Home Blog Is Dairy Healthy? The Whole Story – Part 2

Is Dairy Healthy? The Whole Story – Part 2

Written on September 11, 2011 at 8:01 pm, by Eric Cressey

Today marks the second installment of Brian St. Pierre’s guest contribution on the topic of dairy consumption.  In case you missed Part 1 – which discussed the history of dairy consumption, how dairy production has drastically changed, and the benefits of grass-feeding – you can find it HERE.

The Skinny on Dairy Fat

Whole or full-fat dairy is actually a topic I want to cover in a lot of detail.  I personally feel that this is a grossly misunderstood topic, and I want to clarify several things here.

There is actually a good amount of research, in several populations, that shows that full-fat dairy consumption is associated with lower BMI, lower waist circumference, and lower risk of cardiovascular disease (especially stroke). Yes, you read that right: whole fat dairy is associated with a decreased risk of CVD, especially stroke. Low-fat or fat-free dairy is actually often associated with increased BMI and waist circumference (though to be fair this is not always the case).

In fact Dr. Ronald Krauss, one the world’s leading lipid researchers, showed that while saturated fat from dairy does raise LDL, it is an increase in large, fluffy and benign LDL – not the small, dense and atherogenic LDL.

Whole fat dairy from grass-fed cows contains a boatload of powerful vitamins and healthful fatty acids.  These vitamins are fat-soluble, meaning they are bonded to the fatty acids in the dairy, and are therefore nearly non-existent in fat-free dairy, same for the fatty acids obviously.  The fat is where vitamins A, D, E and K2 are, as well as conjugated linoleic acid (CLA), butyric acid, omega-3 fatty acids, trans-palmitoleate and medium chain triglycerides.  Low-fat and fat-free dairy are woefully lacking in these properties.

CLA is present in human body fat in proportion to dietary intake, and has been shown to be a powerful ally in the fight against cancer.  Meat and dairy from grass-fed animals provide the richest source of CLA on the planet, containing three to five times more CLA than feedlot-raised animals.  CLA has been found to greatly reduce tumor growth in animals, and possibly in humans as well.  In a Finnish study, women who had the highest levels of CLA in their diet had a 60% lower risk of breast cancer than those with the lowest levels.  Simply switching from conventionally-raised grain-fed meat and dairy to pasture-raised grass-fed versions would have placed all the women in the lowest risk category.

In addition, CLA may also help to fight against heart disease. In a study of 3626 Costa Rican men and women (a country that uses traditional pasture-grazing for dairy cows), people with the highest level of CLA in their body fat were 49% less likely to have had a heart attack, compared to those with the lowest level. This may be due to CLA intake and tissue levels being associated with greater amounts of large and fluffy LDL, and inversely associated with small and dense LDL.

Vitamin D is pretty much the best thing since sliced bread, and getting some from food is always a good thing.  Low blood levels of vitamin D are associated with lowered immunity, increased risk of 17 cancers (and counting), increased risk of heart disease, neurological and psychological disorders (including ADD and depression), diabetes, stroke, hypertension, bone loss, and loss of muscle mass and strength as we age and more.

Omega-3s are absolutely amazing, as they may improve nerve, brain, eye, heart and cardiovascular function as well as decreasing inflammation, joint pain, arthritis, psychological disorders, and risk of breast cancer and heart disease – all while improving mood and body composition!

Medium chain triglycerides are unique fatty acids that are more readily utilized as fuel rather than stored as energy, as well as particular ones, like lauric acid, containing anti-viral and anti-microbial properties.

Vitamins A and E are powerful antioxidants.

Butryric acid may help with bodyweight regulation, and is a primary fuel source for our intestinal flora.

Notice that I didn’t mention vitamin K2 yet?  That is because I was saving what might be the best for last.  Several studies have found that a higher vitamin K2 intake is associated with a lower risk of heart attack, ischemic stroke, cancer incidence, cancer mortality and overall mortality.  Men with the highest vitamin K2 consumption had a 51% lower risk of heart attack mortality and a 26% lower risk of all cause mortality compared to men consuming the lowest amount!

One of the ways vitamin K2 improves cardiovascular health is its ability to prevent and decrease arterial calcification by 30-40%.  And, this only speaks to vitamin K2’s effects of cardiovascular health; it is also crucially important for proper fetal development and bone health, to name a few additional benefits.

What about Dairy and Diabetes?

With little fanfare, a study recently came out by Dr. Dariush Mozaffarian and colleagues. Why so little fanfare, you ask? Because the study suggests that dairy fat may actually protect against diabetes, and that goes against conventional wisdom and government recommendations.

