Is Dairy Good or Bad for You? Here's What the Long-Term Scientific Evidence Says

Smart Health Key 7/12 – Have Lower-Fat Dairy Every Day

If you've been trying to lose weight, lower your cholesterol, manage your blood pressure, or improve your overall health, you may have found yourself wondering: Should I even be eating dairy?

For years, we've been told that dairy — especially full-cream milk, cheese and other high-fat products — is bad for our hearts because of its saturated fat content. So perhaps you've started avoiding it altogether.

Or maybe you've switched to plant-based alternatives and assumed you're automatically making the healthier choice.

But here's where things get interesting... Dairy is actually an important part of a healthy diet.

The trick is knowing which dairy products to choose, how much to eat, and where the hidden fat and kilojoules can creep in.

Let's start with the people who don't seem to break their bones

The Blue Zone community in Costa Rica is home to some of the longest-living people on the planet. And there's something remarkable about the older people living there...

Unlike many elderly people around the world, they don't seem to break bones as easily when they fall. They get up... and keep walking.

One reason may be the exceptionally high calcium content of the natural water source in the area. The water percolates through limestone rock, making it naturally rich in calcium.

Unfortunately, as far as we can tell, there aren't many water sources in South Africa that are particularly high in calcium.

So, like most people around the world, we need to get much of our calcium from our diet — and dairy is one of the best sources available to us.

The dairy advice we were given decades ago has changed

Data on dairy consumption in South Africa show that many people don't consume enough calcium from milk and dairy products.

Part of the problem may be the advice people received in the 1950s. Back then, many scientists warned people not to consume too much dairy because of its saturated fat content, which were believed to increase the risk of heart disease.

Fast-forward several decades, and we now have a much wider range of low-fat, fat-free and reduced-fat dairy products available.

And later scientific research into low-fat and fat-free dairy consumption showed something very different from those early concerns.

Regularly consuming 2–3 portions of low-fat or fat-free milk and dairy products per day is associated with a reduced risk of heart disease and stroke.

People who consume dairy regularly also tend to have a lower BMI than those who avoid it, and the calcium in dairy may bind some of the fat it contains.

Large clinical studies have also found that regular consumption of low-fat milk and other dairy products can reduce the risk of high blood pressure, high blood cholesterol, insulin resistance syndrome (and diabetes), overweight and osteoporosis. They also found that calcium is absorbed much better from the matrix of dairy products than from just taking calcium supplements or calcium enriched plant-based milk alternatives.

So how can dairy be good for you?

Well, when you remove much of the saturated fat naturally found in whole milk, you're left with a nutrient-dense, balanced food containing low-GI carbohydrates, protein, calcium and only a small amount of fat.

That's a pretty good nutritional package.

Calcium isn't the only reason to eat dairy

Milk is also a very good source of vitamin A (except fat-free dairy), vitamin B12 (like all animal products), and a fair source of folic acid. These vitamins are associated with reducing homocysteine levels in the body, which in turn can help reduce cholesterol levels.

Milk is also the main dietary source of vitamin B2 (riboflavin), which is important for healthy eyes and vision. And enriched milk (in some countries and of speciality milks in others) provides vitamin D.

So yes, dairy has a lot going for it. The key is choosing the right kind.

Smart Health's recommendation: Eat lower fat dairy every day

The Smart Health Diet recommends that adults consume 2–3 portions of low-fat or fat-free milk and dairy products every day as part of a varied diet.

Here's what one portion looks like:

• Milk: 250 ml (1 cup)

• Plain low-fat/fat-free/"lite" yoghurt: 175 ml

• Low-fat sweetened yoghurt: 100 ml

Where possible, choose low-fat or fat-free milk. Low-fat milk contains around 1.5 g of fat per 100 ml, which works out to 3.75 g of fat per 250 ml. 2% milk is now called medium fat milk. Fat-free milk contains around 0.5 g of fat per 100 ml, which is negligible.

But here's where you need to pay attention...

