Research & Education

Dairy & the (Full) Fat Wars


“The emerging scientific evidence indicates that the consumption of regular fat dairy foods is not associated with an increased risk of cardiovascular disease and inversely associated with weight gain and the risk of obesity. Dairy foods including regular-fat milk cheese and yogurt can be important components of an overall healthy dietary pattern.”

Arne Astrup et al. 2016

The fat wars continue to rage. Olive oil avocado and salmon get a free pass but lard and tallow will kill you. And don’t even think about using heavy cream in your coffee or eating full-fat yogurt! (Good luck finding any amidst the shelves full of low-fat and fat-free anyway.)

Along with delicious beef and lamb full-fat and whole milk dairy products have been additional victims of the misguided yet longstanding war on saturated fat. For decades nutrition authorities have advised the public to consume low-fat or fat-free dairy products seemingly ignoring the good ol’ French paradox. They offered no explanation for how cheese cream crème fraiche and butter were neutral or even beneficial for health in France yet somehow became deadly when consumed in the US. 

Fortunately a growing body of scientific literature suggests that we need not forgo rich creamy full-fat dairy products in favor of their reduced fat counterparts—at least not for the sake of cardiovascular health. Total energy balance is still important with regard to maintaining a healthy weight but increasing evidence indicates that the saturated fats found in dairy products are not harmful. According to a paper in The American Journal of Clinical Nutrition “The totality of evidence does not support that dairy SFAs [saturated fatty acids] increase the risk of coronary artery disease or stroke or CVD mortality.”

A study from Luxembourg a nation with a relatively high dairy intake determined “Higher intakes of whole fat milk yogurt and cheese were associated with better cardiovascular health.”

How can this be? How can it be that consuming more of the foods we’ve been cautioned against seems to result in improved cardiovascular status? Let’s not forget that full-fat dairy as well as other high-fat European delicacies such as goose or duck liver pâté are very rich in vitamin K2 a critical element for cardiovascular health. Vitamin K2 directs calcium into the bones and teeth while helping to prevent its deposition in the arterial walls and other soft tissues. Being that K2 is found in the fattier dairy foods it makes sense that reduced fat versions might not offer the same protection.

Of course dairy products aren’t suitable for everyone. There are many people with sensitivities to lactose or casein and others simply feel best avoiding dairy. But for those who do enjoy dairy and have no sensitivities to milk-based compounds there is no need to preferentially consume low-fat or fat-free yogurt cheese cream cheese and the like unless someone prefers those flavors or textures. In the choice between full-fat and reduced-fat taste preference should be the deciding factor rather than concern for heart health.

Study after study confirms this. 

According to Dr. Ian Givens one of the authors of a new meta-analysis of prospective cohort studies looking at dairy consumption and risk of cardiovascular disease and all-cause mortality: “There’s quite a widespread but mistaken belief among the public that dairy products in general can be bad for you but that’s a misconception. While it is a widely held belief our research shows that that’s wrong. There’s been a lot of publicity over the last five to 10 years about how saturated fats increase the risk of cardiovascular disease and a belief has grown up that they must increase the risk but they don’t.”

The study found: “Despite their fat content and composition milk and dairy products are naturally rich in various minerals (e.g. calcium potassium) protein and vitamins (e.g. vitamins A and B12). Nutrients including calcium potassium and magnesium have been suggested to be associated with lower risk of stroke. Short-term human intervention studies also indicated that subjects who have high-fat diets enriched with dairy minerals or calcium have significantly lower total cholesterol and LDL-cholesterol levels than those on a control diet. This may explain in part why total dairy consumption has a neutral role in terms of the effect on health outcomes.”

In the interest of honest reporting this analysis published in the European Journal of Epidemiology was funded in part by dairy industry organizations including Global Dairy Platform Dairy Research Institute and Dairy Australia. But many other studies have come to similar conclusions—that saturated fats including those from dairy foods are not harmful and might even be beneficial.

“Almost all national dietary guidelines recommend a reduction in SFAs as a key intervention to reduce incidence and mortality of cardiovascular disease (CVD). This has been translated into advice to reduce the intake of the major sources of SFAs that is dairy produce meat products and eggs. However recent meta-analyses of both observational studies and randomized controlled trials not only have raised doubts about the scientific substantiation for this advice but have actually undermined it.” This comes from Arne Astrup a professor in the Department of Nutrition Exercise and Sports at Copenhagen University. The department received funding from numerous food companies and organizations including the Danish Dairy Research Council.

Research favorable to the consumption of dairy foods—including full-fat dairy—is sometimes funded by organizations with a vested interest in increasing consumption of these foods. We cannot dismiss this potential bias but neither can we dismiss the aforementioned French paradox nor indeed the entire Mediterranean paradox. According to Colin Champ MD our rarified notion of the vegetable and grain-heavy Mediterranean diet is far from the true diet consumed in the region—one that includes substantial amounts of cured meats fatty pork organ meats and full-fat cheese.

The meta-analysis prompted headlines in the popular media stating “Eating cheese does not raise risk of heart attack or stroke study says.”

The journalist said it well: “Consuming cheese milk and yoghurt – even full-fat versions – does not increase the risk of a heart attack or stroke according to research that challenges the widely held belief that dairy products can damage health […] The findings from an international team of experts contradict the view that dairy products can be harmful because of their high saturated fat content. The experts dismiss that fear as “a misconception [and] mistaken belief.” 

When in doubt follow the advice of Julia Child who enjoyed rich food and lived to be 91: “If you’re afraid of butter use cream.”