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There are a lot of opinions about dairy? Find out what is fact and what is myth by reading here >> https://www.fortitudenutritioncoaching.com.au/blog/3-dairy-myths

We are big fans of dairy products however understand that not everyone can tolerate dairy, not everyone likes dairy and not everyone is comfortable eating animal products.

In this blog we want to focus on these 3 common myths and the evidence that could impact your decisions:

Does dairy cause acne?
Is dairy bad for you because of hormones?
Will dairy make you fat?

Plus we’ll give a little bit of background info on:

Lactose intolerance
Which dairy products contain the most lactose
The best dairy alternatives

Lactose Intolerance

Lactose is the naturally occurring carbohydrate in milk. It is broken down into glucose and galactose in the small intestine. There is an enzyme called lactase which breaks down lactose, however some people are lactase deficient. They do not have enough lactase to digest lactose which can result in bloating, gas, stomach upset and diarrhoea(1)(2).

Approximately 70-75% of the world's population has some level of lactose intolerance(1)(3)(4), however it is heavily dependent on ethnicity. Here are the approximate percentage levels of lactose intolerance:

15% of adults with Northern European heritage
70-80% of adults with Eastern European, African, Latino, South American heritage
90% of adults with Asian, Aboriginal heritage

Just because not all humans can tolerate dairy does not make it unhealthy for all humans. There are many things that not every human can or should do and this is just another example. If you tolerate dairy and enjoy it - count yourself lucky.

Lactose intolerance is not the same as a cow’s milk allergy which affects about 2% of babies in Australia. A milk allergy can result in visual allergic reactions and anaphylaxis, however these are not symptoms of lactose intolerance (5).

What should you do if you suspect you are lactose intolerant?

Speak to your doctor as there are a few tests that can be done (6). There is a suggestion that many people are incorrectly self-diagnosing lactose intolerance so best to get a formal diagnosis and information on how to replace the nutrients, such as calcium, which are found in dairy (4).

Which dairy products contain the most lactose and are there dairy options with lower levels of lactose?

Many people who are lactose intolerant can actually still consume some dairy products, potentially 2 serves per day of up to 12 grams of lactose each time. If you are lactose intolerant but can tolerate some dairy products, it’s likely a good idea to split the serves across the day.

The amount of lactose tends to reduce with processing, so more cheese and yoghurt might be tolerated compared to milk.

(6)

Does dairy cause acne?

Short answer - maybe.

There is no proven cause and effect at this stage but it’s possible. It might be something you decide to test over time, if you notice differences in your own skin with and without dairy. However we would recommend speaking to your Dermatologist first before making changes, rather than relying on blogs, articles and anecdotes (even ours).

There are some factors relating to dairy that correlate with acne. However it is far from cause and effect and the outright statement that ‘dairy causes acne’ doesn’t appear to be supported at this time.

There are mechanisms in the human body which suggest that reducing dairy products may be a good idea for those with acne. Dairy contributes to higher levels of insulin and growth hormone, which in term correlate with higher levels of acne, so theoretically dairy could cause acne (7)(8).

Most of the research with dairy and acne is observational, which are basically surveys. They are great for indicating correlations and further areas to study, however they do not show causations. Eg, they show us interesting relationships without giving us certainty of what is actually happening.

To give an extreme example of why correlations and relationships should be taken with a grain (or pinch) of salt - have a look at this correlation.

Fortitude Nutrition Coaching dairy myths correlation chart

In 2019 a review was conducted on available observational research (surveys) into acne and dairy. Some of these surveys indicated a link between dairy and acne and others did not, however overall across all of the available surveys it was concluded that there does appear to be an association (correlation) between milk consumption (particularly skim milk) and acne, whilst there is no association between yoghurt, cheese and acne (7).

So does dairy cause acne? There is no proven cause and effect at this stage but it’s possible. So it could be worth testing it on yourself as an individual and noticing any changes. If you do reduce your dairy consumption, just be sure to consider getting calcium from other sources and we’ll give you some more information about that below.

Is dairy bad for you because of hormones?

Short answer - no.

As is often the case when we hear potential myths with nutrition, we can try to ask more specific questions such as “what or which hormones in dairy should we actually be concerned about?”

Dairy does contain steroid hormones, which sounds scary but in reality we are talking about naturally occurring hormones like estrogen. Only a tiny amount of these steroid hormones are available to be absorbed and active in the body, around 0.2% (9). When studied in mice, they were fed milk with 100 times the natural amount of estrogen that is found in milk from pregnant cows, and it did not cause any rise in blood levels of estrogen. Only when the mice were given 1000 times that natural amount of estrogen in milk was there a rise in blood levels (10).

