Dairy and heart health – what the science shows

Could milk and dairy increase your risk of heart disease? Research suggests otherwise
Dairy can be part of a heart-healthy diet, with current research showing that milk, yoghurt and cheese have an effect that ranges from neutral to protective when it comes to cardiovascular health. For years, we’ve been told to limit saturated fat in our diets. Research has shown that eating lots of foods rich in saturated fats, such as processed meat other sources of animal protein, can raise cholesterol levels. And because high levels of unhealthy cholesterol (LDL-cholesterol) and other blood fats, together with high blood pressure, increase the risk of heart disease, cutting back on foods high in fats and particularly saturated fat may seem like a sensible choice.

This is particularly relevant at a time when health authorities predict that, globally, the rate of deaths caused by non-communicable diseases (NCDs) such as heart conditions, high blood pressure and obesity-related conditions may rise by 20% more over next 10 years than it is today.

***But what does this mean for milk and dairy in our diets?
***About 60% of the fat in milk is saturated fat. But does this mean you should choose only low-fat milk and dairy products – or even go to the extreme of cutting out dairy altogether?

From new research, nutrition experts make the case against this, because foods containing saturated fat are not necessarily all the same.

In fact, rigorous analyses of several large studies suggest that including dairy in your diet can have a beneficial or neutral effect on heart health. While the findings aren’t completely consistent, many studies have found that milk, yoghurt and cheese either reduce the risk of heart disease, stroke and high blood pressure, or have no effect.

In a systematic review of 95 meta-analyses, none found that dairy intake was linked to a higher risk of developing heart disease.

Understanding the dairy matrix effect

One reason the saturated fats in dairy may have a different effect is the dairy matrix.

Milk and dairy are whole foods, and the dairy matrix refers to their unique physical and biochemical structure – the way their nutrients and other components work together within a particular structure. This can influence how those nutrients are digested, absorbed and used by the body.

The food matrix of dairy products is complex and beneficial. It includes nutrients such as good quality protein, minerals, vitamins, fatty acids and bioactive components as well as the combinations and interactions between these components

This means that it isn’t possible to look at the health effects of dairy simply in terms of one nutrient, such as saturated fat, or one risk marker, such as unhealthy cholesterol(LDL). Research suggests that nutrients in foods, including dairy, work together and that their combined effect can be stronger than the effect of individual nutrients.

Registered dietitian at Rediscover Dairy, Maretha Vermaak, says: “Studies do show that, overall, a lower intake of saturated fat can be healthier and can reduce the chance of heart disease. But what you replace dairy with matters.”

Foods that contain less saturated fat than dairy may have a very different nutrient profile. Simply replacing dairy with less fatty foods could therefore mean a lower intake of important micronutrients and may have less of a beneficial effect than expected.

Maretha adds, “Most dairy foods are heart healthy, and consumers should choose carefully when excluding dairy from the diet or replacing it. Before making significant, or drastic changes to your dietary habits, it’s advisable to consult with a dietitian. They provide evidence-based nutritional advice and design nutritional plans that are tailored to each person’s unique needs.”

Making better food choices

There are good reasons why the South African Food-based Dietary Guidelines Overall (FBGDs) steadfastly advise us to ‘have milk, maas or yoghurt every day’. Dairy is nutritious and delicious; versatile, affordable and accessible to most South Africans. “Dairy has also been an integral part of South Africa’s diverse cultures for generations. Now, current evidence shows that including dairy in your daily diet has a largely neutral to protective effect on heart health”, says Maretha.

For healthy individuals, having up to 200 g of dairy per day does not appear to be harmful, irrespective of whether you are choosing full fat or low-fat dairy options. Fermented dairy products, such as yoghurt and amasi, offer extra benefits due to the presence of gut friendly bacteria.

Research increasingly highlights the importance of looking at milk and dairy as whole foods – and considering the dairy matrix, processing, fermentation and the wider dietary context – rather than focusing on individual nutrients in isolation.

When it comes to supporting good health, including heart health, it’s your overall dietary pattern that really matters.