Thursday, February 27, 2014

The Women's Health Initiative Randomized Controlled Dietary Modification Trial: an inconvenient finding and the diet-heart hypothesis.


The Women's Health Initiative Randomized Controlled Dietary Modification Trial: an inconvenient finding and the diet-heart hypothesis.
S Afr Med J. 2013 Nov;103(11):824-5
Authors: Noakes TD

One goal of the US$700 million Women's Health Initiative Randomized Controlled Dietary Modification Trial was to determine whether post-menopausal women who adopted what was regarded as a 'heart healthy' low-fat diet, high in vegetables, fruits and grains, reduced their risk of developing cardiovascular disease. The trial substantially favoured the outcome in the intervention group, who also received an intensive nutritional and behaviour education programme not offered to the control group. These studies neatly disprove the diet-heart hypothesis since adoption of 'heart healthy' eating not only failed to influence future cardiac events in the healthy but it increased such events in the unhealthy and worsened diabetic control in those with type 2 diabetes mellitus. 

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Tuesday, February 25, 2014

Correlation between physical activity and sedentary behavior with healthy and unhealthy behaviors in Italy and Tuscan region: a cross sectional study.


Correlation between physical activity and sedentary behavior with healthy and unhealthy behaviors in Italy and Tuscan region: a cross sectional study.
J Prev Med Hyg. 2013 Mar;54(1):41-8
Authors: Lazzeri G, Azzolini E, Pammolli A, De Wet DR, Giacchi MV

INTRODUCTION: Regular physical activity (PA) has associated with various positive health aspects such as a decreased risk of chronic or generic illnesses, furthermore, a sedentary lifestyle has been associated with health problems such as obesity. To examine the relationship between patterns of PA, screen-based media use (SBM) and social health indicators within a specific demographic group and highlight the regional vs. national differences in these relationships.
METHODS: The data is drawn from the Health Behaviour in School-Aged Children (HBSC) database, a national cross-sectional survey in a representative sample (N = 3920) of students aged 11-13-15 years and compared to those of the Tuscan region (N = 3381). Variables considered other than PA and SBM use includes positive health indicators such as physical health status, quality of family and peer relationships, fruit consumption, breakfast consumption as well as negative health indicators, such as health complaints, smoking and alcohol use.
RESULTS: Some positive health indicators showed a positive correlation with PA. Students adopting healthy behaviours often met the Physical Activity Guide Line (PAGL). On the contrary, negative health indicators were associated with PAGL in a negative way. In general SBM was positively related to several of the negative health indicators and vice versa. SBM was related in a positive fashion to tobacco use that represents a protective factor.
DISCUSSION: The results show that met PAGL is associated with positive health indicators and that high levels of SBM use is associated with negative health indicators. The study also emphasizes the relationship between PA, SBM use and socialfactors. Increasing PA and decreasing SBM use should be an aim in general health behaviour promotion.

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comment: more physical activity is good for your health. 

Diet and the microbial aetiology of dental caries: new paradigms.


Diet and the microbial aetiology of dental caries: new paradigms.
Int Dent J. 2013 Dec;63 Suppl 2:64-72
Authors: Bradshaw DJ, Lynch RJ

The microbial and dietary factors that drive caries have been studied scientifically for 120 years. Frequent and/or excessive sugar (especially sucrose) consumption has been ascribed a central role in caries causation, while Streptococcus mutans appeared to play the key role in metabolising sucrose to produce lactic acid, which can demineralise enamel. Many authors described caries as a transmissible infectious disease. However, more recent data have shifted these paradigms. Streptococcus mutans does not fulfil Koch's postulates - presence of the organism leading to disease, and absence of the organism precluding disease. Furthermore, molecular microbiological methods have shown that, even with a sugar-rich diet, a much broader spectrum of acidogenic microbes is found in dental plaque. While simple sugars can be cariogenic, cooked starches are also now recognised to be a caries threat, especially because such starches, while not 'sticky in the hand', can be highly retentive in the mouth. Metabolism of starch particles can yield a prolonged acidic challenge, especially at retentive, caries-prone sites. These changes in the paradigms of caries aetiology have important implications for caries control strategies. Preventing the transmission of S. mutans will likely be inadequate to prevent caries if a sufficiently carbohydrate-rich diet continues. Similarly, restriction of sucrose intake, although welcome, would be unlikely to be a panacea for caries, especially if frequent starch intake persisted. Instead, approaches to optimise fluoride delivery, to target plaque acidogenicity or acidogenic microbes, to promote plaque alkali generation, to increase salivary flow or replace fermentable carbohydrates with non-fermentable alternatives may be more promising.

