RHR: Is Dairy Dangerous or Useful?

by Joselyn Kent · February 10, 2023

On this episode, we talk about:

The background of dairy consumption by people
A wide range of analysis research that present that dairy merchandise, and full-fat fermented dairy merchandise specifically, have advantages for cardiometabolic operate and several other different markers of well being
The mechanisms behind the advantages of full-fat dairy
The parable that dairy meals contribute to osteoporosis by “acidifying” our our bodies
How you can know should you’re illiberal to lactose or the proteins in dairy and the right way to handle that in your food regimen

Present notes:

“Milk signalling within the pathogenesis of kind 2 diabetes” by Bodo C. Melnik
“Trans-Palmitoleic Acid, Metabolic Danger Elements, and New-Onset Diabetes in U.S. Adults” by Dariush Mozaffarian, Haiming Cao, Irena B. King, Rozenn N. Lemaitre, Xiaoling Tune, David S. Siscovick, and Gökhan S. Hotamisligil
“Biomarkers of milk fats and the danger of myocardial infarction in women and men: a potential, matched case-control examine” by Eva Warensjö, Jan-Håkan Jansson, Tommy Cederholm, Kurt Boman, Mats Eliasson, Göran Hallmans, Ingegerd Johansson, and Per Sjögren
“Dairy consumption and patterns of mortality of Australian adults” by M. Bonthuis, M. C. B. Hughes, T. I. Ibiebele, A. C. Inexperienced, and J. C. van der Pols
“Milk ingesting, ischaemic coronary heart illness and ischaemic stroke II. Proof from cohort research” by P. C. Elwood, J. E. Pickering, J. Hughes, A. M. Fehily, and A. R. Ness
“Complete Evaluation of the Influence of Dairy Meals and Dairy Fats on Cardiometabolic Danger” by Jean-Philippe Drouin-Chartier, Julie Anne Côté, Marie-Ève Labonté, Didier Brassard, Maude Tessier-Grenier, Sophie Desroches, Patrick Couture, and Benoît Lamarche
“The connection between high-fat dairy consumption and weight problems, cardiovascular, and metabolic illness” by Mario Kratz, Ton Baars, and Stephan Guyenet
“Results of Full-Fats and Fermented Dairy Merchandise on Cardiometabolic Illness: Meals Is Extra Than the Sum of Its Elements” by Arne Astrup, Nina Rica Wium Geiker, and Faidon Magkos
“Influence of low-fat and full-fat dairy meals on fasting lipid profile and blood stress: exploratory endpoints of a randomized managed trial” by Kelsey A. Schmidt, Gail Cromer, Maggie S. Burhans, Jessica N. Kuzma, Derek Ok. Hagman, Imashi Fernando, Merideth Murray, Kristina M. Utzschneider, Sarah Holte, Jana Kraft, and Mario Kratz
“Oral butyrate for mildly to reasonably lively Crohn’s illness” by A. Di Sabatino, R. Morera, R. Ciccocioppo, P. Cazzola, S. Gotti, F. P. Tinozzi, S. Tinozzi, and G. R. Corazza
“Results of Ruminant trans Fatty Acids on Cardiovascular Illness and Most cancers: A Complete Evaluation of Epidemiological, Medical, and Mechanistic Research” by Sarah Ok. Gebauer, Jean-Michel Chardigny, Marianne Uhre Jakobsen, Benoît Lamarche, Adam L. Lock, Spencer D. Proctor, and David J. Baer
“Milk and acid-base steadiness: proposed speculation versus scientific proof” by Tanis R. Fenton and Andrew W. Lyon
“Carbonated drinks and urinary calcium excretion” by Robert P. Heaney and Karen Rafferty
“Phosphate decreases urine calcium and will increase calcium steadiness: A meta-analysis of the osteoporosis acid-ash food regimen speculation” by Tanis R. Fenton, Andrew W. Lyon, Michael Eliasziw, Suzanne C. Robust, and David A. Hanley
“A dairy and fruit dietary sample is related to a decreased probability of osteoporosis in Korean postmenopausal girls” by Sangah Shin and Hyojee Joung
“The Affiliation Between Osteoporosis and Hypertension: The Function of A Low Dairy Consumption” by Massimo Varenna, M. Manara, L. Galli, L. Binelli, F. Zucchi, and L. Sinigaglia
“Dairy Merchandise, Dietary Calcium and Bone Well being: Risk of Prevention of Osteoporosis in Ladies: The Polish Expertise” by Lidia Wadolowska, Kamila Sobas, Justyna W. Szczepanska, Malgorzata A. Slowinska, Magdalena Czlapka-Matyasik, and Ewa Niedzwiedzka
Cyrex Labs Array 4
Vibrant Wellness Dairy Zoomer
Articles by Chris:
- “Does Dairy Trigger Osteoporosis?”
- “The Acid-Alkaline Fable, Half 1”
- “The Acid-Alkaline Fable, Half 2”
- “Dairy: Meals of the Gods or Neolithic Agent of Illness?”
- “Nonetheless Suppose Low-Fats Dairy Is the ‘Wholesome Alternative’? Suppose Once more!”

