The United States Food and Drug Administration (FDA) announced on March 1 that companies selling yogurt can now make a “qualified claim” regarding the potential reduction of type 2 diabetes risk based on limited evidence.
This claim states that “Eating yogurt regularly, at least 2 cups (3 servings) per week, may reduce the risk of type 2 diabetes, according to limited scientific evidence.”
What Effect Could Yogurt Have on Type 2 Diabetes Risk?
The FDA’s decision concluded there “is some credible evidence” of benefit from consuming yogurt as a whole food, rather than any specific nutrient or ingredient within it.
Yogurts containing probiotics, in particular, may possess anti-inflammatory properties that could help combat elevated blood sugars (hyperglycemia), a key factor in type 2 diabetes risk.
Beth Czerwony, RD at Cleveland Clinic’s Digestive Disease and Surgery Institute, explains that hyperglycemia, an inflammatory response causing damage to blood vessels, may be mitigated by the anti-inflammatory properties found in some yogurts.
However, Dr. Czerwony notes that the evidence supporting the role of yogurt in reducing type 2 diabetes risk is limited, and further research is needed to confirm this hypothesis.
“It is too difficult to support a claim that a single food could help prevent type 2 diabetes on its own. Certainly, if yogurt is being used as part of a healthy and balanced diet, there may be some correlation between cause and effect, but again, research is limited,” she says.
A ‘Qualified’ Health Statement Indicates Limited Evidence
The request to make the qualified health claim was initiated over five years ago by Danone North America, the leading yogurt producer in the United States, known for brands such as Dannon, Light + Fit, Two Good, Silk, Oikos, and YoCrunch. Even Danone recognized the lack of sufficient evidence to claim that yogurt can prevent type 2 diabetes.
That’s why the company requested a qualified claim supported by only “limited evidence,” according to Bonnie F. Liebman, director of nutrition at the Center for Science in the Public Interest, a food and health advocacy group based in Washington D.C.
A qualified health claim does not have to meet the more rigorous “significant scientific agreement” standard required for an authorized health claim, as stated by the FDA.
Liebman explains that ‘the company’s evidence is limited because it comes from observational studies that cannot prove cause-and-effect.’
“Those studies may find that yogurt eaters have a lower risk of diabetes, but something else about yogurt eaters could explain their lower risk. They may eat a healthier diet, exercise more, or get more regular checkups, for example,” she says.
She adds, “Danone failed to cite stronger evidence from randomized controlled trials showing that yogurt can reduce the risk of type 2 diabetes or even markers of diabetes risk, like lower blood sugar levels.”
The New Claim Applies to All Yogurt Types, Including Sugar-Loaded Varieties
The new qualified health claim applies to all yogurt that meets the FDA’s “standards of identity,” which outline the requirements for the content and production of specific foods. This includes specifications on the amount of live and active yogurt cultures required, as well as the allowable levels of sugar and other ingredients while still being classified as yogurt.
Recent changes to the standards of identity for yogurt by the FDA have been made. A rule change in 2022 allowed for the use of all safe and suitable sweeteners, including nonnutritive sweeteners, and permitted the inclusion of fat-containing flavors such as coconut flakes and chocolate in lower fat yogurt varieties.
These regulations apply uniformly to all yogurt products, including those with added sugars. This consistency is because much of all the existing research on yogurt and type 2 diabetes does not differentiate between yogurts with varying sugar or fat content when demonstrating potential benefits. Amanda Blechman, RD, director of Health and Scientific Affairs at Danone North America, suggests that yogurt of any type could potentially have a protective effect.
Will the Claim Provide People with Empowerment or Confuse Them?
According to the company press release, the FDA approval of the qualified health claim “supports Danone’s broader mission to bring health through food to as many people as possible.”
Vice president of Health and Scientific Affairs at Danone North America, Miguel Freitas, PhD, said in the statement, “Our hope is that this announcement will empower consumers with simple, actionable information they can use to help lower their risk of developing type 2 diabetes through a realistic, easy-to-make dietary modification.”
However, since the new claim can be put on all yogurts, despite those that are “loaded” with sugar, Liebman believes its more likely to cause confusion for consumers.
She points out that “Danone’s YoCrunch line, for example, comes with Oreos, M&Ms, Twix, or Snickers you can mix in. One YoCrunch with Oreo Cookie Pieces has a third of a day’s added sugar.” In an 8-ounce serving, there are 24 grams of total sugars, with 18 grams being added sugar. This already accounts for 36 percent of the recommended daily sugar intake.
“Even an ordinary Dannon strawberry yogurt has a quarter of a day’s added sugar,” says Liebman.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, one of the most crucial steps in preventing type 2 diabetes is to avoid added sugar, along with limiting trans and saturated fats.
She also points out that the FDA’s own studies indicate that consumers don’t differentiate between health claims based on strong evidence versus those citing limited evidence.
“What’s more, companies can slap a large ‘may prevent diabetes’ claim on the front of a yogurt package with an asterisk that cites ‘limited evidence’ in tiny print on the back,” says Liebman.
How to Choose the Right Yogurt For You
Czerwony acknowledges that not all yogurts are the same, and consumers may need to educate themselves on how to interpret food labels to determine if a specific yogurt aligns with their health goals.
“Knowing what ‘budget’ you have for categories such as added sugar, total carbohydrates, or protein will allow you to make a better decision on what brand to purchase,” she says.
Czerwony provides some tips to help choose the right yogurt for your particular needs.
- Add your own fresh fruit. If you’re looking for a healthy, low-fat snack, a low-fat or fat-free plain yogurt with added fresh fruit may be the best option.
- Pick Greek yogurt if you want more protein. For someone who has higher protein needs, such as someone actively looking for weight loss or had recent surgery, Greek yogurt may be a better choice.
- New to yogurt? Try blending. For people who aren’t familiar with yogurt, try blending both low-fat and Greek yogurt to help you get used to the consistency and tang.
- Look for live cultures. Find a yogurt that has live cultures, which can help with healthy gut microbiome.
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