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comment: Simply rinsing out the mouth with plain water, in addition to fluoride, will greatly decrease dental cavities

Sunday, February 23, 2014

Exercise Helps You Smell

This study found that exercise seems to help people keep their sense of smell as they age.



Association of exercise with... [JAMA Otolaryngol Head Neck Surg. 2013] - PubMed - NCBI

Friday, February 21, 2014

Physical activity and sedentary behaviors in postpartum Latinas: Madres para la Salud.

Physical activity and sedentary behaviors in postpartum Latinas: Madres para la Salud.
Med Sci Sports Exerc. 2013 Jul;45(7):1298-306
Authors: Ainsworth BE, Keller C, Herrmann S, Belyea M, Records K, Nagle-Williams A, Vega-López S, Permana P, Coonrod DV

PURPOSE: To describe the physical activity (PA) and sedentary behaviors of postpartum Latinas who are overweight or obese before initiating Madres para la Salud, a social support-mediated walking intervention to promote postpartum weight loss.
METHODS: One hundred thirty-nine postpartum women (13.6 ± 7.7 wk since childbirth, age = 28.3 ± 5.6 yr, BMI = 29.7 ± 3.5 kg · m(-2); mean ± SD), recruited from organizations serving Latino residents in the Phoenix, Arizona, area completed the Stanford Brief Activity Survey and concurrently wore an accelerometer (ActiGraph) and a pedometer for 7 d and kept a PA record.
RESULTS: Most were classified as inactive and lightly active on the Stanford Brief Activity Survey (51% inactive, 37% light, 11% moderate). Most time was spent in sedentary (512.0 ± 169.9 min · d(-1)) and light-intensity PA (242.4 ± 51.4 min · d(-1)) with less time in moderate-intensity lifestyle (78.3 ± 39.9 min · d(-1)), moderate-intensity walking (16.6 ± 14.4 min · d(-1)), and vigorous-intensity PA (0.34 ± 1.5 min · d(-1)). Pedometer steps per day were low (total = 4973 ± 2202 steps, aerobic = 412 ± 774 steps), with most participants rated as sedentary (61%) or low active (28.1%). Consistent with objective PA measures, PA records showed more time spent in light-intensity PA such as home care, cooking, child care and self-care tasks, occupation, religious events, and watching television.
CONCLUSION: By and large, the postpartum Latinas enrolled spent most of their day in low-intensity activity levels with little time spent in health-enhancing PA levels/behaviors. This demographic should be the focus of PA interventions to increase PA to health-enhancing levels.

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Wednesday, February 19, 2014

Exercise and coronary heart disease risk markers in South Asian and European men.

Exercise and coronary heart disease risk markers in South Asian and European men.
Med Sci Sports Exerc. 2013 Jul;45(7):1261-8
Authors: Arjunan SP, Bishop NC, Reischak-Oliveira A, Stensel DJ