Hey, everyone, Chris Kresser right here. Welcome to a different episode of Revolution Well being Radio. One of the frequent questions I’ve obtained through the years is what position dairy merchandise can play in a nutrient-dense, entire meals food regimen. On one finish of the spectrum, you’ve got people who consider that we shouldn’t be consuming dairy merchandise in any respect. These are folks within the Paleo diet neighborhood and in many different, integrative, or Practical Drugs communities. They argue that dairy merchandise are inflammatory and linked with plenty of completely different illnesses and that we shouldn’t be consuming them as a result of human beings haven’t eaten dairy for very lengthy. On the opposite finish of the spectrum, you’ve got the standard medical view, which is that dairy merchandise are health-promoting and needs to be included within the food regimen when well-tolerated. So on this episode, I’m going to discover what the scientific proof says about this declare and share somewhat bit about my medical expertise. Prepared? Let’s dive in.

Irrespective of the place you personally stand on [the] query of dairy merchandise, there’s little question that it’s a contentious problem within the diet neighborhood. As I discussed within the [introduction], on one finish of the spectrum, you’ve got people, for instance, within the Paleo diet neighborhood, represented initially by Loren Cordain, who claimed that dairy will not be safe to eat for 2 causes. Primarily, primary, as a result of it’s a Neolithic meals, that means it was not consumed through the Paleolithic period and, due to this fact, it’s not a part of our evolutionary heritage. After which [also] due to proposed physiological mechanisms by which dairy causes hurt when it’s consumed, like irritation for example. On the opposite finish of the spectrum, you’ve got the standard medical view that dairy is wholesome when it’s well-tolerated. You might have the Weston A. Value Basis [and] Nourishing Traditions, who’ve advocated for full-fat, typically uncooked, dairy merchandise and [the] well being advantages there. [You have] researchers like Stephan Guyenet, Chris Masterjohn, Kurt Harris, who’s not likely writing anymore within the well being world however used to, and other people like myself. In my first ebook, The Paleo Remedy, I argued that dairy will be a part of a wholesome, entire meals food regimen if it’s well-tolerated.

Somewhat than simply share [my] opinion about this matter, I need to evaluate the analysis and what the analysis says. Earlier than I do this, I need to handle one of many arguments that’s typically made as to why we shouldn’t eat dairy merchandise. I feel it’s a nugatory argument, but it surely’s one which I hear typically, so I simply need to deliver it up earlier than we dive into the analysis and the main points. That is notably frequent within the vegan neighborhood and the uncooked meals vegan neighborhood, however I’ve heard it from different folks, too. [The argument] is that people mustn’t eat dairy merchandise as a result of we’re the one mammal that drinks milk into maturity. As you in all probability know, most mammals, together with people, previous to about 10,000 [or] 12,000 years in the past, solely consumed milk from their mom previous to being weaned. As soon as we had been weaned, we didn’t go on consuming dairy merchandise after that. So the declare is that, due to that, we shouldn’t eat milk or dairy merchandise.

