“Lactose intolerance is a tricky topic. So I was really interested to hear experts talk about yogurt in this context. Patients usually know very little about their yogurt consumption ability. They do not know that lactose intolerant can eat yogurt. On top of that, like all of us, they have a tendency for drama. So for a lot of my patients, what usually turns out to be a light intolerance is self-diagnosed as a severe form of lactose intolerance. In the end, they choose to act as though they were lactose intolerant, by being over-cautious. And as a consequence simply do not eat dairy anymore.”

“Like everyone, my patients google information. They look up diet options for the lactose intolerant. And I notice that they often are easy targets for “miracle” stories, which are quite common in general media, on the internet, in ladies magazines, lifestyle blogs… Some of my patients thus reckon that they follow recommendations they read online. Some say they can have dairy products only if those are “bio” products. Others explain they can have cheesecake as a desert, but not yogurt. ”

Lactose intolerant patients first suffer from a lack of information

“So in my experience, what lactose intolerant patients suffer most from is lack of information. This is also true for us, registered dietitians: we lack information about lactose and dairy/yogurt consumption abilities as well. For instance, with yogurt I think that dietitians have recommendation habits. I am used to recommending small portions of yogurt to my patients, because it seems like a reasonable assumption. This is precisely where the Yogurt in Nutrition Initiative’s symposium and its online resources are of great help. For example, when I heard Professor Morelli explain that lactose intolerant can eat yogurt everyday, I was most interested!”

We focus on calories intake, and neglect the density and richness of nutrients

Healthcare professionals and nutrition experts in particular, tend to focus on the obesity epidemic. In this respect, Professor Moreno‘s presentation on yogurt as the signature of healthy diet and lifestyle was really fascinating. We generally focus on calories intake, and thus neglect the density and richness of nutrients. Dairy products, and yogurt more specifically, are a great illustration of this tendency. Indeed there is a risk to avoid dairy products, even for people with lactose intolerance. Patients might lack essential nutrients like calcium and vitamins, which may in turn lead to low energy, changes in metabolism…”

“I think registered dietitians must remember that nutrient richness has a protective effect against obesity as well as long term/global health effects. Naturally, here I am not talking about one “magical” food. There is no such thing. Yes, consuming yogurt bears many benefits, but it needs to be included in a healthy/balanced diet.”

As Azmina Govindji’s says: “more volume, for not so much calories”

“I use yogurt as a stomach filler and I usually suggest low fat yogurt, as it has a low effect on blood glucose. Regarding the benefits of yogurt, I fully agree with Azmina Govindji‘s approach: “more volume, for not so much calories”. I have been recommending yogurt for 20 years as a snack. Yogurt is convenient for all snacking situations: in the afternoon, before dinner in the evening, as a late evening snack…”

“In addition to versatility, we also heard during the symposium, a lot about yogurt as a healthy swap option. Swapping is a great way to explore the versatility of yogurt, which you can easily use in several manners. It is interesting because that is the approach I used to recommend to my lactose intolerant patients. I used to tell them to have yogurt once every few days and to always combine it with a dish: as a sauce, in a stew, in their curry preparations…

Now after the #yogurt2016 symposium, I know that not only all this is true, but my patients who are lactose intolerant can eat yogurt everyday. That’s a good reminder!”

Indonesia still faces many nutritional problems among infants and children, with a high prevalence of stunting, underweight and thinness in school age children. Here, Yekti Widodo et al. investigated the associations between nutrient intake, dairy intake and socioeconomic variables in Indonesian children. They highlighted the interest of dairy in achieving the Recommended Dietary Allowances (RDA).

Low dairy consumption and high stunting prevalence

Apart from the lack of intake, sociodemographic factors and food habits may also contribute to explain the high prevalence of stunting and the poor nutritional status among Indonesian children. To analyse the associations between nutrient intake, dairy intake and socioeconomic variables, the authors collected food consumption data among 3600 children, aged 0.5 to 12 years old. They also determined the frequency of dairy use and anthropometric and sociodemographic variables. The results showed that dairy consumption was low, with more than 70 % of children, on average, reporting to be a non-dairy user.

