Is yogurt part of a healthy diet?

Yes, of course. First of all, a healthy diet helps to preserve or even enhance overall health. A healthy diet complies with the dietary guidelines regarding the macro and micronutrient contents.

National and international organizations, such as the Food and Agriculture Organization of the United Nations, and the US Dietary guidelines, recommend the daily consumption of dairy products, such as yogurt.

Several scientific studies have reported that regular consumers of yogurt have a better overall diet quality, a more diverse and balanced diet that respects the dietary guidelines regarding nutrient intake, than non-consumers.

Recent studies have showed that adult yogurt consumers are more likely to be physically active and are less likely to smoke, than non-yogurt consumers are. Yogurt consumers have also a better knowledge of the relationship between food and health than those, who do not eat yogurt.

Yogurt consumption is also associated with lower levels of circulating triglycerides, glucose, and lower systolic blood pressure and insulin resistance.

Yogurt consumption could also be involved in the control of body weight and energy homeostasis, since analysis of cohorts has shown that regular consumers of yogurt gain less weight over time than non-consumers.

Sources:

• Keast et al. Nutrients 2015;7:1577-93.
• Lecerf et al. The FASEB Journal 2014;28.
• Martinchik et al. Voprosy pitaniia 2016;85:56-65.
• Mistura et al. International journal of food sciences and nutrition 2016;67:232-8.
• O’Connor et al. Diabetologia 2014;57:909-17.
• Panahi et al. J Am Coll Nutr 2016:1-15.
• Savaiano et al. m J Clin Nutr 2014;99:1251S-5S.
• Wang et al. Nutrition research 2013;33:18-26.
• Wang et al. Int J Obes (Lond) 2014;38:299-305
• Webb et al. Nutrition reviews 2014;72:180-9.

In the United Kingdom, as in many other countries, the common diet population habits fail to meet dietary recommendations. These dietary patterns not only contribute to a high prevalence of obesity, but may also have a high environmental impact. It’s estimated that the food system accounts for 18–20% of UK annual GHGEs (greenhouse gas emissions), which is one element of environmental sustainability. The aim of this study was to estimate if the reduction of GHGEs could be achieved, while meeting dietary requirements for health, by using mathematical modeling.

Eating healthy and sustainable is feasible without upsetting habits

The first model (without any acceptability constraints) failed. With a 90% reduction in GHGEs, it included only 7-food items, all in unrealistic quantities. The addition of acceptability constraints (which includes a number of cultural, nutritional, and economic reasons for both consumers and producers) gave a more realistic final sustainable diet with 52 foods meeting the nutrient recommendations of fruits, dairy, fish intakes and smaller amounts of meat than in current diet with reduced GHGEs by a lesser amount of 36%.

The proportion of dairy products in the sustainable diet was similar to current dietary intakes, but the type of dairy products were lower in fat.  In the current UK diet, 24.5% of dairy products come from ice cream, butter, and cream. In the other hand,  only 5.3% of this dairy subtypes are present in the sustainable diet, which included more milk than the current diet (62% vs 42% of the dairy products). This study demonstrates therefore that it is possible to create healthy diet with lower GHGEs without the elimination of meat and dairy.

No additional cost to consumers

The changes to be made wouldn’t result either in a increased cost for the consumer. On the basis of the cost of midrange supermarket products in the United Kingdom in September 2010, the cost of the food in the sustainable diet was estimated to be£ 29.00 ($46.00)/wk, which is equivalent to 89% of the current average UK ex-penditure on food.

To learn more, read the original article.

Source: Macdiarmid JI et al. American Journal of Clinical Nutrition 2012 ; 96 (3) : 632-639

Lactose is a type of sugar naturally found in milk and dairy products. In the intestine, lactose is transformed by lactase, an enzyme, into glucose and galactose, both simpler sugars used by our body for energy and various functions. The activity of lactase is high during infancy and slowly declines after weaning. In some individuals, a residual lactase activity is maintained.

Undigested lactose subsequently enters the colon, where it is fermented by the resident microbiota (the microorganism population that lives in the digestive tract). Bacterial fermentation is responsible for the formation of gas, lactic and acetic acids, which increase gut transit time and intracolonic pressure, resulting possibly in bloating, diarrhea, and flatulence. Symptoms generally do not occur until there is less than 50% of lactase activity, compared to the level of lactase activity before weaning.

