Dairy product consumption and incident prediabetes in Dutch middle-aged adults: the Hoorn Studies prospective cohort

Eur J Nutr. 2022 Feb;61(1):183-196. doi: 10.1007/s00394-021-02626-9. Epub 2021 Jul 10.


Purpose: Our aim was to investigate prospective associations of consumption of total dairy and dairy types with incident prediabetes in a Dutch population-based study.

Methods: Two enrolment waves of the Hoorn Studies were harmonized, resulting in an analytic sample of 2262 participants without (pre-) diabetes at enrolment (mean age 56 ± 7.3 years; 50% male). Baseline dietary intake was assessed by validated food frequency questionnaires. Relative risks (RRs) were calculated between dairy, fermented dairy, milk, yogurt (all total/high/low fat), cream and ice cream and prediabetes. Additionally, substituting one serving/day of dairy types associated with prediabetes with alternative dairy types was analysed.

Results: During a mean 6.4 ± 0.7 years of follow-up, 810 participants (35.9%) developed prediabetes. High fat fermented dairy, cheese and high fat cheese were associated with a 17% (RR 0.83, 95% CI 0.69-0.99, ptrend = 0.04), 14% (RR 0.86, 95% CI 0.73-1.02, ptrend = 0.04) and 21% (RR 0.79, 95% CI 0.66-0.94, ptrend = 0.01) lower risk of incident prediabetes, respectively, in top compared to bottom quartiles, after adjustment for confounders. High fat cheese consumption was continuously associated with lower prediabetes risk (RRservings/day 0.94, 95% CI 0.88-1.00, p = 0.04). Total dairy and other dairy types were not associated with prediabetes risk in adjusted models, irrespective of fat content (RR ~ 1). Replacing high fat cheese with alternative dairy types was not associated with prediabetes risk.

Conclusion: The highest intake of high fat fermented dairy, cheese and high fat cheese were associated with a lower risk of prediabetes, whereas other dairy types were not associated. Cheese seems to be inversely associated with type 2 diabetes risk, despite high levels of saturated fatty acids and sodium.

Keywords: Dairy; Impaired glucose metabolism; Prediabetes; Prospective cohort.

MeSH terms

  • Adult
  • Animals
  • Dairy Products
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diet
  • Dietary Fats
  • Female
  • Humans
  • Male
  • Middle Aged
  • Milk
  • Prediabetic State* / epidemiology
  • Risk Factors
  • Yogurt


  • Dietary Fats