Not all yoghurt is actually healthy

Many low-fat fruit or flavoured yoghurts are sweetened with added sugar. That means they're more calorie-dense and have a higher glycaemic load (GL) per serving than plain, low-fat or fat-free yoghurt options. However, some food companies are reducing the added sugar gradually, while keeping the natural sugars in the flavoured yoghurt. This is not bad as it comes from the low GI lactose that is naturally present in milk and yoghurt, as well as from the sugars that are naturally present in the fruit that is added.

If you can't find a plain, low-fat or fat-free flavoured yoghurt you enjoy, here's a simple trick: Buy your favourite low-fat sweetened yoghurt and a plain low-fat or fat-free yoghurt. Mix them 50:50.

Over time, you'll probably find that you actually prefer the less-sweet version.

Want to eat higher-GI fruit? Here's a smart trick.

When you're eating higher-GI fruits such as watermelon, paw paw, banana or pineapple as a snack or dessert, try combining them with a portion of low-fat or fat-free milk, evaporated milk or yoghurt.

The combination helps lower the overall GI. It's a simple way to make food work for you.

Cheese is where things get sneaky

You might think: "I'm eating dairy every day. I'm doing the healthy thing!" But if most of your dairy comes in the form of regular Cheddar or Gouda or speciality cheeses like Parmesan, Roquefort, Brie or Camembert, you may be getting a lot more fat than you realise.

Regular Cheddar and Gouda can contain more than 30 g of fat per 100 g, most of it saturated fat. That's why cheese isn't always the best substitute for milk.

Instead, look for reduced-fat or "lite" cheeses. Mozzarella, Edam, Ricotta and some varieties of feta contain less fat than regular Cheddar or Gouda.

And here's an important habit: Read the food label, check the fat content per 100g and then choose the lower-fat option. Alternatively, obtain Eat Smart and Stay Slim: the GI diet from www.gifoundation.com, where all cheeses and their fat content are listed neatly in a table for easy reference.

Be particularly careful with "low-fat" cream cheese. It may not be nearly as low in fat as you think. Some contain around 20 g of fat per 100 g and provide less protein than cottage cheese.

Low-fat cottage cheese, on the other hand, contains around 4 g of fat per 100 g, while also providing protein and calcium.

The hidden fat in dairy can quietly sabotage your weight-loss goals

Dairy itself is a very healthy food. But the hidden fat and kilojoules in full-cream and especially double-cream products (which contain more fat from cream than protein and calcium) can seriously undermine your health and weight-management goals over time.

You should absolutely include dairy in your diet every day. It's an excellent source of calcium, vitamin A (except fat-free dairy), vitamins B2 and B12, and phosphate.

But you also need to keep an eye on how much fat your dairy is contributing to your diet.

The typical woman should aim to get no more than 3 portions of fat (3 × 5 g) from dairy on any given day.

The typical man should aim for no more than 4 portions of fat (4 × 5 g) from dairy per day.

Here's a number that might make you rethink your morning coffee

If you're in the habit of using full-cream dairy products, the above recommendation would allow you roughly one cup of full-cream milk per day. That one cup would need to cover your cereal, tea, coffee and any other milk drinks you have throughout the day.

But let's be honest... One cup of milk doesn't go very far.

You may easily end up having another cup without even thinking about it. And that second daily cup of full-cream milk adds around 643 kJ to your diet.

Over a year, that's enough to potentially contribute to a 7 kg weight gain. Just from that extra glass of full-cream milk every day!

That's the kind of hidden energy that can make weight management feel incredibly frustrating. You're thinking: "I'm eating pretty healthily. Why am I still gaining weight?"

And sometimes, the answer isn't the obvious food on your plate. It's the little things you don't think twice about.

Don't underestimate yoghurt

Yoghurt is an exceptionally healthy food. It provides all the usual benefits of dairy, including calcium and important vitamins, but it also contains probiotics — beneficial microorganisms that live in your intestines and help with digestion and bowel health.

