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Is Milk Bad for You? Diabetes and Milk

Check your shopping list — how many liters of milk do you plan to purchase for you and your family this week? What types of milk do you buy?

Milk, available in various forms, has been a part of human nutrition since ancient times. There are several types of milk in the market, the most popular varieties of milk came from cows, sheep, and goats, these are from animal based. However, as time progressed, numerous other types of milk were discovered and produced. For certain reasons, some people would opt for plant-based milk, such as soy milk, almond milk and so on.

Back to our topic, is milk good food for us? We will discuss it further.

We’re not sure if you’ve noticed, but our food pyramid has quite recently undergone a change. Nevertheless, the recommendation for milk and dairy products remain the same. According to Malaysia Food Pyramid 2020, it is recommended that we take 1 to 2 servings of milk and dairy products daily. In the other word, you would be able to achieve it by having 1 to 2 glasses of milk daily. From the perspective of nutrition, incorporate milk in your diet is an easy way to get calcium and high quality protein.

What milk is made of?

Milk can be separated into animal-based and plant-based milk. For animal-based milk, it is produced by mammal mothers to feed their young. Mammal milks are all similar in terms of the amount of protein, but different in some other nutrients, vitamins and minerals.

There are other milks besides human and cow. Goat milk is gaining popularity. At the same time, milks suitable for vegetarians or vegans include soy milk, rice milk, and almond milk.

Lactose is a disaccharide commonly found in animal-based milk and is comprised of a galactose and glucose molecule linked by a beta 1,4 glycosidic bond. Lactose intolerance may limit the intake of milk and dairy products due to the inability of the body to digest lactose.

People who don’t have sufficient lactase, a type of digestive enzyme to digest lactose will be “lactose intolerant” and may suffer diarrhea, intestinal gas, cramps, and bloating from drinking animal-based milk.

It is thought that Asian populations have decreased amounts of lactase in adulthood compared to Caucasian populations. It has been a popular notion that, within our multiracial population, lactose intolerance prevalence is high in all three major ethnic groups — Malays, Chinese, and Indians.

Regardless of the types of milk, from animal-based to plant-based lactose free milk, they remain a naturally nutrient-rich, simple and wholesome food. Understanding your choices and their differences can help you determine the most suitable type of milk for each member of your family.

What research studies say about milk?

Some evidence supports milk fat as being protective against Type 2 diabetes. A study published in the December 2010 issue of Annals of Internal Medicine found that dairy foods had 60% less chance of developing Type 2 diabetes than men with the lowest levels. Several other studies have demonstrated that dairy consumption lowers risk for insulin resistance, metabolic syndrome.

In various studies, higher levels of trans-palmitoleic acid were associated with numerous desirable outcomes: lower body-mass index, smaller waist circumference, lower triglyceride levels, lower levels of C-reactive protein (a marker of inflammation), lower fasting insulin levels, and less insulin resistance.

Diabetes specific formulas improve glucose control and outcomes

Diabetes-specific formulas (DSFs) are specialized forms of therapy that consist of macro- and micronutrient ingredients to manage malnutrition, dysglycemia, and other cardiometabolic risk factors. These formulas have low glycemic indix (GI) and complement dietary recommendations for patients with type 2 diabetes (T2D).

According to the 2017 American Diabetes Association standard of care, two key goals for nutrition therapy of hospitalized patients are to:

  1. Optimize glycemic control

  2. Provide adequate nutrients to meet metabolic demands.

Unlike standard formulas, DSF are designed specifically to help meet these goals. While both formulas are designed to provide nutrients to help meet metabolic nutrition requirements, only DSF are designed to help minimize glycemic response. Hence, it is recommended for people with diabetes, either type I or type II diabetes people. Many studies have reported that DSF can improve glucose control and metabolic risk factors among patients with diabetes or stress-induced hyperglycaemia compared with a standard formulas.

Diabetes specific formulas have some of the following features compared to standard nutritional formulas:

  • Lower carbohydrate content

  • Higher proportion of carbohydrates that have a low GI and/or are slowly digestible, e.g. by replacement of high glycemic-index maltodextrin, starch, and sucrose with low GI carbohydrates such as isomaltulose

  • Fat content enriched in unsaturated fatty acids, particularly monounsaturated fatty acids

  • Higher fibre content

Poor glycemic control leads to poorer health outcomes

Diabetes patients have a 3-fold greater chance of hospitalization than those without diabetes. Further, hyperglycemia is often the culprit for hospitalization due to illness or injury, treatment, and changes in eating patterns. Other hospitalized patients experiencing hyperglycemia may not have a diabetes diagnosis on admission, but the metabolic stress of illness, injury, or anesthesia and surgery can lead to insulin resistance and hyperglycemia.

Effect of DSF as meal replacements on blood glucose

When replacing one meal, a lower GI has been linked with the consumption of DSF formulas with extended-release carbohydrates, if compared with the same amount of carbohydrates from a reference food, such as bread or glucose. This means that a lower glycemia was observed in subjects consuming DSF formulas.

A systemic review revealed that, for patients with uncontrolled diabetes, DSF should be incorporated 1-2 times per day into a meal plan, either as a calorie replacement for a meal, as a partial meal or as a snack.

DSF are a safe and cost-effective strategy to support the management blood glucose control. Evidence shows that use of DSF helps manage blood glucose levels, aiding recovery from illness or injury, and reducing health care costs.

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