Dairy are useful for achieving RDA and better nutrition

The study also found that dairy use was similar for both boys and girls. A higher dairy consumption was associated with urban areas, a higher education of the mother, a working mother and an upper level of wealth status of the family. Dairy users achieved more frequently the RDA for all nutrients, compared to non-dairy users. This remained the case after correcting for the confounding effect of the higher energy intake (from dairy) and socio-demographic variables. The contribution to the RDA increased with the increasing frequency of dairy use. They concluded that adequate dairy intake can substantially add to the achievement of RDA in Indonesian children.

To learn more, read the original article.

Source: Widodo et al. Asia Pacific Journal of Clinical Nutrition 2016; 25 : 356-367.

More and more people avoid dairy in their diet, due to beliefs arguing that dairy may be detrimental to health. This article examines some clinical evidence and provides information for health professionals to enable them to help their patients make informed decisions about consuming dairy products, as part of a balanced diet.

Dispelling the myth and beliefs

By understanding fully the accumulating scientific data in this area, health professionals can play an important role in dispelling these beliefs surrounding dairy products. Despite that the benefits for bone health are well established, some people adopt dairy free diets, due to beliefs that dairy may be detrimental to health, for instance, according to weight management or lactose intolerance issues. This commentary from the Belgian Bone Club and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases focusses on the most robust available evidence, and where possible with the most recent publications consulted.

Dairy as a provider of key nutrients

Dairy products, which are part of the official nutritional recommendations in many countries worldwide, provide a package of key nutrients that are difficult to obtain in diets with limited or no dairy products, such as vegan or dairy restrictive diets. In addition to include calcium with a high absorptive rate and availability, the authors notes that dairy products provide more calcium, protein, magnesium, potassium, zinc and phosphorus per calorie than any other typical food found in the adult diet. If dairy products are excluded, calcium, potassium and magnesium are the nutrients most at risk, pointed the report.

Up to three servings of dairy per day is safe

Serge Rozenberg et al stated that there may be a weak association between dairy consumption and a potential small weight reduction, with decreases in fat mass and waist circumference and increases in lean body mass. They specified that both yogurt and hard cheese are well tolerated, so that lactose intolerant individuals may not need to completely eliminate dairy products from their diet. Regarding the belief that eliminating dairy products would be useful for arthritis, they stated that there is no evidence for a benefit to avoid dairy consumption. Dairy products do not increase otherwise the risk of cardiovascular disease, particularly if they are choose in low fat version. They concluded that the intake of up to three servings of dairy products per day appears to be safe and may confer a favorable benefit in bone health. To learn more, read the original  article.

Source : Rozenberg et al. Calcified Tissue International. 2016; 98: 1–17.

Calcium is renowned to be a key nutrient for bones. In this review, James H O’Keefe et al. determined the optimal dietary strategies and nutritional supplements for long-term skeletal and cardiovascular health. They emphasized that calcium is ideally obtained from dietary sources.

Dietary calcium versus supplement

The majority of calcium in the human body (1000 to 1200 g) is located in bones and teeth, mainly in the form of calcium-hydroxyapatite. In most countries, the amount of dietary calcium is below the recommended dietary allowance. This is unfavorable for bone and cardiovascular health. In their review, the authors pointed out that the calcium intake for optimizing cardiovascular longevity is about 1000 mg/day. They also discussed the role of calcium, regardless other characteristics of the diet, like proteins. On one hand, high protein diet with inadequate intake of calcium increases the risk of fractures. On the other hand, a diet with moderate amounts of fresh, lean, animal protein, when combined with adequate calcium intake, promotes bone strength and reduces fracture risk.

Previous research confirms that a diet, supplemented with mononutrient calcium, may not be ideal for improving bone health, and may increase the risk of arterial plaque growth and vascular calcification. Plant dietary calcium can positively influence the acid–base status and calcium metabolism of the body, but compared to animal sources, plant are relatively poor sources of calcium. The authors highlighted that among dairy source of calcium, fermented dairy is of particular interest as they has been linked to favourable outcomes for bone health and mortality risk.

