A Persistent, Questionable Fear of Whole Milk

The Bowl of MilkOverheated rhetoric in nutrition is nothing new. But the Center for Science in the Public Interest (CSPI) set a high bar yesterday. In a press release, the organization rang alarm bells, saying that “big dairy” is on its way to “making school meals less healthy by allowing whole milk.” Oh my. Is the persistent fear of whole milk reflected in this rhetoric really justified by objective evidence?

It Has Saturated Fat!

The argument from CSPI rests on the idea that all saturated fat is bad. No exceptions. Though there is great diversity of saturated fats in different foods and they can have very different metabolic effects, the grounding principle here is that all of them are bad. CSPI says any contrary thinking emanates from big dairy “running elaborate PR campaigns seeking to cast doubt on the science of saturated fat.”

But Erin Hennessy, a researcher of child nutrition at Tufts, has a different view:

“For a long time we lumped all saturated fats together. The story is more complicated than that. People are becoming a little bit more open to the idea of whole milk.”

Evidence for Lower Risks with Whole Milk

In fact, evidence is accumulating that whole milk might confer less health risk than low or nonfat milk.

For example, a Mendelian randomization study recently showed that whole milk reduced the risk of essential hypertension in comparison to skim milk, which increased the risk. Zhangyan Shi and colleagues conducted their analysis using public summary-level statistics from genome-wide association studies to compare the risk of hypertension caused by different types of milk.

They found that whole and semi-skimmed milk had a protective effect against high blood pressure. Soy milk had a weaker protective effect. But skim milk actually caused risk of high blood pressure to rise in this study.

Likewise, a recent systematic review and meta-analysis by Shelley Vanderhout and colleagues found whole milk consumption is associated with a lower risk of childhood obesity. In a narrative review for the New England Journal of Medicine, Walter Willett and David Ludwig concluded that “no clear benefit of consuming reduced-fat dairy over whole dairy products has been established.”

They went on to say guidelines should “deemphasize reduced-fat milk as preferable to whole milk.”

Let It Go

In sum, hanging on to old guidance to avoid whole milk would appear to be nothing more than an expression of stubbornness. There’s no evidence to support it. It might actually cause modest harm.

The time has come to set aside the fear of whole milk.

Click here for the study by Shi et al, here for the study by Vanderhout et al, and here for the review by Willett and Ludwig. You can find the press release by CSPI here, and further reporting here.

The Bowl of Milk, painting by Pierre Bonnard / WikiArt

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


 

June 7, 2023

4 Responses to “A Persistent, Questionable Fear of Whole Milk”

  1. June 07, 2023 at 6:11 am, Al Lewis said:

    I’ve been following the whole-milk thing for years. I only drink whole milk now, and I get the Fage yogurt with 5% milkfat.

    I still limit my consumption of marbled steak and other fatty meats, though.

  2. June 07, 2023 at 9:27 pm, Carrie RDN said:

    Should the DASH diet modify its low fat dairy recommendation? I have always suggested to patients that low fat dairy plus plant fat (nuts, EVOO, avocado) was equivalent to full fat dairy as far as calorie balance – choose how to spend your fat allowance. CSPI is also against most artificial sweeteners so stopped following them a while ago

  3. June 09, 2023 at 10:42 am, Richard Atkinson said:

    I first was alerted to the falsity of the FDA and CDC guidelines about low fat vs high fat milk by an article by von Kries in 1999 ( von Kries R, Koletzko B, Sauerwald T, von Mutius E, Barnert D, Grunert V et al. Breast feeding and obesity: cross sectional study BMJ 1999; 319 :147 doi:10.1136/bmj.319.7203.147) They studied >9000 kids age 5-6 in Germany and focused on breast feeding. However, they had a table that showed the odds of obesity with hi and low fat milk (and other diary products) was 3 times higher on low fat milk vs hi fat, and hi fat protected from obesity (odds ratio 0.54 vs 1.77). Numerous studies and reviews since then have confirmed this – although CDC personnel defended until recently the concept that kids needed low fat milk. Scientists and physicians need to believe facts, not spin from supposed “authorities.”