The Dairy Debate

Taylor Reagan & Talia Slanker

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A Little Bit About Milk Good vessel for delivering key nutrients

-Calcium, Fat, Protein, Vitamins D, A, B12, and riboflavin, potassium, and and magnesium

Places confusion on consumers Celebrities with “milk mustaches” vs. Vegans and other groups who abstain from animal products

Chagas et al., 2012

http://creativecriminals.com/got-milk/most-complete-compilation

Confounding Factors Positive and negative studies both could

have confounding factors skewing results Portion sizes and type of dairy product

consumed Socioeconomic class Physical activity level Other healthy behaviors Potential unknown factors The synergistic nature of total food nutrients

Elwood, Gallacher, Givens, & Pickering, 2010

Without Milk… Americans may fail to meet:

56% of daily calcium recommendations 43% of daily magnesium

recommendations 43% of daily potassium recommendations

The USDA’s Dietary Guidelines for Americans recommend three servings a day of low-fat

dairy products

Weaver, 2009

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Type 2 Diabetes Dairy consumption may help prevent type 2

diabetes: Review of all studies Found inverse relationship between dairy

consumption and diabetes risk Low-fat dairy may be more beneficial

Niu et al., 2012 & Tong et al., 2011

www.lchdhealthcare.org

Blood Pressure Low-fat dairy consumption may aid in

decreasing blood pressure

8 week study with 35 overweight/obese participants: no dairy vs. low-fat dairy consumption

Systolic blood pressure decreased with intake of low-fat dairy

Mejil et al., 2009

Weight Gain Although dairy consumption has been shown

to improve insulin resistance, there was no impact on weight or lipid status (Rideout et al., 2009).

1 year study with 23 subjects: half had 4+ servings daily and half consumed 2 or fewer servings daily

High protein/high dairy diet was associated with the most visceral fat loss (Josse et al., 2011).

16 week study with 90 women: High protein/high dairy group Adequate protein/medium dairy group Adequate protein/low dairy group

Seniors & Dementia Positive neurocognitive health in seniors with

regular dairy consumption

May help protect against dementia

Camfield et al., 2011

www.healthline.com

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Cancer Pros Swedish study in 2005 found that women

consuming high fat dairy products had a lower risk for developing cancer than women who consumed no dairy

Another study found that colon cancer incidence was reduced with regular consumption of milk and dairy

Case control and cohort study showed that 3 servings a day had no increase in bladder cancer

Chagas et al., 2012

Pros: Breast Cancer 1 in 8 women will develop breast cancer in

her lifetime

Positive results have been reported by studies examining breast cancer and dairy intake Zhange et. al (2011) studied 438 cases and

controls and found no association Pala et al. (2009) studied 319,826 women and

found dairy intake was not a risk factor for the development of breast cancer

Chagas et al., 2012

Cons: Hormone Dependent Cancers

Higher milk intake is associated with higher IGF-1 levels (Esterle et al., 2009).

Higher IGF-1 levels are associated with increased risk for some cancers

Estrogen-dependent breast cancer: large collaborative reanalysis of 17 studies (The Endogenous Hormones and Breast Cancer Collaborative Group, 2010).

Prostate cancer: several studies (Gunnell et al., 2009).

Ovarian cancer: Danish case-control study (Blaakaer et al., 2012).

Cons: Breast Cancer Higher levels of circulating IGF-1 are

associated with increased risk of Estrogen-dependent breast cancer: large collaborative reanalysis of 17 studies across 12 countries Both pre-menopausal women and post-menopausal

women Because milk is associated with higher circulating IGF-

1 levels, milk could be associated with increased risk of estrogen-dependent breast cancer

The Endogenous Hormones and Breast Cancer Collaborative Group, 2010.

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Cons: Prostate Cancer Several studies show an association between

higher dairy consumption and higher risk of prostate cancer (Gunnell et al., 2009).