The benefits of fermented dairy foods for bone health

The authors also discussed the difference between milk and fermented dairy food. They noted that d-galactose, which comes from the breakage of lactose, has been found to increase inflammation and oxidations in adult humans. They reported that cow’s milk, though rich in many nutrients, has issues that render it less than ideal as a dietary staple for many adults. On the contrary, fermented dairy foods, such as yogurt and cheese, appear to be safer than milk, possibly because most or all of the d-galactose has been metabolised by bacteria.

To learn more, read the original article.

Source : O’Keefe et al., Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa, Open Heart 2016;3

“Hablando del yoghurt, hay un gran mal entendido de la información disponible, lo que hace más complicado que los nutriólogos o los profesionales de la salud en general tengan el escenario completo sobre los beneficios del consumo de yoghurt en la salud. Por lo tanto, aunque hay información disponible en internet, mucha de ésta no puede ser considerada como válida porque no está sustentada en la evidencia científica y lamentablemente muchas personas no tienen idea de cómo buscar en bases de datos y obtener información confiable basada en la evidencia científica, y esto es algo que también veo en los estudiantes del área de la salud. Al parecer, existe poca habilidad para encontrar información confiable y esto favorece que se propague la circulación de información inadecuada que sólo genera una mayor desconocimiento y confusión.

Por ejemplo, podemos ver que hay personas que tienen un impacto relevante en las redes sociales y que toman ventaja de éste alcance para difundir información falsa sin sustento científico, como es en el caso de la leche. En esta perspectiva, la Iniciativa para una Dieta Correcta: Efectos del Yoghurt en la Salud tiene una contribución clara, pues explica los beneficios del consumo de yoghurt respaldados por la evidencia científica, incluyendo su beneficio al ser integrado en la alimentación de las personas que viven con diabetes”.

Todos los días en mi consultorio compruebo los beneficios del consumo de yoghurt en el control de glucosa de mis pacientes

“Sin embargo, la principal barrera que encuentro en mis pacientes es con respecto a los mitos que existen sobre el tema de los lácteos y el consumo de yoghurt. En el caso de la intolerancia a la lactosa, creen que afecta su capacidad para disfrutar del yoghurt, y así nos enfrentamos otra vez a un problema de desinformación. En el caso de la Diabetes, puede ser aún más evidente, especialmente cuando se trata de las dudas que hay sobre la alimentación que debe llevar una persona que sufre ésta condición”.

“La mayoría de mis pacientes que acuden a mi consultorio tienen Diabetes tipo 2 y me he percatado de que no siempre conocen los beneficios del consumo de yoghurt. Y tal como lo hace el resto de las personas, buscan información en internet, encuentran recomendaciones dietéticas distorsionadas y creen que el yoghurt tiene mucha azúcar, y que no lo pueden incluir en su alimentación”.

“Cuando los pacientes vienen por primera vez a mi consultorio, empieza mi labor en la Educación en Diabetes. Primero identifico sus necesidades, su vivencia de la experiencia con el diagnóstico y sus conocimientos sobre la Diabetes, además me aseguro que tengan claro qué es la Diabetes y cuáles son los aspectos claves en su tratamiento para tener una mejor calidad de vida. Les comento que la investigación científica reciente ha comprobado que el consumo de yoghurt está asociado con un menor riesgo de Diabetes tipo 2, que está relacionado a un mejor metabolismo de la glucosa y control de peso. Algunos estudios epidemiológicos demuestran que existe una reducción de un 17% en el riesgo de padecer diabetes cuando se consumen 3 raciones de yoghurt en un día.”

Esta es una manera en que les enseño que el yoghurt integrado en su alimentación diaria puede ser parte de su tratamiento en el control de la Diabetes

“En conclusión, en mi experiencia como Nutrióloga y Educadora en Diabetes, he comprobado que existe la suficiente evidencia científica que respalda los beneficios del consumo de yoghurt en el control de la glucosa en sangre. La prueba para medir la glucosa en sangre, es una herramienta práctica de validación para que mis pacientes comprueben que sus niveles de glucosa en sangre se mantienen estables mientras consumen yoghurt de manera regular. Esta es una manera en que les enseño que el yoghurt integrado en su alimentación diaria puede ser parte de su tratamiento en el control de la Diabetes.”

