Milk bottles; dairy

Cardiologists have been admonishing Americans to avoid saturated fat in the diet. Whole fat dairy products have been especially vilified. That is why skim milk, margarine and low-fat yogurt have become so popular over the last few decades. Admit it, if you put cream in your coffee, don’t you feel just a wee bit guilty? And if you buy full-fat ice cream doesn’t it seem as if you are committing a sin? Surprisingly, though, The data to support restricting whole fat dairy products has been conflicting and confusing. Now a new study suggests that telling people to avoid dairy products might have been mistaken (Lancet, Sept. 11, 2018).

Whole Fat Dairy Intake and Heart Disease

It has long been assumed that saturated fat was the culprit underlying cardiovascular disease (CVD), heart attacks and premature death. Sat-fat was thought to raise LDL cholesterol which would in turn clog coronary arteries. But this lipid theory of heart disease doesn’t work as well as the advocates would like to believe. More about that in a moment.

PURE to the Rescue:

A large multinational epidemiological study involving more than 136,000 people challenges the old assumptions about whole fat dairy products. This research is called the PURE (Prospective Urban Rural Epidemiology) study. Investigators recruited volunteers from 21 countries in five continents.

Over 9 years there were more than 10,000 heart attacks or deaths in this population. People who reported consuming at least two servings of dairy products daily were less likely to suffer a cardiovascular event or die during the study. Some people ate only full-fat dairy products. If they had three servings a day, their chance of dying during the study was lower than people who had only half a serving daily.

The researchers noted that a higher intake of total dairy (more than two servings daily) compared to no dairy intake was associated with:

  • Less total mortality
  • Less non-cardiovascular mortality
  • Less cardiovascular mortality
  • Less major cardiovascular disease
  • Fewer strokes

The researchers offered the following implication of the PURE study:

“Dairy consumption was associated with lower risk of mortality and major cardiovascular disease events in a diverse multinational cohort.”

The authors of this study pointed out that:

“…a meta-analysis of cohort studies suggested a lower risk of hypertension with increasing milk consumption, with a neutral effect on cardiovascular disease.” (refs: Hypertension, Nov. 2012; Circulation, Jan. 12, 2016).

They acknowledge that most dietary guidelines restrict whole fat dairy products on the grounds that this approach should reduce the risk of cardiovascular disease. They hasten to add:

“However, dairy products and dairy fat also contain potentially beneficial compounds— including specific aminoacids, medium-chain and odd-chain saturated fats, milk fat globule phospholipids, unsaturated and branched-chain fats, natural trans fats, vitamin K1 and K2, and calcium—and can contain probiotics, many of which might also affect health outcomes.”

The Conclusions in Their Own Words:

“In this large, multinational, prospective cohort study involving participants from 21 countries in 5 continents, we found inverse associations between total dairy consumption and mortality or major cardiovascular disease events. The risk of stroke was markedly lower with higher consumption of dairy.”

“Our study (unpublished data) and others have shown a lower blood pressure with higher consumption of dairy and this effect might explain the lower risks of strokes that we have observed. Furthermore, there was no impact on LDL cholesterol but a lower triglyceride blood concentration with higher dairy consumption, and this finding might explain the non-significant and lower risk of myocardial infarction observed in this study.”

Whole Fat Dairy Is Not the Enemy:

Did you catch the statement that consumption of dairy foods did not impact LDL cholesterol? That should have come as a major shock. For decades you have been told that the saturated fat in whole fat dairy products would raise your LDL cholesterol and lead to terrible cardiovascular consequences. In the PURE study, however, dairy consumption didn’t  impact LDL cholesterol and actually led to lower triglyceride levels.

This is not the first time that the demonization of saturated fat has fallen flat. Here is an article you may find compelling that provides a broad perspective on saturated fat and heart disease. It was based on an article in the British Journal of Sports Medicine (April 25, 2017) titled “Saturated Fat Does Not Clog the Arteries.” Here is a link:

Should a Flip Flop on Saturated Fat Freak You Out?

What do you think about whole-fat dairy products? Share your thoughts in the comment section below.

The Lancet, Sep. 11, 2018

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  1. John
    Croydon, PA

    If you Google PURE study crticism, you will find that the conclusions are not that solid.

    The international PURE study included people who had marginal protein and calorie status. Full fat dairy would benefit those people. Most of your readers have access to abundant protein and calories. It is not clear that they would benefit from consuming more whole fat dairy. There are healthy, long lived people, who do not consume dairy products.

    Saturated fat has been implicated in fatty liver and dementia.

    The research in the unique properties of dairy fat is not yet ready to be used for dietary recommendations.

    • Tom
      Raleigh, NC

      I found this summary of expert analyses most helpful: (google for) “expert reaction to study looking at dairy consumption, cardiovascular disease and death”.

      Since this a “bet your life” proposition, I’ll go with the moderate path that these experts tended toward: lower-fat dairy, not full (or – I’m assuming here – zero) fat, until better evidence becomes available.

