A relationship between saturated fat intake and blood cholesterol levels has been established for decades, and has led to recommendations around the world to switch to lower-fat milk and dairy products.
Yet, even back in the 1980s, there were hints in the literature of a paradox – people who consumed a lot of milk didn’t automatically develop high blood cholesterol. Since then, tantalising glimpses of evidence, recently summarised by Givens, have run counter to current recommendations.
Most recent of these is the Prospective Urban Rural Epidemiology (PURE) study, published in The Lancet in September 2018, a prospective cohort study that looked at the association between dairy intake and cardiovascular disease in more than 135,000 people in 21 countries from five continents.
The authors found that, over the nine-year follow-up, consuming more than two daily portions of milk and yogurt (compared with no dairy) was associated with a 16% reduction in the risk of various cardiovascular events (heart-related and strokes) and cardiovascular-related death.
They concluded “consumption of dairy products should not be discouraged and perhaps should even be encouraged in low-income and middle-income countries where dairy consumption is low” (and the reported association was greater).
Perhaps surprisingly, the strength of the association was similar, regardless of whether people had whole fat dairy products (especially whole milk) or low-fat versions. Most of the benefit appeared to be associated with milk and yogurt.
It’s intriguing that, after all, there may be a component of milk fat that is advantageous to health, or that other nutrients in milk override the effect of saturated fat. But until potential mechanisms are unravelled, caution is needed. Meanwhile, dietary advice will continue to focus on low-fat (lower-calorie) dairy products.