | 0.89 | 0.86 | ||||
| Total milk | ||||||||
| 0 to <1 | 0.2 | 183/41 | 1989.2 | 2.1 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 to <4 | 2.5 | 300/62 | 3549.7 | 1.7 | 0.85 (0.58, 1.27) | 0.86 (0.58, 1.28) | 0.84 (0.56, 1.25) | 0.80 (0.53, 1.19) |
| 4 to <7 | 5.3 | 207/43 | 2462.6 | 1.7 | 0.91 (0.59, 1.40) | 0.90 (0.58, 1.40) | 0.90 (0.57, 1.41) | 0.72 (0.45, 1.13) |
| 7 to <14 | 9.3 | 153/33 | 1735.6 | 1.9 | 0.99 (0.62, 1.58) | 1.01 (0.63, 1.62) | 0.94 (0.57, 1.55) | 0.83 (0.50, 1.37) |
| ≥14 | 17.5 | 82/17 | 920.4 | 1.8 | 0.91 (0.51, 1.63) | 0.94 (0.52, 1.69) | 0.89 (0.47, 1.67) | 0.90 (0.47, 1.70) |
| P-trend | 0.95 | 0.86 | 0.93 | 0.89 | ||||
| Skim milk | ||||||||
| 0 to <1 | 0.1 | 247/58 | 2722.7 | 2.1 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 to <4 | 2.4 | 281/58 | 3344.4 | 1.7 | 0.82 (0.57, 1.18) | 0.79 (0.55, 1.14) | 0.81 (0.55, 1.18) | 0.80 (0.54, 1.16) |
| 4 to <7 | 5.3 | 184/38 | 2169.6 | 1.8 | 0.91 (0.60, 1.38) | 0.88 (0.58, 1.34) | 0.86 (0.56, 1.33) | 0.73 (0.47, 1.14) |
| 7 to <14 | 9.3 | 138/26 | 1567.0 | 1.7 | 0.85 (0.53, 1.36) | 0.88 (0.54, 1.41) | 0.82 (0.49, 1.38) | 0.73 (0.43, 1.23) |
| ≥14 | 17.5 | 75/16 | 853.8 | 1.9 | 0.89 (0.51, 1.57) | 0.92 (0.52, 1.63) | 0.87 (0.47, 1.64) | 0.89 (0.47, 1.68) |
| P-trend | 0.76 | 0.93 | 0.73 | 0.64 | ||||
| Whole milk | ||||||||
| 0 to <1 | 0 | 802/163 | 9228.7 | 1.8 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| ≥1 | 2.3 | 123/33 | 1428.8 | 2.3 | 1.20 (0.82, 1.75) | 1.16 (0.79, 1.71) | 1.23 (0.82, 1.85) | 1.16 (0.77, 1.76) |
| P-trend | 0.35 | 0.45 | 0.33 | 0.48 | ||||
| Cheese | ||||||||
| 0 to <1 | 0.6 | 188/53 | 2025.4 | 2.6 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 to <4 | 2.3 | 558/114 | 6466.6 | 1.8 | 0.66 (0.47, 0.92) | 0.69 (0.49, 0.97) | 0.68 (0.48, 0.96) | 0.64 (0.45, 0.90) |
| ≥4 | 5.5 | 179/29 | 2165.5 | 1.3 | 0.47 (0.29, 0.76) | 0.48 (0.30, 0.79) | 0.45 (0.27, 0.76) | 0.37 (0.22, 0.62) |
| P-trend | 0.003 | 0.004 | 0.003 | <0.001 | ||||
| Cream and butter | ||||||||
| 0 to <1 | 0.4 | 274/61 | 2999.1 | 2.0 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 to <4 | 2.2 | 285/60 | 3378.9 | 1.8 | 0.84 (0.59, 1.20) | 0.86 (0.60, 1.23) | 0.89 (0.62, 1.29) | 0.88 (0.61, 1.28) |
| 4 to <7 | 5.2 | 124/27 | 1417.4 | 1.9 | 0.95 (0.60, 1.50) | 0.88 (0.55, 1.39) | 0.85 (0.53, 1.36) | 0.79 (0.49, 1.28) |
| 7 to <14 | 9.7 | 139/30 | 1666.1 | 1.8 | 0.89 (0.57, 1.39) | 0.89 (0.57, 1.40) | 0.89 (0.56, 1.42) | 1.00 (0.63, 1.61) |
| ≥14 | 19.8 | 103/18 | 1196.0 | 1.5 | 0.72 (0.42, 1.25) | 0.73 (0.42, 1.27) | 0.72 (0.41, 1.29) | 0.81 (0.45, 1.46) |
| P-trend | 0.36 | 0.35 | 0.34 | 0.68 | ||||
| Yogurt | ||||||||
| 0 | 0 | 362/81 | 4016.9 | 2.0 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| >0 to <1 | 0.4 | 299/69 | 3518.6 | 2.0 | 0.97 (0.70, 1.34) | 0.98 (0.70, 1.36) | 0.89 (0.64, 1.26) | 0.96 (0.68, 1.35) |
| 1 to <3 | 1.7 | 196/30 | 2353.2 | 1.3 | 0.61 (0.40, 0.94) | 0.63 (0.41, 0.96) | 0.63 (0.40, 1.00) | 0.65 (0.41, 1.02) |
| ≥3 | 4.2 | 68/16 | 768.8 | 2.1 | 1.05 (0.61, 1.82) | 1.15 (0.66, 1.99) | 1.07 (0.58, 1.98) | 1.24 (0.67, 2.29) |
| P-trend | 0.40 | 0.58 | 0.67 | 0.89 | ||||
Cox proportional hazards models to estimate HRs (95% CIs) were adjusted as follows: Model 1 was adjusted for age, sex, and energy intake. Model 2 was adjusted as for model 1, plus parental history of diabetes, baseline smoking status, dyslipidemia or treatment, and hypertension or treatment. Model 3 was further adjusted for means of other dietary characteristics, including intake of coffee, nuts, fruits, vegetables, meats, alcohol, and fish; the glycemic index (used as a measure of carbohydrate quality); and other dairy intake, as appropriate (for example, for associations of low-fat dairy intake, high-fat dairy intake was included in model 3). Model 4 was adjusted as for model 3, with further adjustment for baseline BMI and weight change over follow-up. Where Model 4 trends seemed to be potentially nonlinear, tests for nonlinearity were conducted using restricted cubic splines; no nonlinear associations were statistically significant (all P-nonlinear trend > 0.05).
Units are servings per week, with the following grams per serving: skim milk, 245 g; whole milk, 245 g; cream, 15 g; sour cream, 12 g; sherbet and ice milk, 96 g; ice cream, 66 g; yogurt, 227 g; cottage and ricotta cheese, 105 g; cream cheese, 28 g; other cheese, 28 g; butter, 5 g.