PURPOSE: South Asians have a higher-than-average risk of CHD. The reasons for this are unclear, but physical inactivity and/or poor responsiveness to exercise may play a role. This study compared the effect of prior exercise on postprandial triacylglycerol (TAG), glucose, insulin, interleukin-6, and soluble intercellular adhesion molecule-1 concentrations in South Asian and European men.
METHODS: Ten healthy South Asian men (i.e., nine Indian men and one Pakistani man) and 10 healthy European men age 20 to 28 yr completed two 2-d trials (exercise and control) in a randomized crossover design. On the afternoon of day 1 of the exercise trial, participants ran on a treadmill for 60 min at approximately 70% of maximal oxygen uptake. Participants rested on day 1 of the control trial. On day 2 of both trials, participants rested and consumed high-fat (57% of energy content) test meals for breakfast (0 h) and lunch (4 h). Fourteen venous blood samples were collected from a cannula between 0 and 9 h for metabolic measurements.
RESULTS: Three-way ANOVA identified higher (P < 0.05) postprandial TAG and insulin concentrations in South Asian versus European men. Exercise lowered postprandial TAG and interleukin-6 and elevated soluble intercellular adhesion molecule-1 concentrations. An interaction effect indicated a greater decrease (22% vs 10%) in TAG area under the concentration versus time curve after exercise in South Asian than in European men.
CONCLUSIONS: Postprandial TAG and insulin responses to high-fat meals were elevated in these South Asian men, but acute exercise was equally, if not more, effective for reducing postprandial lipemia in South Asian than in European men.

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Monday, February 17, 2014

Vitamin D deficiency in early life and the potential programming of cardiovascular disease in adulthood.

Vitamin D deficiency in early life and the potential programming of cardiovascular disease in adulthood.
J Cardiovasc Transl Res. 2013 Aug;6(4):588-603
Authors: Gezmish O, Black MJ

Vitamin D deficiency is a major worldwide public health problem affecting people of all ages, from infants to the elderly. Of particular concern is the high incidence of vitamin D deficiency in women during pregnancy and lactation, leading to the exposure of the growing fetus/infant to inadequate levels of vitamin D, which is essential for normal development. Vitamin D deficiency in adulthood is linked to the etiology of hypertension and to a multitude of adverse cardiovascular outcomes. It is now well-established that the antecedents of cardiovascular disease can originate very early in life. The purpose of this review is to highlight how maternal vitamin D deficiency, and its effects in upregulating the fetal renin-angiotensin system and altering cardiomyocyte growth in the fetal heart, has the potential to program long-term vulnerability to cardiovascular disease.

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Sunday, February 16, 2014

Prevalence of and associations with reduced exercise capacity in peritoneal dialysis patients.

Prevalence of and associations with reduced exercise capacity in peritoneal dialysis patients.
Am J Kidney Dis. 2013 Nov;62(5):939-46
Authors: Zuo ML, Yue WS, Yip T, Ng F, Lam KF, Yiu KH, Lui SL, Tse HF, Siu CW, Lo WK

BACKGROUND: Exercise capacity is reduced in patients with end-stage renal disease on maintenance home peritoneal dialysis therapy, although the potential mechanisms and clinical implications remain unclear.
STUDY DESIGN: Cross-sectional study.
SETTING & PARTICIPANTS: 95 ambulatory prevalent and incident peritoneal dialysis patients in a well-established renal dialysis center (mean age, 58.26 ± 12.6 [SD] years; 63% men; mean duration of peritoneal dialysis therapy, 3.2 ± 4.1 years).
PREDICTOR: Estimated volume status using spectral bioelectrical impedance, echocardiography-derived hemodynamic parameters.
OUTCOME: Exercise capacity measured as peak oxygen consumption using symptom-limiting treadmill exercise testing.
RESULTS: Exercise capacity was reduced in 96% of patients and severely reduced in 65%. Extracellular to intracellular fluid volume ratio showed the strongest correlation with reduced exercise capacity (R = -0.63; P < 0.001) and was superior to age, pulmonary capillary wedge pressure (E:E' ratio), lean tissue mass index, and hemoglobin and albumin levels in predicting exercise intolerance.
LIMITATIONS: Relatively small sample size and echocardiogram that was performed only at rest.
CONCLUSIONS: There was a strong relationship between body extracellular to intracellular fluid volume ratio and exercise capacity in peritoneal dialysis patients. These findings provide new evidence for a connection between fluid distribution, muscle mass, and exercise capacity. Therapeutic strategies targeting fluid status and muscle mass may improve the exercise capacity of patients on peritoneal dialysis therapy.

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Physical activity in people with COPD, using the National Health and Nutrition Evaluation Survey dataset (2003-2006).

