Yogurt makers can now say that eating yogurt reduces the risk of Type 2 diabetes. What to know about this new “qualified claim”?
Yogurt makers can now say that eating yogurt reduces the risk of Type 2 diabetes. What do know about this new “qualified claim”?
Mentioned in this episode:
Dairy consumption and risk of type 2 diabetes (BMS Medicine)
Hello I’m Monica Reinagel and you’re listening to the Nutrition Diva podcast, a show where we take a closer look at nutrition news, research and trends so that you can make more informed decisions about what you eat. Earlier this year, yogurt companies got a gift from the U.S. FDA in the form of permission to make a new health claim about their products: Regular consumption of yogurt may reduce your risk of developing Type 2 diabetes.
Today, I want to take a closer look at the science behind this new claim as well as at the process that companies go through to get these sorts of claims approved.
There are pretty strict rules about what kinds of health-related statements manufacturers are allowed to make about food products. You’re allowed to talk about the nutrients it contains. For example, you can say that a product is high in fiber–but only if it contains at least 20% of the RDA for fiber.
You’re also allowed to describe the role that a given nutrient or ingredient plays in the body–which is called a structure/function claim. So you can say, “Fiber promotes healthy bowel function” as long as that statement is supported by credible, scientific evidence. You can’t say “Fiber promotes healthy joints” because there isn’t yet enough credible evidence to support that.
You also generally can’t make a statement that implies that a food prevents or treats a specific disease or condition. Imagine for a moment that there actually was enough credible evidence to support the claim that fiber promotes healthy joints.” You still wouldn’t be able to say “Fiber helps prevent arthritis. Because that would not be a nutrient claim or a structure/function claim, but a health claim.
If you want to make a health claim about your food, you need to submit a petition to the FDA, documenting the scientific evidence to support it. If the FDA, in its infinite wisdom, determines that there is significant consensus in the scientific community to support your claim, it may approve it as an authorized health claim. It can then be included in marketing (including packaging), but you have to adhere to very strict wording.
The FDA can also approve a “qualified health claim.” These claims are based on emerging evidence that suggests a relationship between a food or nutrient and a reduced risk of a disease or health-related condition. However, the evidence is not strong enough to be an authorized health claim. If you want to use a qualified health claim, you must include a disclaimer indicating that the evidence is limited and not conclusive.
The new claim for yogurt is a qualified health claim and it came in response to a petition from Danone North America, the company behind popular brands like Activia, Dannon, and Oikos. They submitted extensive research data showing a possible link between regular consumption of yogurt and a reduced risk of Type 2 diabetes. And, in March of 2024, the FDA approved a qualified health claim. The claim only applies to dairy-based yogurts, but it can be used on both plain and sweetened varieties.
The FDA's approval was based on a review of 28 studies that examined the relationship between yogurt consumption and the risk of developing Type 2 diabetes, including several large-scale observational studies. For example, in one study from 2014, researchers analyzed data from nearly 200,000 U.S. adults and found that those who consumed two servings or more of yogurt per week had a 12% lower risk of developing Type 2 diabetes compared to those who rarely ate yogurt.
Sweetened yogurts were included in the analysis because they represent the majority of the yogurt consumed. Non-dairy yogurts, on the other hand, are a relatively recent addition to the market. As a result, they don’t really show up in these big datasets, which were collected decades ago. So there just isn’t enough evidence to evaluate their potential impact on diabetes risk reliably. But this does not necessarily mean that non-dairy yogurts don’t have any protective effects. As we like to say in statistics, “Absence of evidence is not evidence of absence.”
And, as always, we have to note that all the studies reviewed by the FDA were observational. This means they can show an association between yogurt consumption and a reduced risk of Type 2 diabetes but cannot prove causation. Factors like overall diet, lifestyle, and other health behaviors of yogurt consumers could also play a role in the observed benefits.
Not all studies reviewed by the FDA found a significant link between yogurt consumption. Some found no significant association between yogurt consumption and Type 2 diabetes–which demonstrates the challenges with drawing conclusions from observational data. Without clinical studies to test the effect, we can’t be sure that the association isn’t due to other confounding factors. Maybe the people who eat more yogurt tend to exercise more, for example. And that may be part of the reason that the FDA ultimately issued a qualified claim and not an authorized one.
So, we can’t say for sure that yogurt consumption reduces the risk of Type 2 diabetes. But we can think about why it might. Why would yogurt (including sweetened yogurt) be more protective than regular milk, for example? The most likely explanation is the beneficial bacteria that it contains.
We know that the gut microbiome plays an important role in metabolic health, Consuming probiotic foods can modulate gut flora composition in ways that might contribute to reduced diabetes risk. So there is a plausible mechanism. And non-dairy yogurt, which also contains probiotic bacteria, could potentially play the same role.
But again, there just isn’t enough data yet to see that association. After all, Danone makes non-dairy yogurt too. The popular Silk brand, for example, is also in their product portfolio. If they could have scrounged up enough data to support a qualified health claim for soy yogurt, I’m sure they would have!
But this raises an important point. Obviously, these sorts of health claims could potentially have a big impact on consumers’ perceptions of specific foods. But it’s a significant process to get them approved and not every company has the clout and resources to pursue this. It’s possible that these sort of authorized and qualified health claims could disproportionately benefit larger corporations. Then again, now that Danone has gotten this qualified health claim approved, all yogurt manufacturers are free to use it on their products.
More likely, it means that health claims are more likely to be approved for foods or ingredients that have really big market share, and less likely to be sought on behalf of foods and ingredients that aren’t as ubiquitous. Oat-based foods, for example, get to say that “consuming soluble fiber from whole oats, as part of a diet low in saturated fat and cholesterol, may reduce the risk of coronary heart disease.”
Millet, barley, and quinoa also contain soluble fiber that could reduce the risk of heart disease but the FDA has not authorized a health claim for them. That doesn’t mean they aren’t heart-healthy. Absence of an authorized health claim does not equal an absence of beneficial impact.
Finally, remember that no individual food prevents (or, for that matter, causes) a disease or condition on its own. We need to look at the broader context–how individual foods fit into our larger eating patterns and how our eating patterns fit into our larger lifestyle.
Here’s my bottom line on this new health claim: Yogurt (including sweetened as well as non dairy varieties) provides a variety of valuable nutrients, including calcium, protein, and probiotic bacteria. It can be part of a healthy eating pattern which, together with other healthy habits, can contribute to a reduced risk of Type 2 diabetes and other lifestyle-related diseases. But it's not a silver bullet. And, because sweetened varieties can contain a significant amount of added sugar, be sure you’re accounting for that in your overall added sugar budget.
Question or comments about today’s episode, or want to suggest a topic for a future episode? You can email me at nutrition@quickanddirtytips.com You can also leave me a message at 443-961-6206
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