Effect of Pre-meal Serving of Dairy and Dairy Alternatives on Post-meal Satiety and Glycaemia in Healthy Young Adults
Condition: Obesity; Type 2 Diabetes Mellitus
MeSH terms: Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Regular consumption of dairy products is found to negatively associated with metabolic
      diseases and improve body composition in long term studies and has positive effect on acute
      glycemia control and satiety. However, new Canada's Food Guide released in 2019 promotes a
      shift from traditional dairy products to plant-based dairy alternatives. The present study
      examines the effect of traditional dairy products in comparison with plant-based alternatives
      on glycemic response and satiety.
    

Detailed description: 
      In the past forty years, the prevalence of obesity in adults has doubled, and nearly two
      thirds of Canadian adults are currently overweight or obese (Kenneth and Eggleton,2016). The
      incidence of diabetes, heart disease, stroke and certain cancers has also increased
      correspondingly (Xavier P. 2010). Obesity not only leads to other chronic diseases but also
      decreases life expectancy and puts a strain on the health care system (Tremmel 2017).
      Therefore, it is important to find strategies to minimize obesity and type-2 diabetes.
      Postprandial glycemia (PPG) has been identified to be one of the implications of risk factor
      of metabolic diseases such as obesity (Black 2012). To better help identify foods that
      increase satiety and decrease PPG, Health Canada released a draft guidance document to
      validate health food claims related to "reduction of post-prandial glycaemic response"
      (Health Canada 2013).

      Regular consumption of dairy products correlates with improved body composition and lower
      incidences of obesity and type 2 diabetes in both observational and long-term clinical
      studies (Hirahatake et al. 2014; Lee et al. 2018; Murphy et al. 2013; Soedamah-Muthu and de
      Goede 2018). Within typical dietary patterns, high-fat dairy consumption is inversely
      associated with the risk of obesity or overweight (Kratz et al. 2013; Rautiainen et al.
      2016). Frequent cheese consumption was associated with lower BMI in a 10 year follow-up study
      (Guo et al. 2018). The hypothesis that these associations between dairy and obesity and
      chronic metabolic diseases can be attributed to lasting metabolic effects of dairy when
      consumed with high glycemic carbohydrate or as a between meal snack is supported by short
      term studies. A recent meta-analysis of clinical trials concluded that, dairy products when
      consumed alone result in significant decreases in appetite and later energy intake (Onvani et
      al. 2017). Other recent studies have shown that milk consumed with a high glyemic breakfast
      cereal significantly reduced PPG as well as appetite in both young (Kung et al. 2018; Law et
      al. 2017a) and older adults (Law et al. 2017b). Among dairy products, semi solid and solid
      dairy products such as cheese and yogurt consumed with carbohydrates increased satiety and
      lowered PPG more than milk or soy beverages (Law et al. 2017b). PPG and appetite were
      significantly reduced following single serving amounts, of skim-milk, full fat milk, yogurt
      and cheese when consumed alone (Vien et al. 2019). Appetite measured over three hours was
      reduced after dairy consumption compared to a water control, particularly skim milk reducing
      appetite more than full fat milk, yogurt or cheese. Over 120 minutes, PPG was the lowest
      after cheese (Vien et al. 2019).

      This data suggests that dairy consumed immediately before a meal will affect satiety and
      glycemic responses to a later meal, but the response will depend on the type of dairy product
      consumed. The updated Canada's Food Guide promotes the consumption of plant-based protein and
      a shift away from consuming dairy products as plant-based products may provide more fibre and
      less saturated fat (Canada Food Guide 2019). As a result, many plant based dairy substitutes
      have appeared in the marketplace. However, these new products, in addition to being of low
      protein quality, my lack the physiological functionality of dairy in metabolic regulation.
    

Intervention name(s): Dairy-based greek yogurt; Dairy-based cheddar cheese; Plant-based yogurt; Plant-based cheese
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Plain Greek yogurt (2% M.F; Danone, Boucherville, Quebec, Canada); Mild cheddar cheese (31% M.F. ; Armstrong, Saputo Dairy Products, Saint-Laurent, Quebec, Canada); Plain Greek yogurt alternative (Daiya, Rupert Street, Vancouver, Canada); Medium cheddar style block (Daiya, Rupert Street, Vancouver, Canada)
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Dairy; Yogurt; Cheese; Postprandial glycaemia; Satiety; Plant based dairy alternative