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What Is Nutrition: The Real "Truth" About Milk and Dairy

Director Cardiology, Fortis Escorts Hospital
Jul 15, 2018 3:56 AM 5 min read

Along with Eggs, another staple which forms an integral part of our breakfast menu is Milk. In addition to the mandatory or occasional glass of Milk, most of us also consume a wide variety of Milk products (i.e. "Dairy") such as cheese, yoghurt, lassi (buttermilk), butter, ghee, ice cream etc.


However, what once formed an intrinsic part of our diet is now shrouded in controversy. Recurrent queries are thrown around what kind of Milk is healthy, whether consumption of cheese is healthy, is ghee good or bad for you et al. Here I will attempt to clear the issues surrounding Milk and Dairy products.  

What Is Nutrition: The Real “Truth” About Milk and Dairy

Milk and Dairy products have been mostly seen as a single group. Consumption recommendations are based on a shared framework, mostly talking of Milk alone. However, it must be understood that Dairy comprises a whole range of products including Milk (whole and low-fat), yoghurt (sweetened-flavoured or unsweetened curd), cheese (processed, cottage), desserts (ice cream, kheer, burfi and other khoya sweets) and  butter and desi ghee. As these have very different properties, it only makes sense to discuss them separately.


Milk is a tricky one. It has been an integral part of human diet from infancy to old age. It is rich in fat (60% saturated), proteins, carbohydrates, and acts as a filling meal. Often loaded with hormones and antibiotics (injected in cows and buffaloes) it may however not be the best diet, especially for adults. Lactose intolerance also plays a role, with nearly two-thirds of adults unable to digest Milk.

What Is Nutrition: The Real “Truth” About Milk and Dairy

Various guidelines recommend Milk intake as a necessity to push child growth as well as to prevent fractures in the elderly. Both presumptions have little support from scientific studies. In several studies, countries with lower average intake of Milk have reported a lower incidence of hip fractures vs. countries with a higher Milk intake. Also, there are several viable alternatives for calcium including unsweetened curd, cheese, leafy vegetables and salads. Regular exercise (much ignored) is probably the best bet for better calcium absorption, for promoting growth in children, and preventing fractures in the elderly.


Greater controversy surrounds around which variety of Milk is the best – low fat or full fat?


American Dietary guidelines recommend that all adults should drink 3 servings (cups) of low fat Milk every day, while children should consume at least 2 servings to maintain bone health. There is little data to back this recommendation. Instead, studies indicate that children who drink low fat Milk gain more weight in comparison to those who consume full-fat Milk. This is probably due to the greater satiety associated with the full fat variety. Moreover, kids often drink Milk with cookies if it’s the low-fat variety, which increases their sugar consumption. Sweetened Milk, especially flavoured Milk (i.e. chocolate, shakes, sherbets etc.) is even worse.


What Is Nutrition: The Real “Truth” About Milk and Dairy

The most beneficial Milk products are yoghurt and cheese. Apart from the common cottage cheese, processed cheese also has proteins and fats, and can be consumed in moderate quantities. Post-fermentation, these are rich in healthy bacteria required by the human body, especially with rampant antibiotic use increasing the risk of multi-drug resistant bacteria. They can also be safely consumed by those who are lactose intolerant.


Milk has two proteins – Whey and Casein. Whey is the liquid that remains after Milk is curdled and cheese is removed. Being rich in healthy protein, it is usually branded and marketed as the muscle building "Whey Protein".


Lassi or buttermilk (and its variants) are a popular breakfast drink, especially in North India. It is the liquid remaining after taking out butter from Milk, but is also made from mixing curd with water, and can be had unsweetened, sweetened, with salt or other flavourings. This has not been subjected to large studies, but lassi is a refreshing drink (served chilled) and is rich in protein, some carbs and low fats. There appear to be no major concerns, except for the added sugar, which is a no-no.


Butter and ghee have long been maligned due to the fat hypothesis associated with heart disease. For years, most studies that have tracked diets of large populations have been unable to find any association of butter with heart attacks or strokes. A recent meta-analysis which tracked over 500,000 individuals for 6,500,000 person-years have concluded that butter intake (1 tablespoon or 14 grams per day) has a minimal effect on mortality and heart attacks. Moreover, it reduces the risk of diabetes. But, it must be kept in mind that consuming large amounts of butter regularly is not advisable as it will lead to weight gain. Ghee, having a high smoking point, is also a better medium for frying (although eating fried foods regularly is not a healthy option).

What Is Nutrition: The Real “Truth” About Milk and Dairy

Finally, Milk is used to make several tasty desserts, the most common being ice cream. As alluded to in earlier articles, sugar is one of the worst components of our diet, whose intake should be avoided or minimised.


The take home message after this entire discussion is: Milk is acceptable for children, especially if it is whole-Milk rather than low-fat. Adults may drink Milk if they are very fond of it, and if they have no intolerance or allergies. Milk should also be procured from a reliable source where the cow / buffalo is given a good feed and not injected with hormones and antibiotics (although that is difficult to determine). Unsweetened yoghurt is an excellent option and should be part of one’s daily diet. Cheese also is a healthy option within reasonable limits. Lassi (unsweetened, maybe mildly salted) is also a healthy and tasty drink. Butter and ghee, which have minimal effect on the heart can be consumed in small amounts daily as they also help in reducing the risk of diabetes.


Ice creams, kheer and khoya-based sweets are popular desserts - they should be had only occasionally, especially by those who are overweight (though there is nothing like a savoury kulfi, a sundae or burfi to celebrate any happy occasion).


Together, Eggs and Dairy make a tasty breakfast without any increased risk of heart disease.


This is a recurring column published every Sunday under the title: What is Nutrition. Next week I will do a deep-dive on “Debunking Common Breakfast Ideas”. Stay tuned.


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