      Unfortunately, this means less butter: (“The findings from PURE support the current evidence that yoghurt (a fermented dairy product) and milk has a beneficial effect, whilst butter (non-fermented dairy) showed a non-significant trend for a negative impact on mortality and cardiovascular outcomes.”)

  2. Richard
    Durham, NC

    When I asked about “chemicals” being added to low-fat and no-fat dairy — I was really looking for answers about milk, cheese, and plain yogurt, because that’s the dairy I eat. I skip yogurt with flavors and fruit, and I skip ice cream.

  3. Richard
    Durham, NC

    To those who talk about “chemicals” being added to low-fat and no-fat dairy — What ‘chemicals are added? Do they appear on labels? Someone mentioned sugar. Is there anything else?

  4. Ann

    For summaries of studies such as this, it would be helpful to include who funded the study. It is relevant information and I am willing to bet the majority of us don’t click the link to the original study. Thanks!

  5. Carrol

    The dairy products sold are not fresh or wholesome, unless directly from a farm. I think it is wise to practice moderation, but milk is another processed dietary product. I would be misleading to call this and other dairy products food.

  6. Jerry
    North Dakota

    I believe it was about 1970 when Adelle Davis wrote her books on nutrition. In at least one she blamed the Hydrogenation industry that turned oils into hard fats by bubbling hydrogen through the oil at high temperature thus replacing the oxygen (or some such). Naturally, she claimed margarine was a bad thing. As was Crisco, lard, and hydrogenated peanut butter.
    Now the (medical researchers?) use the word “Saturated Fats” and claim margarine is now good for us.
    Adele Davis was more believable.

    We pasteurize milk to kill really bad stuff like undulant fever. Really important. No one will ever convince me that “certified raw milk” has a doctor checking each cow each day.

  7. Martha Dudley

    Full fat tastes horrible.

  8. Cindy
    Seattle, WA

    I agree with this article and I do think the difference has something to do with the added chemicals and other processes they use to make “lo-fat” and “no-fat” dairy products taste good. These things may well cancel out any benefits from such products.

  9. Gary

    I am skeptical about the outcome of the PURE study. Before my diet was whole food plant-based, I had enlarged varicose veins in my right leg. When I stopped dairy and eggs the varicose veins disappeared. Milk and all milk products are for baby cows and not humans. What about the bovine growth hormone that is in milk products?

    By the way, I am 81 and do not take any medication. I had a catheter ablation procedure in August of 2017, and I am a-fib free, and I do NOT take blood thinners as my veins and arteries are not full of fat, grease, and cholesterol from meat, and dairy.

  10. Carol

    My doctor said I’d have less arthritis pain in my joints if I cut down on dairy products, and said they (along with sugar) caused inflammation. All this is so confusing. I’ve been cutting back on sugars (other than that in fruit and an occasional spoonful of honey), and I use some low fat dairy cottage cheese, But I eat full-fat cheeses each day as well. I eat ice cream and froze yogurt. So I eat a mixture of the two. I tried going without much dairy and didn’t notice any change in arthritic pain. But I did notice that less sugar and also less carbs means that my arthritis is less painful. Not very scientific, is it? But so far I’m doing okay.

    • Trish

      Carol, you might want to try taking Hyaluronic Acid. Since starting it (3 times a day), I’ve been able to quit using my cane and feel very little pain from my hip arthritis

  11. Joanne

    Digestive enzymes are destroyed by the pasteurizing of milk. Due to homogenization, an enzyme has been found in coronary artery plaque. Fat aids in the digestion of protein in meat, eggs, fish, whole milk. Raw milk might be better, but not safe we are told. Wonder what the heart disease statistics are of the Scandinavian countries that consume much dairy. The calf drinks whole, raw milk from mama cow. It survives as long as mama cow is healthy. That milk was meant for the calf, not us. Do we drink the milk of other animals? There are other factors that also contribute to heart disease such as smoking, stress, heredity, depression, hypothyroidism, etc. For years, I drank whole milk, cheese, yogurt, etc
    Also, low thyroid. At 82, I have coronary blockage, Might be due to heredity from
    dad’s side of family. All food for thought.

    • Linda

      I have been drinking whole raw milk for seven years. I consume a half gallon each week which is about how long it stays fresh (unless I make yogurt, which I do w/o raising the milk above 118 degrees). I am about the healthiest person I know. I am mostly of Norwegian descent which I like to believe is why I tolerate milk and love it so much.

  12. Kassandra

    I checked 2 containers of milk (whole and skim) for their sugar content. There is MORE SUGAR in skim milk than in whole milk. In addition to whole milk having more fat, it is healthier because it has LESS sugar.

  13. Penelope

    Which leads to questions for those of us who are lactose intolerant. How can we get the same benefits without dairy?

    • John

      I buy lactose free milk and take lactase enzyme with other dairy.

  14. Fran
    North Carolina

    I am lactose intolerant. I can’t drink milk but I can eat home made yogurt.