However, the symptoms associated with lactose intolerance are not specific to this condition and can be observed in other frequent gastro-intestinal dysfunctions such as irritable bowel syndrome, inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) and intolerance to FODMAP (Fermentable, Oligo-, Di-, Mono-saccharides And Polyols, which are short-chain carbohydrates poorly absorbed in the small intestine). Psychological factors such as somatic anxiety, stress and depression can also cause the occurrence of these symptoms.

Moreover, a temporary lactose malabsorption, appearing in cases of infectious diarrhea, radiotherapy, mucosal damage due to coeliac disease or some medicine use, can also give rise to similar symptoms.

Thus, self-diagnosis of lactose intolerance based solely on intestinal discomfort and made without proper medical diagnosis, is not possible. Self-diagnosed lactose intolerance can lead to unnecessary avoidance of dairy food.

Sources

Deng Y, Misselwitz B, Dai N, Fox M. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients 2015;7:8020-35.

Eadala P, Matthews SB, Waud JP, Green JT, Campbell AK. Association of lactose sensitivity with inflammatory bowel disease–demonstrated by analysis of genetic polymorphism, breath gases and symptoms. Aliment Pharmacol Ther 2011;34:735-46.

Ledochowski M, Sperner-Unterweger B, Fuchs D. Lactose malabsorption is associated with early signs of mental depression in females: a preliminary report. Dig Dis Sci 1998;43:2513-7.

Misselwitz B, Pohl D, Fruhauf H, Fried M, Vavricka SR, Fox M. Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European Gastroenterol J 2013;1:151-9.

Nicklas TA, Qu H, Hughes SO, Wagner SE, Foushee HR, Shewchuk RM. Prevalence of Self-reported Lactose Intolerance in a Multiethnic Sample of Adults. Nutrition Today 2009;44:222-7.

Suarez FL, Savaiano DA, Levitt MD. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N Engl J Med 1995;333:1-4.

Yang J, Fox M, Cong Y, et al. Lactose intolerance in irritable bowel syndrome patients with diarrhoea: the roles of anxiety, activation of the innate mucosal immune system and visceral sensitivity. Aliment Pharmacol Ther 2014;39:302-11.

Indeed, the ability to digest lactose (a type of sugar naturally found in milk and dairy products) is due to the persistence of lactase (an enzyme) in the intestine, where lactose is transformed into glucose and galactose, for energy and various functions. Lactase activity reaches its maximum at birth and slowly declines after weaning. Lactase activity may persist in some populations where dairy products are consumed into adulthood, especially Caucasians from Northern Europe (Scandinavia, the British Islands and Germany) and specific communities in Asia, Africa, South America, Southern Europe and Australia.

Lactose intolerance can occur in individuals with lactose maldigestion, the reduced capacity to digest lactose, which consumes large amounts of lactose in one intake (>12 g) or during the day (>24 g) apart from meals.

Lactose intolerance is a type of lactose maldigestion, which results in one or more of the following symptoms: bloating, diarrhea, and flatulence.

Similar symptoms of lactose intolerance can be observed after consumption of some short-chain carbohydrates, the FODMAP (Fermentable, Oligo-, Di-, Mono-saccharides And Polyols), which are poorly absorbed in the small intestine.

Lactose maldigesters, including lactose intolerants, can consume foods containing lactose, such as dairy products, in small amounts. Yogurt consumption is particularly encouraged since yogurt contains live ferments, Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus, which have been officially acknowledged to improve digestion of lactose in yogurt, in individuals with lactose maldigestion.

For more information about lactose-free food, please go to question 19.

Sources:

Adolfsson et al. Am J Clin Nutr 2004;80:245-56.

Deng et al. Nutrients 2015;7:8020-35.

Eadala et al. Aliment Pharmacol Ther 2011;34:735-46.

Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA Journal 2010;8:n/a-n/a.

Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion (ID 1143, 2976) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;8:n/a-n/a.

Ledochowski et al. Dig Dis Sci 1998;43:2513-7.

Misselwitz et al. United European Gastroenterol J 2013;1:151-9.

Suarez et al. N Engl J Med 1995;333:1-4.

Szilagyi et al. Can J Gastroenterol Hepatol 2015;29:149-56.

