By Dr. Mercola
A new study confirms (again) that whole-fat dairy is not associated with a higher risk of cardiovascular disease as has been asserted for more than 60 years. The evidence is overwhelming that consuming whole fats can be an important part of maintaining optimal health and actually fights heart disease and other diseases prevalent today rather than causing them.
The Prospective Urban Rural Epidemiology (PURE) study1 was published in Lancet, one of the world's most prestigious medical journals, and gives one cause to second-guess the 2015-2020 Dietary Guidelines for Americans2 set forth by the U.S. Department of Health and Human Services and U.S. Department of Agriculture (USDA).
Those agencies continue to maintain that your best bet for reducing your heart disease risk is to pass up full-fat dairy products and reach for no-fat and low-fat options instead.
However, while some doctors are finally beginning to acknowledge that full-fat dairy isn't the killer it's been made out to be, just as many are still touting those erroneous recommendations for their patients. The confusing guidelines mentioned above may be one of the reasons, but evidence to the contrary is overwhelming.
As lead study author Mahshid Dehghan, a senior research associate and nutrition epidemiology investigator at McMaster University in Hamilton, Ontario, noted in the featured study, "Our results showed an inverse association between total dairy and mortality and major cardiovascular disease. The risk of stroke was markedly lower with higher consumption of dairy."3
The PURE study was large and extensive, involving researchers from Canada, India, Sweden, South Africa, Brazil, Pakistan, Columbia, Zimbabwe, Saudi Arabia, the Philippines, Iran, Turkey, Chile, Poland, Malaysia, United Arab Emirates, Argentina, China, Bangladesh and the U.S.
Lasting an average of nine years, the study used controls for such factors as age, sex, smoking, physical activity, education levels and consumption of vegetables, fruit, red meat and starchy food for a total of 136,384 people in 21 countries, with ages ranging from 35 to 70.
At the end, researchers reported that when people ate two or more servings of full-fat dairy (one serving being defined as 8 ounces of milk or yogurt, 1 teaspoon of butter or a half-ounce slice of cheese), it was associated with:
- A 22 percent lower heart disease risk
- A 34 percent lower risk of stroke
- A 23 percent lower risk of death from cardiovascular disease or a major cardiovascular event4
Semantics on Fat Consumption: Full-Fat Versus Low-Fat Dairy Products
According to Dehghan, current guidelines are rooted in the belief that saturated fatty acids are harmful based on a single risk marker: LDL, aka "bad," cholesterol. However, she says dairy products contain a number of nutrients and avoiding them prevents you from getting other important nutrients.
Dehghan noted that people shouldn't be discouraged from eating dairy products, and if they don't eat much already, they should in fact be encouraged to increase their consumption.5
Overall, people should focus on moderation, she added, especially since cardiovascular disease is a global epidemic. In fact, 80 percent of heart disease cases are found in low- and middle-income countries, Reuters observes, quoting Dehghan from an earlier study.6
It should be noted that eating more whole-fat foods from the dairy section did not make a significant difference in the overall outcome of the study for either total mortality or major cardiovascular disease, MedPage Today explains. In fact, "the findings were similar but not significant for people who ate both full-fat and low-fat dairy."7
The controversy continues, however, and the naysayers are still adamant. Jo Ann Carson, a spokesperson for the American Heart Association from UT Southwestern Medical Center in Dallas, maintains that "Currently with the evidence that we have reviewed, we still believe that you should try to limit your saturated fat including fat that this is coming from dairy products."
With those statements, Carson essentially upholds the now-disproven assertions of Ancel Keys, the University of Minnesota professor who started the "fat is bad" ball rolling back in 1953. Keys used faulty science and patchy data to conclude that eating saturated fat raises your cholesterol and then leads to heart disease. The medical community embraced the concept and adopted a collective stance.
Saturated fat was then summarily vilified, and in its place, vegetable oils and shortening, partially hydrogenated vegetable oils and margarine were pushed to the forefront and quickly became all the rage. Unfortunately, the "fat kills" mantra launched a movement in the food industry that's proving very difficult to turn around, but the PURE study helps lay the myth to rest.
'Robust, Widely Applicable' Science Supports Whole Dairy Consumption
Dehghan says that while the PURE study was largely observational, it was still "robust and more widely applicable" because it was all-encompassing over a broad range of types of dairy consumption and reflected many different settings and cultures.
In 2017, Dehghan and her cohorts involved in the featured PURE study submitted another facet of the review that looked at the issue from another view, associating fat and carb intake with cardiovascular disease and mortality, and concluded:
"We found that high carbohydrate intake (more than about 60 percent of energy) was associated with an adverse impact on total mortality and noncardiovascular disease mortality. By contrast, higher fat intake was associated with lower risk of total mortality, non-cardiovascular disease mortality, and stroke.
Furthermore, higher intakes of individual types of fat were associated with lower total mortality, noncardiovascular disease mortality, and stroke risk and were not associated with risk of major cardiovascular disease events, myocardial infarction, or cardiovascular disease mortality.
Our findings do not support the current recommendation to limit total fat intake to less than 30 percent of energy and saturated fat intake to less than 10 percent of energy. Individuals with high carbohydrate intake might benefit from a reduction in carbohydrate intake and increase in the consumption of fats."8
It's interesting to note that the PURE study was considered controversial for several reasons, such as the stance it made on healthy salt intake and increased vegetable recommendations.
Additionally, while there have been inquiries into the entities that funded the study, Marion Nestle, a master of public health at New York University, notes that while numerous government entities and pharmaceutical companies around the world helped fund the study, the dairy industry did not.9
What's the Skinny on US Health Organization Recommendations for Dairy?
