RT Journal Article SR Electronic T1 Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries JF BMJ Open Diabetes Research & Care JO BMJ Open Diab Res Care FD American Diabetes Association SP e000826 DO 10.1136/bmjdrc-2019-000826 VO 8 IS 1 A1 Bhavadharini, Balaji A1 Dehghan, Mahshid A1 Mente, Andrew A1 Rangarajan, Sumathy A1 Sheridan, Patrick A1 Mohan, Viswanathan A1 Iqbal, Romaina A1 Gupta, Rajeev A1 Lear, Scott A1 Wentzel-Viljoen, Edelweiss A1 Avezum, Alvaro A1 Lopez-Jaramillo, Patricio A1 Mony, Prem A1 Varma, Ravi Prasad A1 Kumar, Rajesh A1 Chifamba, Jephat A1 Alhabib, Khalid F A1 Mohammadifard, Noushin A1 Oguz, Aytekin A1 Lanas, Fernando A1 Rozanska, Dorota A1 Bengtsson Bostrom, Kristina A1 Yusoff, Khalid A1 Tsolkile, Lungiswa P A1 Dans, Antonio A1 Yusufali, Afzalhussein A1 Orlandini, Andres A1 Poirier, Paul A1 Khatib, Rasha A1 Hu, Bo A1 Wei, Li A1 Yin, Lu A1 Deeraili, Ai A1 Yeates, Karen A1 Yusuf, Rita A1 Ismail, Noorhassim A1 Mozaffarian, Dariush A1 Teo, Koon A1 Anand, Sonia S A1 Yusuf, Salim YR 2020 UL http://drc.bmj.com/content/8/1/e000826.abstract AB Objective Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.Methods The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes).Results In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake; OR 0.76, 95% CI 0.71 to 0.80, p-trend<0.0001) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone (OR 0.72, 95% CI 0.66 to 0.78, p-trend<0.0001), or consumed jointly with low fat dairy (OR 0.89, 95% CI 0.80 to 0.98, p-trend=0.0005), were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS (OR 1.03, 95% CI 0.77 to 1.38, p-trend=0.13). In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension (HR 0.89, 95% CI 0.82 to 0.97, p-trend=0.02) and diabetes (HR 0.88, 95% CI 0.76 to 1.02, p-trend=0.01). Directionally similar associations were found for whole fat dairy versus each outcome.Conclusions Higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.