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Review
. 2017 Nov 15;8(6):812-829.
doi: 10.3945/an.116.013946. Print 2017 Nov.

Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms

Melissa Anne Fernandez  1   2   3 , Shirin Panahi  4 , Noémie Daniel  1   2   3 , Angelo Tremblay  1   3   4 , André Marette  1   2   5
Affiliations
Review

Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms

Melissa Anne Fernandez et al. Adv Nutr. .

Abstract

Associations between yogurt intake and risk of diet-related cardiometabolic diseases (CMDs) have been the subject of recent research in epidemiologic nutrition. A healthy dietary pattern has been identified as a pillar for the prevention of weight gain and CMDs. Epidemiologic studies suggest that yogurt consumption is linked to healthy dietary patterns, lifestyles, and reduced risk of CMDs, particularly type 2 diabetes. However, to our knowledge, few to no randomized controlled trials have investigated yogurt intake in relation to cardiometabolic clinical outcomes. Furthermore, there has been little attempt to clarify the mechanisms that underlie the potential beneficial effects of yogurt consumption on CMDs. Yogurt is a nutrient-dense dairy food and has been suggested to reduce weight gain and prevent CMDs by contributing to intakes of protein, calcium, bioactive lipids, and several other micronutrients. In addition, fermentation with bacterial strains generates bioactive peptides, resulting in a potentially greater beneficial effect of yogurt on metabolic health than nonfermented dairy products such as milk. To date, there is little concrete evidence that the mechanisms proposed in observational studies to explain positive results of yogurt on CMDs or parameters are valid. Many proposed mechanisms are based on assumptions that commercial yogurts contain strain-specific probiotics, that viable yogurt cultures are present in adequate quantities, and that yogurt provides a minimum threshold dose of nutrients or bioactive components capable of exerting a physiologic effect. Therefore, the primary objective of this review is to investigate the plausibility of potential mechanisms commonly cited in the literature in order to shed light on the inverse associations reported between yogurt intake and various cardiometabolic health parameters that are related to its nutrient profile, bacterial constituents, and food matrix. This article reviews current gaps and challenges in identifying such mechanisms and provides a perspective on the research agenda to validate the proposed role of yogurt in protecting against CMDs.

Keywords: bioactive peptides; cardiometabolic diseases; dairy; fermented dairy; food matrix; hypertension; microbiota; obesity; type 2 diabetes; yogurt.

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Conflict of interest statement

Author disclosures: AM is a consultant for and his research is funded, in part, by Danone Nutricia Research. He holds a Canadian Institutes of Health Research (CIHR)/Pfizer research chair on the pathogenesis of insulin resistance and cardiovascular diseases. AT serves on the Yogurt in Nutrition Initiative for Health Advisory Board for Danone Institute International and on the board of the Danone Institute of Canada. His research has been funded, in part, by Dairy Farmers of Canada, the Dairy Research Institute of the United States, Danone, Wyeth Consumer Healthcare, Nestlé, General Mills, and Lallemand. He has also been partly funded over the last years by the Canada Research Chair in Environment and Energy Balance and the Government of Quebec. SP is a co-investigator on the 2015 Yogurt in Nutrition Initiative grant, has previously received an honorarium from Danone Nutricia Research unrelated to this work, and is also the recipient of a postdoctoral fellowship from the Canadian Diabetes Association. MAF is a CIHR Fellow, and her salary is paid, in part, through a research grant from Danone International. ND is involved in a research project with Danone Nutricia Research but receives no salary from the company and is a recipient of a Jean-Paul-Houle doctoral award from the Laval University School of Nutrition.

Figures

FIGURE 1
FIGURE 1
Suspected mechanisms of action responsible for yogurt's protective cardiometabolic properties. ACE, angiotensin-converting enzyme.
FIGURE 2
FIGURE 2
Potential physiologic effects of bioactive yogurt peptides. ACE, angiotensin-converting enzyme.
See this image and copyright information in PMC

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