This Facts About reviews low-fat/non-fat dairy and gives examples of foods to choose from as well as foods to avoid. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

• Optional: 1-3 servings per day

Why choose low-fat/non-fat dairy products?

• Though many foods contain calcium, dairy foods are some of the richest sources of calcium
• They are high in protein, vitamin B12 and other minerals the body needs, such as selenium, zinc, phosphorus, potassium and magnesium
• Most milk is fortified with vitamin D, which helps the small intestine absorb calcium
• Low-fat and fat-free milk are also typically fortified with vitamin A, which is lost in the removal of milk fat
• Selecting low-fat/non-fat dairy products helps reduce total and saturated fat intake and calories
• While low-fat and non-fat dairy products are made using 1%, ½%, or non-fat milk instead of using whole milk or cream, artificial ingredients may be added to enhance color, shelf-life, and texture. Read labels and avoid products if the ingredients are chemicals or names too long to pronounce.
• Although recent research suggests that dairy product intake may be associated with lower body weight or body fat, definitive evidence is pending.

Why choose fermented/probiotic milk products such as yogurt?

Probiotic foods contain healthy living bacteria. Eating such foods can help re-establish a healthy bacteria balance in the digestive tract that may have been disrupted by poor diet or medications. Research has shown that the healthful bacteria in yogurt may provide many benefits, such as:

• Offering a safe and effective means of treating acute infectious diarrhea in children
• Preventing antibiotic-associated diarrhea
• Protecting against tumor formation in the colon
• Reducing intestinal transit time which helps prevent constipation
• Improving the digestion of lactose in persons with lactose intolerance
• Enhancing gut and systemic immune function by increasing IgA antibody production
• Preventing allergic reactions by reducing hypersensitivity reactions
• Helps reduce symptoms of inflammatory bowel disease (IBD) such as Crohn’s and ulcerative colitis
• Increasing HDL (good) cholesterol and decreasing the ratio of LDL (bad) to HDL cholesterol with long-term, daily intake of yogurt; this may be due to the fatty acid distribution and the type of fats in the milk

Other fermented milk products, such as low-fat/non-fat sour cream, cottage cheese, and cheeses (Swiss and Cheddar), may have similar benefits.

Selected Food Sources with Serving Sizes

Specific Considerations

Choosing low-fat/non-fat dairy products

• Low-fat dairy products have less than 3 g of total fat per serving
• Check expiration date on containers
• Choose dairy products from "free-range", "grass-fed" or "organic" animals to minimize consumption of antibiotic residues and other toxins

Full-fat cheese

Although full-fat cheese is high in total fat and saturated fat, small amounts of natural, minimally processed cheese can be an important dietary component. The Mediterranean diet, known for its health benefits, includes small amounts of cheese almost daily. Full-fat cheese should be consumed in small portions.

Buy high-quality cheese made by local farmers or imported from reputable creameries. This decreases the chance of antibiotic and hormone residues and use of trans-fats/hydrogenated oils as a means of processing cheese to increase shelf-life. Avoid pre-packaged cheeses for the same reasons.

Examples of Full-fat Cheeses

Lactose Intolerance

Many people are lactose intolerant, meaning that they lack the enzyme lactase that breaks down the natural sugar (lactose) found in dairy products. Around the world, various ethnic groups have different proportions of those who are lactose intolerant; approximately 90% of Asians, 70% of African and Native Americans and 50% of Hispanics are lactose intolerant, versus only about 15% of people of Northern European descent.

Lactose intolerance can cause bloating, gas, and stomach aches after intake of dairy products. Symptoms may be avoided by choosing fermented dairy products such as yogurt or lactose free milk.

Casein Sensitivity

The milk protein casein, found in dairy products, stimulates the production of mucus in some people and can potentially aggravate conditions like auto-immune disease, asthma, bronchitis or sinusitis. Some studies suggest that casein may irritate the immune system which should be considered by people who have “overactive immune systems” – often manifested by chronic allergies, lupus and rheumatoid arthritis, for example.

Choose Organic

We recommend organic, free-range animal products because they contain less antibiotic or hormone residue and have a higher omega-3 and vitamin E content. These qualities make organic animal products a better nutritional choice. We believe they generally provide better flavor than conventionally raised animals.

Organic food is produced by farmers who emphasize the use of renewable resources and the conservation of soil and water to enhance environmental quality for future generations. Organic meat, poultry, eggs, and dairy products come from animals that are given no antibiotics or growth hormones. With the increase in incidence of hormone-related diseases such as breast and prostate cancer, it may be prudent to consume only organic dairy products.

