The Debate on Dairy – is it essential?

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Dairy for many was once a staple in our diet – with milk poured over cereal, added to tea or coffee, blended into milkshakes or served straight from the carton as a refreshing drink. Today however, dairy often takes a back seat with more people opting for dairy free alternatives whether it be due to ethical reasons, intolerances or the increase of popular “wellness trends”.

Statistics confirm that dairy consumption is on the decline. According to the most recent 2011-2012 Australian Health Survey, more than half the Australian population (aged 2 years and over) have inadequate intakes of calcium. This means a lot of people are not consuming the recommended three serves of dairy per day.

Milk consumption in Australia is higher than most western nations, with figures from Dairy Australia showing the average Australian consumes 105 litres of fresh milk per year, but with the rise in popularity of alternate, dairy free milks, yoghurts and cheeses this figure is set to decline.

Why do we consume dairy in the first place?

The Australian Dietary guidelines suggest we have 2.5-4 servings of dairy a day depending on your age group but what is the reasoning behind this? Dairy is an excellent source of calcium, and in most parts of Australia it is easily accessible and affordable. Calcium is an essential mineral required to build strong, healthy bones and teeth, it also assists in muscle and nerve function, prevents osteoporosis and helps with blood clotting. Dairy products are also a rich source of complete protein, meaning they contain all the essential amino acids. In addition, dairy contains B12, an essential vitamin found only in animal products, this can be of particular importance for those who don’t eat meat.

Is dairy consumption linked to heart disease?

It was once thought the saturated fat content in full-cream milk and other dairy products was linked to an increased risk of heart disease. However recent studies show that this may not be true. A detailed study published in the American Journal of Clinical Nutrition investigated the relationship between dairy fat intake and cardiovascular disease (1). The study which collected information over several decades found that various foods including full-fat dairy milk, yoghurt, butter, cheeses, and cream were not found to increase heart disease risk. However it is important to note that dairy foods were not found to decrease risk either.

Is lactose intolerance on the rise?

Lactose is the main carbohydrate or “sugar” found in milk. When we are born, our bodies produce large amounts of the digestive enzyme, lactase, to break down lactose in breast milk. As we age, the amounts of lactase our bodies produce declines and for many people they lose the ability to break down lactose becoming intolerant.

The number of adult Australians who report being lactose intolerant has risen by 240,000 people to 4% of the overall population, from 2011 to late 2015 (2). This increase is almost entirely made up of women. Unfortunately it is hard to tell how many are diagnosed by a health care professional. This rise in self-diagnosis could be due to increased awareness and diagnostic measures or it may be the result of increased reliance on online information for symptoms.

It is important to note that people experience varying levels of lactose intolerance and some may be able to tolerate more than others. Similarly many causes of lactose intolerance are temporary, due to as illness or injury in the gut. However often those with sensitivity to lactose are afraid of reintroducing dairy due to severity of symptoms, resulting in sometimes unnecessary avoidance of all dairy even those that don’t contain much lactose.

What are the best types of dairy?

Despite being told for years that reduced fat dairy is best, a number of studies have shown that consumption of full fat dairy can be beneficial. Full fat dairy has been associated with reduced obesity and reduced risk of type 2 diabetes.

In a review that looked at 16 studies, 11 showed that full-fat dairy was associated with reduced obesity, with none finding such an effect for low-fat dairy (3). Research has also found that people with higher levels of different by-products of full-fat dairy have, on average, a 46% lower risk of getting diabetes than those with lower levels (4).

Despite being lower in kilojoules, there is currently no compelling human evidence to prove that people who eat low-fat dairy are healthier than those who eat full-fat. For those with weight issues, reduced fat may be best, however full-fat dairy does have its benefits. Fat is required for the absorption of fat soluble vitamins – A, D, E and K, all which our found in milk. The fat content in milk can also create a sense of food enjoyment and richness, promoting satiety.

Fermented dairy products such as yoghurt and kefir contain probiotics that can have numerous health benefits on gut bacteria and overall health. Choose unsweetened, natural flavoured yoghurts such as good quality pot set or Greek yoghurt to get the most benefits. It is important to always check the labels for calcium content as some are higher than others.

What if choose not to eat dairy?

Dairy can be a valuable part of a varied diet for those with no tolerances or ethical issues surrounding it. However you can still meet your calcium requirements through other nutritious foods if you make informed dietary decisions.

Here are some ways how:

Milk Substitutes: with numerous milk substitutes on the market today it can be difficult to know which one is best. It is important to always look for options that have been fortified with calcium, preferably with about 300mg per 250ml (the same content as cow’s milk). Milk substitutes are not recommended for infants or children.

Dark green vegetables: bok choy, kale, parsley and broccoli are all good sources of calcium, but it is important to note that you need to eat much larger quantities to get the same benefits. For example 2 ½ cups of steamed bok choy equals the same amount of calcium as 1 cup of cow’s milk.

Fish: Canned salmon or sardines are a great source of calcium with one small tin providing approximately the same as a glass of milk. It is important to choose those with edible bones.

Tofu: 100g of tofu has the same amount of calcium as a cup of milk, making it an excellent choice for vegans and vegetarians. However, it does need to be calcium set, so always check the label.

Seeds and Nuts: Seeds are nutritional powerhouses with many being great sources of calcium including sesame, poppy and chia seeds. 1 tablespoon of poppy seeds has 13% of the recommended daily intake of calcium or the same as half a glass of milk. As for nuts, almonds contain the highest amount of calcium with 300mg of calcium per 100 almonds.

The Verdict

Adequate calcium intake is essential throughout all life stages. During adolescence, calcium consumption allows our bones to reach optimal density and growth. In adulthood, we naturally start to lose bone mass so calcium intake can help slow this process. Dairy is an excellent and readily available source of calcium. Whilst eliminating dairy from your diet can make it difficult to meet daily requirements for calcium, it is possible to get adequate calcium from other sources as long as you make smart choices. If you tolerate dairy products, then enjoying moderate amounts as part of your everyday diet has positive effects, just be sure to choose quality dairy products with at least 250mg of calcium per serve, preferably full fat as it is thought that many of the benefits of dairy are due to the fatty components.
1. Chen, M., et al. (2016). Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults. Am J Clin Nutr. pii: ajcn134460.
2. Morgan, R. (2016). Lactose Intolerance on the rise amongst Australian women. Roy Morgan Research, Finding no. 6673.
3. Kratz, M., Baars, T., Guyenet, S. (2013).The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. European Journal of Nutrition, 52(1), 1-24.
4. Mohammad, Y., Yakoob, Peilin Shi, Walter, C., Willett, Kathryn, M., Rexrode, Hannia Campos, E., John Orav, Frank B., Hu, Dariush Mozaffarian. (2016). Circulating Biomarkers of Dairy Fat and Risk of Incident Diabetes Mellitus Among US Men and Women in Two Large Prospective Cohorts. Circulation AHA, 17(133), 1645-1654.

Nicole Poidevin

Nicole Poidevin completed her Bachelor of Nutrition and Dietetics at Griffith University on the Gold Coast in 2015. She is passionate about educating people around evidence based nutrition and living a well-balanced lifestyle. Nicole is currently working full time at a medical nutrition company within the home enteral nutrition team and strives to deliver best care to patients who are discharged from hospital and requiring ongoing nutritional care.

When not working, Nicole enjoys keeping fit either at the gym or getting outside and going hiking, she also loves cooking and developing/adapting recipes to meet specific nutritional requirements.

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