Physical activity in people with COPD, using the National Health and Nutrition Evaluation Survey dataset (2003-2006).
Heart Lung. 2013 Jul-Aug;42(4):235-40
Authors: Park SK, Richardson CR, Holleman RG, Larson JL

BACKGROUND: People with chronic obstructive pulmonary disease (COPD) are sedentary but the extent of the problem is not fully understood.
PURPOSES: This study examines sedentary time and physical activity (PA) and the relative effects of demographic and clinical characteristics on sedentary time and PA in a population-based sample of people with COPD and a comparison group from the general population.
METHODS: Subjects were drawn from the National Health and Nutrition Examination Survey dataset (2003-2006). Physical activity was measured by accelerometry.
RESULTS: People with COPD were sedentary and spent less time in most levels of PA. Age, gender, race, level of education, working status, shortness of breath, self-reported health, and body mass index were significantly associated with sedentary time or level of PA.
CONCLUSION: Findings emphasize the need to decrease sedentary time and increase PA in people with COPD.

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Diet, nutraceuticals and the tear film.

Diet, nutraceuticals and the tear film.
Exp Eye Res. 2013 Dec;117:138-46
Authors: Jalbert I

Nutrition disorders and their correlates such as obesity are increasingly prevalent worldwide. A number of studies to date have suggested numerous potential associations between diet and tear film health; this paper will provide a summary of the available literature. The tear film is characterized through its protein and lipid content and through clinical measurements of characteristics such as osmolarity, volume and stability. Malnutrition, protein and vitamin-A deficiencies are extremely deleterious to tear film health and supplementation with oral vitamin A in this setting is of clear benefit. The relative impact of diet on tear film within what would be considered normal ranges of consumption is less clear. A number of population studies have suggested that hyperlipidemia and a diet low in omega-3 fatty acids are risks factor for dry eye disease. Numerous studies have investigated the effectiveness of oral supplementation with antioxidants, omega-3 (e.g. fish oil and linseed oil) and omega-6 (e.g. evening primrose oil) fatty acids in the last 10 years. Taken together, these suggest a small benefit of oral supplementation on tear film volume, stability and decreased ocular symptoms in patients previously diagnosed with diseases involving the ocular surface (e.g. Sjögren's syndrome, meibomian gland dysfunction, dry eye disease) and contact lens wearers suffering from dry eye. More research is required to determine the exact composition, dosage and indications for their use and to fully characterize how these nutraceuticals modulate the tear film.

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Physical activity, diabetes, and risk of thyroid cancer: a systematic review and meta-analysis.

Physical activity, diabetes, and risk of thyroid cancer: a systematic review and meta-analysis.
Eur J Epidemiol. 2013 Dec;28(12):945-58
Authors: Schmid D, Behrens G, Jochem C, Keimling M, Leitzmann M

Thyroid cancer incidence has been increasing more rapidly over time than the occurrence of cancers of other sites, and interest in potential adverse relations of diabetes and lack of physical activity to thyroid cancer risk is accumulating. We conducted a systematic review and meta-analysis of published epidemiologic studies on the relations of physical activity and diabetes to thyroid cancer according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Published studies were identified through a search in MEDLINE and EMBASE. Random-effects models were used to summarize thyroid cancer risk estimates comparing high versus low levels of physical activity, and separately, comparing individuals with diabetes versus those without diabetes. Meta-regression analyses were performed to evaluate potential effect modification by study design and thyroid cancer risk factors. Information was extracted from seven studies of physical activity and thyroid cancer and from six studies of diabetes and thyroid cancer. The number of individuals from studies on physical activity was 939,305 (yielding 2,250 incident thyroid cancer cases) and from studies on diabetes it was 960,840 (yielding 1,230 cases). The summary relative risk (RR) estimate from cohort and case-control studies combined indicated no association between physical activity and thyroid cancer (summary RR 1.06, 95 % confidence interval (CI) 0.79-1.42). Subgroup-analyses revealed a significant positive association between physical activity and thyroid cancer in cohort studies (summary RR 1.28; 95 % CI 1.01-1.63), whereas the relation was suggestively inverse in case-control studies (summary RR 0.70; 95 % CI 0.48-1.03; p for heterogeneity = 0.005). Individuals with diabetes showed a borderline statistically significant increased risk of thyroid cancer compared with those without diabetes (summary RR 1.17; 95 % CI 0.99-1.39). The relations of physical activity and diabetes to thyroid cancer were not modified by sex, number of adjustment! factors, and adjustments for adiposity, smoking, and study quality. In this comprehensive systematic review and meta-analysis, no significant association between physical activity and thyroid cancer was found. Diabetes showed a suggestive positive relation with risk of thyroid cancer.