The issue with that argument is [that] there are many issues that people do now that no different mammals do. On the earth of consuming, a superb instance can be darkish chocolate. We eat darkish chocolate. I don’t know of another mammals or animals on the market which might be cultivating and producing their very own chocolate and consuming it. However we do, and it appears to have many well being advantages, should you have a look at the analysis. We cook dinner our meals. That’s one other instance. I don’t know another mammals or animals which might be cooking meals, but cooking meals has been proven to extend nutrient absorption and supply many well being advantages. Some scientists even consider that cooking meals is a part of what made us human as a result of it enabled us to extract extra vitamins extra rapidly, spend much less of our time gathering and consuming meals, and led to [a] bigger mind and the intelligence that distinguishes us from different animals. We additionally fly on airplanes, we drive vehicles, [and] we use telephones. Definitely, a few of these issues have downsides, however in addition they have super advantages. So I don’t suppose it’s an excellent argument that we shouldn’t do one thing simply because different mammals or animals aren’t doing it. I simply wished to begin there.

Background of Dairy Consumption By People

Let’s speak somewhat bit in regards to the background of dairy consumption amongst people as a result of I feel that’s essential to set the stage. Dairy product consumption didn’t start till about 10,000 to 12,000 years in the past. So it’s true [that] it’s a Neolithic meals [and] was not a part of our routine meals consumption through the Paleolithic period. However there was a purpose that dairy merchandise began to be consumed, and that is true for many behaviors which might be preserved, from an evolutionary perspective—they serve some objective, or they wouldn’t proceed. It appears, from the latest analysis, that the consumption of dairy arose in numerous components of the world individually, or distinctly. One was the Center East; one other was East Africa. At the least these two. Dairy merchandise offered a fantastic supply of hydration, which might have been protecting during times of drought, and [they] additionally offered a significant supply of energy and diet. In these components of the world the place folks started to eat dairy merchandise, that habits was preserved over time after which unfold to different components of the world.

Now, it’s true that human beings require a specific enzyme referred to as lactase to digest the sugar in milk, lactose. Previous to the emergence of dairy consumption in these areas, people solely produced lactase once we had been infants, previous to being weaned, as a result of mom’s milk was the one supply of milk within the food regimen. As soon as we had been weaned, we didn’t must proceed to provide lactase. The physique would simply shut that [production] down, and we might not be capable to digest milk into maturity. And immediately, that’s nonetheless true for two-thirds of the worldwide inhabitants. In different phrases, solely about 35 % of the inhabitants world wide continues to provide lactase into maturity and is thus capable of digest lactose, the sugar in milk. We’re going to speak somewhat bit extra about this later within the present. Nevertheless it’s value simply mentioning briefly that even should you’re one of many 65 % that doesn’t produce lactase in maturity, that doesn’t imply that you would be able to’t take pleasure in dairy merchandise. There are lots of methods that you would be able to nonetheless profit from dairy, should you select to, even should you can’t digest lactose. So, after round 10,000 [to] 12,000 years in the past, we had [the] first emergence of pastoralist cultures that raised animals for milk, after which that unfold to different components of the world, notably Northern Europe and Scandinavia, the place immediately, about 95 % of persons are lactose tolerant as a result of they produce the lactase enzyme into maturity. So your private tolerance of lactose, the sugar in milk, will rely in your genetic heritage. In fact, that’s not black or white, as a result of we’re a real melting pot. In most locations on the earth, most individuals have blended genetic heritage. You may consider lactose tolerance as extra of a spectrum, [rather] than an off-on, black-white, binary operate. Most individuals fall someplace on that spectrum. Some persons are fully tolerant of lactose. Different persons are fully illiberal to the purpose the place, even when they’ve a minute or small quantity, they’ve bother. Many individuals are someplace in between, and it’s extra of a threshold-based tolerance, the place they’ll tolerate some quantity of lactose, but when they eat an entire bunch of it, they don’t do nicely. That’s what I’ve seen in my medical follow working with hundreds of sufferers through the years and the suggestions I’ve gotten from the hundreds of healthcare practitioners that I’ve educated, as nicely.