When it comes to some of the biggest names and entities in the medical community, most still say low-fat dairy is best. As an example, an American Heart Association (AHA) article on milk, yogurt and cheese10 still insists that adults should opt for two to three servings of fat-free, zero-fat, no-fat or nonfat milk dairy products, and children, teenagers and older adults should have four servings, per day.
The USDA says pretty much the same thing.11 People in Europe and North America have the highest dairy consumption, as they have more than four servings per day, the study notes, but in Africa, China, South Asia and Southeast Asia, individuals tested had less than one serving per day.
When comparing people who ate three servings of dairy per day with those who ate none, WebMD12 noted that those who ate no dairy had higher rates of:
- Overall death — 3.4 percent versus 5.6 percent
- Heart-related deaths — 0.9 percent versus 1.6 percent
- Major heart disease — 3.5 percent versus 4.9 percent
- Stroke — 1.2 percent versus 2.9 percent
Significantly, studies are stacking up that support the PURE study. One is very significant for two reasons: one because a two-decade-long review concluded that full-fat dairy consumption led to a reduced diabetes risk and better weight management consequences, as well.
Nutrition & Metabolism published research showing evidence that fewer carbs, not adopting low-fat foods, is the key to reducing and often completely eliminating diabetes medication in 90 percent of the participants.13
In 2003, a study14 in The New England Journal of Medicine found that when people focused more on healthy fats and less on non-vegetable carbs, it improved insulin sensitivity and fasting blood glucose. It also stabilized the A1C or average blood glucose tests for diabetic patients.
According to a 2015 study15 in The Journal of Allergy and Clinical Immunology, children who drink raw milk, which is typically full-fat, have lower rates of viral and respiratory tract infections, including regular colds, fevers and respiratory infections by around 30 percent.
Raw Milk and Pasteurized Milk: What's the Difference?
While governmental agencies such as the U.S. Food and Drug Administration (FDA) and USDA contend that consuming raw milk is a ticket to disease and maybe even death, it's interesting to observe that Europe has no such issues. Ted Beals, a pathologist from the University of Michigan Medical School, writes that you are actually 35,000 times more likely to get sick from any other food than raw milk.16
Pasteurized milk products are heated to kill bacteria because of the often dreadful conditions cows in concentrated animal feeding operations (CAFOs) live in, and that's where the overwhelming majority of milk in the U.S. is produced. Animals in CAFOs are often deprived of sunlight, are fed genetically engineered (GE) grains and soy products and stand knee-deep in each other's excrement.
To counteract these conditions, the animals are given antibiotics. What pasteurized milk offers is essentially milk laced with dead bacteria; the bacteria are dead, but not removed. When your body is hit with these foreign proteins, an allergic response is often the result because your body tries to fight them off.
Conversely, when cows raised on grass (as opposed to grains) produce milk, the raw, unpasteurized form contains whey protein, which stabilizes those same fighting cells in your body and reduces the allergic effect some people experience.
When cows eat grains, their body composition is altered, and with it, their milk. Pasteurization destroys many valuable nutrients, some which are important for your digestion and immune function.
What About Cheese, Butter, Yogurt and Kefir?
Not a few experts in the field noticed that the PURE study "exonerates" high-fat cheese. As a whole, one food analyst reported, the combination of nutrients in cheese are varied and plentiful, and many are new to the conversation in regard to nutritional value.
One study17 found whole-fat cheese can improve your overall health because it raises your HDL, or high-density lipoprotein, cholesterol, which protects your body against both heart disease and metabolic diseases.
Further, when it's made from the milk of grass-pastured animals, cheese provides several important nutrients, including protein, amino acids, omega-3 fats, vitamins A, D, B2, B12 and K2 (especially Gouda, Brie, Edam and to a lesser degree hard goat cheese, Colby, Swiss, Gruyere and Cheddar), minerals such as phosphorus, calcium and zinc, and conjugated linoleic acid or CLA.
In another study described in The Telegraph, researchers found that eating eight servings of full-fat milk, cheese, cream and butter was linked to a 23 percent lower risk of developing diabetes, compared to those who ate fewer portions. One serving counted as 200 milliliters (ml, a little under a cup) of milk or yogurt, 20 grams (0.7 ounces) of cheese, 25 grams (2 tablespoons) of cream or 7 grams (1.4 teaspoons) of butter.
More importantly, "There was no link between low fat dairy products and diabetes."18 Kefir, a traditionally fermented food that is loaded with probiotic bacteria, as well as yogurt, both of them ideally made from organic, grass fed raw milk, present excellent ways to boost your immunity and increase your energy.
The bacteria used to make kefir and yogurt consumes most of the lactose in milk, which can otherwise be a problem for someone with insulin resistance. Both help you develop and maintain a healthy microbiome.
When it comes to butter, the best you can do is to seek out the organic raw form from grass-pastured cows. The next best is pasteurized butter from grass fed or pastured organic cows, followed by regular pasteurized butter common in supermarkets. Surprisingly, fat levels in your blood are lower after eating a meal rich in butter than after eating one rich in olive oil, canola oil or flaxseed oil, one study noted.19
Taken altogether, the message is clear: Including saturated fats, including raw, organic and full-fat dairy products, is a healthy choice. That includes organic butter from grass fed cows, virgin coconut oil and raw whole milk and cheese. Far from being the culprits in cardiovascular and "high cholesterol" issues, eating them can actually improve your heart, and at the same time, improve your insulin sensitivity.
In any case, avoid trans fats and non-vegetable carbohydrates that have led to ever-rising rates of chronic disease and obesity. Reversing this trend is simpler than you might think, at least on an individual level. Don't just eat more dairy; go for healthy, full fat, grass fed dairy instead.