RHR: Is Dairy Dangerous or Helpful?

by Joselyn Kent · February 13, 2023

On this episode, we talk about:

The background of dairy consumption by people
Quite a lot of analysis research that present that dairy merchandise, and full-fat fermented dairy merchandise specifically, have advantages for cardiometabolic operate and a number of 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
The best way to know should you’re illiberal to lactose or the proteins in dairy and the 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 Threat Components, 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 chance 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 consuming, 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 Evaluate of the Impression of Dairy Meals and Dairy Fats on Cardiometabolic Threat” 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
“Impression of low-fat and full-fat dairy meals on fasting lipid profile and blood strain: 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 energetic 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 Evaluate of Epidemiological, Scientific, 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 stability: 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 stability: A meta-analysis of the osteoporosis acid-ash food regimen speculation” by Tanis R. Fenton, Andrew W. Lyon, Michael Eliasziw, Suzanne C. Powerful, and David A. Hanley
“A dairy and fruit dietary sample is related to a diminished probability of osteoporosis in Korean postmenopausal girls” by Sangah Shin and Hyojee Joung
“The Affiliation Between Osteoporosis and Hypertension: The Position 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: Chance of Prevention of Osteoporosis in Girls: 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 Delusion, Half 1”
- “The Acid-Alkaline Delusion, 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 over time is what function dairy merchandise can play in a nutrient-dense, entire meals food regimen. On one finish of the spectrum, you will have people who consider that we shouldn’t be consuming dairy merchandise in any respect. These are folks within the Paleo vitamin neighborhood and in many different, integrative, or Purposeful Medication communities. They argue that dairy merchandise are inflammatory and linked with numerous totally 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 will have the standard medical view, which is that dairy merchandise are health-promoting and must 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 just a little bit about my scientific expertise. Prepared? Let’s dive in.

Regardless of the place you personally stand on [the] query of dairy merchandise, there’s little question that it’s a contentious challenge within the vitamin neighborhood. As I discussed within the [introduction], on one finish of the spectrum, you will have people, for instance, within the Paleo vitamin neighborhood, represented initially by Loren Cordain, who claimed that dairy isn’t safe to eat for 2 causes. Primarily, primary, as a result of it’s a Neolithic meals, that means it was not consumed throughout 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 instance. On the opposite finish of the spectrum, you will have the standard medical view that dairy is wholesome when it’s well-tolerated. You’ve gotten the Weston A. Worth 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 probably not writing anymore within the well being world however used to, and other people like myself. In my first guide, The Paleo Remedy, I argued that dairy will be a part of a wholesome, entire meals food regimen if it’s well-tolerated.

Moderately than simply share [my] opinion about this matter, I need to assessment the analysis and what the analysis says. Earlier than I try 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, however it’s one which I hear typically, so I simply need to convey it up earlier than we dive into the analysis and the main points. That is significantly 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 devour 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 have been weaned, we didn’t go on consuming dairy merchandise after that. So the declare is that, due to that, we shouldn’t devour 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 planet of consuming, a superb instance could be darkish chocolate. We devour darkish chocolate. I don’t know of every other mammals or animals on the market which can 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 prepare dinner our meals. That’s one other instance. I don’t know every other mammals or animals which can 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 shortly, 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 large advantages. So I don’t assume it’s an excellent argument that we shouldn’t do one thing simply because different mammals or animals aren’t doing it. I simply needed to begin there.

Background of Dairy Consumption By People

Let’s discuss just a little bit concerning the background of dairy consumption amongst people as a result of I feel that’s necessary 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 ordinary meals consumption throughout the Paleolithic period. However there was a purpose that dairy merchandise began to be consumed, and that is true for many behaviors which can be preserved, from an evolutionary perspective—they serve some objective, or they wouldn’t proceed. It appears, from the newest analysis, that the consumption of dairy arose in several elements of the world individually, or distinctly. One was the Center East; one other was East Africa. No less than 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 vitamin. In these elements of the world the place folks started to devour dairy merchandise, that habits was preserved over time after which unfold to different elements of the world.

Now, it’s true that human beings require a specific enzyme known 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 have 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 have been weaned, we didn’t have to proceed to provide lactase. The physique would simply shut that [production] down, and we’d not be capable of digest milk into maturity. And right now, that’s nonetheless true for two-thirds of the worldwide inhabitants. In different phrases, solely about 35 p.c of the inhabitants world wide continues to provide lactase into maturity and is thus in a position to digest lactose, the sugar in milk. We’re going to speak just a little bit extra about this later within the present. But it surely’s price simply stating briefly that even should you’re one of many 65 p.c that doesn’t produce lactase in maturity, that doesn’t imply that you could’t take pleasure in dairy merchandise. There are lots of methods that you could 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 elements of the world, significantly Northern Europe and Scandinavia, the place right now, about 95 p.c 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’ll be able to 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 hassle. 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 devour a complete bunch of it, they don’t do properly. That’s what I’ve seen in my scientific observe working with hundreds of sufferers over time and the suggestions I’ve gotten from the hundreds of healthcare practitioners that I’ve educated, as properly.

