Dear Dietitian,

I typically drink skim milk, but I love the rich taste of whole milk. A friend recently said dairy fat is good for us and doesn’t clog the arteries like the fat in meat. Is this true?

Laura

Dear Laura,

A rich, creamy glass of milk is soothing, satisfying, and nutritious. Dairy products, such as milk, cheese, and yogurt, are excellent sources of calcium, which we need for healthy teeth and bones. Around the age of twenty-five, our bodies no longer build bone, where most of our calcium is stored. To preserve bone mass, it is vital to consume calcium in our diets. It is especially important for post-menopausal women to consume a consistent source of calcium, since estrogen levels are lower. In women, estrogen plays an essential role in preventing bone loss.

Of course, there are vegetarian sources of calcium, such as fortified soy milk and broccoli. Surprisingly, shrimp is a good source of calcium. However, the majority of Americans get their calcium from dairy products. According to the USDA, in 2019, the average American consumed 20 pounds of ice cream, 148 pounds of fluid milk, and 40 pounds of cheese (1).

As part of a heart healthy diet, the Dietary Guidelines for Americans recommend low-fat dairy over whole-fat. Recent studies have challenged this position, with some research revealing that dairy fat may have a protective effect against heart disease.

In the Prospective Urban Rural Epidemiology (PURE) study, over 136,000 people documented dairy intake using food frequency questionnaires. Dairy products recorded were milk, yogurt, and cheese. After fifteen years, those with a higher intake of dairy (more than two servings per day) compared with no intake had fewer deaths from heart disease, as well as fewer major heart attacks and strokes (2).

Other studies have associated dairy intake with decreased rates of Type 2 diabetes. Randomized, controlled trials (RCTs) are considered the gold standard of research, and few exist on this topic. The RCTs available suggest no effect or a moderate positive relationship between dairy intake and type 2 diabetes. 

It is important to note that the vast majority of studies on dairy consumption do not show an advantage of whole-fat over low-fat when it comes to preventing heart disease. Furthermore, many studies (excluding the PURE study) that tout the health benefits of dairy fat are funded by the dairy industry. When an industry finances research on its own product, there is a risk of bias in favor of the product.

What is one to do? We mustn’t look at just one nutrient or one food when deciding on a healthy diet. We need to have an overall attitude towards healthy eating. Research has consistently shown that replacing saturated fat with unsaturated fat lowers cholesterol and the risk of heart disease. That said, a healthy diet has to be livable. You will find low-fat yogurt and 1% milk in my refrigerator but not low-fat cheese because, well, it just isn’t cheese.

Until next time, be healthy!

Dear Dietitian

References

1. Dairy products: Per capita consumption. United States (Annual) 4 Sept 2020. https://www.ers.usda.gov/webdocs/DataFiles/48685/pcconsp_1_.xlsx?v=4821.3
2. Dehghan M, Mente A, Rangarajan S, et al. (2018). Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study. The Lancet 392 (10161), 2288-2297. https://doi.org/10.1016/S0140-6736(18)31812-9

Leanne McCrate, RDN, LD, CNSC, is an award-winning dietitian based in St. Louis, Missouri. Her mission is to educate consumers on sound, scientifically-based nutrition. Do you have a nutrition question? Email her today at deardietitian411@gmail.com. Dear Dietitian does not endorse any products, health programs, or diet plans.