Dr. Mozaffarian and company collected two measures of dairy fat intake in 3,736 Americans. They took six 24-hour dietary recall questionnaires, as well as taking blood levels of trans-palmitoleate. Trans-palmitoleate comes almost exclusively dairy fat and red meat fat, and therefore it reflects the intakes of these foods. Dairy provided most of the trans-palmitoleate fatty acid in this study.

Adjustments were made for confounding factors, and trans-palmitoleate levels were associated with a smaller waist circumference, higher HDL cholesterol, lower serum triglycerides, lower C-reactive protein, lower fasting insulin and lower calculated insulin resistance. In addition to that awesome data, people who had the highest levels of trans-palmitoleate had 1/3 the risk of developing diabetes over the 3 year study period.

Again, it is important to note that trans-palmitoleate is a fatty acid, and so is only significant from whole fat dairy, not from low-fat or fat-free. The investigators also noted that “greater whole-fat dairy consumption was associated with lower risk for diabetes.” This is an important distinction as it wasn’t just trans-palmitoleate levels that were associated with the decreased risk, but the actual consumption of the food that provides that element was as well.

Here’s another nice quote from the authors: “Our findings support potential metabolic benefits of dairy consumption and suggest that trans-palmitoleate may mediate these effects. They also suggest that efforts to promote exclusive consumption of low-fat and nonfat dairy products, which would lower population exposure to trans-palmitoleate, may be premature until the mediators of the health effects of dairy consumption are better established.”

While it is certainly possible that trans-palmitoleate is mediating a lot of these positive health outcomes that were associated with it, in all reality it only makes up a tiny fraction of the fat content of milk. I tend to believe that instead it is more of a marker of dairy fat intake, with the benefits more likely coming from the other elements contained in dairy fat – CLA, vitamin K2, butyric acid, vitamin D, etc.

Stay tuned for part 3!

References

Berkey CS, Rockett HR, Willett WC, Colditz GA.  Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents.  Arch Pediatr Adolesc Med. 2005 Jun;159(6):543-50.

Rosell M, Håkansson NN, Wolk A.  Association between dairy food consumption and weight change over 9 y in 19 352 perimenopausal women.  Am J Clin Nutr.  2006 Dec;84(6):1481-1488.

University of Gothenburg (2009, November 4). Children Who Often Drink Full-fat Milk Weigh Less, Swedish Research Finds. ScienceDaily.

German JB, Gibson RA, Krauss RM, et al.  A reappraisal of the impact of dairy foods and milk fat on cardiovascular disease risk.  Eur J Nutr. 2009 Jun;48(4):191-203.

Bonthuis M, Hughes MCB, IbiebeleTI, Green AC, and van der Pols JC.  Dairy consumption and patterns of mortality of Australian adults.  Eur J Clin Nutr.  2010;64:569–577.

Elwood PC, Strain JJ, Robson PJ, et al.  Milk consumption, stroke, and heart attack risk: evidence from the Caerphilly cohort of older men.  J Epidemiol Community Health.  2005;59:502-505

Elwood PC, Pickering JE, Hughes J, Fehily AM, Ness AR.  Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies.  Eur J Clin Nutr. 2004 May;58(5):718-24.

Krauss RM, et al. Change in dietary saturated fat intake is correlated with change in mass of large low-density-lipoprotein particles in men. Am J Clin Nutr. 1998 May;67(5):828-36.

Aro A, Männistö S, Salminen I, et al. Inverse association between dietary and serum conjugated linoleic acid and risk of breast cancer in postmenopausal women. Nutr Cancer. 2000;38(2):151-7.

Smit LA, Baylin A, Campos H.  Conjugated linoleic acid in adipose tissue and risk of myocardial infarction.  Am J Clin Nutr. 2010 Jul;92(1):34-40.

Sjogren P, Rosell M, Skoglund-Andersson C, et al. Milk-derived fatty acids are associated with a more favorable LDL particle size distribution in healthy men. J Nutr. 2004 Jul;134(7):1729-35.

Geleijnse JM, Vermeer C, Grobbee DE, et al.  Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study.  J Nutr.  2004 Nov;134:3100-3105.

Gast GC, de Roos NM, Sluijs I, et al.  A high menaquinone intake reduces the incidence of coronary heart disease.  Nutr Metab Cardiovasc Dis.  2009 Sep;19(7):504-10.

Nimptsch K, Rohrmann S, Kaaks R, Linseisen J.  Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg).  Am J Clin Nutr. 2010 May;91(5):1348-58.