“Considero desde mi punto de vista, que las dos mejores opciones para el paciente con Diabetes son el yoghurt natural; que preferentemente contenga probióticos (cultivos vivos y activos) y el yoghurt griego natural. Por lo que recomiendo incluir al menos una ración de cada uno en su plan de alimentación diario. Al final, ésta es la manera como mis pacientes se dan cuenta de que el consumo de yoghurt puede ser un componente valioso en el tratamiento de la Diabetes”.

Tomo en cuenta sus preferencias y negocio con ellos un plan de alimentación que se adecúe a su estilo de vida y que puedan mantener por más tiempo

“A mis pacientes, siempre les pregunto por sus preferencias de alimentos y negocio con ellos un plan de alimentación que se les facilite, para que lo puedan seguir y mantener por más tiempo como parte de su tratamiento para la Diabetes. Afortunadamente, el yoghurt es un alimento versátil y práctico que se puede consumir de diferentes maneras y combinarse con una gran variedad de alimentos.”

“Como resultado, siempre encontramos la manera de incluirlo dentro del plan de alimentación en cualquier tiempo de comida, ya sea como parte de un desayuno, en las colaciones (intermedios o snacks) o incluso, como aderezo para las ensaladas, como sustituto de mayonesa o crema agria, en salsas o sopas-cremas a la hora de la comida, como postre combinado con fruta para los que tengan preferencia por lo dulce y también en otras combinaciones para quienes tengan preferencia por lo salado. Hay una gran gama de posibilidades que permiten el intercambio de ciertos alimentos menos saludables por el consumo de yoghurt.”

“Como Nutrióloga, te das cuenta que el cambio de hábitos en el patrón de alimentación de tus pacientes no puede suceder de manera drástica. Además, hay un comportamiento particular en las personas que sufren una condición crónica, por lo que es preferible que los cambios se vayan realizando paso a paso, al ritmo de cada paciente. Esto es lo que mejor funciona para que se logren cambios de manera más efectiva en la conducta alimentaria. Hay que invertir tiempo en conocer a cada uno de tus pacientes, tomar en cuenta sus preferencias y ser prácticos al momento de construir una solución personalizada para cada uno de ellos”.

For the English version

Referencias recomendadas por Alejandra

• Díaz‐López, et al. (2016). Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. Eur J Nutr.
55:1, 349-360
• Chen et al. (2014). Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated. BMC Medicine, 12:215. http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0215-1
• Tong, X.; Dong, J.Y.; Wu, Z.W.; Li, W.; Qin, L.Q. (2014). Dairy consumption and risk of type 2 diabetes mellitus: A meta-analysis of cohort studies. Eur. J. Clin. Nutr. http://www.nature.com/ejcn/journal/v65/n9/pdf/ejcn201162a.pdf
• O’Connor, L. M.; Lentjes, M. A. H.; Luben, R. N.; Khaw, K.; Wareham, N.J.; Forouhi, N. G. (2014). Dietary dairy product intake and incident type 2 diabetes:
a prospective study using dietary data from a 7-day food diary. Diabetologia, 57:909–917. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980034/pdf/125_2014_Article_3176.pdf
• Salas-Salvadó J, et al. (2014). Prevention of Diabetes With Mediterranean Diets: A Subgroup Analysis of a Randomized Trial. Ann Intern Med 7;160(1):1-10
• Ramon Estruch, Emilio Ros, Jordi Salas-Salvadó, Maria Isabel Covas, Dolores Corella, Fernando Arós, Enrique Gómez-Gracia et al.(2013) Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. Engl J Med 368:1279-1290. http://www.nejm.org/doi/pdf/10.1056/NEJMoa1200303
• Mozaffarian, D.; Hao, T.; Rimm, E.B.; Willett, W.C.; Hu, F.B. (2011). Changes in diet and lifestyle and long-term weight gain in women and men. N. Engl. J. Med., 364, 2392–2404. http://www.nejm.org/doi/pdf/10.1056/NEJMoa1014296
• Nancy Babio Sánchez, Guillermo Mena Sánchez and Jordi Salas-Salvadó. Report New Scientific Evidence of Benefits or Yoghurt Consumption. IISPV Institute D’ Investigació Sanitaria Pere Virgili. Reus, Tarragona (Spain). http://nutriciohumana.com/pdf/informe_beneficios_yogur_ENG.pdf
• Panahi  et al. (2016). The Potential Role of Yogurt in Weight Management and Prevention of Type 2 Diabetes. J Am Coll Nutr. Jun 22:1-15 May; 67(3):232-8. http://www.tandfonline.com/doi/full/10.1080/07315724.2015.1102103