The Analysis on Dairy Consumption

So with all of that context in thoughts, let’s transfer into speaking somewhat bit in regards to the analysis. Loren Cordain’s group printed some evaluate papers proposing numerous physiological mechanisms by which dairy causes hurt. One was a paper by Melnik referred to as “Milk signalling within the pathogenesis of kind 2 diabetes.” They current a concept that milk consumption past the weaning interval might overstimulate pancreatic beta-cells and promote beta-cell dying. And for the reason that proliferation and dying of beta-cells are hallmarks of kind 2 diabetes, it follows that milk consumption should contribute to kind 2 diabetes. But when that concept was true, we’d count on to see elevated charges of kind 2 diabetes in folks consuming dairy merchandise. In actual fact, we don’t see that, and we regularly see the alternative. For instance, one examine checked out serum ranges of trans-palmitoleic acid, which is a fatty acid present in dairy fats, and correlated these ranges with danger elements for diabetes. They discovered that greater circulating ranges of trans-palmitoleic acid had been related to more healthy ranges of blood ldl cholesterol, inflammatory markers, insulin ranges, [and] insulin sensitivity, even after adjustment for different danger elements. In the course of the follow-up interval, folks with greater circulating ranges of trans-palmitoleic acid had a a lot decrease danger of growing diabetes, with about 60 % decrease danger amongst members within the highest quintile of trans-palmitoleic acid ranges, in comparison with folks within the lowest quintile. Put extra merely, this examine straight contradicted the speculation that was posed in [the] milk signaling paper, and located that folks with the very best ranges of this explicit fatty acid from dairy merchandise had about one-third the danger of growing diabetes over a three-year interval. I’m going to cowl some extra research that clearly present that dairy merchandise both don’t enhance the danger of diabetes or scale back it.

One other examine discovered that folks with the very best ranges of milk fats biomarkers had been at decrease danger of coronary heart assault. For girls, the danger was decreased by 26 %, and for males, it was 9 % decrease. One other examine confirmed that individuals who ate essentially the most full-fat dairy had a 69 % decrease danger of dying from heart problems than those that ate the least. After which a big evaluate of 10 research discovered that ingesting milk was related to a small however important discount in coronary heart illness and stroke danger. That is analysis from the 2010 to 2015 interval. I need to evaluate some more moderen analysis to provide you an thought of what the research over the previous 5 to 10 years have proven, as nicely.

There’s a paper that was printed in Advances in Diet in 2016 referred to as “Complete Evaluation of the Influence of Dairy Meals and Dairy Fats on Cardiometabolic Danger.” I’m going to cite from this paper as a result of it’s fairly easy. “This complete evaluation of proof from RCTs means that there is no such thing as a obvious danger of potential dangerous results of dairy consumption, regardless of the content material of dairy fats, on a big array of cardiometabolic variables, together with lipid-related danger elements, blood stress, irritation, insulin resistance, and vascular operate. This means that the purported detrimental results of saturated fatty acids on cardiometabolic well being could in reality be nullified when they’re consumed as a part of complicated meals matrices comparable to these in cheese and different dairy meals. Thus, the concentrate on low-fat dairy merchandise in present pointers apparently will not be fully supported by the prevailing literature and will should be revisited on the idea of this proof.” So, [there are] a number of fascinating issues about this paper and this conclusion. Primary, no dangerous impact of dairy merchandise for cardiometabolic danger elements. In actual fact, in lots of the research that they reviewed, they noticed advantages and enhancements [in] folks consuming dairy. The second fascinating level is that low-fat or nonfat dairy was not higher than full-fat dairy. In lots of circumstances, really, full-fat dairy exhibits extra advantages and enhancements than nonfat and low-fat dairy. I feel the rationale for that’s what we simply reviewed. There are some fatty acids in full-fat dairy merchandise, like trans-palmitoleic acid, but in addition conjugated linoleic acid and some others, that appear to have explicit advantages. I’m going to cowl these in additional element shortly, however I simply wished to level that out as we reviewed this paper.

There was one other examine a pair [of] years earlier that [was] printed within the European Journal of Diet by Stephan Guyenet, who’s a pal and colleague. He was on the College of Washington on the time, [and] a PhD who studied the neurobiological regulation of fats mass. They reviewed 16 research and located that high-fat dairy consumption was inversely related to measures of adiposity. Inversely related signifies that individuals who consumed extra high-fat dairy had higher metabolic well being, on this case. This affiliation was not seen with nonfat or low-fat dairy. That’s a really fascinating discovering. One other paper [was] printed extra lately within the journal Advances in Diet in 2019 referred to as “Results of Full-Fats and Fermented Dairy Merchandise on Cardiometabolic Illness.” I’m going to cite straight from the summary right here as a result of it’s fairly clear. “In actual fact, the burden of proof from latest giant and well-controlled research, systematic critiques, and meta-analyses of each observational research and randomized managed trials signifies that full-fat dairy merchandise, notably yogurt and cheese, don’t exert the detrimental results on insulin sensitivity, blood lipid profile, and blood stress as beforehand predicted on the idea of their sodium and saturated fats contents; they don’t enhance cardiometabolic illness danger and will in reality defend towards heart problems and sort 2 diabetes.” [It] can’t get extra clear than that. [It’s] yet one more paper, a big meta-analysis of different critiques, discovering that full-fat dairy not solely doesn’t enhance irritation or hurt metabolic or cardiovascular well being, [but] it usually improves it.

