Dairy Consumption and Incident Type 2 Diabetes Among American Indians: The Strong Heart Family Study

Thesis (Master's)--University of Washington, 2016-06

Background: Type 2 Diabetes (T2D) disproportionately impacts American Indians (AIs); the prevalence of T2D is two to three times higher among AIs than the general US population. Obesity and poor diets are common in AI communities and the relationships of specific dietary factors with T2D have not been well studied in this population. Whether dairy consumption, specifically high-fat intake and low-fat dairy intake, are associated with risk of T2D in AIs has yet to be explored. Methods: Using data collected as part of the Strong Heart Family Study (SHFS), we examined the associations of high-fat dairy and low-fat dairy intake with incident diabetes. The analytic cohort comprised of SHFS participants free of diabetes at baseline and who participated in a follow-up exam 8 years later (n=1,623). Dietary intake was assessed using a Block FFQ at baseline. Incidence of diabetes was defined based on the American Diabetes Association criteria at the follow-up exam. GEE were used to evaluate the associations between dairy intake and incident diabetes. Results: Reported intake of dairy products was exceedingly low [median high-fat dairy intake 0.11 servings/1000kcal; median low-fat dairy intake 0.03 servings/1000kcal]. There were 172 participants who developed diabetes during follow-up. No statistically significant associations were observed between high- or low-fat dairy intake and development of diabetes. Despite low reported dairy intake in the SHFS, those who reported the highest levels of high-fat dairy consumption compared to the lowest showed a trend for an inverse association with T2D [OR (95%CI): 0.69 (0.45,1.05)]. In contrast, higher consumption of low-fat dairy products showed no significant association with T2D. Conclusions: The SHFS population has very low consumption of both high- and low-fat dairy products.