Yogurt: an easily adoptable & healthy eating habit

According to Azmina Govindji, a smart way to move towards a healthier diet trough the lifecycle is to eat nutrient-dense foods that are high in vitamins and minerals, but low in calories. Yogurt is a good example of such a habit. Actually, swapping out regular foods for yogurt can easily help to reduce energy intake and provide an increased portion size within the same calorie content. Some good examples are coming from substituting a granola bar or a dessert for a plain yogurt, a can of sugared drink or fruit juice for yogurt smoothie, or enjoying frozen yogurt instead of an ice cream bar. High protein foods, like yogurt, can also promote more satiety than their swapping alternatives. Therefore, yogurt, including sweetened yogurt, can be a potentially satisfying snack for people of all ages and activity levels to get more nutrients.

A component of a balanced diet

Nutrient-dense and low energy-dense food choices, such as yogurt, can help people to meet nutritional requirements, said Govindji. Many national guidelines recognize dairy products as being an essential part of a balanced diet (2-3 per day or more), primarily to facilitate required daily intakes of calcium. US Dietary Guidelines 2015 advise on a shift to consuming more dairy products in nutrient-dense forms, recommending low-fat yogurt rather than cheese. The UK Eatwell Guide graphic portrays plain yogurt as a daily source of dairy foods. Spanish and Turquish Food-Based Guidelines both recommend to consume milk and dairy products, including yogurt every day. Last but not least, recent scientific studies amongst international cohorts, that followed people’s eating habits over the course of several years, appear to point towards a similar correlation: yogurt consumers are likely to have a healthier dietary pattern.

Yogurt is more than a snack and a dessert

Yogurt can be eaten at any time of the day, making it a versatile pleasure and a habit, which can be easily integrated into our daily lives. For example, in the United States yogurt is often consumed in the morning for breakfast, and 25% of consumers use yogurt as a cooking ingredient. While in France, more than 80% of yogurts are eaten at lunch or dinner. However, Brazilians often prefer to consume yogurt as a snack. As there exist different moments and options to integrate pleasures, such as yogurt, into our lives, instilling healthy eating habits can become both simple and enjoyable.

Govindji concludes that yogurt may provide nourishing swaps throughout the day and is a marker of diet quality.

Highlights

• As a low energy-dense food, yogurt may help to reduce energy intake.
• Yogurt may also provide an increased portion size within the same calorie content and can be a potentially satisfying snack to get more nutrients every day.
• Many national guidelines recognize dairy products, like yogurt, as being an essential part of a balanced diet.
• Moreover, several studies have linked yogurt to a healthier diet and improved long term health outcomes.

*International Congress of Dietetics – Yini Symposium – Are we underestimating the health effects of yogurt – Palace of Congresses of Granada – Spain – 7th of September from 5:15-7:15 PM

“So concerning yogurt, there is a big misunderstanding with some of the available information. Thus it is difficult for nutritionists to get a full picture about the benefits of yogurt. Therefore they read on the internet, where they find a lot of unverified information, which has no scientific base. That is because they have a limited knowledge on how to get reliable information. Moreover it’s a difficulty that I see with my students. Their inability to find reliable information thus works in favor of poor information circulation. For instance, we see online personalities take advantage of their audience to spread a bad buzz about milk, without any scientific evidence. In this perspective, the Yogurt in Nutrition Initiative has a clear contribution, because it helps explain, with science-backed facts, what the benefits of yogurt are, including in diet for diabetes.”

