Welcome to another edition of “You’re wrong”, “No, you’re wrong.” Today’s dispute: Should diabetics consume dairy products at all, and if so, in whole-fat or non-fat/low-fat form?
This one has high-confidence, high-conviction advocates all over the place.
“Eliminating dairy cured my diabetes!”
“Adding dairy cured my diabetes!”
Who’s right?
One expert advises most of his patients, diabetic or not, to avoid dairy altogether, because, “[t]he majority of humans naturally stop producing significant amounts of lactase—the enzyme needed to digest lactose, the sugar in milk—sometime between the ages of two and five.”
Fair enough. His concern is lactose intolerance, which causes gas, bloating, and other gut discomfort.
But this isn’t a black-or-white, on-or-off issue
It’s true that some 65 percent of people worldwide—yes, the majority of humans—have “reduced ability” to digest lactose, the naturally occurring sugar in all mammals’ milk.
But it’s tricky to pin down—people have varying degrees of intolerance, from mild to severe. Those who are mildly intolerant might trade a bit of bloating for a bowl of ice cream. Those who are severely intolerant can only gaze wistfully at Ben & Jerry’s in the freezer section.
The American Diabetes Association (ADA) has no problem with diabetics consuming dairy products. They recommend 2–3 daily servings of low-fat milk or other low-fat dairy food such as cheese and yogurt, citing them, rightfully, as good sources of calcium and protein.
OK, except for one thing.
Note the qualifier low-fat. Along with no-fat, it appears not only in the ADA’s recommendation, but also in the US Department of Agriculture’s (USDA)—3 cups a day of no-fat or low-fat milk or yogurt for everyone age nine and older.
And it also shows up in the National Institute of Diabetes and Digestive and Kidney Diseases, which specifies that any dairy intake should be no-fat or low-fat.
No fat, no function
Way over on the other side of the discussion are those of us who recognize that the low-fat/no-fat approach gets it totally wrong.
It’s the fat that carries most of what we need for optimal health. Milk’s fats include monounsaturated fat that can help reduce bad cholesterol, and polyunsaturated fat that’s a great supporter of heart health—one of many vulnerabilities that put diabetics at risk.
Whole cow’s milk also delivers:
- 30–35 grams of protein per liter
- Carbs
- Minerals
- Essential fatty acids omega-3 and omega 6 that enable and manage billions of cellular interactions
- Essential vitamins A, B complex, C, D, K, and E.
It’s also important to note, that your body needs fat in order to absorb calcium and vitamin D3.
So, strip away the fat and you’re doing milk’s health benefits a gross disservice.
Take all of this out of milk’s arsenal of nutrients and the machine that is our body slows down.
Prevent? Yes. Reverse? I hope so
Any number of studies have found that consumption of dairy reduces the risk of becoming diabetic.
One study showed that dairy consumption lowers the risk for insulin resistance, the fundamental cornerstone of diabetes. The research team believes one of dairy’s fatty acids, trans-palmitoleic acid, is the possible heroic compound.
Others agree. In various studies of non-diabetic people, higher levels of trans-palmitoleic acid were associated with not just reduced risk of diabetes, but also several additional excellent outcomes:
- Lower body-mass index
- Smaller waist circumference
- Lower triglyceride levels
- Lower levels of c-reactive protein (a marker of inflammation)
- Lower fasting insulin levels
- Reduced insulin resistance
In 2010, a 10-year study of 3,736 men found that those with the highest blood levels of a type of fatty acid from whole-fat—not nonfat—dairy foods had 60 percent lower chance of developing type 2 diabetes than men with the lowest levels.
As one of the study authors commented, “This is an extremely strong protective effect, stronger than other things we know can be beneficial against diabetes.”
I hope that dairy for people already diabetic would work some similar magic. There’s not yet sufficient research to convince me or the larger, more skeptical medical community.
But I think that day will come.
Meanwhile, what should you do?
First, make sure your next checkup includes all the blood work and other tests that can spot the suggestion or presence of prediabetes or diabetes.
If you’re healthy, keep doing what you’re doing. If you’re not a perfect eater or exerciser—and who among us is—try to be “more perfect.” When it comes to dairy products, I recommend upping your intake of fermented products—yogurt, kefir and some cheeses (cheddar has little to no lactose). Fermentation naturally eliminates much of the lactose in those and other products without diminishing their essential nutrients.
If lifestyle and ethnic background put you in an “at-risk” group, measure your tolerance of dairy products. No need to question whether dairy should be eliminated. As far as I’m concerned, the health-improving power of dairy products isn’t the question.
Dairy should be dialed up or down depending on your tolerance. As I said earlier, moderate intolerance opens the door to moderate consumption. Severe intolerance could mean strict limits on dairy intake.
For diabetics who aren’t lactose intolerant, I recommend getting 40 percent of daily caloric intake from fat, including whole-fat dairy.
As always, you’re in charge of your health.
References
- “Component in common dairy foods may cut diabetes risk, study suggests” Science Daily/Harvard School of Public Health. Published December 23, 2010. Last accessed January 15, 2017.
- Greger, Michael. “Diabetes”org. Updated January 9, 2017. Last accessed January 15, 2017.
- “Lactose Intolerance” Genetics Home Reference. Published January 3, 2017. Last accessed January 15, 2017.
- Spero, David. “Is Milk Bad for You? Diabetes and Milk” Published July 5, 2012 by
- “Milk Products and Type 2 Diabetes: An Update” Dairy Nutrition. Published NA. Last accessed January 15, 2017.
- “What is Insulin Resistance?” WebMD Medical Reference. Published October 20, 2016. Last accessed January 15, 2017.
- “HHS and USDA Release New Dietary Guidelines to Encourage Healthy Eating Patterns to Prevent Chronic Diseases” Published January 7, 2016. Last accessed January 15, 2017.
- “Your Guide to Diet and Diabetes” Published January 11, 2017. Last accessed January 15, 2017.
Last Updated: August 16, 2018
Originally Published: February 1, 2017