Milk Bottles

Low-Fat Dairy: Zombie Guidance?

We have come to wonder why the guidance to choose low-fat over whole dairy products is still standing. Two more studies gained considerable attention in the last week, saying that whole dairy products are linked with a lower risk of health issues than low-fat dairy products. Yet across-the-board guidance to choose low-fat dairy marches on like a zombie.

Even the senior author of one of the studies expressed mixed feelings. Dariush Mozaffarian of Tufts says:

I am conservative about setting national dietary guidelines. While evidence remains insufficient to definitively recommend only whole-fat dairy, it certainly is robust enough not to recommend only low-fat dairy.

Mozaffarian’s study, published in Circulation, found that people with higher levels of fatty acids from the fat in dairy products were less likely to develop type 2 diabetes. These observations held up in two large, independent, prospective observational study cohorts. It’s noteworthy that the authors are looking at markers for the fat that people absorbed from dairy products, instead of counting on self-reports for what people claim to have consumed.

The other study, published in the Journal of Nutrition, found that full fat dairy consumption was associated with a lower risk of metabolic syndrome. Low-fat dairy consumption was not.

At the end of the day, this remains an unsettled question. We have no large well-controlled trials that show either benefit or harm for whole dairy food consumption. None show a benefit for switching to low-fat dairy. So why do the brand new Dietary Guidelines for Americans continue to recommend low-fat dairy? Is it so important to tell people what to eat and drink that we must keep on doling out guidance that no longer stands on a solid evidence base?

If you like low-fat dairy products, enjoy them in moderation. If you prefer whole dairy products, there’s no reason to choke down the low-fat stuff.

Best for now to focus on other things that make a clear difference.

Click here for more from Medical Daily and here for more from Time. Click here for the study by Mozaffarian and here for the study from the Journal of Nutrition.

Milk Bottles, photograph © Smabs Sputzer / flickr

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April 11, 2016

11 Responses to “Low-Fat Dairy: Zombie Guidance?”

  1. April 11, 2016 at 7:11 am, TraciMalone said:

    So, why/how do the recs stay in the Dietary Guidelines if there isn’t solid science to back it up?

  2. April 11, 2016 at 7:42 am, Ted said:

    Good question, Traci. The explanation I get is that they are hanging onto the low-fat dairy recommendation because the fat in dairy is saturated and they are still hanging onto the guidance to avoid saturated fats. Of course, the debate over the evidence on saturated fat is yet another can of worms.

  3. April 11, 2016 at 8:23 am, Dr. Anthony Pearson said:

    The continued recommendation for low or nonfat dairy baffles me and I’ve written a lot about it (most recently http://wp.me/p30zF0-86v). It makes no sense for cardiometabolic health or weight control and it flies in the face of the sensible trend to avoid highly processed products.
    In particular, I find infuriating the promotion of non fat yogurt stuffed full of added sugar as a healthy snack!
    I’ve communicated with Mozzafarian on this and he is equally baffled.

  4. April 11, 2016 at 8:59 am, Ted said:

    Thanks, Anthony, for taking time to add your perspective. I agree with you completely.

  5. April 11, 2016 at 10:00 am, Joan Ifland said:

    Dairy contains four different opiates, as well as sugar (lactose, fat, and hormones. It is designed to put a large calf to sleep while it ingests nutrients. It helps the calf gain 500 lbs in a year. Why is dairy being recommended at all? The Diary Council?

  6. April 11, 2016 at 4:20 pm, Ted said:

    Thanks for sharing, Joan. I’m don’t believe it’s accurate to characterize dairy as containing meaningful quantities of opiates.

  7. April 12, 2016 at 4:55 am, Mary-Jo Overwater said:

    I suspect the continued emphasis on low-fat dairy, despite the robust evidence re: fat, may be simply about keeping total caloric intake in check. That combined with a bit of a ‘je ne sais quoi’ resistance to change something that just sounds ‘sensible’. I’ve advised clients and patients through the ‘fat-free this and that ‘ years and confess that I did not harp on about fat-free, skim anything, especially dairy, even when it was what dietitians were taught to do. If clients were able to enjoy whole-dairy products as their source of calcium, protein, vitamins D & A and the satiating wholesome fats from whole-milk, cheese, ice cream, etc. in appropriate portions — this, intuitively, seemed infinitely better than pushing them to consume skim and fat-free dairy, leaving them unsatisfied, feeling let down, and craving to eat more. Often, too people felt, unconsciously, they had a ‘free pass’ to eat more cookies, pastries, cakes, or even double/triple/quadruple portions of the low-fat cheese, frozen yogurt, etc., itself, because of the health halo of low-fat. By the time Snackwell’s Syndrome came along, I really felt vindicated — :). I do understand and appreciate the evidence and am very glad it’s now out. On the other hand, if I am working with a client and find that low-fat or skim dairy products genuinely helps them keep their caloric intake more sensible and closer to their intake needs, than I’m still very grateful that there are tasty, low-fat, lower-in-calorie dairy alternatives. I wouldn’t want to see us reacting to the extreme in starting to make blanket recommendations to include only whole-fat dairy. Perhaps, the guidelines need to somehow reflect that all dairy is advised as a reliable source of essential calcium, protein, vitamins, and other minerals and whether whole, low-fat, or fat-free options are selected are best determined according to a person’s preferences, lifestyle, and optimal nutritional needs…or something to that effect.

  8. April 12, 2016 at 7:20 am, Ted said:

    Thanks for the perspective, Mary-Jo. Regarding calories (and thus weight) there’s no definitive evidence one way or the other. Some think that whole milk may be more satisfying and thus less fattening. You’re right, blanket recommendations aren’t warranted.

  9. April 15, 2016 at 12:24 pm, Paul N. Hopkins, MD, MSPH said:

    There is plenty of data that full fat dairy raise either serum total cholesterol or LDL cholesterol. This is especially true of butter – with less data on other dairy products. Why is this not acknowledged? Why is the 75% reduction in coronary mortality rates, with a large percent attributed to reduced population cholesterol levels acknowledged. Why aren’t the huge reduction in saturated fat (including butter and dairy) and concomitant reductions in CHD risk in Finland acknowledged. How quickly people jump on the bandwagon of hopeless analyses attempting to see connections between dietary fat and coronary disease outcomes within population – such analyses are inevitably doomed because of underlying false assumptions.

  10. April 16, 2016 at 2:29 pm, Dr. Anthony Pearson said:

    Full fat dairy and butter raises total and LDL cholesterol as well as good, HDL cholesterol but these are very imperfect surrogate end-points.
    The small, dense LDL particles that promote atherogenesis are increased by carbohydrates, not fats. The more important question is what is the effect on atherosclerosis.
    The fact that the decline in butter consumption in Finland parallels the decline in CHD mortality proves nothing:correlation does not prove causation. Too many confounding factors.

  11. April 16, 2016 at 2:59 pm, Ted said:

    Thanks, Anthony, for your thoughtful perspective.