Guest Post Sally Marchini, Dietitian
Today I’ll begin with the first in a series of blogs on dairy foods and their alternatives. I’d like to start by making the point that as an Accredited Practising Dietitian my job is to provide you with evidence-based information to you to help you to wade through the minefield of claims made by others for your best health interests.
As I hope you know by now, dairy and alternatives (mostly reduced fat) is one of the five key food groups in the Australian Dietary Guidelines, so in this first blog I thought we’d do a Professor Sumner-Miller and take a closer look at ‘Why Is It So?’.
In the other blogs to follow this one I’m considering taking a closer look at the nutritional differences between dairy and its alternatives as well as ways to incorporate more into your diet if you’re not meeting the guidelines. If you have specific questions relating to dairy and alternatives, please let me know and I’ll do my best to answer them within the blogs. Let’s get started!
The Healthy Eating Guidelines for Adults brochure shows that women aged over fifty need 1.5 more serves than other adults. Children and pregnant women also have different requirements, so click on the links if you’re interested in these groups. We all need different amounts for different reasons, but for us with diabetes it’s a really important food group for many reasons including that they have a low-glycemic index.
Other reasons listed in the Australian Dietary Guidelines that relate to people with diabetes are:
• Coronary heart disease: It is probable that the consumption of at least two serves per day of dairy foods (milk, cheese and yoghurt) is associated with reduced risk of ischaemic heart disease and myocardial infarction (Grade B; Evidence Report, Section 5.3).
• Stroke: It is probable that the consumption of two or more serves of dairy foods per day (milk, cheese and yoghurt) is associated with reduced risk of stroke (Grade B; Evidence Report, Section 5.4) particularly reduced fat varieties.
• Hypertension: It is probable that consumption of three serves of low fat dairy foods (milk, cheese and yoghurt) is associated with reduced risk of hypertension (Grade B; Evidence Report, Section 5.5). The evidence also suggests that consumption of three serves of any milk, cheese or yoghurt products per day is associated with reduced risk of hypertension (Grade C; Evidence Report, Section 5.5).
• Type 2 diabetes: The evidence suggests that consumption of two to four serves of dairy foods (milk, cheese, yoghurt) per day is associated with reduced risk of metabolic syndrome (Grade C; Evidence Report, Section 5.7) and that consumption of at least one and a half serves of milk, cheese and yoghurt per day is associated with reduced risk of type 2 diabetes (Grade C; Evidence Report, Section 5.6).
• Excess weight: The evidence suggests that consumption of dairy foods is not associated with weight change or risk of obesity in adults (Grade C; Evidence Report, Section 5.8) and consumption of milk is not associated with BMI or change in BMI in childhood (Grade C; Evidence Report, Section 5.9). Total energy intake is always important in weight management.
Aside from specifically diabetes related benefits, there are other benefits listed here that show the benefits for health in general including some cancers and bone mineral density issues. If you want to understand more about the Evidence Levels, they’re explained early on in the pdf document of the Australian Dietary Guidelines.
You may ask, ’So what’s in it that makes it so valuable from a nutritional point of view?’
Direct from the guidelines as it’s explained so well: “Milk, cheese and yoghurt have various health benefits and are a good source of many nutrients, including calcium, protein, iodine, vitamin A, vitamin D, riboflavin, vitamin B12 and zinc. These foods provide calcium in a readily absorbable and convenient form. However, in reflecting on Australian consumption patterns and ensuring all nutrient requirements are met within energy requirements, it is recommended that reduced fat varieties should be chosen on most occasions. The inclusion of mostly or all full fat milk, cheese and yoghurts proportionally increases total fat, saturated fat and overall energy components of the diet. Unmodified milk from animal sources such as cows, goats or sheep, should not be given as a main drink before 12 months of age.”
It should be noted that reduced fat varieties of milks and/or plant-based drinks are not suitable as a drink for children under the age of 2 years due to energy requirements for growth and they may also not be appropriate for adults over the age of 70 years due to reduced body weight and energy intake.”
The Guidelines advise for those with Lactose Intolerance that: “The rate of lactose intolerance is relatively high in many Asian communities compared with Caucasians. High rates of lactose intolerance have been described among Aboriginal and Torres Strait Islander groups. Lactose-intolerant adults and children often avoid milk and milk products, however up to 250ml of milk may be well tolerated if broken up throughout the day and consumed with other foods. Cheese contains little lactose and the lactose in yoghurt is partially broken down by bacteria that thicken the yoghurt, so should be well tolerated. Lactose-free dairy products and calcium-fortified beverages are also available.”
And for people who are Vegan or Vegetarian, the Guidelines read: “The 2003 edition of the dietary guidelines addressed vegetarian and vegan diets and their influence on calcium needs because of the relatively high oxalate and phytate content in some plants. However, lacto-ovo vegetarians appear to have calcium intakes similar to those of omnivores. Those who follow a vegan or vegetarian diet and avoid milk products, should consume alternative calcium-fortified products and seek advice from a health professional about whether they need to take supplements.
So I hope you can see good reasons here to meet your dietary targets for dairy and alternatives.
It’s as easy as including a glass of milk or a fruit smoothie made on low-fat milk (or alternative) or a small tub of yogurt as snacks through your day, plus the milk on your breakfast (probably half a serve), a serve of cheese (preferably low-salt) either on a sandwich or in your salad, and/or enjoying a low-fat dairy based dessert like ice cream (preferably without the added ‘discretionary choices’ toppings) if you need to boost your serves.
How do You ensure You get Your serves of dairy or alternatives?
Tune in next week to continue the dairy story, and don’t forget to let me know if you have dairy questions that need answering in the meantime! 🙂
Sally is owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too.