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August 14, 2002

Dairy Products and Insulin Resistance—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(6):693-694. doi:10.1001/jama.288.6.693

In Reply: Mr McCarty raises the interesting hypothesis that dairy consumption may protect against the insulin resistance syndrome by increasing serum calcium levels, thereby lowering serum PTH concentration. We were unable to find support for this possibility in our statistical models because neither calcium nor vitamin D intake explained the associations between dairy and insulin resistance syndrome. Nevertheless, the absence of an independent effect of these micronutrients could conceivably relate, in part, to better absorption of calcium from dairy products than from other sources. Regarding dairy and insulin secretion, we point out that the insulinemic index of milk assessed in recent studies1 examines insulin secretion in response to a standard amount of carbohydrate. However, carbohydrate is not the only macronutrient that affects insulin secretion. Protein and to some extent fat can also be secretagogues. Thus, it is not unexpected that milk would elicit relatively high insulin secretion per gram of carbohydrate in view of its high protein content.

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