Yang et al. Aliment Pharmacol Ther 2014;39:302-11.

Lactose intolerants don’t need to consume lactose-free food. Lactose-free food is only needed for the rare infants with congenital lactase deficiency, a genetic disorder characterized by the absence of lactase, the enzyme that transforms lactose. Lactose is the sugar naturally found in various amount in dairy products, such as milk, cream, yogurt and cheeses.

Lactose intolerance is due to lactose maldigestion, i.e. the reduced capacity to digest lactose, which results into one or many symptoms such as bloating, diarrhea, and flatulence. Most of people with lactose maldigestion can consume dairy food without experiencing any symptoms. Lactose may be consumed in modest amounts, up to 12 g in one intake or up to 24 g, preferably in small amounts across the day, during or at the end of a meal (not at beginning), without symptoms. They are also encouraged to consume altered forms of dairy food such as some cheeses that contains low or no lactose (cheddar, provolone, mozzarella, Grana padano, etc.) and yogurt. Yogurt contains live bacteria that improve the digestion of lactose it contains in lactose maldigesters.

In addition, regular dairy food consumption by lactose maldigesters could lead to colonic adaptation by the gut microbiota (the microorganism population that lives in the digestive tract) and may allow them to consume more dairy foods.

Thus, avoiding dairy foods may not only be unnecessary to manage lactose intolerance, but it may also lead to nutrient shortcomings, which may result in adverse health effects such low calcium intake and poor bone health.

Sources :

• Black et al., Am J Clin Nutr 2002;76:675-80.
• Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA Journal 2010;8:n/a-n/a.
• Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on the substantiation of health claims related to calcium and maintenance of normal bone and teeth (ID 2731, 3155, 4311, 4312, 4703), maintenance of normal hair and nails (ID 399, 3155), maintenance of normal blood LDL-cholesterol concentrations (ID 349, 1893), maintenance of normal blood HDL-cholesterol concentrations (ID 349, 1893), reduction in the severity of symptoms related to the premenstrual syndrome (ID 348, 1892), “cell membrane permeability” (ID 363), reduction of tiredness and fatigue (ID 232), contribution to normal psychological functions (ID 233), contribution to the maintenance or achievement of a normal body weight (ID 228, 229) and regulation of normal cell division and differentiation (ID 237) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;8:n/a-n/a.
• Heaney et al. J Am Coll Nutr 2009;28 Suppl 1:82S-90S.
• Lukito et al. Asia Pac J Clin Nutr 2015;24 Suppl 1:S1-8.
• Misselwitz et al. United European Gastroenterol J 2013;1:151-9.
• Nicklas et al. Am J Clin Nutr 2011;94:191-8.
• Suarez et al.  N Engl J Med 1995;333:1-4.
• Szilagyi et al. Nutrients 2015;7:6751-79.
• Vandenplas et al. sia Pac J Clin Nutr 2015;24 Suppl 1:S9-13.
• Wahlqvist et al. Asia Pac J Clin Nutr 2015;24 Suppl 1:S21-5.

The SUN project

Depression is a common mental disorder. Globally, more than 300 million people of all ages suffer from depression. It’s a huge public health problem and the cures are not easy to support, because they are associated with a number of side-effects. This is what makes the results of this Spanish longitudinal study particularly interesting. For this prospective SUN (Seguimiento Universidad de Navarra) Project a total of 14,539 men and women (mean age: 37 y), initially free of depression, were assessed during a median follow-up period of 9.3 y. The authors evaluated their prebiotic intake and yogurt consumption and registered every incident case of depression during the follow-up period.

Results suggest that high consumption of whole-fat yogurt was related to a lower risk (-22%) of depression in women of the SUN cohort. Prebiotic consumption was not significantly associated with depression risk.

How does yogurt affect the mood? Probably by modulating microbiota

In the second study, researchers at the University of Virginia School of Medicine have reversed depression symptoms in mice by feeding them with Lactobacillus, a probiotic bacteria found in live-cultures yogurt. Further, they have discovered a specific mechanism how the bacteria affect mood, providing a direct link between the health of the gut microbiome and mental health. In particularly the amount of Lactobacillus in the gut affects the level of a metabolite in the blood called kynurenine, which has been shown to drive depression. When Lactobacillus was diminished in the gut, the levels of kynurenine went up – and depression symptoms set in.

