This review examined the evidence behind dietary guidelines for dairy.

Most countries recommend the consumption of dairy products. When amounts are specified, recommendations are typically for 2 or 3 servings per day. Specific recommendations for dairy products are based partly on culture and availability but primarily on meeting nutrient requirements.

Dairy products are a rich source of many minerals and vitamins as well as high-quality protein. Thus, dairy consumption is a marker for diet quality. The recommendation for low-fat dairy is more an argument to reduce energy intake from fat and added sugar than from evidence of health concerns.

Milk and cheese represent 9.2% of the intake of energy, 10.9% of fat, and 8.3% of carbohydrates in the diet of Americans, but these products also contribute 46.3% of calcium, 11.6% of potassium, and 7.9% of magnesium to the American diet, which may provide overriding benefits to health.

A recent report found that yogurt specifically is a good marker of diet quality. The food patterns recommended by the 2010 Dietary Guidelines for Americans Advisory Committee (DGAC) include 3 cups of low-fat milk and milk products. Few people achieve their recommended intakes of several shortfall nutrients without meeting their recommendations for dairy.

Newer data since the recommendations of the 2010 DGAC are presented. However, the strength of the evidence for links between dairy consumption and health is limited by the lack of appropriately powered randomized controlled trials.

Source: Weaver CM. Am J Clin Nutr 2014;99(suppl):1217S.

This brief review focuses on children and adolescents, introducing new concepts underlying the effect of yogurt consumption on body weight maintenance and the prevention of cardiovascular diseases. Yogurt is an easy-to-digest, nutrient-dense, satiating food that contains high-quality protein and specific amino acids such as BCAAs.

Moreover, yogurt may act as a modulator of the gut microbiota in infancy and the specific matrix of yogurt has bioavailability and metabolic properties that can be exploited to increase the functionality of this dairy product.

Epidemiological studies and clinical trials that consider the interactions of yogurt nutrients and bacteria within the food matrix are warranted, in order to evaluate the effect of yogurt on the modulation of gut microbiota and the prevention of obesity and cardiometabolic diseases.

Source: Marette A| Picard-Deland E. Am J Clin Nutr 2014;99(suppl):1243S

Evolutionary evidence shows clearly that the consumption of milk and dairy products into later childhood and adulthood has conferred significant advantages in terms of survival and/or reproductive success among our ancestors.

This ability to consume high amounts of lactose without unpleasant side effects has been achieved through evolution of the lactase persistence (LP) trait and through domestication of lactic acid bacteria to create fermented milk products.

Indeed, for people lacking the LP trait, the fermentation of milk into yogurt and related products (a process known for >/=8500 y) aids milk digestion through the breakdown of some lactose and the provision of beta-galactosidase, which remains active in the gastrointestinal tract. In global ecological comparisons, milk and dairy intakes are strongly associated with adult height, and many international advisory bodies recommend the consumption of 400-500 ml milk equivalents/d. There are very few countries where such high intakes are met.

Populations with a low intake of dairy products have adaptive mechanisms that allow them to grow and maintain good bone health even at calcium intakes that are greatly below the RNI in high-income countries. The disturbance of these adaptations has been reported to cause some adverse sequelae, so it should not always be assumed that increasing calcium intake would be beneficial.

For this reason, a global RNI value may not be appropriate. Despite concerns that the high-saturated-fat content of full-fat dairy products may promote heart disease, recent meta-analyses show that dairy consumption is neutral or beneficial for weight control, coronary disease, diabetes, hypertension, and most cancers.

Source: Prentice AM. Am J Clin Nutr 2014;99(suppl):1212S

Studies analysing the relationship between consumption of yogurt and prevention of obesity or becoming overweight have been carried out in recent years.

The recent publication of the SUN cohort has provided new evidence concluding that high consumption of yogurt (at least 7 units a week) is associated with lower risk of becoming obese or overweight.

The scientific journal “Nutrition, Metabolism, and Cardiovascular Diseases” has published the results of the study “Yogurt consumption, weight change, and risk of overweight/obesity: The SUN cohort study” in which the consumption of yogurt by 8,513 individuals was monitored for six years and eight months. None of these subjects were overweight at the start of the study but 1,860 became overweight or obese during the follow-up period.

Yogurt and healthy lifestyle

The study was led by Prof. Miguel Ángel Martínez, Head of Preventive Medicine and Public Health at the University of Navarra and member of the nutrition and obesity CIBER . The participants were classified according to total consumption of yogurt (full-fat and skimmed) in five categories: less than two, two to five, five to seven, seven, and more than seven yogurts a week. All other variables related to obesity being equal, it was observed that participants in the category of largest yogurt consumption (7 or more units a week) presented significantly less risk of becoming obese or overweight.

Furthermore, the study found that the risk of obesity associated with consumption of yogurt is reduced even more among participants with high fruit consumption, concluding that consumption of yogurt can play a role in the prevention of obesity and becoming overweight and specifically when combined with a healthy overall dietary pattern.

