Should we avoid full-fat dairy?

We’ve been told for years to avoid full fat products, and our supermarkets reacted by stocking 0% or low fat style yoghurts, spreads, cheeses and dairy alternatives. Skimmed milk sales have soared over the decades, with many of us opting for fat-free yoghurt too. But how much fat is in dairy and should we really worry? Probably not!

The advice

We’re told that consuming dairy produce is a great way of getting calcium and protein into our diet, as well as essential vitamins such as vitamin D and B12. However, we’re also told to aim for the lower fat versions  because much of the fat is saturated, which exposes us to risks of heart disease and stroke [1].

Low fat vs. full fat

So how much fat is in a typical dairy product? Let’s compare milk, yoghurt and cheese.

 

	Fat (total)	Fat (saturated)	Protein	Sugars	Calcium	Calories
Whole milk1	3.6g	2.3g	3.4g	4.7g	122mg	65kcal
Skimmed milk1	0.3g	0.1g	3.6g	4.9g	129mg	37kcal
Whole yoghurt2	5g	3.6g	9g	3.8g	121mg	96kcal
0% yoghurt2	0g	0g	10.3g	4g	120mg	57kcal
Whole cheese3	34.9g	21.7g	25.4g	0.1g	739mg	416kcal
Low fat cheese3	24g	16.4g	28.6g	0.1g	960mg	331kcal
1. Based on 100ml Cravendale milk 2. Based on 100g of Fage Greek yoghurt 3. Based on 100g Cathedral city mature cheddar

Let’s look at milk first; the European Union (EU) tells us that we cannot label food as “low fat” unless it contains less than 3g of fat for every 100g of solid food or 1.5g for every 100ml of liquid [2]. Whole milk is therefore not far above the limit to consider itself low fat at 3.6g per 100ml – or 3.6% fat.

This compares pretty favourably to some other foods we might consider to be healthy:

• Eggs (11g per 100g)
• Almonds (49g per 100g)
• Walnuts (65g per 100g)
• Tofu (4.8g per 100g)
• Salmon (13g per 100g)
• Granola (20g per 100g)

So whole milk doesn’t appear to be as high in fat as we might think, so what about yoghurt?

The calorie difference between 0% and full fat yoghurt is 39kcal per 100g – which is less than one half of a chocolate digestive biscuit. In real terms, the difference between a recommended portion (125g [3]) of 0% yoghurt and full fat in calories is one half of a chocolate digestive and a tiny nibble of the other half. The total calories from fat in a full fat single portion would be 40kcal. An apple has more calories than that!

Naturally this will vary from brand-to-brand, but consider this: some companies remove the fat from yoghurt and replace it with sugar to compensate for the taste loss!

Cheese, on the other hand is seriously high in saturated fat. Not only that, it’s usually quite high in salt too – another risk factor for heart disease and strokes, because salt drives up blood pressure [4]. But wait……..

The French Paradox

The Mediterranean diet is among the most healthy in the world, partly because it is low in saturated fat and higher in unsaturated. With the exception of France! The French love their cheese; in fact, they eat (on average) half a kilo of cheese per week [5]. The French have a much lower incidence of heart disease and stroke than the British [6], despite smoking more [7]. The French are, on average, skinnier too [8] – so if they eat more cheese, yet are thinner and less likely to die of heart disease, what we can deduce from this?

So dairy isn’t bad….?

Let’s be clear, dairy does have a high proportion of saturated fat to its total fat. So when you’re looking at your daily intake of fat, the total amount of saturated fat should not exceed 20g for women and 30g for men per day [9]. That’s equivalent to 900ml of whole milk for women and 1300ml of whole milk for men per day (around a litre on average); 100 – 140g of cheddar cheese; and 500-800g yoghurt. Assuming, of course, that you eat no other sources of saturated fat for the rest of the day.

However, there is growing evidence that suggests that the saturated fat in dairy does not raise cholesterol [10,11]! And that’s important because it’s the cholesterol in our blood that creates the risk of heart disease and strokes; the very reason we’re told to eat low fat dairy.

Also, there have been a number of studies that suggest consuming full-fat dairy products is inversely related to obesity. What this actually means is, people who consume dairy products regularly are less likely to be overweight [12].

There have been a number of studies over the years (mostly observational) that have looked at the link between dairy consumption and markers for heart disease risk (such as waist measurement, obesity, blood glucose, blood pressure and blood fats) but what we really need is good clinical trials that answer the question – does it matter if you consume whole dairy products in preference to low fat, and how does that affect our heart disease risk?

In 2016, a systematic review and meta-analysis was conducted in Canada by Drouin-Chartier [13]. What he did was interesting, because most reviewers search for clinical trials or observational reports and pool together the results. Drouin-Chartier looked specifically for meta-analyses that were done in the past and pooled together the results of those. He found 21 different analyses dating back to 2004.

Drouin-Chartier wanted to know: does dairy consumption have a beneficial association with the risk of heart disease related markers such as diabetes and a condition called metabolic syndrome (a set of risk factors that could lead to the development of diabetes which then could lead to heart disease. Typically, these are high waist measurements, raised blood fats and glucose).

He found that intake of whole dairy products (including cheese) did not have any effect on cardiovascular risk, stroke risk or risk of high blood pressure. Consuming low fat products could even have favourable effects for blood pressure, stroke and diabetes risk.

He asked: is the recommendation to consume low-fat as opposed to regular or high fat dairy supported by this very large body of evidence? He could not find any evidence to support this. However, the evidence is only of moderate quality – that is, none of the studies to date are rigorous enough to conclusively say one way or another. But is a large body of moderate quality enough? This is where opinion can (and does) easily divide.

So to answer the question, is fat always bad? We don’t actually know whether it’s the type of fat in dairy or whether it’s the high levels of calcium that protect against the actions of fat. There’s definitely room for more studies, but in the meantime – no, there is no evidence whatsoever that low fat dairy is better.

Takeaway Message

If you find skimmed milk and 0% yoghurt unappealing, then skip it and go for whole milk and full fat yoghurt. With cheese, just remember that these are still loaded with calories and whilst eating full fat cheese is not likely to kill you, you still need to exercise some restraint regarding your portion sizes.

We need to be careful that we don’t take any one part of the diet in isolation, you have to look at everything else that fits into the lifestyle of the French: they’re more active, they eat mindfully, they eat far fewer processed foods and more likely to cook from scratch. They take pride in their food. They eat plenty of fruit and vegetables. They take life easy – less stress (well, in the south anyway!)

If we want to eat cheese, full fat milk and yoghurt, then we have to change our lifestyle too. We have to relook at how we think about food, and we have to take a bit more time in not just preparing it, but eating it. I like cheese, I eat full fat yoghurt – but I also walk everywhere and exercise regularly and together this keeps my cholesterol low and my blood pressure in check.

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Disclaimer

This blog post is intended as an interesting and informative read for anyone with a general interest in health and nutrition. It is not intended to give any form of medical advice or opinion. If you suffer from any of the mentioned symptoms, you should seek the opinion of a medically trained professional and not rely on the contents of this post. I’m a nutritionist guys, not a dietitian or a medical doctor.