    • Barbra

      I am dairy intolerant. Lactose free milk or tablets do not help me at all to eat or drink dairy. Now what?

      • Miriam

        Have you tried the lactose drops? I put 7-8 drops per 2 cups of 1/2 & 1/2 – let it sit 24 hrs & no problem the next day.

    • Cathy

      Yogurt doesn’t have a lot of lactose in it. When I was first diagnosed with lactose intolerance my doctor gave me a list of foods that have lactose in them and those that don’t. I eat yogurt at least once a day, and I don’t have a problem. I actually feel better after eating the yogurt. It has a calming effect on the stomach. Aged cheeses don’t have a lot of lactose either. I was told that hot dogs have lactose in them. I don’t have a problem with goat cheese either. I think goat’s milk has less lactose in it as well. I was drinking the nut milks, but most of them have an ingredient in them that’s all organic, but is used to cause inflammation in mice when they did studies. That was very confusing. I don’t remember the name of the ingredient. Yogurt and aged cheeses have less lactose in it because of the way they are processed. I found whole milk yogurt again. It’s been years. Usually when something is made low fat they add more sugar to make up for the lack of taste.

  15. Jeanette

    I don’t drink a lot of milk, but until a year ago, it was all low-fat from organic brands. Now I buy grass-fed local organic raw milk, skim about 7/8 of the cream off the top and use that to make butter. I’ve also switched from sour cream to organic (full fat) Greek yogurt. My gut’s happier, and I like the taste a lot better. I’ve not seen any health issues, and I’m 70.

  16. Irene
    North Carolina

    My husband and I were ‘low fat’ geeks. I couldn’t lose weight. He was a cyclist and raced with a 6% body fat, yet had high cholesterol. My cholesterol was high. I began reading and hearing the reasons behind the ‘low fat’ craziness. We tossed the low fat with its added real & fake sugars, added whole dairy to our life. Butter & cream is in our diets now. I’ve lost mega weight & for both of us our cholesterol is down. True, it isn’t simply removing the ‘low fat’ It’s removal of all the craziness.

  17. Robyn
    New Jersey

    I am not surprised by these findings. I recently began a ketogenic diet and my cholestorol numbers went down, my energy has increased, and I have lost the stubborn pounds that I could never shed. Full-fat yogurt, cheese, etc are now a part of my daily diet. My cholesterol levels were always high, around 240, before I tried the keto diet, and have dropped to 203 after 2 months. When my cholesterol was high, my doctor tried to persuade me to take statins, which I refused. A recent CT scan revealed not a stitch of calcium in my arteries or aorta, at the age of 63. So much for high cholesterol causing “clogged arteries”. According to research I have come across, the low-fat craze began with the medical opinion of President Eisenhower’s physician, who, after the president had a major heart attack, suggested it was a result of a high fat diet. What wasn’t taken into account was that Eisenhower smoked 3 to 4 packs of cigarettes a day! This doctor’s advice became the mantra of physicians everywhere and led to a plethora of low- or no-fat products flooding the market. Dr. Michael DeBakey, a highly renowned heart surgeon was a cheese lover. He insisted that high fat dairy is not the culprit for heart disease; it’s inflammation, caused by sugar, smoking, stress, alcohol, etc. He stated that the average cholesterol level of his patients with severe heart disease was well below 200. (Dr. DeBakey lived to the age of 99!) Of course everyone’s body chemistry is different and there are no guarantees. But you certainly may be able to enjoy full fat dairy…it’s delicious! You may even see an improvement in your health, weight and energy levels.

  18. Eileen

    I drink skim milk with dinner at least 4-5 nights per week. I drink skim because I prefer the taste over 1-2%. However, I do eat real cheese and butter, and occasionally real ice cream, because I don’t like the chemicals added to the lower fat versions of those foods. I would rather have smaller amounts of the real thing. And my cholesterol is right where it should be.

  19. Valeri

    Everything in moderation is my mantra.

  20. David
    West Palm Beach, FL

    All dairy products have lactose (sugar) in them and not having the fat from whole milk to slow down the absorption of those sugars is probably the biggest cause of so many people getting overweight and getting type 2 diabetes. I am 80 years old and only eat whole milk products while a friend of mine only eats low fat dairy and he can not seem to loose weight. Oh, yes, I am 6 feet tall and an ice cream addict and weigh under 180 pounds. The fat slows down the absorption of the sugar so is better for us to eat what nature made for us instead of processed dairy (like taking the fat out).

  21. Ronald

    Haven’t there been some measurable benefits from a lessened consumption of dairy products in a given or studied population? And I’m curious as to why this study (PURE) was done in the first place. The dairy industry is desperate to reverse the use of substitute products. Even going so far as proposing that the term “milk” cannot be used to describe anything other than animal product. Funding of this study is buried deep in the list of funding sources. The truth will eventually be revealed.

    • Susan

      I agree with Ronald from Virginia.

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