Over the past few years there has been a lot of controversy over whether dairy is good for us or not. Some believe dairy is an essential food for bone health whilst others believe dairy causes cardiovascular disease.
Milk has seen a decline in sales as many of us seek out more dairy-free alternatives such as almond and coconut milk. This may be because we simply believe we are making a healthier choice, we are experiencing digestive issues or have a legitimate allergy or intolerance, or it could be for environmental or animal protection reasons.
We’ve been eating dairy for thousands of years and eliminating it from our diets is not easy. Do we really need to give up on dairy or can it be part of a healthy balanced diet?
How much dairy should we be consuming?
Dairy products include milk, cheese, yogurt, cream and butter.
As part of the government’s newly updated EatWell Guide, we are recommended to have some dairy or dairy alternatives and to choose lower fat and lower sugar options.
Is dairy good for us?
Dairy is a staple part of the British diet and can provide many nutrients which play an important role within the body.
Milk, cheese and yogurt are excellent sources of high-quality protein and calcium, as well as being a good source of potassium, phosphorus, iodine, vitamin B2, B1 and B12.
We need protein to provide the essential building blocks to grow and maintain muscle, bone, skin, hair, nails and hormones. We need calcium for healthy bones and to help maintain muscle contractions and blood clotting. Dairy provides the major source of calcium in the British diet, at more than 40% of calcium intake amongst adults.
A 200ml glass of milk contains around a third of our 700mg daily recommended intake of calcium, with cheese and yogurt containing slightly less. In the UK milk alternatives such as almond milk are fortified with calcium and contain a similar amount. Other high calcium foods include sardines and pilchards, and small amounts are found in almonds, dried fruit, quinoa, broccoli, spring greens and spinach.
Dairy is also one of the major sources of iodine in the UK diet. Iodine is needed to make thyroid hormones, which act on nearly every cell in the body including growth, regulating metabolism and for the development of a baby’s brain during pregnancy and early life. Other sources of iodine include fish and eggs. Although organic milk contains less iodine than conventional milk, it does contain more omega-3 fatty acids, which are good for our heart.
Yogurt is made by fermenting milk with lactic bacteria or cultures. These probiotic bacteria help to keep our digestive system functioning properly and have been shown to support our immune system. 1
Is dairy bad for us?
The reason dairy is thought to be bad for us is because it contains a large amount of saturated fat. Saturated fats, often referred to as “bad” fats, are a type of fat found in relatively large amounts in animals foods including meat and dairy. Processed foods such as cakes, biscuits and pastries also contain a high amount of saturated fats, as well as some vegetable oils including palm oil and coconut oil.
Saturated fats have been demonised since the 1970s, as they have been shown to increase LDL or ‘bad’ cholesterol in the blood and increase our risk of cardiovascular disease (the leading cause of death globally). We have therefore been advised to reduce our intake of saturated fat. As milk and dairy products contribute to 27% of the saturated fat in our diets, cutting down on dairy was highly recommended.
However, a recent review has shown dairy foods, including milk, cheese and yogurt (excluding butter), do not increase LDL or ‘bad’ cholesterol and do not have a detrimental effect on cardiovascular mortality. Blood pressure is another risk factor for cardiovascular disease and dairy foods have actually been shown to help lower blood pressure. These benefits are thought to be due to the role of protein and calcium in dairy. Protein may play a role in helping us feel full after eating and calcium is thought to interact with dietary fat, forming a soap-like substance, which reduces fat absorption. 2
Type 2 diabetes is a risk factor for cardiovascular disease. In the UK the number of people diagnosed with the type 2 diabetes is growing rapidly. Dairy foods, particularly fermented foods like cheese and yogurt, have been shown to reduce our risk of type 2 diabetes. 3
Research has shown that reducing fat in our diets meant that we have mostly replaced it with refined carbohydrates, specifically refined sugar, which may have increased our risk of cardiovascular disease.4 However, replacing saturated fat with polyunsaturated fat does reduce our risk our risk of cardiovascular disease.5
Reducing our intake of dairy may therefore not be the most appropriate way to reduce our risk of cardiovascular disease.
What if I have lactose intolerance?
Some of us may give up dairy because we believe we may be intolerant or allergic to it. Intolerances and allergies are often used interchangeably but they represent a different group of conditions. An intolerance to dairy is often caused by an inability to digest the milk sugar lactose, due to a deficiency in the enzyme lactase. Some people with an intolerance may find they are able to tolerate small amounts of dairy or are able to better tolerate the milk from other animals such as goats and sheep. Yogurt is also better tolerated due to some of the lactose already having been broken down by the bacteria.
Cow’s milk allergy is more severe but less common. It is an immune response to one or more of the proteins in milk, which means our immune system identifies the proteins as dangerous. The only treatment is to fully eliminate cow’s milk and any products containing it.
If you suspect you are intolerant or allergic to dairy products, I would recommend going to see your GP for a diagnosis.
What are the issues with removing dairy from our diets?
Dairy supplies our body with a large amount of nutrients. If we remove dairy from our diets then we need to ensure we are still getting these nutrients.
Our diets change dramatically throughout childhood, especially as we enter our teenage years. It is during this time that bone development is most important and can increase our risk of bone fractures later in life. By the time we get to our late 20s it is too late to reverse the damage caused by poor diet and nutrient deficiencies and the opportunity to build strong bones has passed.
It’s important to remember that dairy-free alternatives are not a direct replacement for dairy. Many alternatives are fortified with calcium but, with the exception of soya milk, are often very low in protein. Many of them also contain added sugar and yogurt alternatives such as coconut yogurt can be very high in saturated fat.
So can dairy be part of a healthy balanced diet?
Dairy can be part of a healthy balanced diet when consumed in moderation.
I would recommend consuming butter and cream sparingly as they contain more saturated fat and less nutrients than other dairy. When it comes to yogurt, try to avoid low-fat varieties as these often contain added sugars. Choose a natural or Greek yogurt and add your own flavourings to it, such as berries and honey. We all know how easy it is to overindulge in cheese, so it’s best to stick to the 30g recommended portion.
Gemma, The Food Doctor Nutritionist
- Meydani S N, Ha W K. Immunologic effects of yogurt. Am J Clin Nutr 2000; 71: 861-72
- Lovegrove J A, Hobba D A. New Perspectives on dairy and cardiovascular health. Proc Nutr Soc 2016; 75: 247-258.
- Lovegrove J A, Givens D I. Dairy foods: good or bad for cardiometabolic disease. Nutr Res Rev 2016; 29: 249-267.
- DiNicolantonio J J, Lucan S C, O’Keefe J H. The evidence for saturated fat and for sugar related coronary heart disease. Prog Cardiovasc dis 2016; 58: 464-472.
- Siri-Tarino P W, Chiu S, Bergeron N, Krauss M K. Saturated fat versus polyunsaturated fats versus carbohydrates for cardiovascular disease prevention and treatment. Annu Rev Nutr 2015; 35: 517-543.