Spronk HM, Soute BA, Schurgers LJ, et al.  Tissue-specific utilization of menaquinone-4 results in the prevention of arterial calcification in warfarin-treated rats.  J Vasc Res. 2003 Nov-Dec;40(6):531-7.

Mozaffarian et al. Trans-palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in US Adults. Ann Internal Med. 2010.

About the Author

Brian St. Pierre is a Certified Sports Nutritionist (CISSN) and a Certified Strength and Conditioning Specialist (CSCS). He received his degree in Food Science and Human Nutrition with a focus in Human Nutrition and Dietetics from the University of Maine, and he is currently pursuing his Master’s degree in Human Nutrition and Dietetics from the same institution. He was the Nutritionist and a Strength and Conditioning Coach at Cressey Performance in Hudson, MA for three years. He is also the author of the Show and Go Nutrition Guide, the accompanying nutrition manual to Eric Cressey’s Show and Go Training System.

With his passion for seeing his clients succeed, Brian is able to use his knowledge, experience, and energy to create highly effective training and nutrition programs for clients of any age and background. For more information, check out his website.

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  • Brian great job again!!!! Here are some great links concerning milk from Dr. Ray Peat:

    Milk in context: Allergies, Ecology, and some Myths- http://raypeat.com/articles/articles/milk.shtml

    Ray Peat: Milk, Calcium and Hormones- http://www.blogtalkradio.com/eastwesthealing/2011/06/03/ray-peat-milk-calcium-and-hormones

    Dr. Ray Peat is a scientist/practitioner/teacher who does research on other scientists, he has been doing this for over 50 years. Dr. Peat always provides fantastic scientific references from research that comes from various countries and shows patterns in research over the last 100 years.

  • One of my clients has told me the same is true for lean grass-fed cows’ meat. In the respect that the fat from the cows is the healthy kind like from salmon. Have you come across any studies or research that supports this?

  • Hey Brian, I really enjoyed the second part of this article. I think you are shedding some much needed light on this subject. I will be forwarding this to all my clients to read.

  • Great article! I’m curious as to what if any recommendations there are for daily servings per body weight?

  • John

    Great article and revealing analysis. I have been a non-fat non-meat eating guy for almost 25 years since the non-fat craze way back when.
    I am wondering about the efficacy of your analysis if we don’t go grass fed. We tried it because of the balances of Omega 3s and 6s etc for a short while but the expense was 2X normal store stuff. We did stick with organic whole milk for my grandson when he was little.
    I would appreciate your perspective.
    J

  • Thanks Brian for a great post. I am sitting here eating my full fat organic cottage cheese! I find that many of my younger female clients avoid dairy altogether, let alone full fat. Sometimes they admit they think dairy is too high in calories, which, of course, is ridiculous. But I have also found that they have been told by a naturopath/holistic practitioner that dairy will cause abdominal distress and produces phlegm….congestion. Even my acupuncturist claims this. I tell them that studies have completely refuted the phlegm myth and,as far as abdominal distress, that should only occur if they are lactose intolerant, and, 90% of them are not. While I like my clients to be enlightened and holistic, I\’d rather they do it with current science, as you have given us, and not old wives tales. I don\’t want to throw anyone under the bus, but we need nutrition recommendations that are current and proven, and not set by either holistic myths, nor the government,as we know how they have already screwed up things with corn!

  • ws

    I have to say, the quality of the references and work here is much better!

    It’s of course difficult to say how much of an effect full-fat dairy in and of itself is really having on people’s health. Sure, they’re getting more vitamins, but milk is fortified with vitamins, and people can get those from other sources. CLA might be good stuff, but it’s hard to say how much of an effect it’s really having.

  • Ben

    Yay, the “fat is bad for you” fools take another blow!
    Honestly, I think the whole stigma against fat is due to corellations between high fat diets and high bodyfat, helth problems, etc. Everybody was quick to blame the fat itself while forgetting that fat is the most concentrated source of calories, so the average sedentary person with a high fat diet is just getting too many calories and thus getting overwieght, and possibly gaining some associated health problems.

    We need articles like this one dealing with the fat in meat and eggs as well. Thanks for the article! Well done!

  • Doug & Lisa,

    Thanks!

    Nick,

    Grass-fed meat is certainly higher in omega-3’s, CLA and more. Research has shown that consumption of grass-fed meat vs grain-fed leads to increase blood and platelet levels of omega-3’s.
    http://www.ncbi.nlm.nih.gov/pubmed/20807460

    Wendy,

    I dislike providing recommendations like that, mainly because I wouldn’t say that anyone NEEDS dairy per se. 1-3 servings per day seems like a reasonable intake, however you could choose to consume more if it fits within your calorie needs and macronutrient ratios, and you could choose to consume none if you so desire. The answer really is – it depends. On the individual, within the context of the rest of their diet, access, allergies, intolerance and more.