But full-cream (and especially double cream) yoghurt can contain around 5 g+ of saturated fat in every 200 ml tub. That's not necessarily a huge amount on its own. But add it to the rest of the saturated fat you're eating throughout the day, and it can quickly start to add up, as saturated fat must be < 10% of total kJ/day.

That's why low-fat yoghurt is generally the smarter everyday choice. And yes — it's still delicious.

And then there's cheese... glorious cheese.

Say "cheese," and everybody smiles - and with such a wide variety available, it's easy to understand why. Unfortunately, the lower-fat versions aren't always quite as delicious. If you really don't enjoy them, you'll need to be careful with your portions.

Regular Cheddar and Gouda can be around 30% fat. So, a good habit is limiting yourself to one 30 g portion per day — roughly the size of a matchbox.

Because cheese is so high in fat, adding a second portion every day could potentially contribute to around 4 kg of weight gain over a year. And no, it won't be 4 kg of lean muscle.

What about cream?

Cream is around 37% fat, most of it saturated. So don't make it a regular ingredient in your meals and sauces.

Instead, try healthier alternatives such as:

• Lite evaporated milk

• Low-fat milk

• Yoghurt

If you don't have a weight problem, a small amount of whipped cream — perhaps one or two teaspoons on apple crumble once a month — isn't going to do much damage. But using plain yoghurt is much healthier.

The point isn't to panic about the occasional treat. It's to stop the everyday extras from quietly becoming a problem.

The bottom line on dairy

Dairy is a food you shouldn't need to eliminate from your diet. In fact, you should ideally be eating it every day.

The key is to choose 2–3 low-fat or fat-free portions daily so that you get the calcium, protein and vitamins your body needs without loading your diet with unnecessary saturated fat and kilojoules. Because dairy isn't the enemy.

But full-cream and especially double-cream products can quietly add up.

And if you're trying to lose weight, lower your cholesterol, manage your blood pressure or reduce your risk of lifestyle diseases, those seemingly insignificant daily choices can make a much bigger difference than you realise.

So, next time you pour yourself a glass of milk, spoon out your yoghurt or cut yourself a piece of cheese, take a second look.

The question isn't whether dairy belongs in a healthy diet. It's whether you're choosing the kind of dairy that actually supports your health goals.

🌟 This is just 1 of the 12 Smart Health Keys to long-term health. They're simple principles, yet life-changing when you apply them!

Now take a look at Key 8 (Snack on Fruit and a Few Nuts) →

Scientific References:

Buettner D (2008): The Blue Zones: lessons for living longer from the people who’ve lived the longest. The National Geographic Society.

Craig, WJ (1997): Phytochemicals:guardians of our health. J Am Dietetic Assoc, 97 (10 Suppl 2): S199 – S204.

Haag M and Dippenaar NG (2005): Dietary fats, fatty acids and insulin resistance: short review of a multifaceted connection. Med Sci Monit, 11(12): RA359 – 367. Dietary Fats, Fatty Acids and IR – Haag, Dippenaar, FattyAcidsandIR-Haag,Dippenaar.pdf

Margioris AN (2009): Fatty acids and postprandial inflammation, Curr Opin Clin Nutr Metab Care, 12: 129 -137.

Recommendations of the World Cancer Research Fund and the American Insitute for Cancer Research. Food, Nutrition, Physical activity and the Prevention of Cancer. 2007

Rossouw JE (2015): The diet-heart hypothesis, obesity and diabetes. S Afr J Clin Nutr, 28(1):38-43.

AUTHOR: ELIZABETH (LIESBET) DELPORT - Registered Dietitian, M.Sc. Dietetics.

Liesbet Delport has over 40 years of experience helping over 10,000 people improve their health through practical, evidence-based nutrition.

After struggling with her own weight as a teenager, Liesbet learned that lasting health isn't about willpower or another restrictive diet. Her approach is simple: people aren't failing, the diets are. She helps people build a balanced, delicious way of eating they can actually follow for life.