I see the evidence of the benefits of yogurt everyday with my patients’ blood control

“But the main difficulty is that my patients have myths about dairy products and yogurt consumption. In the case of lactose intolerance, they believe that it impacts their ability to enjoy yogurt. So here again, we are facing a question of misinformation. With diabetes, it is even more obvious, especially when it comes to diet for diabetes. Most of my patients suffer from diabetes. People who live with diabetes usually do not know anything about the benefits of yogurt. Just like everyone, they look on the internet for dietary recommendations and see yogurt contains too much sugar for instance. So they are concerned it may not fit in their diet for diabetes.

So when they come to me, I start to give them explanations, and we start their diabetes education. I then explain that recent research indicates that eating yogurt is associated with a lower risk of developing type 2 diabetes, linked to better glucose metabolism and weight management. Some studies even demonstrated 17% lower diabetes risk with 3 or more servings of yogurt a day.

In conclusion, as a trained and experienced nutritionist, I see the evidence of the benefits of yogurt everyday with their blood sugar control. Indeed the test is a powerful validation. Patients see that their blood sugar level remains perfectly stable through time while they regularly have yogurt. I consider that the two best options are plain yogurt, which preferably contains probiotics (live and active cultures) and plain greek yogurt. These are the best options for people who live with diabetes. I recomend to include at least one portion of each daily in my patients’ diet for diabetes.

In the end, that is how they see that yogurt can be a valuable component in diabetes management.”

I take their preferences into account and I try to negotiate a meal plan, which they can follow as a diet for diabetes

“So with patients, I always start from their preferences. Indeed I take their preferences into account and I try to negotiate a meal plan, which they can follow as a diet for diabetes. Fortunately yogurt is a very versatile food, so it is easy to recommend its consumption in different ways. As a result we always find a way to integrate it in their diet. For example, some of my patients prefer to have it at breakfast, some as snacks, or even during meals, add it in their sauce. Also, some enjoy sweet things, others prefer salty tastes. There are lots of possibilities for healthy food swaps with yogurt, which we explore together.

Therefore, what you realize as a nutritionist is that change in patients’ dietary pattern cannot happen drastically. In addition, there is a particular behaviour for people who suffer from a chronicle disease. As a result changing things step by step works better. So you need to get to know each patient, take their habits into account, and be practical to build a personalized solution.”

Alejandra’s biography and links

Yogurt is a nutrient-dense food

Yogurt is tasty, nutrient-dense, accessible and easily digestible. It can help people to reach their daily dairy intake without excess calories. Recent studies have also shown that people, who eat yogurt, have higher intakes of essential nutrients. In adults, key findings (1,2) from cohort studies in US showed that frequent yogurt consumers had a greater intake in key nutrients (calcium, magnesium, vitamin B12, D and protein) and lower intake of total and saturated fats, compared to non-consumers. This pattern is observed in both men and women.

Yogurt and dairy consumption also increase the intake of key shortfall nutrients in British and American children (3,4), including potassium, calcium and vitamin D. Furthermore, yogurt consumption had additional favorable associations with lower total fat and saturated fat intakes, while the opposite trend was observed in consumers of dairy.

A better diet quality

Yogurt consumers have a better diet quality and showed a better compliance to the dietary guidelines. In both American adults and children, yogurt consumers had a higher Dietary Guidelines Adherence Index (DGAI) score (ie, better diet quality) than non-consumers (1,5). In another study, from Canada (6), yogurt was a contributor to the Prudent dietary pattern along with fruits, vegetables, legumes, nuts, non-hydrogenated fats, fish and other seafood. Yogurt consumers tend to eat less fast food, French fries and fried foods, processed and red meats, pizza, snacks, regular soft drinks or alcohol.  Other studies conducted in France (7), have drawn to similar conclusions for both children and adults.

Last but not least, several cohort studies showed that yogurt consumption may reduce weight gain over time (8). This association seems to be independent of other lifestyle factors, but there is a potential combined effect of yogurt consumption with such factors.

Yogurt may lead healthy behaviors

Furthermore, yogurt consumption seems to be a good marker of some other healthy behaviors. In Brazil, a population-based study (9) revealed the lowest amount of yogurt intake among smokers, instead of non-smokers or ex-smokers. A fact that is in agreement with literature: smokers show lower consumption of vegetables, fruit, and dairy products (like yogurt), and their diets are higher in sugar and fat rich foods.

