Increased fat-free milk consumption improves weight loss, body composition, metabolic syndrome, and cardiometabolic outcomes in adults with type 2 diabetes mellitus

• Ano de defesa: 2016
• Autor(a) principal: Gomes, Júnia Maria Geraldo
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Viçosa
• Palavras-chave em Português: Diabéticos; Síndrome metabólica; Dieta - Leite; Pesos e medidas; Diabetes; Nutrição
• Link de acesso: http://www.locus.ufv.br/handle/123456789/21173

INTRODUCTION: It has been suggested that the consumption of fat-free dairy and of dietary calcium (Ca) seem to act on glycemic and body weight control, favoring type 2 diabetes mellitus (T2DM) prevention and treatment. However, to our knowledge, the effects of increased fat-free milk consumption on metabolic control of individuals with T2DM have not been assessed in any other study. OBJECTIVE: To evaluate the effects of fat-free milk consumption on body weight, body composition, metabolic syndrome (MetS) components, and cardiometabolic outcomes in aldults with T2DM. METHODS: Two randomized crossover clinical trials (N = 14) (Articles 1 and 2), and one randomized parallel design clinical trial (N = 36) (Article 3) were performed. Subjects with T2DM and low habitual Ca consumption (< 600 mg/d) participated of two 12-week experimental phases: high-Ca fat-free milk (MD) or low-Ca control diet (CD). In the crossover studies (Articles 1 and 2) there was an 8-week washout between experimental phases. Subjects daily consumed a breakfast shake containing 700 mg of Ca from fat-free milk (MD) (~3 servings of fat-free milk) or 6.4 mg of Ca (CD). Energy restricted diets (-500 kcal/d) containing 800 mg of Ca/d were prescribed. RESULTS: Article 1: Fat-free milk enhances weight loss, improves body composition, and promotes glycemic control in adults with type 2 diabetes mellitus – a randomized clinical trial - Dietary records data indicated the consumption of 1,200 mg of Ca/d during MD and of 525 mg of Ca/d during CD. There was a greater reduction in body weight, body fat mass, waist circumference (WC) and waist-hip ratio after MD. Serum 25- hydoxyvitamin D and HOMA2-B% increased and serum uric acid, parathormone, and glycated hemoglobin concentrations reduced after MD. The consumption of approximately 3 servings of fat-free milk (700 mg of additional Ca) enhanced weight loss, improved body composition, and promoted glycemia control in individuals with T2DM and low habitual Ca consumption. Article 2: Increased fat-free milk consumption, metabolic syndrome, and cardiometabolic outcomes in adults with type 2 diabetes mellitus. There was a greater reduction in WC, systolic (SBP) and diastolic blood pressure (DBP), and lipid accumulation product (LAP) index after MD compared with CD. Only MD phase increased HDL (high-density lipoprotein cholesterol) / LDL (low- density lipoprotein cholesterol) ratio and decreased total cholesterol, LDL-c, SBP and DBP, and LAP index. We conclude that the consumption of approximately 3 servings of fat-free milk (700 mg of additional Ca) decreased some MetS components and cardiometabolic measures adults with T2DM. Article 3: Dietary calcium from dairy, body composition and glycemic control in patients with type 2 diabetes: a parallel group randomized clinical trial. MD group final anthropometric measures (body weight, body mass index (BMI), WC, waist-hip ratio, and fat mass) decreased compared to baseline. MD group showed greater decrease in WC compared to CD group. Fasting glucose decreased in CD group. Both groups reduced glycated hemoglobin. Consumption of high-Ca diet from fat-free milk for 12 weeks was effective in reducing abdominal adiposity, but provided no additional effect on glycemic control in patients with T2DM. CONCLUSION: The increased consumption of fat-free milk (700 mg of additional Ca/d) seems to improve metabolic control of T2DM subjects.