New advice on eating fermented dairy foods

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Dietary guidelines are changing in recognition of a growing body of evidence pointing to benefits of consuming fermented dairy foods in protecting us from heart disease and diabetes, researchers say. A recent review of the evidence adds to doubts over previous advice to restrict full-fat dairy in our diet – rather than focus solely on the saturated fat content of dairy foods, dietary guidelines should consider the characteristics of the whole food, say the researchers.

They recommend inclusion of dairy products, especially fermented dairy products such as yogurt and cheese, within a healthy diet.

Fermented dairy foods are associated with benefits in heart disease and diabetes

Scientists previously thought that the saturated fats in dairy products might cause a bunch of health problems and so for many years dietary guidelines recommend consumption of fat-free or low-fat dairy products in place of full-fat dairy. But now, although evidence is still mixed, the overall view of experts is that fermented dairy products, particularly yogurt, are associated with improved outcomes when it comes to cardiovascular disease (CVD) and Type 2 diabetes (T2D).

Reviewing the evidence behind the dietary recommendations, researchers analysed many observational studies on the effects of different types of dairy foods on CVD and T2D, with a focus on fermented dairy products (1).

They concluded that advice to avoid foods with high saturated fatty acid content is too simplistic, and suggested that the specific characteristics of dairy foods could be the reason behind the large body of evidence that dairy foods don’t worsen the rate or mortality for CVD, coronary heart disease, and stroke.

Are all fatty foods bad for us?

For dairy foods overall, based on evidence so far, the researchers concluded that uncertainty remains over the association between dairy foods and risk for future CVD. For healthy people who don’t have CVD risk factors, the risk is likely to be negligible if any. This spells good news for people needing to increase their consumption of nutritious staple foods..

But for people at increased CVD risk, it may be best to stick to reduced fat dairy products, the researchers advise. Such products remain a handy source of essential vitamins and minerals, as well as high-quality protein.

Fermented dairy foods stand out for their associated benefits in CVD risk

Looking at individual dairy types, the researchers concluded that the evidence supports the view that consuming fermented dairy products such as yogurt and cheese appear especially beneficial in CVD outcomes (2).

Butter, on the other hand, stands out among dairy foods as having the highest saturated fat content and has frequently been associated with increased CVD risk.

Dairy consumption and diabetes risk

Convincing evidence now confirms that consuming fermented dairy foods, especially yogurt, may help prevent T2D, the review found. Regularly eating yogurt is associated with improvements in several components of cardiometabolic health, including hyperglycaemia, raised blood pressure, lipid profiles, and perhaps overweight, say the researchers.

Although reduced fat products are recommended, a difference in the effects of low-fat versus high-fat products is not clear-cut.

Why do some dairy types seem healthier than others?

Differences between dairy types in their associated cardiometabolic health effects may be due to their food matrix and bioactive compounds, the researchers suggest. The dairy matrix varies in its physical, chemical and structural properties -including the size of fat globules in the food.

Full-fat milk is an emulsion of fat globules enclosed in the milk fat globule membrane:

In yogurt, fat globules are dispersed in a gelled protein matrix
In cheese the globules are in a solid matrix rich in proteins.
Butter, which is associated with raised LDL cholesterol, is an emulsion containing little protein and the milk fat is not enclosed by a globule membrane (3).

“The apparent beneficial effects of fermented milk products, particularly yogurt, allow for increased consumption of nutritious staple foods. Recent national guidelines reflect this view.’ – Nestel PJ, et al, 2023”