Low Fats, No Fats

Ask the DOC

It has been 40 years since the federal government first suggested that everyone except young children should opt for low-fat or nonfat dairy products over high-fat products. This recommendation was based on the overall goal of reducing saturated fat and calorie intake. A decade later, U.S. sales of low-fat and skim milk exceeded sales of whole milk for the first time. In 2010, the Healthy, Hunger-Free Kids Act required schools to follow dietary recommendations and replace whole milk with nonfat or low-fat unflavored milk and nonfat flavored milk. Recent studies, however, have suggested that high-fat milk, yogurt, and cheese are at least as healthful as their low-fat or nonfat counterparts, and some authors are questioning the wisdom of advising people to avoid whole milk and products made from it due to the additional nutrients contained in the higher fat products. For example, most yogurt contains probiotics.

There are great differences in worldwide patterns of consumption of dairy products. U.S. consumers chow down on cheeseburgers and pizza while Europeans are more likely to eat cheese for cheese’s sake, not as a topping for foods that without cheese would still be high in fats and sodium. In Malaysia, people do not consume milk or yogurt and, in developing countries, people who have money can afford to eat more dairy and meats and therefore less carbohydrates, making them healthier than their poorer countrymen. While dairy products account for about 10 percent of total fats in the average U.S. diet, most Americans do not consume the recommended three daily servings of dairy. In addition, recent studies have shown that whole fat dairy products are more protective against heart disease than their low-fat alternatives. This may be due to the additional nutrients found in whole-fat products. Consider that a person who consumes three servings of low-fat milk will eat more fat than a person that consumes one serving of whole milk. Multinational studies of dairy consumption have encountered issues because of the differences in dairy consumption from country to country. As most of the studies are observational, meaning they ask participants to self-report dairy consumption, there is also an aspect of observational bias—the authors note that many people may not be aware of how much dairy they consume in a range of foods that include baked goods, sauces, fried foods, and coffee drinks.

The government publishes Dietary Guidelines for Americans every five years, and the panel that writes the guidelines is already working on the 2020-2025 version. While most panel members are unlikely to recommend that Americans consume more butter and whole-fat cheese and milk, the panel members are using recent evidence to at least consider changes to the recommendation to use only low-fat and no fat versions. As more evidence comes to light, what is clear is that more studies are needed to fully evaluate the risks and benefits of low-fat and no fat versus whole-fat dairy products.

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