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High calcium intake from fat-free milk, body composition and glycaemic control in adults with type 2 diabetes: a randomised crossover clinical trial

  • Júnia Maria Geraldo Gomes (a1), Jorge de Assis Costa (a2), Priscila Vaz de Melo Ribeiro (a2) and Rita de Cássia Gonçalves Alfenas (a2)


We evaluated the effects of high-Ca fat-free milk v. low-Ca control diet on adiposity and on glycaemic control. Fourteen subjects with type 2 diabetes (aged 49·5 (sd 8·6) years, BMI 29·4 (sd 4·5) kg/m2, low habitual Ca consumption (<600 mg/d)) were included in this randomised, crossover clinical trial. Subjects participated in two 12-week experimental sessions (high-Ca fat-free milk (HC) or low-Ca control (LC)) separated by 8-week washout. Subjects daily consumed in the laboratory a breakfast shake containing 700 mg (HC) or 6·4 mg (LC) of Ca. Energy-restricted diets containing 800 mg of dietary Ca/d were prescribed. Dietary records data indicated the consumption of 1200 mg of Ca/d during HC and of 525 mg of Ca/d during LC. There was a greater reduction in body weight, body fat mass, waist circumference and waist:hip ratio after HC. Serum 25-hydoxyvitamin D and homeostatic model assessment-2 β-cell function (HOMA2-%B) increased, and serum uric acid, parathormone (PTH) and glycated Hb (HbA1c) concentrations reduced after HC. In addition, changes from baseline in terms of serum uric acid, glucose, HbA1c and PTH concentrations were lower, and those of HOMA2-%B, serum Ca and 25-hydoxyvitamin D were higher after the HC than after LC. The consumption of approximately three servings of fat-free milk and 1200 mg of dietary Ca/d enhanced weight loss, improved body composition and promoted glycaemic control in subjects with type 2 diabetes and low habitual Ca consumption (<600 mg/d).


