Modelled Substitution of Meat with Dairy Products and Cardiometabolic Risk: A Mini-Review of Epidemiological and Mechanistic Evidence

Ioanna Kechagia; Dionysia Voutsa; Olga Tsiotsiou

doi:10.53941/ijctm.2026.100005

Abstract

Background: Epidemiological evidence consistently links higher consumption of red and processed meat with increased risk of type 2 diabetes (T2D) and adverse cardiometabolic outcomes, whereas dairy intake—particularly full-fat and fermented varieties—has shown neutral or protective associations. Understanding how substituting meat with dairy influences long-term metabolic and cardiovascular health can inform dietary recommendations and refine risk prediction models. Objective: This mini-review summarizes current epidemiological and mechanistic evidence on the modelled substitution of meat with dairy products in relation to T2D and broader cardiometabolic risk, with particular emphasis on findings from large-scale prospective studies. Evidence synthesis: Substitution analyses from multiple cohorts, including ATTICA, EPIC, and the Nurses’ Health Studies, indicate that replacing one daily serving of red or total meat with dairy—especially fermented or full-fat forms—tends to reduce T2D risk by approximately 15–40% and may favorably influence lipid and blood pressure profiles. Proposed mechanisms include improved lipid and glucose metabolism, enhanced insulin sensitivity, modulation of the gut microbiota, and attenuation of systemic inflammation and oxidative stress, through dairy-derived bioactive compounds such as calcium, vitamin D, odd-chain fatty acids, and probiotics. Conclusions: Current evidence suggests that replacing meat with dairy products, particularly fermented and full-fat types, may modestly reduce long-term cardiometabolic risk, including T2D. This substitution framework highlights the importance of dietary quality and food-source replacement, offering a practical, evidence-based approach to metabolic and cardiovascular disease prevention.