IGF-1 association Low fat/skim milk associated with low-grade, early

stage, and screen-detected cancers Whole milk associated with fatal prostate cancer

Another study showed similar results (Chagas et al., 2012).

5 alpha-pregnanedione found in milk Increase in risk was small Total dairy intake not associated with prostate cancer

when calcium intake is adjusted

Bone Mineral Density Cheese and cream were not associated

with higher bone mineral density. Higher milk consumption, yogurt consumption, and dairy consumption were associated: Middle-age men and women study (Casey et al., 2013).

Cheese and other dairy products were not associated with higher bone mineral density. Only milk alone was associated: Adolescent girls study (Esterle et al., 2009).

healthfitnessrevolution.com

Fermented Dairy Fermented dairy may offer additional

health benefits: Review of numerous cohort studies and clinical trials (Huth & Park, 2012)

i.e. yogurt, but only some bacterial strains showed beneficial attributes

www.ultimate-guide-to-greek-food.com

High vs. Low Fat Few studies cite negative effects of low-fat dairy,

but those that cite negative effects of high-fat dairy may have confounding factors -Some studies allow “ice cream” in the high-fat

category (Baars, Guyenet, & Kratz, 2013).

There may be health benefits in certain fatty acids in milk but content fluctuates based on cow diet (Baars, Guyenet, & Kratz, 2013).

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Dairy Allergies An estimated 5 – 20% of parents

think their child(ren) may have dairy allergies

Only 2 – 3% of infants are actually thought to have dairy allergies Dairy allergies are often transient,

disappearing by age 3

Kneepkens & Meijer, 2009

Lactose Intolerance Most people can digest lactose at birth

but about 75% lose the ability at some point in life (non enough lactase) Diarrhea, nausea, gas, etc.

It is thought that even lactose intolerant people may tolerate small amounts of lactose if consumed with other food. Some types of dairy have less lactose

and are tolerated better than others (yogurt, cottage cheese, other cheeses)

Carrilho, de Campos Mazo, & Mattar, 2012

Dairy & Gluten

α- and β-caseins in milk have been associated with gluten intolerance (celiac disease) Some milk proteins can incite an almost

identical immune response to that caused by gluten (“cross-reactive” proteins) Possibly because of strong peptide similarity

between the two

Cabrera-Chavez & Caldaron de la Barca, 2009

www.celiacinorlando.com

What Does This Mean for Consumers?

Healthy people can safely consume dairy. However, those with certain health issues (lactose intolerance and celiac disease) may have difficulties More choices now than ever before: soy milk,

almond milk, coconut milk, rice milk, Lact-aid Calcium concerns

Moderation is key Avoid excessive amounts of individual dairy

products, especially those with high saturated fat (i.e. cheese, cream, ice cream)

How Does This Apply to Your Major?

Dietetics/Wellness: knowledge necessary in order to make recommendations to clients/patients (both those who want to consume or exclude dairy)

Business & Industry: how dairy nutrients react with other nutrients/foods and prevalence of allergies/intolerance = helpful when designing/marketing products, creating package labels, and planning for shelf stability

Culinary: knowing prevalence of lactose intolerance may help with menu design, dairy substitutes have become common in cooking/baking, maintain/increase calcium retention during preparation

Take AwayThere is no right or wrong answer!

Studies show both positive and negative effects but there are many confounding factors.

Healthy people can consume dairy as part of diet.People who refrain from milk and dairy may have a harder time getting adequate nutrients but there

are many options out there to help meet recommendations.

Focus on overall nutritional health whether choosing to consume dairy or not.