The final paper I need to discuss was a randomized management[led] trial from [the] American Journal of Medical Diet[in] 2021. It’s referred to as “Influence of low-fat and full-fat dairy meals on fasting lipid profile and blood stress.” This was a trial of about 70 members, the place that they had a four-week run-in interval with restricted dairy consumption. Then they randomly assigned folks to one in all three diets—both containing a restricted dairy food regimen, or switching to at least one with nearly three and a half servings of both low-fat or full-fat milk, yogurt, and cheese for 12 weeks. They measured a bunch of markers and located that, in women and men with metabolic syndrome, a food regimen wealthy in full-fat dairy had no results on fasting lipid profile or blood stress, in contrast with diets restricted in dairy or wealthy in low-fat dairy. Subsequently, dairy fats, when consumed as a part of complicated entire meals, doesn’t adversely influence these basic heart problems danger elements.

I might go on. I’m simply sharing a number of the analysis to provide you an thought, however there are tens, if not tons of, of research investigating this query. And as I’ve indicated from the critiques and meta-analyses that I’ve shared, the conclusion is kind of clear. Dairy merchandise, and full-fat fermented dairy merchandise specifically, appear to have advantages for cardiometabolic operate and several other different markers of well being.

The vast majority of proof signifies that standard knowledge may very well be proper about dairy. #chriskresser #dairy #bonehealth

Advantages of Full-Fats Dairy

So, why would that be? Why would full-fat dairy, specifically, be extra helpful than nonfat and low-fat dairy? Nicely, we already talked about it somewhat bit. Among the fatty acids in dairy merchandise, like trans-palmitoleic acid, appear to have distinctive well being advantages. We additionally know that a few of the compounds which might be current in high-fat dairy merchandise, like butyrate and conjugated linoleic acid, have advantages that, over the previous few years, have grow to be far more clear. Butyrate offers power to the cells lining the colon, it inhibits irritation, which can clarify why dairy will not be inflammatory, and [it] could forestall colonic micro organism from coming into the bloodstream. In actual fact, butyrate’s anti-inflammatory impact is so robust that we use it in Practical Drugs, and even in standard drugs, to deal with critical inflammatory bowel illnesses like Crohn’s illness. One trial confirmed that 4 grams per day of butyrate for eight weeks induced full remission in a bunch of [patients with] Crohn’s illness. One other fatty acid in milkfat is named phytanic acid, and it’s been proven to cut back triglycerides, enhance insulin sensitivity, and enhance blood sugar regulation in animal fashions. Conjugated linoleic acid is a pure trans fats present in dairy merchandise. I do know you’re in all probability conversant in synthetic trans fat, that are very dangerous. However conjugated linoleic acid is a pure trans fats, and it’s been proven to cut back the danger of coronary heart illness, most cancers, and diabetes. Dairy fats can be a superb supply of fat-soluble nutritional vitamins like retinol, preformed vitamin A, and vitamin K2 when it comes from grass-fed cows, and people will be troublesome to seek out elsewhere within the food regimen. After which, after all, dairy is an efficient supply of different vitamins like bioavailable calcium.

Most individuals don’t get sufficient calcium in [their] food regimen, and there aren’t very many good sources of bioavailable calcium. On paper, darkish leafy greens, like spinach, are a superb supply. For instance, one serving of spinach comprises about 115 milligrams of calcium. However what the meals label received’t inform you is that the bioavailability of calcium in spinach is extraordinarily low. It’s about 5 %. So that you’re solely going to soak up about 6 milligrams of that 115 milligrams of calcium in that spinach, whereas the bioavailability of calcium in milk is on the order of 30 to 40 %. This implies you’d should eat 16 cups of spinach to get the identical bioavailable calcium that you just get from one glass of milk.