References

1.
Duncan, B.B.; Magliano, D.J.; Boyko, E.J. IDF Diabetes Atlas 11th Edition 2025: Global Prevalence and Projections for 2050. Nephrol. Dial. Transplant. 2025, 41, 7–9. https://doi.org/10.1093/ndt/gfaf177.
2.
The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD); Aas, A.-M.; Axelsen, M.; et al. Evidence-Based European Recommendations for the Dietary Management of Diabetes. Diabetologia 2023, 66, 965–985. https://doi.org/10.1007/s00125-023-05894-8.
3.
American Diabetes Association Professional Practice Committee; ElSayed, N.A.; McCoy, R.G.; et al. 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2025. Diabetes Care 2025, 48, S50–S58. https://doi.org/10.2337/dc25-S003.
4.
Sanders, L.M.; Wilcox, M.L.; Maki, K.C. Red Meat Consumption and Risk Factors for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Eur. J. Clin. Nutr. 2023, 77, 156–165. https://doi.org/10.1038/s41430-022-01150-1.
5.
Gu, X.; Drouin-Chartier, J.-P.; Sacks, F.M.; et al. Red Meat Intake and Risk of Type 2 Diabetes in a Prospective Cohort Study of United States Females and Males. Am. J. Clin. Nutr. 2023, 118, 1153–1163. https://doi.org/10.1016/j.ajcnut.2023.08.021.
6.
Li, C.; Bishop, T.R.P.; Imamura, F.; et al. Meat Consumption and Incident Type 2 Diabetes: An Individual-Participant Federated Meta-Analysis of 1·97 Million Adults with 100,000 Incident Cases from 31 Cohorts in 20 Countries. Lancet Diabetes Endocrinol. 2024, 12, 619–630. https://doi.org/10.1016/S2213-8587(24)00179-7.
7.
Akyil, S.; Winkler, S.; Meyer, D.; et al. Association between Dairy Intake and Multiple Health Outcomes: A Scoping Review of Systematic Reviews and Meta-Analyses. Eur. J. Clin. Nutr. 2026, 80, 16–27. https://doi.org/10.1038/s41430-025-01639-5.
8.
Gill, P.A.; Inniss, S.; Kumagai, T.; et al. The Role of Diet and Gut Microbiota in Regulating Gastrointestinal and Inflammatory Disease. Front. Immunol. 2022, 13, 866059. https://doi.org/10.3389/fimmu.2022.866059.
9.
Givens, D.I. Dairy Foods and Cardiometabolic Diseases: An Update and a Reassessment of the Impact of SFA. Proc. Nutr. Soc. 2023, 82, 329–345. https://doi.org/10.1017/S0029665123000083.
10.
Gautam, S.K.; Kumar, B.; Pandey, P.K.N.K. Dynamics of Dairy Product Consumption, Confounding Factors, and Their Influence on the Risk of Type 2 Diabetes. Int. J. Prev. Med. 2024, 15, 68. https://doi.org/10.4103/ijpvm.ijpvm_356_23.
11.
Taormina, V.M.; Unger, A.L.; Kraft, J. Full-Fat Dairy Products and Cardiometabolic Health Outcomes: Does the Dairy-Fat Matrix Matter? Front. Nutr. 2024, 11, 1386257. https://doi.org/10.3389/fnut.2024.1386257.
12.
Kiesswetter, E.; Neuenschwander, M.; Stadelmaier, J.; et al. Substitution of Dairy Products and Risk of Death and Cardiometabolic Diseases: A Systematic Review and Meta-Analysis of Prospective Studies. Curr. Dev. Nutr. 2024, 8, 102159. https://doi.org/10.1016/j.cdnut.2024.102159.
13.
Sharifan, P.; Roustaee, R.; Shafiee, M.; et al. Dairy Consumption and Risk of Cardiovascular and Bone Health Outcomes in Adults: An Umbrella Review and Updated Meta-Analyses. Nutrients 2025, 17, 2723. https://doi.org/10.3390/nu17172723.
14.
Ibsen, D.B.; Steur, M.; Imamura, F.; et al. Replacement of Red and Processed Meat with Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations: The EPIC-InterAct Study. Diabetes Care 2020, 43, 2660–2667. https://doi.org/10.2337/dc20-1038.
15.
Kechagia, I.; Yannakoulia, M.; Barkas, F.; et al. Modelled Substitution of Meat with Dairy Products and the 20-Year Cumulative Incidence of Type 2 Diabetes: Insights from the ATTICA Cohort Study (2002–2022). Diabetes Metab. 2025, 51, 101701. https://doi.org/10.1016/j.diabet.2025.101701.
16.
Ibsen, D.B.; Warberg, C.K.; Würtz, A.M.L.; et al. Substitution of Red Meat with Poultry or Fish and Risk of Type 2 Diabetes: A Danish Cohort Study. Eur. J. Nutr. 2019, 58, 2705–2712. https://doi.org/10.1007/s00394-018-1820-0.
17.
Würtz, A.M.L.; Jakobsen, M.U.; Bertoia, M.L.; et al. Replacing the Consumption of Red Meat with Other Major Dietary Protein Sources and Risk of Type 2 Diabetes Mellitus: A Prospective Cohort Study. Am. J. Clin. Nutr. 2021, 113, 612–621. https://doi.org/10.1093/ajcn/nqaa284.
18.
Zhang, S.; Janzi, S.; Du, Y.; et al. Dairy Intake, Plasma Metabolome, and Risk of Type 2 Diabetes in a Population-Based Cohort. Am. J. Clin. Nutr. 2025, 121, 1137–1148. https://doi.org/10.1016/j.ajcnut.2025.02.023.
19.
Neuenschwander, M.; Stadelmaier, J.; Eble, J.; et al. Substitution of Animal-Based with Plant-Based Foods on Cardiometabolic Health and All-Cause Mortality: A Systematic Review and Meta-Analysis of Prospective Studies. BMC Med. 2023, 21, 404. https://doi.org/10.1186/s12916-023-03093-1.
20.
Wu, S.; Luo, H.; Zhong, J.; et al. Differential Associations of Erythrocyte Membrane Saturated Fatty Acids with Glycemic and Lipid Metabolic Markers in a Chinese Population: A Cross-Sectional Study. Nutrients 2024, 16, 1507. https://doi.org/10.3390/nu16101507.
21.
Zhang, T.; Geng, S.; Cheng, T.; et al. From the Past to the Future: Fermented Milks and Their Health Effects against Human Diseases. Food Front. 2023, 4, 1747–1777. https://doi.org/10.1002/fft2.304.
22.
Zhang, R.; Fu, J.; Moore, J.B.; et al. Processed and Unprocessed Red Meat Consumption and Risk for Type 2 Diabetes Mellitus: An Updated Meta-Analysis of Cohort Studies. Int. J. Environ. Res. Public Health 2021, 18, 10788. https://doi.org/10.3390/ijerph182010788.
23.
Zhong, H.; Wang, L.; Jia, F.; et al. Effect of Probiotic Fermented Milk Supplementation on Glucose and Lipid Metabolism Parameters and Inflammatory Markers in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. Biology 2024, 13, 641. https://doi.org/10.3390/biology13080641.
24.
Laursen, A.S.D.; Thomsen, A.L.; Beck, A.; et al. Theoretical Substitutions between Dairy Products and All-Cause and Cause-Specific Mortality. Results from the Danish Diet, Cancer and Health Cohort. Br. J. Nutr. 2022, 127, 1557–1566. https://doi.org/10.1017/S0007114521002464.
25.
Vogtschmidt, Y.D.; Soedamah-Muthu, S.S.; Imamura, F.; et al. Replacement of Saturated Fatty Acids from Meat by Dairy Sources in Relation to Incident Cardiovascular Disease: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Study. Am. J. Clin. Nutr. 2024, 119, 1495–1503. https://doi.org/10.1016/j.ajcnut.2024.04.007.
26.
Kennedy, J.; Alexander, P.; Taillie, L.S.; et al. Estimated Effects of Reductions in Processed Meat Consumption and Unprocessed Red Meat Consumption on Occurrences of Type 2 Diabetes, Cardiovascular Disease, Colorectal Cancer, and Mortality in the USA: A Microsimulation Study. Lancet Planet. Health 2024, 8, e441–e451. https://doi.org/10.1016/S2542-5196(24)00118-9.

Scilight Press

Author Information

Abstract

Keywords

References

About Scilight

Journals

Publishing Policies

Contact Us