The Analysis on Dairy Consumption

So with all of that context in thoughts, let’s transfer into speaking just a little bit concerning the analysis. Loren Cordain’s group printed some assessment papers proposing numerous physiological mechanisms by which dairy causes hurt. One was a paper by Melnik known as “Milk signalling within the pathogenesis of kind 2 diabetes.” They current a concept that milk consumption past the weaning interval may 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 might count on to see elevated charges of kind 2 diabetes in folks consuming dairy merchandise. The truth is, we don’t see that, and we regularly see the other. 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 threat elements for diabetes. They discovered that larger circulating ranges of trans-palmitoleic acid have been related to more healthy ranges of blood ldl cholesterol, inflammatory markers, insulin ranges, [and] insulin sensitivity, even after adjustment for different threat elements. Through the follow-up interval, folks with larger circulating ranges of trans-palmitoleic acid had a a lot decrease threat of creating diabetes, with about 60 p.c decrease threat amongst individuals within the highest quintile of trans-palmitoleic acid ranges, in comparison with folks within the lowest quintile. Put extra merely, this examine instantly contradicted the speculation that was posed in [the] milk signaling paper, and located that individuals with the best ranges of this specific fatty acid from dairy merchandise had about one-third the chance of creating 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 chance of diabetes or cut back it.

One other examine discovered that individuals with the best ranges of milk fats biomarkers have been at decrease threat of coronary heart assault. For ladies, the chance was diminished by 26 p.c, and for males, it was 9 p.c decrease. One other examine confirmed that individuals who ate essentially the most full-fat dairy had a 69 p.c decrease threat of dying from heart problems than those that ate the least. After which a big assessment of 10 research discovered that consuming milk was related to a small however vital discount in coronary heart illness and stroke threat. That is analysis from the 2010 to 2015 interval. I need to assessment some newer analysis to present you an thought of what the research over the previous 5 to 10 years have proven, as properly.

There’s a paper that was printed in Advances in Vitamin in 2016 known as “Complete Evaluate of the Impression of Dairy Meals and Dairy Fats on Cardiometabolic Threat.” 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 isn’t a obvious threat 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 threat elements, blood strain, irritation, insulin resistance, and vascular operate. This implies that the purported detrimental results of saturated fatty acids on cardiometabolic well being could in actual fact be nullified when they’re consumed as a part of advanced meals matrices equivalent to these in cheese and different dairy meals. Thus, the give attention to low-fat dairy merchandise in present pointers apparently isn’t totally supported by the present literature and should have to be revisited on the premise of this proof.” So, [there are] a number of attention-grabbing issues about this paper and this conclusion. Primary, no dangerous impact of dairy merchandise for cardiometabolic threat elements. The truth is, in most of the research that they reviewed, they noticed advantages and enhancements [in] folks consuming dairy. The second attention-grabbing level is that low-fat or nonfat dairy was not higher than full-fat dairy. In lots of instances, truly, 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 specific advantages. I’m going to cowl these in additional element shortly, however I simply needed 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 Vitamin 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 attention-grabbing discovering. One other paper [was] printed extra just lately within the journal Advances in Vitamin in 2019 known as “Results of Full-Fats and Fermented Dairy Merchandise on Cardiometabolic Illness.” I’m going to cite instantly from the summary right here as a result of it’s fairly clear. “The truth is, the burden of proof from latest massive and well-controlled research, systematic critiques, and meta-analyses of each observational research and randomized managed trials signifies that full-fat dairy merchandise, significantly yogurt and cheese, don’t exert the detrimental results on insulin sensitivity, blood lipid profile, and blood strain as beforehand predicted on the premise of their sodium and saturated fats contents; they don’t enhance cardiometabolic illness threat and should in actual fact shield in opposition to 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 typically improves it.

The final paper I need to speak about was a randomized management[led] trial from [the] American Journal of Scientific Vitamin[in] 2021. It’s known as “Impression of low-fat and full-fat dairy meals on fasting lipid profile and blood strain.” This was a trial of about 70 individuals, 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 1 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 strain, in contrast with diets restricted in dairy or wealthy in low-fat dairy. Due to this fact, dairy fats, when consumed as a part of advanced entire meals, doesn’t adversely impression these traditional heart problems threat elements.