ReferencesBaars, T., Guyenet, S., & Kratz, M. (2013). The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. European Journal of Nutrition, 52(1), 1 – 24.Blaakaer, J., Faber, M. T., Hodgal, C., Hodgal, E., Jensen, A., Kjaer, S. K., & Sogaard, M. (2012). Use of dairy products, lactose, and calcium and risk of ovarian cancer: Results from a Danish case-control study. Acta Oncologica, 51, 454 – 464. Retrieved from:

http://informahealthcare.com/doi/pdf/10.3109/0284186X.2011.636754Cabrera-Chavez, F. & Caldaron de la Barca, A. M. (2009). Bovine milk intolerance in celiac disease is related to IgA reactivity to α- and β-caseins. Nutrition. 25(6), 715 – 716. Camfield, D., Owen, L., Scholey, A., Pipingas, A., & Stough, C. (2011). Dairy constituents and neurocognitive health in ageing. British Journal of Nutrition, 106, 159-174.Carrilho, F. J., de Campos Mazo, D. F., & Mattar, R., (2012). Lactose intolerance: Diagnosis, genetic, and clinical factors. Clinical and Experimental Gastroenterology, 5, 113 – 121. Casey, V. A., Hannan, M. T., Kiel, D. P., Quach, L.,Sahni, S., & Tucker, K. L. (2013). Milk and yogurt consumption are linked with higher bone mineral density but not with hip fracture: The Framingham offspring study. Arch Osteoporosis, 8, 119.Chagas, C., Rogero, M., & Martini L. Evaluating the links between intake of milk/dairy products and

cancer. Nutrition Reviews, 70(5), 294-300.Elwood, P. C., Gallacher, J. E., Givens, D. I., & Pickering, J. E. (2010). The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: An overview of the evidence. Lipids, 45(10), 925 – 939. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950929/Esterle, L., Garabedian, M., Guaydier-Souquieres, G., Guillon-Metz, F., Jehan, F., Sabatier, J. P., & Walrant-Debray, O. (2009). Milk, rather than other foods, is associated with vertebral bone mass and circulating IGF-1 in female adolescents. Osteoporosis International,20(4), 567 – 575. Gunnell, D., Harris, R., Holly, J. M. P., Martin, R. M., Rowlands, M., & Vatten, L. J. (2009). Circulating insulin-like growth factor peptides and cancer risk: A systemic review and meta-analysis. International Journal of Cancer, 124(10), 2416 – 2429.

References ContinuedHuth, P. J. & Park, K. M. (2012). Influence of dairy product and milk fat consumption on cardiovascular disease risk: A review of the evidence. Advances in Nutrition, 3, 266 –285.Josse, A., Atkinson, S., Tarnopolsky, M., & Phillips, S. (2011). Increased Consumption Of Dairy Foods And Protein During Diet- And Exercise-Induced Weight Loss Promotes Fat Mass Loss And Lean Mass Gain In Overweight And Obese Premenopausal Women. Journal of Nutrition, 1626-1634.Kneepkens, C. M. F., Meijer, Y. (2009). Clinical practice: Diagnosis and treatment of cow’s milk allergy. European Journal of Pediatrics, 168, 891 – 896. Meijl, L, & Mensink, R, (2009). Low-fat dairy consumption reduces systolic blood pressure, but does not improve other metabolic risk parameters in overweight and obese subjects. Nutrition, Metabolism and Cardiovascular Diseases, 21:355-361.Niu, K., Kobayashi, Y., Guan, L., Monma, H., Guo, H., Cui, Y., . . . Nagatomi, R. (2012). Low-fat dairy, but not whole- /high-fat dairy, consumption is related with higher serum adiponectin levels in apparently healthy adults. European Journal of Nutrition, 52:771-778.Rideout, T,. Marinangeli, C., Martin, H., Browne, R., & Rempel, C, (2013). Consumption of low-fat dairy foods for 6 months improves insulin resistance without adversely affecting lipids or bodyweight in healthy adults: A randomized free-living cross-over study. Nutrition Journal, 12:56-56.The Endogenous Hormones and Breast Cancer Collaborative Group (2010). Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: Pooled individual data analysis of 17 prospective cohort studies. The Lancet: Oncology, 11(6), 530 – 542.Weaver, C. (2009). Should Dairy Be Recommended As Part Of A Healthy Vegetarian Diet? Point. American Journal of Clinical Nutrition, (89), 1634S-1637S.