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Thursday, February 13, 2014

The importance of parental beliefs and support for pedometer-measured physical activity on school days and weekend days among Canadian children.

The importance of parental beliefs and support for pedometer-measured physical activity on school days and weekend days among Canadian children.

BMC Public Health. 2013;13:1132

Authors: Vander Ploeg KA, Kuhle S, Maximova K, McGavock J, Wu B, Veugelers PJ


BACKGROUND: Parental influences are essential to the behaviours and physical activity of their children. Our study aimed to determine if parental beliefs and support are associated with children's pedometer measured physical activity levels on school days and weekend days.
METHODS: In the spring of 2009 and 2011, we analyzed cross-sectional data from 1,355 grade five students and parents in 30 schools in Alberta, Canada. Parents reported how much they care about exercising, how much they encourage their child to be physically active, and how frequently they engage in physical activities with their child. Physical activity was assessed from step counts obtained from time-stamped pedometers collected over nine consecutive days.
RESULTS: Increased parental encouragement was positively associated with boys' and girls' physical activity on school days (Boys: beta = 1373, 95% CI: 606, 2139; Girls: beta = 632, 95% CI: 108, 1155) and girls' physical activity on weekend days (beta = 997, 95% CI: 130, 1864). Increased parental care was positively associated with boys' physical activity on weekend days (beta = 1381, 95% CI: 85, 2676). Increased parental support and engagement was associated with an additional 632-1381 steps/day for children in this study.
CONCLUSIONS: Parental care, encouragement and engagement are associated with physical activity levels of children 10-11 years of age. Policy makers and researchers should consider the importance of targeting parents when designing strategies to promote physical activity in children. This is particularly relevant to weekends and holidays when children's activity levels are low.

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The effect of zinc and vitamin C supplementation on hemoglobin and hematocrit levels and immune response in patients with Plasmodium vivax malaria.

The effect of zinc and vitamin C supplementation on hemoglobin and hematocrit levels and immune response in patients with Plasmodium vivax malaria.

Southeast Asian J Trop Med Public Health. 2013 Sep;44(5):733-9

Authors: Zen Rahfiludin M, Ginandjar P


Plasmodium vivax infection in humans can relapse and is associated with iron deficiency. The immune response plays an important role in preventing relapse. In this study we analyzed the effect of zinc and vitamin C supplementation on hemoglobin and hematocrit levels and immune response in patients with P. vivax malaria. We measured immune response by examining interferon gamma (IFN-gamma) and interleukin-10 (IL-10) levels. Subjects were divided into either treatment or control groups. The treatment group received daily zinc and vitamin C supplementation for 45 days. Compliance with supplement consumption was recorded weekly. After 45 days of supplementation, IFN-gamma and IL-1 levels were remeasured. All study subjects in both groups had normal hemoglobin and hematocrit levels. The hemoglobin levels increased only in the supplementation group (p=0.011), while hematocrit levels increased in both the supplementation (p=0.001) and control (p=0.023) groups. IFN-gamma decreased slightly in the supplementation group, but the change was not significant (p=0.688). IL-10 increased slightly in both the supplementation and the control groups, but the change were not significant (p=0.421 and p=0.556, respectively), suggesting the elevated hemoglobin and hematocrit levels were unrelated to immune response.

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Wednesday, February 12, 2014

Fish Consumption Rates in the Pacific Northwest

This is an interesting article that concludes cleaner water will lead to increased commercial fishing which will result in a significant health benefit.... more consumption of fish.



