Dairy- Friend or Foe?

As with my post on gluten, I will preface my discussion on dairy consumption by stating that this article is being written solely to identify some comment misconceptions about dairy and help you make an informed decision about whether or not you choose to consume dairy products. This article is not and should not be taken as medical advice and is not meant to diagnose, treat, or cure disease. This is another difficult topic, so I will do my best to present information in a clear and concise manner. The difficulty here (like gluten) is that 5 “experts” will give you 5 contradicting opinions. This is because every individual has a different set of genes, lives in a different environment, and processes certain food groups better than others as a result. It is for these reasons that I have chosen to do this post- to hopefully give you a basic understanding of all the noise surrounding this topic. To start, I will begin by introducing some basic definitions before moving on to more detail regarding the risks and benefits (in my opinion) of dairy consumption.


Lactase Persistence vs. Non Persistence and Dairy Allergies vs. Lactose Intolerance:

With the topic of dairy, there is a lot to take in. As I don’t claim to be an expert on this topic, I will use this article to focus on the areas I find most important for human health. Similar to gluten, some individuals will have a genetically determined allergy to the proteins found in dairy products (casein and/or other proteins). This will lead to an immune response accompanied by symptoms such as rashes, coughing, chest tightness, and sneezing. While those with dairy allergies should just avoid dairy products unless using supplemental lactase, for the rest of the population, the situation get’s a little more complicated. To really understand this, we need to take a look at dairy consumption from an evolutionary perspective, which I will attempt to do below.

Upon birth, we are all born with an enzyme called lactase, which is present and necessary for us to consume and digest the vital breast milk from our mothers and contains the necessary raw materials for growth. However, between the ages of 2 and 4, most individuals lose the ability to produce the lactase enzyme, rendering them ill-equipped for processing dairy into adulthood. This would be classified as lactase non persistence or lactose Intolerance and is most common across our population (roughly 2/3rds). Now, just because you no longer produce the lactase enzyme, it doesn’t necessarily mean you have to omit all dairy products. Those with lactose intolerance can often tolerate dairy products such as raw milk, plain yogurts and cheeses (which contain the lactase enzyme) but will typically get symptoms (typically GI or skin) with overconsumption OR more pasteurized dairy forms as pasteurization destroys the lactase present in the dairy product.

What about the other 1/3rd of the population? Well, over the past 100,000 years or so, certain populations began to rely heavily on cows milk to obtain vital protein, fat, and vitamins and minerals in times of famine or decreased access to other food sources. This led to evolutionary pressure resulting in an increase in the number of individuals who retain the ability to breakdown the lactose sugars in milk (1/3rd of the population) into adulthood. This would classified as lactase persistence and refers to the continued production of the enzyme (lactase) into adulthood, allowing for continued consumption of dairy products with little to no adverse effects. I suspect that this number will continue to rise, but until then, it’s best to get tested for a dairy allergy or intolerance before housing a box of Ben and Jerry’s! Now that you’re aware of these basic definitions, let’s attack the real question, is dairy even healthy?

Okay, So Is Dairy Healthy?

First off, what defines healthy? If one were to ask me, I’d probably venture to say that nutrient density is the best measure of the “health” of a food, assuming no allergies or intolerances at play. Now, the issue in answering this question with dairy is that it comes in so many forms- cheese, cream cheese, raw dairy products, pasteurized milk, chocolate milk, yogurt, greek yogurt, Icelandic yogurt, and many more that I don’t have the time or energy to look up. A lot, right?

To make this easier, I’m going to identify some misconceptions associated with dairy consumption and let you make your own informed decision:

1) Milk consumption will not lower your (or your childs) risk of bone fracture- Yes, I said it, and it’s true. Research has shown that Vitamin D is a much more important factor in preventing fractures than calcium and/or dairy (https://academic.oup.com/ajcn/article/77/2/504/4689714). Some studies have even shown that milk consumption during teenage years will increase fracture risk later in life (this surprised me).

2) Not all dairy products are created equally- Pasteurization is a beautiful process that has allowed us to keep milk fresh for much longer periods of time. However, the heating involved in the process leads to the destroying of beneficial bacteria, nutrients, and carrier enzymes necessary for proper absorption. Thus, pasteurized milk really offers little to no health benefit in my opinion. Is it harmful? I can’t really answer that question with confidence, but I would tend to say that overconsumption of heavily pasteurized dairy forms will cause more harm than good (because most of us don’t product lactase in adulthood!)

3) Just because it’s Greek, doesn't mean it’s healthy (check the label)- I don’t want to burst anyone’s bubble, but the yogurt industry is an absolute joke. From Gogurt to Yo-Crunch, this industry is certainly one of the contributors to the obesity and diabetes epidemics. Don’t get me wrong, some greek and Icelandic yogurts are filled with beneficial bacteria, protein, and high quality fats. However, the majority of what I see on the shelves today are nothing but cups full of sugar with no more nutritive value than a candy bar.

4) Low-fat dairy offers zero benefits to your health- In fact, studies show that full-fat dairy consumption is the main driver of the reduction of cardiovascular disease risk. **Note that the study also showed that dairy consumption in general showed no significant benefit in disease risk.

There are many more examples, but for the sake of time, I will stop here.


Now that I have identified some of the misconceptions, let’s look at some of the potential benefits of dairy consumption:

1) Raw and Fermented Dairy Products offer a variety of bioavailable nutrients, with the added benefit of lactase- This is good news! This means that for all you lactase non-persisters, you may be able to enjoy these products in moderation! Examples include- Kefir, greek yogurt, raw milks and aged cheeses.

2) Some studies have shown that dairy consumption is protective over type-II diabetes, cardiovascular disease and metabolic syndrome- The evidence isn’t huge, but a few studies have made associations. As stated above, full-fat varieties are always preferred over low-fat.

3) Consumption of local, raw milk may be protective over the development of asthma and allergies- This makes sense to me. If the cows graze on local grass to obtain nutrients, and you drink the milk produced from that cow, then you could potentially build up some immunity to pathogens in the environment. However, this only holds for raw milk consumption (from pasture raised animals)- https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2222.2006.02640.x

What if I’m Allergic, Intolerant, or Dairy-Free?

Can’t eat dairy for genetic, environmental, or personal reasons? Don’t sweat it! First off, you may want to try fermented products as a lot of the lactose is removed during the fermentation process, which may make it more easy on your digestive system. If you’re against all dairy forms, you can still obtain the same benefits from adding some other items to your diet. Calcium is present in high amounts in sardines, kale, almonds and broccoli. Vitamin D is available easily in supplemental forms as well as egg yolks, fish, and mushrooms. For the healthy bacteria (probiotics), you can supplement or even better obtain them in the diet through food items such as kimchi, kombucha, sauerkraut, and even fermented pickles.

If you’re looking for a milk substitute, I would suggest Almond or Coconut milk. Stay away from Soy Milk (This can be really nasty stuff for men and women). When buying alternative milk forms, avoid those with an ingredient titled Carrageenan to avoid potentially dietary distress.

Summary

All in all, I think you could do worse than having a cup of milk here and there, especially if you know you can tolerate it. However, I do think everyone should be sure they can handle dairy before going on a binge of pizza, ice cream, and beer. This is best done through doing a dairy tolerance test or direct testing for an allergy or intolerance. Once you are sure you can process dairy products, I would suggest sticking to fermented yogurts (i.e. kefir) or raw milks and cheeses from a trusted and local source. As always, just monitor how you feel and let that guide your decisions.

Lastly, I may have missed a lot with this post due to the vast amount of information to cover. If you feel I misunderstood a topic or have anything to add, please feel free to drop me a comment of message.