Now, I do know a few of you’re considering, “However I can’t drink milk. I don’t really feel good.” We’re going to speak about that, as a result of it’s true. Milk and dairy will not be applicable for everyone. However for these [who] can tolerate dairy, that is the primary level I’m making an attempt to make with this podcast—should you can eat dairy merchandise and you’re feeling good and also you’re not lactose illiberal, and also you’re not delicate to the proteins in dairy merchandise, the analysis overwhelmingly exhibits that it’s a helpful meals, notably if you eat high-fat dairy merchandise, and notably if you eat natural dairy merchandise from animals which have been grass-fed and raised on pasture with out hormones, antibiotics, GMO meals, and many others. The query of uncooked dairy, and A2 versus A1, these are different subjects, which I’m not going to cowl on this present. I’ve talked about these earlier than. However there are methods of constructing dairy merchandise much more health-promoting.

The False Criticism That Dairy Has a Unfavorable Influence on Bone Well being

Now that we’ve lined the analysis on dairy merchandise normally for cardiometabolic well being, irritation, insulin, [and] coronary heart illness, [and] we’ve talked about why full-fat dairy tends to be extra helpful for cardiometabolic well being as a result of distinctive compounds that it comprises, I need to discuss one other criticism of dairy merchandise, which is that consuming dairy has a destructive influence on bone well being. After that, we’re going to speak somewhat bit about a few of the practicalities, like the right way to know should you’re illiberal to lactose or the proteins in dairy and the right way to handle that within the food regimen.

The declare that dairy merchandise contribute to osteopenia and osteoporosis is essentially based mostly [on] the acid-alkaline speculation. I’ve debunked the acid-alkaline speculation normally on my podcast, [and] additionally [in] weblog articles. I actually encourage you to seek for “Chris Kresser, acid-alkaline” should you haven’t seen or listened to that content material and should you nonetheless consider that the acid and alkaline content material of meals that we eat makes a big influence on our well being, as a result of there’s no proof to assist that and plenty of proof that contradicts it. I’m going to focus proper now on the particular declare that dairy merchandise acidify our our bodies and contribute to osteopenia and osteoporosis.

So, once more, this declare relies on the acid-ash speculation of osteoporosis. The concept is that, once we eat meals which might be excessive in phosphate, they go away an acid ash after digestion, which lowers the pH of our blood, after which the physique supposedly compensates for this to revive regular blood pH by stealing alkaline minerals like calcium from the bones, which then decreases bone density. There are a number of issues with this speculation, and we will use a 2011 examine that particularly addresses the dairy, acid steadiness, [and] osteoporosis connection to focus on these. The examine is named “Milk and acid-base steadiness: proposed speculation versus scientific proof,” and the authors reviewed each the acid-ash speculation, normally, and the particular declare that dairy contributes to osteoporosis. Not surprisingly, after reviewing the proof, they reached the identical conclusions that I’ve. The research simply don’t assist this speculation. First, they emphasize that urine pH will not be indicative of systemic pH. In actual fact, besides in circumstances of great renal insufficiency [or] kidney illness, food regimen has no influence on serum pH. If it did, we’d be in plenty of bother as a result of the pH of our blood is maintained in a really tight vary and if it deviates considerably, we will die. If human beings needed to rigorously monitor the acid-alkaline content material of their food regimen, we’d not have survived this lengthy, as a result of as you understand, our distant ancestors didn’t have any idea of acid-alkaline steadiness. There have been intervals of various meals availability, [and] it wouldn’t make sense from an evolutionary perspective that we might so simply alter such a vital issue that might decide our survival [just] by [shifting] what we eat.

