Guest Columns

Perspective:
Dairy Research

How much dairy should we consume?

John Lucey

John Lucey, director of the Wisconsin Center for Dairy Research at the University of Wisconsin-Madison, contributes this column for Cheese Market News®.

A recent article in The Wall Street Journal asked this question, “How much cheese should you eat?” This certainly isn’t the first article to question the role of dairy in a healthy lifestyle. Current federal nutritional guidelines recommend around three servings of dairy per day, and many other countries have similar types of recommendations. These guidelines provide consumers with plausible options for including various foods in a diet in order to meet key nutrient requirements (e.g., calcium, protein, vitamin D). 

Recently, nutritionists have started to think differently about dairy, looking holistically at how products like cheese and milk impact critical health outcomes like cardiovascular disease (CVD). In the past few decades, many clinical studies have been published looking at dairy consumption and health outcomes, and these have been comprehensively summarized in various meta-analyses (where they combine many individual studies).

Two recent meta-analysis reports were conducted by Zhangling Chen, postdoctoral researcher at Erasmus University, and others (2022), published in Advances in Nutrition, and Justyna Godos, assistant professor of Food Sciences and Dietetics at the University of Catania, and others (2020), published in the International Journal of Food Science and Nutrition. Both found that total dairy consumption was associated with a modestly lower risk of hypertension, CVD and stroke, and each of these meta-analyses included over 50 published individual clinical studies. This is strengthening the consensus view of nutritionists that consumption of dairy contributes positively to our health and wellness.

Some groups like the World Health Organization use various terms to discuss life expectancy and the leading causes of death. One metric is called disability adjusted life years (DALYs), with one DALY representing the loss of the equivalent of one year of full, healthy life. The DALYs for a disease or health condition are the sum of the years of life lost due to premature mortality and the years lived with a disability due to prevalent cases of the disease or health condition in a population. This metric recognizes that there are years of life that are “lost” if we are living in a state of less than full health (e.g., with a disability or a serious health condition).

A recent study by Sarah S. Cohen, principal epidemiologist at EpidStat Institute, and others (2022), published by BMC Public Health, conducted a comprehensive review of current literature to determine whether high dairy intake has a positive impact on the DALYs here in the U.S. The authors of the paper looked at increased dairy consumption and its impact on breast cancer, colorectal cancer, CVD, Type 2 diabetes (T2D), stroke and hypertension. Across the board, the researchers found that high dairy intake can prevent lost DALYs due to these risk factors.

The authors found that a “higher dairy consumption in the U.S. population may have a pronounced impact on reducing the number of DALYs due to breast cancer, colorectal cancer, CVD, T2D, stroke and hypertension, and that a substantial proportion of these diseases may be attributable to low population consumption of dairy.”

Specifically, the paper found that “nearly 850,000 DALYs (or 5.0% of estimated years of healthy life lost) due to CVD and 200,000 DALYs (4.5%) due to T2D may be prevented by increased dairy consumption.” They also calculated that increased dairy consumption could significantly reduce lost DALYs caused by several types of cancers, stroke and hypertension. This prediction or calculation suggests that increasing dairy consumption can decrease the risk of multiple chronic diseases.

Another interesting approach is to determine what risk factors mainly contribute to diseases, and that was the objective of the Global Burden of Disease Studies that were conducted in 2017 and again in 2019, published by The Lancet. The study identified dietary excesses and deficiencies that contribute to the burden of global death and disease. Alice Stanton, a professor at the Royal College of Surgeons in Ireland and director of human health for Devenish Nutrition, took a deeper dive into these studies as part of her presentation at the American Dairy Science Association’s Annual Meeting in 2022.

Stanton highlighted the excesses and deficiencies that contribute to negative health outcomes. For example, the critically impactful excesses included diets high in calories, sodium, trans fats, high-calorie beverages and processed meats. The nutrient deficiencies included diets low in omega fats, calcium and vitamins. The first thing that I should point out is that dairy doesn’t contribute to any of the excesses they identified and can obviously help with many of the deficiencies. For example, poor child and maternal malnutrition is the No. 1 deficiency listed in these Global Burden of Disease studies, and dairy products could obviously help address that problem. This Global Burden of Disease approach was also criticized by Stanton as underestimating various meta-analysis studies that have demonstrated that increased dairy consumption reduced the risks of specific cancers like colorectal, as well as improved CVD outcomes.

There is also a changing view of dairy fats from a negative perception starting in the 1950s (based on a faulty hypothesis around the risks from dietary cholesterol) to a realization that dairy fats are complex and likely have a mostly neutral impact on the risk of CVD. Some researchers are using the term of the dairy matrix as part of a discussion highlighting that products like cheese are much more complicated from a nutritional viewpoint than a simple collection of some protein and minerals.

Cheese is also a nutrient-dense food providing important nutrients like protein, calcium, vitamins and minerals. And it is critical to realize that cheese and dairy products provide this array of nutrients without a lot of excess calories. Recall that high-calorie diets are one of the top risk factors for human health.

Some articles seem to be trying to tarnish dairy in order to promote other diets or food types. Some of these substitutes are ultra-processed foods and are often high in calories and salt, as well as lacking critical nutrients. I recommend that we need to look at the growing evidence that foods like dairy positively (and significantly) impact our overall health. That’s a different conversation with consumers from focusing on dairy as needed to provide nutrients like calcium for bones. I believe that cheese and dairy products will continue to play an important role in healthy diets.

CMN

The views expressed by CMN’s guest columnists are their own opinions and do not necessarily reflect those of Cheese Market News®.

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