I may go on. I’m simply sharing a collection of the analysis to present you an thought, however there are tens, if not a whole lot, 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 a number of 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? Effectively, we already talked about it just a little bit. A number of 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 can be current in high-fat dairy merchandise, like butyrate and conjugated linoleic acid, have advantages that, over the previous few years, have turn out to be way more clear. Butyrate gives vitality to the cells lining the colon, it inhibits irritation, which can clarify why dairy isn’t inflammatory, and [it] could stop colonic micro organism from coming into the bloodstream. The truth is, butyrate’s anti-inflammatory impact is so robust that we use it in Purposeful Medication, and even in standard medication, 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 gaggle of [patients with] Crohn’s illness. One other fatty acid in milkfat is named phytanic acid, and it’s been proven to scale 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 accustomed to synthetic trans fat, that are very dangerous. However conjugated linoleic acid is a pure trans fats, and it’s been proven to scale back the chance of coronary heart illness, most cancers, and diabetes. Dairy fats can also 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 search 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 incorporates about 115 milligrams of calcium. However what the meals label gained’t inform you is that the bioavailability of calcium in spinach is extraordinarily low. It’s about 5 p.c. 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 p.c. This implies you’d should devour 16 cups of spinach to get the identical bioavailable calcium that you simply get from one glass of milk.

Now, I do know a few of you might be pondering, “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 principle level I’m making an attempt to make with this podcast—should you can devour dairy merchandise and you are 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, significantly once you devour high-fat dairy merchandise, and significantly once you devour natural dairy merchandise from animals which were 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 creating dairy merchandise much more health-promoting.

The False Criticism That Dairy Has a Damaging Impression on Bone Well being

Now that we’ve lined the analysis on dairy merchandise basically 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 because of the distinctive compounds that it incorporates, I need to speak about one other criticism of dairy merchandise, which is that consuming dairy has a adverse impression on bone well being. After that, we’re going to speak just a little bit about a few of the practicalities, like the way to know should you’re illiberal to lactose or the proteins in dairy and the 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 basically 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 major impression on our well being, as a result of there’s no proof to help 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 devour meals which can be excessive in phosphate, they depart 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 stability, [and] osteoporosis connection to spotlight these. The examine is named “Milk and acid-base stability: proposed speculation versus scientific proof,” and the authors reviewed each the acid-ash speculation, basically, 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 help this speculation. First, they emphasize that urine pH isn’t indicative of systemic pH. The truth is, besides in instances of significant renal insufficiency [or] kidney illness, food regimen has no impression on serum pH. If it did, we’d be in a number of hassle 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 might not have survived this lengthy, as a result of as you recognize, our distant ancestors didn’t have any idea of acid-alkaline stability. There have been intervals of various meals availability, [and] it wouldn’t make sense from an evolutionary perspective that we may so simply alter such a crucial 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. That is why your urine adjustments pH relying on what you eat. It’s an indication that your kidneys are doing their job. That’s necessary to know as a result of advocates of this speculation typically suggest and even promote urine pH exams, they usually declare that if the pH of your urine is low, meaning your physique is acidified and you’ll want to devour 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 impression in your bone well being or total well being. What’s additionally significantly attention-grabbing is that, even should you settle for this acid-alkaline speculation basically, the authors of this paper cite two research that point out that milk truly leaves an alkaline ash, versus an acid ash, based mostly on measurements of urine pH and internet acid excretion following milk consumption in scientific trials. So, even when we go together 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 once you actually have a look at the proof.

Maybe much more necessary, it’s useful to have a look at proof that hyperlinks dairy consumption on to bone well being. As a substitute of arising 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 scientific endpoint that we’re involved with, which is bone well being. So, what do research which have checked out this present? Effectively, they present that consuming milk tends to result in optimistic calcium stability, 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 numerous bone well being dietary supplements. Elevated dairy consumption is constantly related to decrease charges of osteopenia, osteoporosis, and higher bone well being throughout many various cultures world wide. For instance, elevated dairy consumption in postmenopausal Korean girls was related to a decreased threat of osteoporosis. One other examine discovered that within the [United States], dairy consumption was a major predictor of osteoporosis amongst postmenopausal girls, that means girls who devour extra dairy had decrease charges of osteoporosis. And in Poland, larger dairy consumption throughout childhood and adolescence predicted higher bone well being in adults. Once more, these are simply three research I’m choosing which can be consultant. There are lots of different research within the scientific literature that help 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 assessment the majority of the proof [and] not simply these research that I’ve chosen. However I selected ones that have been consultant. I selected massive, systematic critiques that checked out all several types of proof, different critiques, randomized managed trials, observational information, potential research, retrospective analyses, and many others., they usually all level to the identical conclusion—that dairy consumption, significantly full-fat dairy, is useful for cardiometabolic and bone well being.