Calcium is key

A possible biological mechanism suggested by other studies that may explain the relationship between consumption of yogurt and lower risk of gaining weight is the calcium content. The study presented in this paper proposed that calcium affects the metabolism of fats; therefore, increased ingestion of calcium, contained in dairy products, may increase the oxidation of fats.

Source : Martinez-Gonzalez MA et al. Nutr Metab Cardiovasc Dis. 2014 Jun 15. pii: S0939-4753(14)00197-5. doi: 10.1016/j.numecd.2014.05.015. [Epub ahead of print]

The satellite symposium will provide an overview of the latest scientific evidence related to yogurt consumption and their importance to reduce the risk of metabolic diseases, across the lifespan, from childhood and adulthood. It will also unveil data from epidemiological studies and clinical interventions that suggest that one or more dairy components might directly affect weight management. Finally, the symposium will examine the evidence and prospect behind dietary guidelines for dairy and yogurt consumption.

More info about the venue is available on the World Congress of Public Health Nutrition.

Download the program of Yogurt symposium in_III World Congress  of Public Health Nutrition (419 ko) 

The practical #YINI information sheets on healthy snacking provide a structured and documented approach to the main questions you tend to encounter in consultations with your patients about snacking.

Right snacks + right amount + right time= healthy lifestyle. Find out how. It is important to make  snacks as nutritious as possible and relatively low in calories and fat to avoid weight gain. Yogurt can be a new routine to make proper food choices when it comes to snacking.

Yogurt is a nutrient-dense, tasty, handy and easily digested product to help people reach their daily dairy intake without excess calories. Find out more here!

Yogurt is a dairy product that is generally very similar to milk, but it also has some unique properties that may enhance its possible role in weight maintenance.

The RCT evidence is limited to 2 small, short-term, energy-restricted trials. They both showed greater weight losses with yogurt intervention, but the difference between the yogurt intervention and the control diet was only significant in one of these trials. There are some prospective observational studies that have examined the association between yogurt and weight gain.

The results of these studies are equivocal. Two of these studies reported that individuals with higher yogurt consumption gained less weight over time. One of these same studies also considered changes in waist circumference (WC) and showed that higher yogurt consumption was associated with smaller increases in WC.

Another examined weight and WC change separately by sex and baseline weight status. This showed benefits for both weight and WC changes for higher yogurt consumption in overweight men, but also found that higher yogurt consumption in normal-weight women was associated with a greater increase in weight over follow-up.

As we accumulate additional evidence for or against any benefit of yogurt consumption on weight management, it remains important to include yogurt as part of a healthy diet; it is a nutrient-dense, lower-calorie, satiating food that can help many people meet their recommended dairy intake.

Source: Jacques PF & Wang H. Am J Clin Nutr 2014 ; 99(5) : 1229S-1234S.

Paradoxically, observational studies indicate that the consumption of milk or dairy products is inversely related to incidence of cardiovascular disease (CVD).

It has been suggested that the consumption of dairy products can improve characteristics of this metabolic syndrome, which encompasses a cluster of risk factors including dyslipidaemia, insulin resistance, increased blood pressure, and abdominal obesity, all of which markedly increase the risk of diabetes and CVD.

In actual fact, the effect of particular foods on CAD cannot be predicted solely by their total SFA content because individual SFAs have different effects on CAD risk, and foods which are major sources of SFAs also contain other nutrients that influence CAD risk.

Dairy products, such as cheese, do not exert the negative effects on blood lipids as predicted solely by their saturated fat content. Calcium and other bioactive components may modify the effects on LDL cholesterol and triglycerides. Fermented milk products, particularly yogurt, may also exert beneficial probiotic effects.

The consumption of yogurt and other dairy products in observational studies is associated with a reduced risk of weight gain, obesity, and CVD, and these findings are, in part, supported by randomized trials.

Source: Astrup A. Am J Clin Nutr 2014 ; 99(5) : 1235S-1242S.

Milk and dairy products like yogurt are an optimal source of calcium and other nutrients (e.g. protein, potassium, magnesium, vitamin D, etc.) and have an important effect on bone health. A significant positive association between dairy food intake and bone turnover markers BMC and BMD has been shown in clinical studies.

Fortified dairy products also induce more favourable changes in biochemical indices of bone metabolism than calcium supplements alone. The associations between the consumption of dairy products and the risk of hip fracture are less well established, although yogurt intake does show a weak yet positive protective trend for hip fracture.

By increasing dairy food intake to the recommended 3–4 servings/d, a good bone health may be readily achieved and osteoporosis-related health care costs could be reduced by at least 20% in the United States, translating to savings of $3.5 billion/y.

Source: Rizzoli R. Am J Clin Nutr 2014 ; 99(5) : 1256S-1262S.

The lactose in yogurt is digested more efficiently than other dairy sources of lactose because the bacteria inherent in yogurt assist with its digestion.

Yogurt with sufficient amounts (10⁸ bacteria/mL) of S. thermophilus and L. bulgaricus (as is the case in most commercial yogurts) is very well tolerated by lactose “maldigesters”, because it is effectively comparable to taking enzyme supplements with dairy food, due to the bacterial lactase.

Is the bacterial lactase active in the yogurt ?