Back in 1985, the United States Department of Agriculture (USDA) first officially recommended Americans opt for skim or low-fat milk and dairy over whole-fat versions to reduce their risk of heart disease. (That's why, if you grew up in the '80s and '90s, you were probably raised on skim milk and subjected to fat-free cream cheese, American cheese and more.)
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But more recently, researchers have begun to challenge the wisdom that whole-milk products should be avoided. Now a new study from British medical journal The Lancet adds to the growing body of evidence that suggests full-fat dairy may not be so terrible after all.
After analyzing self-reported data on the diets of more than 130,000 participants, aged 35 to 70, from 21 different countries (part of the PURE study), the Lancet study authors found that people who ate three or more servings of whole-fat dairy per day had lower rates of death and heart disease compared to those who ate less than half a serving of whole-fat dairy per day.
Should You Swap Your Skim Milk for Whole?
No, not necessarily. As Nicole Harkin, M.D., attending cardiologist at Manhattan Cardiovascular Associates, explains to LIVESTRONG.COM, "This study was primarily conducted in low to middle income countries, where unfortunately, poor quality carbohydrates comprise a large part of the diet and micronutrient malnutrition is a reality."
Given those circumstances, it makes sense that higher total dairy intake (which may provide much-needed micronutrients) would be "associated with reductions in major cardiovascular disease and mortality," Dr. Harkin notes.
She goes on to say that, it would be "too much of an assumption" to apply the findings to the typical American diet "where one rarely encounters micronutrient deficiencies and dairy is typically consumed in large quantities."
However, Dr. Harkin does agree with the authors' conclusion that "consumption of dairy products should not be discouraged and perhaps should even be encouraged in low-income and middle-income countries where dairy consumption is low."
In spite of the current study's limitations, Dr. Harkin concedes that it's "increasingly unclear" whether full-fat dairy, which is higher in saturated fat, is actually worse for your heart than the lighter alternatives. "In my counseling of patients, I actually don't distinguish between low/non-fat and full-fat dairy," she says, noting that both should be consumed in moderation.
Can Full-Fat Dairy Prevent Heart Disease?
Dr. Harkin's stance makes sense, particularly in light of last month's study in the American Journal of Clinical Nutrition, which found that consuming full-fat milk and dairy products could actually cut an individual's risk for cardiovascular disease and stroke.
To reach their conclusion, researchers evaluated 3,000 adults age 65 and older over the course of 13 years. They began the study in 1992, measuring three different fatty acid levels in the participants' blood over three different occasions — the first at the onset of the study in 1992, the second six years later and the third and final time at the 13-year mark — to determine their risk for coronary heart disease and stroke.
At the end of the study, they found that none of these fatty acids were linked to total mortality or cardiovascular disease. What's more, researchers discovered that the participants who showed higher levels of these fatty acids, all of which are found in full-fat dairy, had a 42 percent lower chance of dying of stroke. And another type of fatty acid was linked to fewer deaths from cardiovascular disease.
One 2015 study also examined the relationship between consumption of dairy and the risk of stroke and coronary disease, finding no tangible connection between the two, while a 2013 study, published in the Scandinavian Journal of Primary Health Care, actually found a health benefit to high dairy fat, linking intake to a reduced risk of central obesity in males.
"These findings are important because they showed that long-term consumption of full-fat dairy had no negative effect on heart disease," says Roger E. Adams, Ph.D., Houston-based dietitian, nutritionist and founder of Eat Right Fitness. "Long-term studies like this are needed to show effects on health with any dietary change, as short-term dietary change studies are hard to draw good conclusions," he tells LIVESTRONG.COM.
Is Whole Milk Making a Comeback?
Nutrition experts agree that research like this is a step in the right direction and that it's aiding in the recovery from the fat-free craze of the '80s and '90s. "Since the 1970s, public policy told us to restrict our calories and fat — and specifically our saturated fat intake — out of fear that it raises the risk of heart disease," explains Abbey Sharp, registered dietician and founder of Abbey's Kitchen. "It seems logical that less fat and less calories would lead to weight loss as well. However, we now know that not all saturated fats are the same and that there are a number of unique fats in dairy products that actually are very healthy for us."
Higher-fat milks, for example, contain more omega-3s (the good kind of fat), which is not only more satiating, but keeps you fuller for longer. (That may be one reason dairy has been linked to weight loss.) "And let's not forget that the vitamin D in fortified milk products is fat soluble," adds Sharp. "Consuming it with fat — like that found in whole milk — will lead to better absorption."
Christen Cupples Cooper, Ed.D., RDN, founding director of Nutrition and Dietetics, Pace University, College of Health Professions, believes that there's a bigger picture that we're missing. "If one is consuming the right amount of calories to maintain a healthy weight and eating a variety of foods from all major food groups, plus exercising, most of us can moderate our risks of heart disease," she tells LIVESTRONG.COM. "Full-fat dairy is unlikely to throw a wrench in an otherwise-healthy diet. However, if an individual is consuming too much fat and too many calories in general, which is the case for the majority of Americans, then consuming full-fat dairy is one opportunity for a cutback."
In general, experts agree that full-fat dairy does have a place in an overall healthy and balanced diet. If people are consuming excess fat in their diet, they may want to decrease their consumption of high-fat dairy, but if they maintain a healthy, well-balanced diet, there's not enough research to support that high-fat dairy, in moderation, can lead to significant health issues.