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The CARDIA Study

Mark A. Pereira, PhD; David R. Jacobs, Jr, PhD; Linda Van Horn, PhD,RD; Martha L. Slattery, PhD,RD; Alex I. Kartashov, PhD; David S. Ludwig, MD,PhD

JAMA. 2002;287:2081-2089.

Context  Components of the insulin resistance syndrome (IRS), including obesity, glucose intolerance, hypertension, and dyslipidemia, are major risk factors for type 2 diabetes and heart disease. Although diet has been postulated to influence IRS, the independent effects of dairy consumption on development of this syndrome have not been investigated.

Objective  To examine associations between dairy intake and incidence of IRS, adjusting for confounding lifestyle and dietary factors.

Design  The Coronary Artery Risk Development in Young Adults (CARDIA) study, a population-based prospective study.

Setting and Participants  General community sample from 4 US metropolitan areas of 3157 black and white adults aged 18 to 30 years who were followed up from 1985-1986 to 1995-1996.

Main Outcome Measure  Ten-year cumulative incidence of IRS and its association with dairy consumption, measured by diet history interview.

Results  Dairy consumption was inversely associated with the incidence of all IRS components among individuals who were overweight (body mass index 25 kg/m²) at baseline but not among leaner individuals (body mass index <25 kg/m²). The adjusted odds of developing IRS (2 or more components) were 72% lower (odds ratio, 0.28; 95% confidence interval, 0.14-0.58) among overweight individuals in the highest (35 times per week, 24/102 individuals) compared with the lowest (<10 times per week, 85/190 individuals) category of dairy consumption. Each daily occasion of dairy consumption was associated with a 21% lower odds of IRS (odds ratio, 0.79; 95% confidence interval, 0.70-0.88). These associations were similar for blacks and whites and for men and women. Other dietary factors, including macronutrients and micronutrients, did not explain the association between dairy intake and IRS.

Conclusions  Dietary patterns characterized by increased dairy consumption have a strong inverse association with IRS among overweight adults and may reduce risk of type 2 diabetes and cardiovascular disease.

Author Affiliations: Department of Medicine, Children's Hospital, and Department of Pediatrics, Harvard Medical School (Drs Pereira and Ludwig), and Clinical Research Program, Children's Hospital (Dr Kartashov), Boston, Mass; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, and Institute for Nutrition Research, University of Oslo, Oslo, Norway (Dr Jacobs); Department of Preventive Medicine, Northwestern University Medical School, Chicago, Ill (Dr Van Horn); University of Utah Medical School, Salt Lake City (Dr Slattery).

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