    John,

    I am not totally sure what you are asking. There is no doubt that grass-fed is more expensive. Whether or not it is worth the price is an individual choice. I personally feel that it is, but if it is outside of your budget then it may not be worth it. If you can fit grass-fed versions of each into your food budget then I would highly recommend it, as it provides a superior food, but if not then just do the best you can with what you have.

    Brian

  • I am a huge proponent of pastured everything. I purchase pastured beef, pork,chickens, eggs, and goat from the local farmers market, as well as raw goat milk. The largest problem with grass-fed or pastured dairy is that it’s hard to find. You may be able to find local pastured or grass fed dairy products on this site.

    http://www.localharvest.org/

    I know in Arizona a woman who goes to some of the farmer’s markets carries it, but I haven’t tried it myself.

  • This was a great piece, as was the first part. I’m not really a big milk drinker but I do find the subject (or “debate”) really interesting. I can’t wait for part 3!

  • Jean

    I not against full-fat milk, but vitamins A, D E & K are not naturally found in high amounts in milk as it comes from the cow. These components are fortified in milk in the US, and the quantity that is fortified in milk is the same, whether the milk is low or high fat. Also, the long-chain omega-3 fatty acids that have been shown to have impacts on cardiovascular outcomes (DHA & EPA) are not found in milk (at least not the standard kinds sold in stores). On the USDA nutrient database website, you can see the natural content of unfortified whole milk:

    http://www.nal.usda.gov/fnic/foodcomp/cgi-bin/list_nut_edit.pl

    Fat-containing milk is the major natural source of CLA, but the research with CLA is complicated because researchers do not test natural dairy-based CLA in pill form. It’s a lab-created form from plant oils, though there is some evidence that whole milk may contain the cancer-fighting isomers.

  • Kim

    Brian- Are there any commercially available brands of milk from grass-fed cows? Horizon and Organic Valley claim their cows are grass-fed as much as possible but it sounds like maybe that’s 30% their food. Any recommendations? We don’t have a local farm/farmer’s market that provides this.

  • matt

    Brian – thanks for the informative articles. I think John may have had the same questions in mind that I have. I realize that grass-fed is superior, but if grass-fed dairy were not always an option (due to price or availability), would full-fat versions of regular dairy have these advantages over the low/nonfat versions?

  • Jean,

    You are partly correct. Vitamins A and D are added to milk. A because it is removed along with the fat to make lowfat/skim options. D because it was a way to prevent the rickets epidemic back in the day. Vitamins E & K are not added.
    In addition these vitamins are higher in animals that are grass-fed. For example have you ever seen butter from a grass-fed cow vs butter from a grain-fed cow? The color difference is striking. This is due to the much higher vitamin A content of the grass-fed butter. While vitamin K2 is not actually all that high in milk, it is very high in cheese and butter, especially, again, from cows that are grass-fed.
    If you look at my references for CLA, I was not looking at supplementation studies. I brought up studies that were looking at CLA levels in the body (because it is stored relative to intake, which is from full fat meat and dairy) and finding associations with health outcomes. Now these are simply associations, but they are compelling none the less.

    Kim,

    Check out Part 3!

    Matt,

    Yes I do believe full fat dairy, even if not grass-fed, has advantages over fat-free. While it won’t have these compounds in as high of levels, they are still there. The research that has found health benefits from full-fat dairy was not making a distinction between grass or grain fed cows.

    Brian

  • Brian,

    Great series of articles thus far, about to read Part 3! I appreciate the response to Matt’s statement because I find that although the area I live in has readily available grass-fed beef and milk, most of my clients are not willing to go out of their way to get it. Therefore, getting them to drink more grain-fed full fat milk will add important vitamins/omega-3s to their diet and hopefully push them towards grass-fed!

  • sean

    Everything looks good except this: neurological and psychological disorders (including ADD and depression)

    You’re born with ADD. It doesn’t come from your diet.

  • Eugene

    You are unclear it seems to me , Brian. Do these benefits of CLA etc. pertain only to grass-fed cows or not. I mean really. Forgive me, but really.

  • eugene

    Please clarify. Since you made it a point to mention the high levels of nutrients in grass-fed cows, please tell us how much of what you say refers to grain-fed cows which “the rest of us” have access to. And of course if it were available to us in many cases the price would be prohibitive. I live in NYC . Not too many grass-fed cows or their products around here.


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