A scan of the dairy case at your local grocery store will show you row upon row of products containing varying fat levels. Low-fat, non-fat, whole — but what’s the healthiest option?
If you consult health authorities like the World Health Organization, the American Heart Association, or U.S. dietary guidelines, the answer is clear — choose a low-fat or fat-free version.
This recommendation stems from the idea that full-fat dairy products have increased saturated fats, so choosing lower-fat versions can help reduce your heart disease risk, according to professor of medicine and cardiologist at Tufts University, Dr. Dariush Mozaffarian.
However, that guidance goes back to 1980, when the first edition of the Dietary Guidelines for Americans was published, said Mozaffarian.
Since then, most studies of the health effects of dairy fat have yet to find any benefits of prioritizing the low-fat versions over whole versions, said Mozaffarian.
The doctor added that what seems more important than the fat level is which dairy product you choose in the first place.
What does research suggest?
In studies that survey people about their diets and track their health over several years, researchers have found associations between lower risks of specific conditions and dairy consumption, including cardiovascular disease, high blood pressure, and Type 2 diabetes, said Mozaffarian.
He added such benefits were often present regardless of whether people chose full-fat or reduced-fat cheese, milk, or yogurt. Although full-fat dairy products are higher in calories, studies have found those who consume them aren’t more likely to gain weight.
In one published study in 2018, researchers followed 136,000 adults from 21 countries for nine years. They found that those consuming two or more were less likely to die during the study period than those who consumed no dairy. Notably, individuals who consumed higher levels of dairy saturated fat weren’t more likely to develop heart disease or die.
In another significant analysis also published in 2018, researchers compiled results from 16 studies involving over 63,000 adults. They found across nine years, on average, those who had higher levels of dairy fats in their bloodstream were 29% less likely than those with lower levels to develop Type 2 diabetes.
The finding suggests a benefit to consuming dairy fat instead of avoiding it, said Mozaffarian.
These studies cannot prove that dairy products reduce certain disease risks. That would require lengthy clinical trials, which haven’t been conducted, said Mozaffarian. However, shorter-term trials have shown consuming dairy products, including dairy with total fat, lowered the blood pressure of study participants and didn’t raise levels of LDL or increase weight, or “bad cholesterol” — suggesting again that dairy fat isn’t harmful to heart health.
Why could dairy fats be good for you?
There are various possible explanations for why dairy fats might not be as harmful as thought previously — and could even be healthy, said Ronald Krauss, professor of medicine and pediatrics at the University of California, San Francisco.
Among the various saturated fat types found in foods, dairy products contain specific ones that appear beneficial or neutral for health, said Krauss, including those linked to reduced risks of coronary heart disease and Type 2 diabetes.
Milk fat is also naturally packaged in a unique structure called the milk fat globule membrane, said Marie-Caroline Michalski, research director at the French National Research Institute for Agriculture, Food, and the Environment. The structure’s components can help bind cholesterol in the digestive tract, potentially improving blood cholesterol levels.
It has also become clear that certain dairy food types might be better for you than others, said Michalski.
For instance, cheese and yogurt appear to be most associated with health benefits. This could be because both are fermented foods, said Michalski, which could supply good bacteria to your gut. They also contain additional beneficial molecules created during fermentation, including vitamin K, which is linked to good heart health, said Mozaffarian.
Hard cheese, like Parmesan and cheddar, also results in a more gradual absorption of fats into the blood than butter and softer cheeses, which can help you feel fuller for longer, said Michalski.
Helpful advice for the dairy aisle
Professor emeritus of nutritional sciences at Pennsylvania State University, Penny Kris-Etherton, said an independent panel of nutrition experts is currently reviewing evidence on how saturated fat consumption affects cardiovascular disease risk. Kris-Etherton said that could lead to upcoming changes to the dairy food recommendations in the United States.
Until then, she believes it is best to aim for three servings of dairy daily as part of a balanced diet, as the current dietary guidelines recommend. However, based on the most recent data on dairy fat, it is likely okay if one or two servings are whole-fat yogurt, cheese, and milk, noting that more than that could add up to too many calories.
Dr. Mozaffarian suggests incorporating at least one or two servings of cheese and yogurt daily, given these foods’ health benefits — preferably unsweetened versions to avoid added sugar.
As for what fat content you should ingest, “choose whatever you like,” said Mozaffarian. Some studies suggest a benefit of consuming full-fat dairy products, “but I don’t think the evidence is convincing enough yet to make that a dietary recommendation,” he added.
Michalski prefers eating whole-fat, plain yogurt. She said that when you remove the natural fats, you lose some vitamins, including vitamins A and D, along with the “pleasure” and good texture.
Instead of butter, Kris-Etherton encourages people to use plant-based oils like canola, olive, and soybean oils or margarine made from the same oils.
Cream and butter appear to raise blood cholesterol levels more than other sources of dairy fat, said Krauss. He recommends limiting them if you have high cholesterol. Although there isn’t good evidence low-fat dairy products are a healthier choice for everyone, people respond differently to different foods, said Krauss. If you have high blood cholesterol, it is worth discussing your dairy choices with your physician, he added.