Second, the bones don’t even come into play within the regulation of serum pH. That’s the job of the kidneys. Any acid ash that’s left behind by the meals we eat will be simply handled and eradicated within the urine. For this reason your urine adjustments pH relying on what you eat. It’s an indication that your kidneys are doing their job. That’s essential to grasp as a result of advocates of this speculation typically advocate and even promote urine pH assessments, and so they declare that if the pH of your urine is low, which means your physique is acidified and you should eat a bunch of alkaline meals. That may result in adjustments in urine pH, however that doesn’t imply something is altering together with your serum pH, or that it’s having any influence in your bone well being or total well being. What’s additionally notably fascinating is that, even should you settle for this acid-alkaline speculation normally, the authors of this paper cite two research that point out that milk really leaves an alkaline ash, versus an acid ash, based mostly on measurements of urine pH and web acid excretion following milk consumption in medical trials. So, even when we go along with the acid-alkaline speculation, this examine discovered that milk is an alkaline meals, not an acid-forming meals. The entire speculation simply fully falls aside if you actually have a look at the proof.

Maybe much more essential, it’s useful to take a look at proof that hyperlinks dairy consumption on to bone well being. As a substitute of developing with a proposed mechanism just like the acid-alkaline speculation and taking a look at that middleman mechanism, it’s finest to go proper to the direct medical endpoint that we’re involved with, which is bone well being. So, what do research which have checked out this present? Nicely, they present that ingesting milk tends to result in optimistic calcium steadiness, that means extra calcium is absorbed than excreted. Different research present that phosphate, which is in milk merchandise but in addition in different meals, will increase calcium retention and improves bone well being, which is why phosphate is present in plenty of bone well being dietary supplements. Elevated dairy consumption is persistently related to decrease charges of osteopenia, osteoporosis, and higher bone well being throughout many alternative cultures world wide. For instance, elevated dairy consumption in postmenopausal Korean girls was related to a decreased danger of osteoporosis. One other examine discovered that within the [United States], dairy consumption was a big predictor of osteoporosis amongst postmenopausal girls, that means girls who eat extra dairy had decrease charges of osteoporosis. And in Poland, greater dairy consumption throughout childhood and adolescence predicted higher bone well being in adults. Once more, these are simply three research I’m choosing which might be consultant. There are lots of different research within the scientific literature that assist the connection between dairy consumption and higher bone well being.

All proper, in order that’s what the analysis says. It’s fairly convincing, particularly should you evaluate the majority of the proof [and] not simply these research that I’ve chosen. However I selected ones that had been consultant. I selected giant, systematic critiques that checked out all various kinds of proof, different critiques, randomized managed trials, observational information, potential research, retrospective analyses, and many others., and so they all level to the identical conclusion—that dairy consumption, notably full-fat dairy, is helpful for cardiometabolic and bone well being.

The Practicalities of Dairy Consumption

Now that we’ve reviewed the proof, let’s discuss a few of the practicalities. It’s true that many individuals don’t tolerate dairy merchandise nicely, and there are two causes for this. One is that some persons are illiberal of the proteins in dairy merchandise and might have an [immunoglobulin G] (IgG)-mediated intolerance, which will be delicate to critical however will not be a real allergy. Or, some folks can really be allergic to the proteins in dairy. That is pretty unusual, really. The prevalence research I’ve seen vary a bit, but it surely’s usually within the 1 to three % vary from what I’ve seen. Whereas lactose intolerance, [which is] the shortcoming to digest the sugar in milk, is far more frequent, as we mentioned earlier within the present. That impacts two thirds of the worldwide inhabitants. Nevertheless, even when somebody is lactose illiberal, that doesn’t imply that they’ll’t take pleasure in some dairy merchandise. Ghee has nearly no lactose in it. Butter has little or no lactose. Laborious cheeses, notably these which have been aged for some time like cheddar, have nearly no lactose. Even full-fat whipping cream is pretty low in lactose. Then as you go down the road, you’ve got delicate cheese and fluid milk, that are fairly excessive in lactose. [With] yogurt and fermented dairy, the lactose content material in these merchandise can fluctuate relying on how lengthy they’ve been fermented. The longer they’ve been fermented, the decrease the lactose content material. Twenty-four-hour, at-home fermented yogurt or kefir will typically be nearly freed from lactose. As you’ll be able to see, there are a lot of completely different choices for dairy merchandise for individuals who need to get the advantages of calcium, the fatty acids which might be in dairy fats, and the opposite dietary advantages of dairy, along with the scrumptious style. For individuals who like dairy merchandise, even should you’re lactose illiberal, you’ll be able to nonetheless take pleasure in these merchandise. And your mileage will fluctuate. For some folks, in the event that they’re extraordinarily lactose illiberal, they might not be capable to eat [many] of these merchandise, even those which might be low in lactose. However for others, they’ll eat fairly a little bit of these merchandise and never have a problem.

