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Should You Eat Full-Fat or Low-Fat Dairy?

Some answers to help you make the best choices in the dairy aisle

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You probably remember that back in the 1980s, fat was routinely vilified. But over the last three decades, the fat-free trend seems to have largely gone the route of big hair and leg warmers, as more and more medical professionals have realized the importance of healthy fats found in foods such as olive oil, nuts, seeds and avocados.

But there’s one area of nutrition where the low-fat fad still seems to reign: dairy. While national health organizations like the Academy of Nutrition and Dietetics seem to be adopting a more laid-back attitude toward fat, they still recommend that you stick to skim or low-fat versions of dairy, as do the 2015-2020 Dietary Guidelines for Americans.

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It’s true that unlike the healthy monounsaturated and polyunsaturated fats found in olive oil, oily fish and nuts, the saturated fat in dairy products can contribute to heart disease risk, points out Mario Kratz, a Seattle nutrition researcher and founder and director of Nourished by Science. But a review published by Kratz in the also found that people who eat full-fat dairy are no more likely to develop heart disease and type 2 diabetes than those who stick to low-fat or fat-free dairy.

In fact, some studies have even suggested that when it comes to preventing weight gain, full-fat dairy is the way to go. AARP’s Whole Body Reset book recommends eating fortified dairy foods two to three times a day, and not to shy away from full-fat products. But that doesn’t mean you should necessarily load up on butter and ice cream, Kratz cautions. Here’s a closer look at what the research shows and what the experts recommend.

The skinny on full-fat dairy

The research on low-fat versus full-fat dairy goes well beyond weight loss and type 2 diabetes. A study done by Kratz published in the American Journal of Clinical Nutrition in 2021 looked at 72 patients with metabolic syndrome — a cluster of conditions that raise the risk of heart disease, type 2 diabetes and stroke — and found that a diet rich in full-fat dairy (at least three servings a day) had no effect on blood pressure or cholesterol compared to a diet limited in dairy or rich in low-fat dairy.

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Another study, published in 2016 in the journal Circulation, tracked more than 3,300 adults over 15 years and found that those who had the highest blood levels of certain fatty acids found in full-fat dairy had a 44 percent lower risk of developing type 2 diabetes than those with the lowest. Why is still unclear, although the researchers do speculate that certain molecules found in dairy fatty acids, known as gangliosides, or even the vitamin D in dairy products themselves, could play a role.

One concern with full-fat dairy is that high saturated fat levels may not bode well for older adults. But a 2018 study published in the American Journal of Clinical Nutrition followed nearly 3,000 adults age 65 and older for more than 20 years. Those with higher fatty acid levels associated with a higher consumption of whole-fat dairy products had a lower risk of death from all causes, as well as a lower risk of heart disease.

“I think what all these studies together say is that we need to stop making blanket recommendations such as ‘Avoid full-fat dairy because it’s high in saturated fat,’ ” says Dariush Mozaffarian, a cardiologist and dean of the Tufts Friedman School of Nutrition Science and Policy, who has authored several studies on the health effects of full-fat dairy.

The bottom line

When it comes to dairy, rather than get hung up on whether to consume full-fat or low-fat products, keep these three points in mind:

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1. Focus on fermented dairy.

Not all dairy is created equal. There may be more of a health benefit to eating fermented dairy products such as cheese and yogurt and drinking fermented milk products such as kefir, says Mozaffarian. Research shows that the consumption of these forms of dairy lower risk of both death and cardiovascular disease, possibly because these foods are also rich in probiotics, a type of good bacteria that lives in your gut. Probiotics themselves can improve body weight and blood glucose and insulin levels, Mozaffarian notes. “This may also help explain why consumption of cheese, which is the dairy product that tends to be highest in fat, is also associated with a significantly lower risk of both coronary artery disease and stroke,” he said. Fermented dairy products are also rich in menaquinones, a form of vitamin K also shown to lower risk of heart disease, he adds.

2. Indulge in full-fat dairy no more than once a day.

There’s not enough evidence to recommend reduced-fat dairy products over whole-fat products, says Mozaffarian. But there’s also not enough research to definitively say that whole fat is better, he stresses. That’s why, until there’s more research, it may be prudent to continue to eat low-fat or fat-free dairy but allow yourself the luxury of one full-fat version of dairy a day, recommends Kratz. “This is especially true if you’re trying to lose weight, since full-fat dairy does have more calories,” he adds. “But if there’s a certain cheese you love, or a type of creamy full-fat yogurt you want to indulge in, that’s fine,” he says. Just check labels for added sugar and sodium content. Consider eating plain yogurt, for example, and adding your own fruit as well as flavors like cinnamon and vanilla. However, Kratz says you should still avoid butter and cream, because unlike other sources of dairy, these aren’t nutrient rich.

3. Don’t stress if you have trouble digesting dairy.

If you are lactose intolerant, Mozaffarian recommends that you stick to dairy products that are naturally lower in lactose, such as hard cheeses and yogurt. You can also look for lactose-free or lactose-reduced milk products or take an over-the-counter lactase pill. Just don’t make the mistake of assuming you’ll get the same health benefits if you eschew dairy and take calcium and vitamin D supplements. “We need to stop thinking of dairy as simply a source of calcium and vitamin D,” says Mozaffarian. A 2019 review published in the journal Advances in Nutrition, for example, looked at 14 studies of older adults in their 60s, 70s and early 80s, and found that dairy protein significantly increased muscle mass. That’s why it’s so important to focus on dairy as a food whose nutrients work together synergistically, Mozaffarian adds.

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