Fish Consumption Rates in the Pacific Northwest

Role of combined zinc, vitamin A, and fish oil supplementation in childhood tuberculosis.

Role of combined zinc, vitamin A, and fish oil supplementation in childhood tuberculosis.

Southeast Asian J Trop Med Public Health. 2013 Sep;44(5):854-61

Authors: Nenni V, Nataprawira HM, Yuniati T


This objective of this study was to determine benefit of one month combined supplementation (zinc, vitamin A, fish oil) along with anti-tuberculosis drugs (ATD) on increasing serum leptin levels and decreasing tumor necrosis factor-alpha (TNF-alpha) in children with tuberculosis (TB). A quasi experimental study was conducted on 22 children (aged 5-14 years) with a positive acid-fast bacilli (AFB) smear. The children were divided into 2 groups. A history, physical examination, anthropometric measurements, serum leptin levels, TNF-alpha levels, retinol and zinc levels were examined in all subjects before and after treatment. Nutritional supplementation and ATD were given to group I while ATD only were given to group II. The change in leptin, TNF-alpha, retinol and zinc levels were analyzed with the Mann-Whitney test, while a t-test was used to determine changes in body mass index (BMI). Group I had a higher significant increase in serum leptin levels than group II (p=0.034). Group I had a significantly greater decrease in TNF-a levels than group II (p=0.032). No significant differences in retinol or zinc levels were seen between the two, but both groups had an increase after treatment. Both groups had a significant increase in BMI (p=<0.001) post-treatment compared to pre-treatment. Supplementation with zinc, vitamin A and fish oil is associated with a significant increase in leptin levels and a significant decrease in TNF-alpha levels among children treated for TB. No significant benefit was seen in BMI among children receiving supplementation compared to those without it, although ATD resulted in a significant increase in BMI in both groups.

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Monday, February 10, 2014

Relations between perceptions of environmental features and physical activity.


Relations between perceptions of environmental features and physical activity.
Percept Mot Skills. 2013 Aug;117(1):1091-106
Authors: Suminski RR, Wasserman JA, Mayfield CA, McClain L
Abstract
Studies have examined associations between environmental features and physical activity, but there has been no exploration of adult perceptions about the influence environmental features have on physical activity. This study assessed associations between perceptions of environmental features and physical activity. 305 women and 229 men (18-91 years of age) were interviewed in their homes. Questions elicited self-report data on physical activities they performed in their neighborhood (sidewalks near home) and perceptions about neighborhood environmental features. Women (86.4%) were more likely than men (79.3%) to be active in their neighborhoods and view the features as influential. The influences features were perceived to have on physical activity were associated with activity performed in the neighborhood, but perceptions of the conditions of features were not. Interviewers of adults about relationships between environmental features and physical activity should consider perceptions about the influence the feature exerts on activity levels.

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The prevalence of gastroduodenal mucosal injuries in aspirin users.


J Med Assoc Thai. 2013 Nov;96(11):1423-7

BACKGROUND: Aspirin is a widely used medication for primary and secondary prevention of cardiovascular and cerebrovascular events. The gastrointestinal risks of aspirin are well known, but the frequency of gastroduodenal mucosal injuries in aspirin users in Thailand is currently unknown.

OBJECTIVE: The present study was performed to investigate the prevalence of gastroduodenal mucosal injuries in asymptomatic aspirin users.

MATERIAL AND METHOD: Asymptomatic patients taking low doses ofaspirin without gastroprotective medication were enrolled and underwent esophagogastroduodenoscopy

RESULTS: One hundred four patients were endoscoped. The prevalence of gastroduodenal mucosal injuries (erosions or ulcer) was 63.5%.

CONCLUSION: The prevalence of gastroduodenal mucosal injuries was very high in asymptomatic aspirin users.



Thursday, February 6, 2014

Low-Fat Dietary Yogurt Decreases Risk of Type 2 Diabetes

This study found that LOW-FAT yogurt appears to decrease the risk of diabetes type 2. Total diary consumption did not decrease the risk, and high fat yogurt did not decrease the risk of type 2 diabetes. http://goo.gl/inECJm