Corresponding author

*Corresponding author: P. V. M. Ribeiro, email


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1.American Diabetes Association (2016) Standards of medical care in diabetes. Diabetes Care 39, Suppl. 1, S1S2.
2.Pittas, AG, Lau, J, Hu, FB, et al. (2007) The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92, 20172029.
3.Institute of Medicine (2011) Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press.
4.Pasin, G & Comerford, KB (2015) Dairy foods and dairy proteins in the management of type 2 diabetes: a systematic review of the clinical evidence. Adv Nutr 6, 245259.
5.Candido, FG, Ton, WTS & Alfenas, RCG (2013) Dairy products consumption versus type 2 diabetes prevention and treatment; a review of recent findings from human studies. Nutr Hosp 28, 13841395.
6.Abargouei, AS, Janghorbani, M, Salehi-Marzijarani, M, et al. (2012) Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Obes 36, 14851493.
7.Stonehouse, W, Wycherley, T, Luscombe-Marsh, N, et al. (2016) Dairy intake enhances body weight and composition changes during energy restriction in 18-50-year-old adults – a meta-analysis of randomized controlled trials. Nutrients 8, 394.
8.Zemel, MB, Thompson, W, Milstead, A, et al. (2004) Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obes Res 12, 582590.
9.Bowen, J, Noakes, M & Clifton, PM (2005) Effect of calcium and dairy foods in high protein, energy-restricted diets on weight loss and metabolic parameters in overweight adults. Int J Obes 29, 957965.
10.Gunther, CW, Legowski, PA, Lyle, RM, et al. (2005) Dairy products do not lead to alterations in body weight and fat mass in young women in a one year intervention. Am J Clin Nutr 81, 751756.
11.Harvey-Berino, J, Gold, BC, Lauber, R, et al. (2005) The impact of calcium and dairy product consumption on weight loss. Obes Res 13, 17201726.
12.Thompson, WG, Holdman, NR, Janzow, DJ, et al. (2005) Effect of energy-reduced diets high in dairy products and fiber on weight loss in obese adults. Obes Res 13, 13441353.
13.Zemel, MB, Richards, J, Mathis, S, et al. (2005) Dairy augmentation of total and central fat loss in obese subjects. Int J Obes Relat Metab Disord 29, 391397.
14.Zemel, MB, Teegarden, D, Loan, MV, et al (2009) Dairy-rich diets augment fat loss on an energy-restricted diet: a multicenter trial. Nutrients 1, 83100.
15.Stancliffe, RA, Thorpe, T & Zemel, MB (2011) Dairy attenuates oxidative and inflammatory stress in metabolic syndrome. Am J Clin Nutr 94, 422430.
16.Josse, AR & Phillips, SM (2012) Impact of milk consumption and resistance training on body composition of female athletes. Med Sport Sci 59, 94103.
17.Jones, KW, Eller, LK, Parnell, JA, et al. (2013) Effect of a dairy- and calcium-rich diet on weight loss and appetite during energy restriction in overweight and obese adults: a randomized trial. Eur J Clin Nutr 67, 371376.
18.Torres, MR & Sanjuliani, AF (2013) Effects of weight loss from a high-calcium energy-reduced diet on biomarkers of inflammatory stress, fibrinolysis, and endothelial function in obese subjects. Nutrition 29, 143151.
19.Devries, MC & Phillips, SM (2015) Supplemental protein in support of muscle mass and health: advantage whey. J Food Sci 80, A8A15.
20.Alberti, KG, Eckel, RH, Grundy, SM, et al. (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association, World Heart Federation, International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120, 16401645.
21.Stunkard, AJ & Messick, S (1985) The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 29, 7183.
22.Pardini, R, Matsudo, S, Araujo, T, et al. (2001) Validation of the International Physical Activity Questionnaire (IPAQ version 6): pilot study in Brazilian young adults. Rev Bras Cien Mov 9, 4551.
23.Mera, R, Thompson, H & Prasad, C (1998) How to calculate sample size for an experiment: a case-based description. Nutr Neurosci 1, 8791.
24.Gomes, JMG, Costa, JA & Alfenas, RCG (2018) Effect of increased calcium consumption from fat-free milk in an energy restricted diet on metabolic syndrome and cardiometabolic outcomes in adults with type 2 diabetes mellitus: a randomized crossover clinical Trial. Br J Nutr 119, 422430.
25.Rideout, TC, Marinangeli, CP, Martin, H, et al. (2013) Consumption of low-fat dairy foods for 6 months improves insulin resistance without adversely affecting lipids or bodyweight in healthy adults: a randomized free-living cross-over study. Nutr J 12, 56.
26.Maki, KC, Nieman, KM, Schild, AL, et al. (2015) Sugar-sweetened product consumption alters glucose homeostasis compared with dairy product consumption in men and women at risk of type 2 diabetes mellitus. J Nutr 145, 459466.
27.Shalileh, M, Shidfar, F, Haghani, H, et al. (2010) The influence of calcium supplement on body composition, weight loss and insulin resistance in obese adults receiving low calorie diet. J Res Med Sci 15, 191201.
28.Kopic, S & Geibel, JP (2013) Gastric acid, calcium absorption, and their impact on bone health. Physiological Reviews 93, 189268.
29.Calvo, MS & Tucker, KL (2013) Is phosphorus intake that exceeds dietary requirements a risk factor in bone health? Ann NY Acad Sci 1301, 2935.
30.Zemel, MB, Shi, H, Greer, B, et al. (2000) Regulation of adiposity by dietary calcium. FASEB J 14, 11321138.
31.Larsson, S, Jones, HA, Göransson, O, et al. (2016) Parathyroid hormone induces adipocyte lipolysis via PKA-mediated phosphorylation of hormone-sensitive lipase. Cell Signal 28, 204213.
32.Candido, FG & Bressan, J (2014) Vitamin D: link between osteoporosis, obesity, and diabetes? Int J Mol Sci 15, 65696591.
33.Gaucheron, F (2005) The minerals of milk. Reprod Nutr Dev 45, 473483.
34.Dugan, CE & Fernandez, ML (2014) Effects of dairy on metabolic syndrome parameters: a review. Yale J Biol Med 87, 135147.
35.Acheson, KJ, Blondel-Lubrano, A, Oguey-Araymon, S, et al. (2011) Protein choices targeting thermogenesis and metabolism. Am J Clin Nutr 93, 525534.
36.Sun, X & Zemel, MB (2007) Leucine and calcium regulate fat metabolism and energy partitioning in murine adipocytes and muscle cells. Lipidis 42, 297305.
37.Monnier, L, Colette, C, Thuan, JF, et al. (2006) Insulin secretion and sensitivity as determinants of HbA1c in type 2 diabetes. Eur J Clin Invest 36, 231235.
38.Yahya, H, Yahya, KM & Saqib, A (2011) Minerals and type 2 diabetes mellitus-level of zinc, magnesium and chromium in diabetic and non diabetic population. J Univer Med Dent College 2, 3438.
39.Ghadirian, P, Shatenstein, B, Verdy, M, et al. (1995) The influence of dairy products on plasma uric acid in women. Eur J Epidemiol 11, 275281.
40.Verdoia, M, Barbieri, L, Schaffer, A, et al. (2014) Impact of diabetes on uric acid and its relationship with the extent of coronary artery disease and platelet aggregation: a single-centre cohort study. Metabolism 63, 640646.
41.Neupane, S, Dubey, RK, Gautam, N, et al. (2016) Association between serum uric acid, urinary albumin excretion, and glycated hemoglobin in type 2 diabetic patient. Niger Med J 57, 119123.
42.Zhu, Y, Hu, Y, Huang, T, et al. (2014) High uric acid directly inhibits insulin signalling and induces insulin resistance. Biochem Biophys Res Commun 447, 707714.
43.American Diabetes Association (2015) Standards of medical care in diabetes. Diabetes Care 38, S11S94.
44.Du, H, Van der, ADL, Boshuizen, HC, et al (2010) Dietary fiber and subsequent changes in body weight and waist circumference in European men and women. Am J Clin Nutr 91, 329336.
45.Silva, FM, Kramer, CK, de Almeida, JC, et al. (2013) Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutr Rev 71, 790801.



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