Vitamin D, Yogurt, and Diabetes

Dr. Fran Cogen Health Pro
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    I have written multiple blogs about the relationship between vitamin D and diabetes. Indeed, evidence based research clearly indicates an association between diabetes and vitamin D; but not necessarily a causal one. As vitamin D levels can be greatly increased by ingesting over the counter (OTC) vitamin D supplements, I am greatly intrigued regarding any possibility of preventing, delaying or decreasing complications of both types 1 and 2 diabetes.

     

    In the February 27, 2014 online issue of Diabetologia, the authors, Raab, Giannopoulou, Schneider, Warncke, Krasmann, Winkler and Zieger, discuss the “Prevalence of vitamin D deficiency in pre-type 1 diabetes and its association with disease progression.”   As we have noted in previous blogs, vitamin D deficiency is common in people with type 1 diabetes (I have now begun to routinely check vitamin D levels in annual labs that include tests for celiac and autoimmune thyroiditis as well as lipid and random urine microalbumin/creatinine ratios when applicable).

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    The goal of the study was to determine the prevalence of vitamin D deficiency in pre-diabetes (presence of antibodies to pancreatic islet cells but no evidence of diabetes as of yet) and if progression to type 1 diabetes occurs at a faster rate in children that actually have vitamin D deficiency.

     

    How did the authors conduct the study?

    1. Levels of 25-hydroxyvitamin D were measured in
      1. 108 children with islet cell antibodies within two years of conversion.
      2. 406 children who did not have islet cell antibodies
      3. 244 children with newly diagnosed type 1 diabetes.

     

    1. The children with autoantibodies were prospectively followed for 5.8 years to determine progression to type1 diabetes.

     

    What were the results?

    1. Vitamin D levels were lower and the prevalence of vitamin D deficiency (<50 nmol/l) was higher in children with prevalent multiple islet cell antibodies than in children that did not have antibodies (p=0.021).
    2. The differences in vitamin D levels between the two groups of children were greater in the summer.
    3. The cumulative incidence of type 1 diabetes 10 years post sero-conversion remained nearly the same between children with vitamin D deficiency and those with appropriate vitamin D levels (p-0.8) (note- not statistically significant).

     

     

    What did the authors conclude?

    1. Vitamin D levels were lower in children with the presence of multiple pancreatic islet cell antibodies and in children with type 1 diabetes than in children without antibodies.
    2. Vitamin D deficiency was not associated with faster progression to type 1 diabetes in children with multiple pancreatic islet cell autoantibodies.

     

    Take home message:

    A therapeutic vitamin D level is appropriate for all children; especially in families with first degree relatives with type 1 diabetes.

     

    What about the about the consumption of yogurt (source of calcium) and relationship to the development of type 2 diabetes?

     

    In an issue of Diabetologia, O’Connor, Lentjes, Luben, Khaw, Wareham and Forouhi, “Dietary dairy product intake and incidence of type 2 diabetes: a prospective study using dietary data from a seven day food diary. (DOI 10.1007/s00125-014-3176-1). The aim of the study was to determine the relationship between total and types of dairy product intake and risk of developing of type 2 diabetes by using a food diary.

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    How did the authors conduct the study?

    1. nested case-cohort within EPIC-Norfolk study using a randm subcohort of 4000 participants.
    2. There were 892 cases of diabetes that developed including 143 in the subcohort
    3. Both groups were followed up for 11 years
    4. Dairy intake was estimated and categorized into high and low fat dairy and then subtyped into yogurt, cheese and milk.
    5. Combined fermented dairy product intake consisting of yogurt, cheese and sour cream were estimated and classified as high and low fat.

     

    What were the results?

     

    1. Total dairy, high-fat dairy, milk, cheese and high fat fermented dairy product intakes were NOT associated with the development of diabetes.
    2. Low-fat dairy intake was inversely associated with diabetes in age and sex adjusted analyses.
    3. Adjustment for BMI, dietary and diabetes risk factors “attenuated “ this association.
    4. An inverse association was found between diabetes and low-fat fermented dairy product intake and specifically with yogurt intake (p=0.017).

     

    Conclusion and take-home message:

    Fermented low-fat dairy products (yogurt) was associated with a decreased risk of type 2 diabetes occurrences in these prospective analyses. Therefore the intake of these products may be of great benefit in the prevention of diabetes!

Published On: March 10, 2014