What’s the Deal with Dairy?
There’s a lot of debate and questions surrounding dairy. Is it the nutritious and health food it is sometimes touted to be, or is really a toxic food that is promoted by a corrupt and powerful industry? While I do not subscribe to either extreme, I will take a side on this one (& deviate from my typical, middle-of-the road stance).
First let’s examine some concerns with dairy. Lactose is a simple sugar naturally occurring in many dairy foods, including milk, yogurt, cheese, and ice cream. Lactase is the enzyme our bodies produce to digest lactose. As we age we lose some amount of lactase and this can result in lactose intolerance (gas, bloating, and discomfort experienced when consuming lactose-containing foods). It’s important to acknowledge, however, that we all lose different amounts of lactase – some ethnicities produce very small amounts of lactase as they get older and thus experience a greater degree of lactose intolerance (particularly African American, Hispanic, and Asian populations). Other populations, such as those of Northern European descent, have evolved to continuing producing higher amounts of lactase throughout the lifespan since dairy is a core component of their diet; These individuals tend to be able to drink milk into their 80’s and 90’s without problem. So there is certainly a genetic component to this and this also demonstrates that it is not necessarily true that we weren’t ‘meant’ to drink milk after infancy (given that some populations have adapted just fine to drinking milk for their entire lives).
It is also important to note that lactose intolerance is not all-or-nothing – some individuals experience gas and bloating after eating ice cream or a large glass of milk and incorrectly assume they should not have any dairy at all. This is simply not the case. Usually as we age we decrease our lactase production, but by degree – maybe a bowl of ice cream is problematic, but a cup of yogurt (that has live, active cultures and enzymes that can assist with digestion) can be digested just fine. Unfortunately, it’s a ‘use it or lose it’ phenomenon – if you cut out all dairy foods, you’ll decrease your production of lactase even more, thus exacerbating your digestive symptoms. So if you enjoy dairy but just can’t handle a big bowl of ice cream, you may continue to have yogurt daily, smaller amounts of milk with cereal, lower lactose-containing cheeses, etc…
All in all, I do think dairy, and particularly dairy foods such as milk, yogurt, and cottage cheese (and to a smaller degree, cheese) can be part of a healthy diet. Milk is actually quite nutrient dense (a high amount of nutrients relative to its weight) – it is a great source of protein, vitamin A, potassium, riboflavin, calcium, vitamin B12, iodine, phosphorous, and Vitamin D. Many of these are nutrients Americans tend to be quite low in, including calcium, potassium and Vitamin D. So for many individuals, milk, yogurt, and cottage cheese can be excellent ways to get these nutrients they may not be getting otherwise.
Does this mean that we need to consume dairy to follow a healthy diet? Absolutely not. There are many cultures and groups of people that consume little to no dairy (particularly many Asian and African cultures) and have very healthful eating patterns that are associated with positive health outcomes. We do not need dairy to be healthy. The challenge is, these eating patterns are not the same dietary patterns Americans tend to follow, and so for many Americans, consuming milk and yogurt may increase the healthfulness of their diets compared with not consuming these foods.
The dairy industry is powerful and influential, and it certainly has influence over governmental guidelines and recommendations. I don’t think this has to negate the health properties of some dairy foods. I have also seen it to be an industry that is genuinely passionate about its food and its animals – having visited many dairy farms it is apparent it cares about its cows. Here’s the thing I have learned – healthy, happy cows produce more milk, and it really is that straightforward. It is not in a farmer’s best interest to mistreat and ‘drug up’ their animals as it would significantly decrease production. As far as antibiotics go, there is practically zero tolerance for antibiotics in milk. All milk that leaves a farm is tested with stringent standards, and if there is even a trace of antibiotics in the milk, the entire supply (thousands of gallons) needs to be dumped. Any cow treated with antibiotics related to infection is removed from the milk production line until they are completely clear of antibiotics. So as consumers, it is very unlikely we are exposed to antibiotics from dairy.
I would not argue that dairy is a ‘perfect’ food; nor is it necessary for health. I do believe it can absolutely be part of a healthy diet, however. Several research studies have demonstrated this, showing that diets including 2-3 servings of dairy a day, for example, can help with weight management, lower blood pressure and manage other chronic diseases. If someone doesn’t like dairy then dairy alternatives are fine, just know that almond milk would not be an ideal replacement for dairy milk – almond milk has virtually no protein, and the calcium in almond milk is supplemental calcium (not naturally occurring) and thus is not as bioavailable as the calcium in dairy milk. I would recommend soy milk as a healthier alternative to dairy milk because of its higher protein and calcium content.
Finally, let’s address the question of dairy fat. A lot of the fat in dairy products is saturated fat. Our understanding of saturated fat is evolving and there is research suggesting the type of saturated fat in dairy (as we now know not all saturated fats are created equally) is not as problematic as the saturated fats in meat, for example. There is even research to suggest some dairy fat found in milk, yogurt, and cheese, may have health benefits or at the very least may be ‘neutral’ (versus causing atherosclerosis which causes heart disease).
Until the science is more conclusive and we have a better understanding, I tend to recommend lower fat dairy products to patients. I do think it’s appropriate for younger children to drink whole milk as they need higher fat contents in their diets; I also think higher fat-containing dairy products such as milk and yogurt can help individuals wanting to gain weight to get more calories in their diets. For individuals wanting to lose weight I do recommend non-fat or lowfat dairy products and this is simply due to their lower calorie content. There is some research to suggest individuals wanting to lose weight may benefit from whole fat dairy because it is more satiating (provides a greater feeling of fullness) and so I recommend individuals experiment with this – if drinking a glass of whole milk is so filling it ends up decreasing what they eat throughout the day, then this can help with weight loss. Otherwise, non-fat and lowfat dairy may be more helpful.
And finally (did I mentioned this is certainly a complicated issue?!) a quick note about dairy for athletes. I will attach an article (not funded by the dairy industry) that demonstrates why lowfat chocolate milk is an effective, and possibly superior, recovery beverage compared with other commercial beverages – milk has a high composition of necessary amino acids including branched-chain amino acids needed for recovery; chocolate milk has needed carbohydrate for recovery; milk provides fluids required in the recovery process; and milk is also high in needed electrolytes (potassium and sodium) that are necessary for fluid retention. While lowfat chocolate milk would not be necessary after a 30 minute run, it would be appropriate after a more exhaustive workout.
As always, let me know your thoughts and questions!!
Article: Recovery beverages