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Milk And Dairy Products: Good Or Bad For Human Health?

Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

Tanja Kongerslev Thorning1, Anne Raben1, Tine Tholstrup1, Sabita S. Soedamah-Muthu2, Ian Givens3 and Arne Astrup1*

1Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark; 2Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands; 3Centre for Food, Nutrition and Health, University of Reading, Reading, UK

Abstract

Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat.

Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality.

Results: The most recent evidence suggested that intake of milk and dairy products was associated with reduced risk of childhood obesity. In adults, intake of dairy products was shown to improve body composition and facilitate weight loss during energy restriction. In addition, intake of milk and dairy products was associated with a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease, particularly stroke. Furthermore, the evidence suggested a beneficial effect of milk and dairy intake on bone mineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder cancer, gastric cancer, and breast cancer, and not associated with risk of pancreatic cancer, ovarian cancer, or lung cancer, while the evidence for prostate cancer risk was inconsistent. Finally, consumption of milk and dairy products was not associated with all-cause mortality. Calcium-fortified plant-based drinks have been included as an alternative to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow’s milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans.

Conclusion: The totality of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most prevalent chronic diseases, whereas very few adverse effects have been reported.

Keywords: obesity; type 2 diabetes; cardiovascular disease; osteoporosis; cancer; mortality

Citation: Food & Nutrition Research 2016, 60: 32527 - http://dx.doi.org/10.3402/fnr.v60.32527

Copyright: © 2016 Tanja Kongerslev Thorning et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

Received: 7 June 2016; Revised: 4 October 2016; Accepted: 21 October 2016; Published: 22 November 2016

Competing interests and funding: Tanja Kongerslev Thorning has no conflicts of interest to declare. Anne Raben is recipient of research funding from the Dairy Research Institute, Rosemont, IL, USA and the Danish Agriculture & Food Council.Tine Tholstrup is recipient of research grants from the Danish Dairy Research Foundation and the Dairy Research Institute, Rosemont, IL. The sponsors had no role in design and conduct of the studies, data collection and analysis, interpretation of the data, decision to publish, or preparation of the manuscripts. Sabita S. Soedamah-Muthu received funding from the Global Dairy Platform, Dairy Research Institute and Dairy Australia for meta-analyses on cheese and blood lipids and on dairy and mortality. The sponsors had no role in design and conduct of the meta-analyses, data collection and analysis, interpretation of the data, decision to publish, or preparation of the manuscripts. Ian Givens is recipient of research grants from UK Biotechnology and Biological Sciences Research Council (BBSRC), UK Medical Research Council (MRC), Arla Foods UK, AAK-UK (both in kind), The Barham Benevolent Foundation, Volac UK, DSM Switzerland and Global Dairy Platform. He is a consultant for The Bio-competence Centre of Healthy Dairy Products, Tartu, Estonia, and in the recent past for The Dairy Council (London). Arne Astrup is recipient of research grants from Arla Foods, DK; Danish Dairy Research Foundation; Global Dairy Platform; Danish Agriculture & Food Council; GEIE European Milk Forum, France. He is member of advisory boards for Dutch Beer Knowledge Institute, NL; IKEA, SV; Lucozade Ribena Suntory Ltd, UK; McCain Foods Limited, USA; McDonald’s, USA; Weight Watchers, USA. He is a consultant for Nestlé Research Center, Switzerland; Nongfu Spring Water, China. Astrup receives honoraria as Associate Editor of American Journal of Clinical Nutrition, and for membership of the Editorial Boards of Annals of Nutrition and Metabolism and Annual Review of Nutrition. He is recipient of travel expenses and/or modest honoraria (<$2,000) for lectures given at meetings supported by corporate sponsors. He received financial support from dairy organisations for attendance at the Eurofed Lipids Congress (2014) in France and the meeting of The Federation of European Nutrition Societies (2015) in Germany.

*Correspondence to: Arne Astrup, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Noerre Alle 51, DK-2200 Copenhagen N, Denmark, Email: Αυτή η διεύθυνση ηλεκτρονικού ταχυδρομείου προστατεύεται από τους αυτοματισμούς αποστολέων ανεπιθύμητων μηνυμάτων. Χρειάζεται να ενεργοποιήσετε τη JavaScript για να μπορέσετε να τη δείτε.

Several media stories and organisations claim that dairy increases risk of chronic diseases including obesity, type 2 diabetes, cardiovascular disease, osteoporosis, and cancer. Therefore, there is an increasing scepticism among the general consumers about the health consequences of eating dairy products. This is reflected in an increasing consumption of plant-based drinks, for example, based on soy, rice, almond, or oats. Dairy is an essential part of the food culture in the Nordic countries; thus, inclusion of milk and dairy products in the diet may be natural for many Nordic individuals. The major causes of loss of disease-free years in the Nordic countries today are type 2 diabetes, cardiovascular diseases, and cancers. Moreover, the increasing prevalence of obesity greatly increases the risk of these chronic diseases. Given the increasing prevalence of these chronic diseases, it is critically important to understand the health effects of milk and dairy products in the diet. Accordingly, this narrative review presents the latest evidence from meta-analyses and systematic reviews of observational studies and randomised controlled trials on dairy intake (butter excluded) and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, and cancer as well as all-cause mortality.

We aim to answer the key questions: 1) For the general consumer, will a diet with milk and dairy products overall provide better or worse health, and increase or decrease risk of major diseases and all-cause mortality than a diet with no or low content of milk and dairy products? 2) Is it justified to recommend the general lactose-tolerant population to avoid consumption of milk and dairy products? 3) Is there scientific evidence to substantiate that replacing milk with plant-based drinks will improve health?

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