Talking personally, I don’t do nicely with fluid milk, an excessive amount of delicate cheese, or store-bought yogurt. However I can have arduous cheese, ghee, butter, cream, and home made yogurt and kefir all day lengthy with no downside in any respect. In case you’re illiberal of the protein in dairy, that’s somewhat bit more difficult, as a result of nearly all dairy merchandise comprise dairy protein. The exception can be ghee. Butter is pretty low in protein, as nicely, however undoubtedly, if somebody’s allergic to the protein, they’re not going to have the ability to tolerate butter, often. They are able to tolerate ghee if it’s simply an intolerance, somewhat than an allergy. It should rely on how important the intolerance is. By way of testing, there are some assessments on the market to display screen for dairy protein intolerance or allergy. A typical meals allergy check ought to check for dairy proteins. By way of intolerance, there are labs like Cyrex, [whose] Array 4 panel is sweet for dairy proteins. Vibrant Wellness has a meals intolerance check that screens for dairy proteins, as nicely. In case you work with a Practical or integrative drugs practitioner, you’ll be able to in all probability ask them to order these assessments. If you wish to learn about your protein tolerance in terms of lactose intolerance, there are additionally assessments on the market [for that]. However I’ve discovered that the most effective and handiest methodology, as a result of it’s extra of a threshold-based situation somewhat than only a black or white binary factor, is an elimination provocation protocol. You take away all dairy merchandise out of your food regimen for a time frame, and then you definitely begin to add them again in, in descending order of lactose content material. So that you’d begin with ghee. Most individuals shall be nice with that, even folks [who] are extraordinarily lactose illiberal. You then go to butter, then you can go to arduous cheeses, that are nearly freed from lactose, [and] then you can go to 24-hour, at-home home made kefir or home made yogurt. In case you nonetheless do nicely with that, you can go to store-bought yogurt and store-bought kefir, and so forth down the road, delicate cheese, fluid milk, and many others. In case you’re nice with ghee and butter and arduous cheese, however then sooner or later, you begin reacting to dairy merchandise, perhaps if you begin consuming yogurt from the shop or fluid milk, then you understand you’ve got some degree of lactose tolerance. In case you had been illiberal of proteins, you’ll have reacted to the arduous cheese as a result of it’s nearly freed from lactose however has loads of dairy protein. Laborious cheese could be a good benchmark for differentiating between lactose intolerance and protein intolerance. That’s the final course of I take advantage of in my follow with sufferers. It really works fairly nicely, and since everybody’s sensitivity tends to be fairly particular person, it’s typically much more efficient than doing the assessments.

I hope this was useful [and] I hope you realized one thing. It’s fascinating to me that dairy merchandise are so hated within the various, Practical [Medicine], [and] Paleo communities, as a result of if you have a look at the scientific proof, it’s clearly helpful from a well being perspective, whether it is nicely tolerated. So, that’s the crux of it. I do suppose it’s value mentioning that, in all the research that I discussed, they didn’t section folks in line with their tolerance of lactose or dairy proteins, and so they simply took a broad pattern of individuals. I feel we will nearly assure that there have been folks in these research [who] had been lactose illiberal or had been illiberal to the proteins in dairy, and but [they] nonetheless skilled a few of these cardiometabolic advantages. That’s fascinating to me. I’m not suggesting that people who find themselves illiberal of dairy ought to eat it. I don’t suppose that they need to, as a result of I feel it might be problematic in these circumstances. I’m simply mentioning that even with out segmenting folks, these research nonetheless confirmed profit. If that they had segmented folks, maybe they might have proven much more profit.

I’m going to place some hyperlinks to articles I’ve written on this matter with extra data and scientific references [in the show notes]. I’ll additionally put hyperlinks to a few of the references that I introduced up within the present that aren’t current in these articles. You may at all times take a look at the present notes to get this data [for] any episode of the present. As soon as once more, I need to thanks for listening. Please maintain sending your inquiries to ChrisKresser.com/podcastquestion, and I’ll see you subsequent time.

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