To learn more, read the original article.

Several international and national medical organizations, including the European Food Safety Agency, the Food and Agriculture Organization of the United Nations and the US National Medical Association, recommend that lactose maldigesters and intolerants should not avoid dairy foods in order to prevent nutrients shortcomings. Instead, lactose maldigesters and intolerants should adapt their diet.

Lactose maldigesters and intolerants can still consume lactose, in modest amounts, up to 12 g in one intake or up to 24 g, preferably in small amounts across the day, during meal, without experiencing symptoms. Several organizations also recommend the consumption of yogurt containing, at least, 108 live bacteria Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus, which improve lactose digestion and prevent symptoms in lactose intolerants.

The World Gastroenterology Organisation has put forth a similar statement, to consume fermented dairy products containing probiotics, with proven benefits on digestive health, which is a tip from their 10 global diet and lifestyle tips on how to improve digestive health.

Sources:

• Bailey et al. J Natl Med Assoc 2013;105:112-27.
• Black et al. Am J Clin Nutr 2002;76:675-80.
• Commission CA. Codex standard for fermented milks. Food and Agriculture Organization United Nation Roma 2003:1-5.
• Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on the substantiation of health claims related to calcium and maintenance of normal bone and teeth (ID 2731, 3155, 4311, 4312, 4703), maintenance of normal hair and nails (ID 399, 3155), maintenance of normal blood LDL-cholesterol concentrations (ID 349, 1893), maintenance of normal blood HDL-cholesterol concentrations (ID 349, 1893), reduction in the severity of symptoms related to the premenstrual syndrome (ID 348, 1892), “cell membrane permeability” (ID 363), reduction of tiredness and fatigue (ID 232), contribution to normal psychological functions (ID 233), contribution to the maintenance or achievement of a normal body weight (ID 228, 229) and regulation of normal cell division and differentiation (ID 237) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;8:n/a-n/a.
• Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion (ID 1143, 2976) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;8:n/a-n/a.
• Heaney et al. J Am Coll Nutr 2000;19:83S-99S.
• Heaney et al. J Am Coll Nutr 2009;28 Suppl 1:82S-90S.
• Nicklas et al. Am J Clin Nutr 2011;94:191-8.
• Suchy et al. NIH Consens State Sci Statements 2010;27:1-27.

Snacks provide actually almost a quarter of the Americans’ daily energy. In this research, Julie Hess et al. applied the Nutrient-Rich Foods (NRF) Index to different snacks. Yogurt gets the best scores on a very large market-leading snack selections.

Interesting things to know about the nutritional profile of popular snacks

Studies suggest that the type of snack is an important determinant of whether snack consumption is associated with adiposity, diet quality or body mass index. The investigators evaluated the nutritional quality of several popular snacks, using the Nutrient-Rich Foods (NRF) Index. This index assigns scores to foods, based on their nutrients to encourage (such as protein, calcium and vitamin D) and nutrients to limit (such as sodium and added sugar). The higher the score, the higher the nutritional density of the snack is. In this study, NRF Index scores were calculated for the top 3 – selling snack category products. Discover it below.

 Yogurt, milk and fruit at the top!

With a NRF score of 55,3, yogurt emerged as the most nutrient-dense snack, followed by milk (52,5), fruit (30,1), and nuts and seeds (26,7). Why?

According to the authors, yogurt contains high amounts of nutrients to encourage, especially protein, calcium, potassium, vitamin D, and magnesium, with relatively small amounts of nutrients to limit (saturated fat, total sugars, and sodium) in a 100 kcal serving. Yogurt scored higher than milk in this analysis, because the leading yogurt products are all non-fat, which has less saturated fat than the market-leading milk varieties (2% and whole).  In contrast, the less nutrient-dense snacks are carbonated drinks (-17,2), pies and cakes (- 11,1), ice cream (-4,4), and candy/gum (-4,0).

The 2015 Dietary Guidelines for Americans recommend “choosing nutrient-dense foods and beverages”. This research provides a more nuanced analysis of the nutritional value of snacks, often considered as “unhealthy” food. It also shows that all yogurt products, milk , fruits, nuts and seeds are nutrient dense choices for snacking.

To learn more, read the original article.

Source: Hess J et al. Global Pediatric Health 2017;4:2333794X17698525.

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