In realistic terms for humans, it appears that whilst milk contains some naturally occurring hormones, these levels are far too low to present any risk or have any biological effect (11).

What about added hormones and antibiotics in milk?

Bovine growth hormones are used in some countries to increase milk production, however are prohibited for use in Australia. Antibiotics may be used to control bacterial infections in the dairy industry, however this is regulated and milk from cows treated with antibiotics is disposed of until the passing of a ‘milk withholding period’. (12)(13)

Bovine growth hormones are used in the USA but are approved for use by the US Food and Drug Administration which deems them safe (14).

Will dairy make you fat?

Short answer - no

Anecdotally we hear about some people removing dairy and losing weight, however this is likely due to a reduction in calorie dense forms of dairy (ice cream, cheese) rather than due to dairy itself.

It’s important to be really clear that weight gain and weight loss is based on the principle of energy balance - so calories in versus calories out. When trying to find out if a particular food might lead to weight gain or weight loss, think about how that would apply in the context of all the food and energy a person eats in a day. As you consider this principle more and more, we’re sure you will come to realise that one particular food is not the cause of weight gain and one particular food will not magically lead to weight loss if you do not consider all of the energy a person consumes and burns in a day.

A 2012 review of 16 studies (not just surveys) concluded that an increase in dairy consumption, even without restricting calories (dieting), didn’t necessarily lead to weight gain. In calorie restricted diets, the inclusion of dairy led to greater weight and fat loss (15).

Low-fat dairy is lower calorie than high-fat dairy, there is nothing sinister or fat-gaining added to low-fat dairy. It’s just the fatty cream which is removed. So you might think that high-fat dairy could be different and actually cause weight gain. However, a 2013 review of 16 studies (surveys) concluded that high-fat dairy does not contribute to obesity and actually lowers the risk of obesity (16).

How much dairy should you eat?

The Australian Dietary Guidelines recommend that most age groups aim for 2-3 serves of dairy per day and consume mostly reduced-fat options (17). Recommendations do differ a little according to age, gender and circumstances. You can find the recommendation that matches you, below:

Fortitude Nutrition Coaching dairy myths graphic 3

(18)

What dairy alternative is best?

If we focus on calcium, the following alternatives contain about the same amount of calcium as a serve of milk, yoghurt or cheese:

100g almonds with skin
60g sardines, canned in water
½ cup (100g) canned pink salmon with bones
100g firm tofu
250ml of milk alternative that is fortified with 100mg of calcium per 100ml

(17)

Check the label on tofu as calcium levels vary depending on whether the tofu is calcium set or magnesium set. Check out this great graphic by @theplantpotential

View this post on Instagram

A post shared by Jacob McGinness, APD (@theplantpotential) on Feb 26, 2020 at 12:01pm PST

What is the best milk alternative?

There is an ever growing list of dairy milk alternatives such as soy, rice, oat, almond. Your personal preference will come into play as well as what you are using the alternative for. Oat milk is apparently the best alternative for baristas looking to replicate a foamy cappuccino.

Soy milk has the most protein of the milk alternatives. It’s important to check the label of your milk alternatives and check they are fortified with at least 100mg of calcium per 100ml. About 1 cup of a calcium fortified milk alternative is the equivalent of 1 serve of dairy. (17)(18)

Summary of the 3 dairy myths

In summary, if you tolerate dairy and you enjoy eating dairy products, they are a great food source and a great source of calcium. Dairy, as with any food source, will not cause weight gain without an excess of calories for you individually. Eating mostly reduced-fat dairy could help you manage your energy intake depending on your goal.

If you do not tolerate dairy, you may still be able to have small amounts without issue, however this will be an individual thing to test.

It’s unclear if dairy causes acne, however this might be a reason to test reducing your dairy intake, as well as your ethical stance on consuming animal products.

If you can’t consume dairy or choose not to, consider the nutrients (especially calcium) you will need to get from other food sources.

Fortitude Nutrition Coaching

Our 1 on 1 Nutrition Coaching service caters for individual preferences and choices. We do not ask anyone to eat anything they do not wish to and search for alternatives for our clients. We are currently helping people lose weight, reduce body fat and improve their overall health. Click the link to learn more about how we can help you reach your goals.

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