Hormones and Antibiotics

• Most commercial animal products contain residues from drugs, hormones, and chemicals used to keep modern dairy cows producing abundantly. These residues in food may increase the risk of breast cancer and other hormone-related cancers including prostate cancer.
• Most commercially-raised animals may have been exposed to antibiotics. This practice contributes to the escalating problem of antibiotic-resistant bacteria throughout the world.

Know Your Limits for Fat

• On a 2,000 calorie diet, about 30% or 600 calories (67g) should come from total fat per day
• A ratio of 1:2:1 of saturated: monounsaturated: polyunsaturated (such as Omega-3s) fat should be the goal. 1:2:1 in calories equals 150:300:150 - no more than 150 calories or 7.5% (17g) of total calories should come from saturated fat
• A low-fat dairy product has less than 3g of fat per serving

Ideas for your dairy consumption

• Freeze yogurt for a frozen dessert. Research shows that probiotic bacteria can survive the freezing process, so freezing yogurt will not diminish its health benefits.
• Plain yogurt, mixed with fresh fruit, makes a quick and easy snack. Since plain yogurt has no added sugars choosing it reduces your sugar and calorie intake. Additionally you get added fiber and antioxidants from the fresh fruit!
• Use cottage cheese like a dip for raw vegetables and whole grain pretzels or pita chips.
• Full-fat cheese has big flavor (and lots of fat). An ounce or two can be a satisfying treat.

This Facts About document is published by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, at University of Michigan Integrative Medicine Clinical Services. Our mission is to care for people using an Integrative Medicine model that reaffirms the importance of relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.

Resources

Added Hormones in Meat and Dairy – Do They Affect Health and If So, How?
Barrett, Amanda
Somerset Medical Center – Healthy Living – Food and Nutrition
www.somersetmedicalcenter.com
Accessed May 9, 2006

Calcium & Milk – What’s Best For Your Bones?
Harvard School of Public Health
www.hsph.harvard.edu/nutritionsource
Accessed May 9, 2006

Cheese, Feta
USDA Agricultural Research Service – Nutrient Data Laboratory
www.nal.usda.gov/fnic/foodcomp
Accessed May 9, 2006

Cheese, mozzarella, part skim milk, low moisture
USDA Agricultural Research Service – Nutrient Data Laboratory
www.nal.usda.gov/fnic/foodcomp
Accessed May 9, 2006

Dairy Products:  Selecting, Storing and Serving
Mayo Clinic
www.mayoclinic.com
Accessed May 9, 2006

A Food Labeling Guide – Appendix A
Center for Food Safety and Applied Nutrition
U. S. Food and Drug Administration
www.cfsan.fda.gov
Accessed June 2, 2006

Bennion M and Scheule B. Introductory Foods. Upper Saddle River, NJ: Prentice-Hall, Inc.:2000.

Milk, lowfat, fluid, 1% milkfat, with added vitamin A
USDA Agricultural Research Service – Nutrient Data Laboratory
www.nal.usda.gov/fnic/foodcomp
Accessed May 9, 2006

A Primer on Fats and Oils
American Dietetic Association
www.eatright.org
Accessed May 17, 2006

Prebiotics and Probiotics:  What Are They and Why Should I Eat Them?
Dixon, Suzanne
U of M Comprehensive Cancer Center
www.cancer.med.umich.edu
Accessed May 9, 2006

Dietary Supplement Fact Sheet:  Vitamin B12
National Institutes of Health
Office of Dietary Supplements
http://ods.od.nih.gov/factsheets/vitaminb12.asp#h4
Accessed May 9, 2006

Yogurt, fruit, low fat, 10 grams protein per 8 ounce
USDA Agricultural Research Service – Nutrient Data Laboratory
www.nal.usda.gov/fnic/foodcomp
Accessed May 9, 2006

Original Research and Review Articles

Adolfsson O, et al.  Yogurt and gut function.  American Journal of Clinical Nutrition.  2004;80:245-256.

Hekmat S, et al.  Survival of lactobacillus acidophilus and bifidobacterium bifidum in ice cream for use as a probiotic food.  Journal of Dairy Science.  1992;75:1415-1422.

Kissling G, et al.  Long-term consumption of fermented dairy products over 6 months increases HDL cholesterol.  European Journal of Clinical Nutrition.  2002;56:843-849.

Savilahti E, et al.  Allergenicity of cow milk proteins.  Journal of Pediatrics.  1992;121:12s-20s.

Senok AC, et al.  Probiotics:  facts and myths.  Clinical Microbiology and Infection.  2005;11:958-966.

Teegarden D.  The influence of dairy product consumption on body composition.  Journal of Nutrition.  2005;135:2749-2752.