Sugar-sweetened product consumption alters glucose homeostasis compared with dairy product consumption in men and women at risk of type 2 diabetes mellitus

Abstract

Background: Dietary patterns characterized by high intakes of fruits and vegetables, whole grains, low-fat dairy products, and low glycemic load have been associated with lower type 2 diabetes mellitus (T2DM) risk. In contrast, dietary patterns that include high intakes of refined grains, processed meats, and high amounts of added sugars have been associated with increased T2DM risk. Objective: This randomized, 2-period crossover trial compared the effects of dairy and sugar-sweetened product (SSP) consumption on insulin sensitivity and pancreatic b-cell function in men and women at risk of the development of T2DM who habitually consume sugar-sweetened beverages. Methods: In a randomized, controlled crossover trial, participants consumed dairy products (474 mL/d 2% milk and 170 g/d low-fat yogurt) and SSPs (710 mL/d nondiet soda and 108 g/d nondairy pudding), each for 6 wk, with a 2-wk washout between treatments. A liquid meal tolerance test (LMTT) was administered at baseline and the end of each period. Results: Participants were 50% female with a mean age and body mass index of 53.8 y and 32.2 kg/m 2, respectively. Changes from baseline were significantly different between dairy product and SSP conditions for median homeostasis model assessment 2-insulin sensitivity (HOMA2-%S) (1.3 vs. 221.3%, respectively, P = 0.009; baseline = 118%), mean LMTT disposition index (20.03 vs.20.36, respectively, P = 0.011; baseline = 2.59), mean HDL cholesterol (0.8 vs.24.2%, respectively, P = 0.015; baseline = 44.3 mg/dL), and mean serum 25-hydroxyvitamin D [25(OH)D] (11.7 vs. 23.3, respectively, P = 0.022; baseline = 24.5 μg/L). Changes from baseline in LMTT Matsuda insulin sensitivity index (20.10 vs. 20.49, respectively; baseline = 4.16) and mean HOMA2-β-cell function (22.0 vs. 5.3%, respectively; baseline = 72.6%) did not differ significantly between treatments. Conclusion: These results suggest that SSP consumption is associated with less favorable values for HOMA2-%S, LMTT disposition index, HDL cholesterol, and serum 25(OH)D in men and women at risk of T2DM vs. baseline values and values during dairy product consumption. This trial was registered at clinicaltrials.gov as NCT01936935.