Rising tide of research supports more milk fat in the diet

WASHINGTON, May 18, 2016 - American diets are at a crossroads on the healthfulness of drinking whole milk and eating high-fat dairy products such as cheese, but lots of well-publicized new research suggests a big nutritional facelift for those products is in the making.

For about a half century, guidance from government and health organizations pushed consumers more and more to choose skim and low-fat milk along with yogurt and other low-fat dairy products. And though the 2015 Dietary Guidelines for Americans (DGA) prescribes two cups of dairy products daily for young kids, and three cups for adults, the DGA has been squeezing more and more milk fat out of those recommendations since 1985, when it favored low-fat dairy choices as a way of limiting intake of all saturated fats. In 2012, USDA ordered whole milk out of school cafeterias, leaving choices of only skim and 1 percent. It followed that up in 2014 with new restrictions for families in its Women, Infants, and Children program. WIC had already eliminated whole milk, but then went further, limiting 2 percent fat milk to those under 2 years old, and only skim or 1 percent fat for all others.

Indeed, the low-fat milk idea has been thoroughly sold to America. For years, the American Academy of Pediatrics online brochure for youngster health, for example, has suggested whole or 2 percent fat milk only for children under age 2, and skim or 1 percent for older children.

And some nutrition experts are convinced that moving away from whole milk and saturated fats, in general, is still the right path.

“The fact that saturated fat raises cholesterol, especially the bad LDL cholesterol, is beyond doubt,” said Martijn Katan, an emeritus professor of nutrition at the Free University of Amsterdam and an expert on diet and cardiovascular disease. He has gone so far as to suggest that many of the new studies came as a result of a coordinated industry effort to “neutralize the negative impact of milkfat by regulators and medical professionals.”

However, a bevy of studies over the last few years  – some funded by industry and some not – have separated milk fat from other saturated fats and concluded that consuming fat, along with the other nutrients, in dairy products is beneficial, or at least not bad for people.

The Institute of Medicine of the National Academy of Sciences reported, for example, in an assessment (see p. 272) of recent dairy fat research that much of it suggests “dairy fat consumption may have different implications for health than other types of saturated fats.” Part of its report was a review of 16 research projects on health and dairy fat. In fact, most of the studies reviewed showed an inverse association between high-fat dairy consumption and obesity or heart disease. One study tracked more than 3,000 Americans for two decades and found sharply fewer incidents of diabetes among those with the most dairy fat in their diets. Another study followed 10,700 children from age 2 to age 4, and found that, across all racial, ethnic and socioeconomic lines, the kids who drank skim and 1 percent fat milk were fatter than those who drank 2 percent moo juice.

Another significant report this year from Brigham and Women's Hospital, Harvard University and Karolinska Institute, looked at the effects of full-fat and low-fat dairy products on obesity for 18,438 women. After nearly 11 years, the women who consumed the most high-fat dairy products were least likely to become obese. In fact, those with the greater intake of high-fat dairy – not low-fat dairy – gained the least weight.

Two years ago, the National Dairy Council summarized emerging research findings to the Dietary Guidelines Advisory Committee and called for a new approach it its dairy fat recommendations. “In summary, recent findings from outcomes studies indicate that milk fat consumption may not be linked to increased risk, and in some cases may even be associated with reductions in the risk to cardiovascular disease, coronary heart disease and type 2 diabetes,” the council said.

The DGA’s view of saturated fat began to change in the 2015 rendition. The 2010 DGA’s suggestion limiting daily cholesterol to 300 milligrams was dropped, which pleased egg producers, dairy farmers and other livestock operators along with consumers who enjoy livestock products. Plus, the new guidelines called for more research specific to milk fat consumption and human health.

“Science is continuously evolving,” says Mickey Rubin, National Dairy Council vice president in charge of nutrition research. “We have better studies… (and) the research now is just saying that saturated fat, in general, is essentially neutral. There is no association. It doesn’t result in increased risk; it doesn’t result in decreased risk for heart disease.”

Based on past DGA experience, USDA and the Department of Health and Human Services will likely begin the process of assigning the advisory committee for the 2020 DGA in 2018. Meanwhile, Rubin says, “The research [on milk fat] is coming out rapidly. So when it comes time to make comments for the 2020 guidelines, I think we’ll have a larger base of research… and it will be more robust than it was (for the 2015) go-round.”

However, Alice Lichtenstein, professor of nutrition science at Tufts University and vice chair of the 2015 Dietary Guidelines Advisory Committee, says “we need to be cautious when making conclusions on the basis of observational data because association does not prove causation. We cannot rule out the possibility that children who are given reduced fat milk tend to be heavier than those given full fat milk. Does that prove that reduced fat milk causes overweight in children? Unlikely.”

Americans’ use of whole milk in 2014 (the latest tally by USDA and state agriculture departments) ticked up to 14 billion pounds.  That total amounts to just half of the 1985 volume, but marked the first annual increase since 2000. Cary Frye, vice president for regulatory and scientific affairs at the International Dairy Foods Association, notes that whole milk and 2 percent fat milk account for 70 percent of fresh U.S. drinking milk consumption.

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