The Practicalities of Dairy Consumption

Now that we’ve reviewed the proof, let’s speak about a few of the practicalities. It’s true that many individuals don’t tolerate dairy merchandise properly, 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 gentle to critical however isn’t a real allergy. Or, some folks can truly be allergic to the proteins in dairy. That is pretty unusual, truly. The prevalence research I’ve seen vary a bit, however it’s typically within the 1 to three p.c vary from what I’ve seen. Whereas lactose intolerance, [which is] the lack to digest the sugar in milk, is way 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 just about no lactose in it. Butter has little or no lactose. Laborious cheeses, significantly these which were 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 will have mushy 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 just about freed from lactose. As you’ll be able to see, there are lots of totally different choices for dairy merchandise for individuals who need to get the advantages of calcium, the fatty acids which can 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 of devour [many] of these merchandise, even those which can be low in lactose. However for others, they’ll eat fairly a little bit of these merchandise and never have a difficulty.

Talking personally, I don’t do properly with fluid milk, an excessive amount of mushy cheese, or store-bought yogurt. However I can have onerous cheese, ghee, butter, cream, and home made yogurt and kefir all day lengthy with no drawback in any respect. When you’re illiberal of the protein in dairy, that’s just a little bit more difficult, as a result of nearly all dairy merchandise comprise dairy protein. The exception could be ghee. Butter is pretty low in protein, as properly, however undoubtedly, if somebody’s allergic to the protein, they’re not going to have the ability to tolerate butter, normally. They are able to tolerate ghee if it’s simply an intolerance, quite than an allergy. It can rely upon how vital the intolerance is. When it comes to testing, there are some exams on the market to display for dairy protein intolerance or allergy. A typical meals allergy take a look at ought to take a look at for dairy proteins. When it comes to intolerance, there are labs like Cyrex, [whose] Array 4 panel is nice for dairy proteins. Vibrant Wellness has a meals intolerance take a look at that screens for dairy proteins, as properly. When you work with a Purposeful or integrative medication practitioner, you’ll be able to in all probability ask them to order these exams. If you wish to find out about your protein tolerance relating to lactose intolerance, there are additionally exams on the market [for that]. However I’ve discovered that the perfect and handiest technique, as a result of it’s extra of a threshold-based situation quite 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 period, 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 might be positive with that, even folks [who] are extraordinarily lactose illiberal. Then you definately go to butter, then you can go to onerous cheeses, that are nearly freed from lactose, [and] then you can go to 24-hour, at-home home made kefir or home made yogurt. When you nonetheless do properly with that, you can go to store-bought yogurt and store-bought kefir, and so forth down the road, mushy cheese, fluid milk, and many others. When you’re positive with ghee and butter and onerous cheese, however then sooner or later, you begin reacting to dairy merchandise, perhaps once you begin consuming yogurt from the shop or fluid milk, then you recognize you will have some stage of lactose tolerance. When you have been illiberal of proteins, you’d have reacted to the onerous cheese as a result of it’s just about freed from lactose however has loads of dairy protein. Laborious cheese generally is a good benchmark for differentiating between lactose intolerance and protein intolerance. That’s the overall course of I take advantage of in my observe with sufferers. It really works fairly properly, and since everybody’s sensitivity tends to be fairly particular person, it’s typically much more efficient than doing the exams.

I hope this was useful [and] I hope you realized one thing. It’s attention-grabbing to me that dairy merchandise are so hated within the various, Purposeful [Medicine], [and] Paleo communities, as a result of once you have a look at the scientific proof, it’s clearly helpful from a well being perspective, whether it is properly tolerated. So, that’s the crux of it. I do assume it’s price stating that, in all the research that I discussed, they didn’t phase folks in response to their tolerance of lactose or dairy proteins, they usually simply took a broad pattern of individuals. I feel we will nearly assure that there have been folks in these research [who] have been lactose illiberal or have been illiberal to the proteins in dairy, and but [they] nonetheless skilled a few of these cardiometabolic advantages. That’s attention-grabbing to me. I’m not suggesting that people who find themselves illiberal of dairy ought to devour it. I don’t assume that they need to, as a result of I feel it could possibly be problematic in these instances. I’m simply stating that even with out segmenting folks, these research nonetheless confirmed profit. If that they had segmented folks, maybe they’d 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’ll be able to at all times try 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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