In addition, new unpublished data from European studies in children and adolescents unveiled that frequent yogurt consumption seems to be associated with high levels of physical activity and low levels of screen based activities in both boys and girls.

All these findings suggest that yogurt consumption might represent a global signature of a healthy diet and lifestyle.

Luis Moreno – ICD 2016 from Yogurt in Nutrition #YINI

What about yogurt in sustainable diets ?

Adam Drewnowski, University of Washington in Seattle (USA), explained to us how yogurt may take care of our health and the health of our planet.*

What exactly do we mean by « sustainable food »?

There are many different views as to what constitutes a « sustainable » food system, and what falls within the scope of the term « sustainability ». Strictly speaking, sustainability implies the use of resources at rates that do not exceed the capacity of the Earth to replace them. For food, the definition of sustainable nutrition security comprises four major domains: health, economics, society and the environment. Sustainable foods and – by extension –sustainable diets need to be nutritionally adequate, healthy and safe, economically affordable, culturally acceptable and sparing of biodiversity and ecosystems, including environmental resources, such as land, water and air.

According to Adam Drewnowski, it is also important to understand that nutritional value is an integral component of sustainability. Low carbon footprint is of little use, when the food has minimal nutritional value. Sustainable foods need to be nutrient-rich.

Yogurt is affordable and nutrient-rich

Dairy products, including yogurt, provide significantly more nutrients than calories. As a source of bone building lacto-nutrients, notably calcium, yogurt may be qualified as a nutrient-rich and a low energy-dense food. In nutrient profiling models, the highest nutrient-density scores are awarded to unsweetened and low-saturated fat yogurts. New metrics of affordable nutrition have also confirmed that yogurts and dairy products are the lowest-cost sources of dietary calcium and a very affordable source of high quality protein.

 The supporting evidence on nutrient-density and the low-cost of dairy products, initially based on data from the US and France, has been expanded to include countries, such as Mexico and Turkey. Yogurt is part of the recommended snacks to be consumed daily by children in schools in Turkey.

A balance between carbon footprint and nutritional value

The land, water and energy use by dairy farmers is a separate area of research. Yes, dairy products, like yogurt, have a higher carbon footprint per calories than grains, oils, and sweets do. But this disadvantage is largely outweighed by their nutritional intake per calories. In addition, several studies have linked yogurt to improved long-term health outcomes (type 2 diabetes, hypertension, weight gain over time, lactose intolerance…) and regular yogurt consumption is associated with a healthy diet and lifestyle.

This is not true at all for sugar, for example. This plant food has the lowest land, water and carbon footprint per calorie… Nevertheless, since 2015, the WHO encouraged people to consume less than 10% of their total daily calories from free sugars… The recommendations are based on analysis of the latest scientific evidence. This evidence shows that adults, who consume less sugars, have a lower body weight and, secondly, that increasing the amount of sugars in the diet is associated with a comparable weight increase. This is why the definition of sustainable foods has to include nutritional value and impact on populations’ health, concludes Drewnowski.

Highlights

• Sustainable foods need to be affordable, acceptable and nutrient rich
• Yogurt is a nutrient-rich and a low energy-dense food
• Yogurt and dairy are the lowest cost source of dietary calcium and a very affordable source of high quality protein
• The nutritional value of yogurt per calorie outweighs its carbon foot print

*International Congress of Dietetics – Yini Symposium – Are we underestimating the health effects of yogurt – Palace of Congresses of Granada – Spain – 7th of September from 5:15-7:15 PM

This new YINI symposium* aimed at rediscovering the health effects of yogurt consumption, as a simple basic food and as part of a healthy & sustainable diet. To fully explore this topic, YINI invited four renowned international experts:

• Prof Lorenzo Morelli (Italy) reminded us how yogurt can benefit lactose maldigesters.
• Prof Luis Moreno (Spain) explained how recent studies reveal that yogurt consumption may be the signature of a healthy diet and lifestyle.
• Azmina Govindji, RD (UK) illustrated how simple yogurt swaps can improve nutrition and help saving calories and getting more nutrients.
• Finally, Prof Adam Drewnowski (USA) unveiled how yogurt can be considered as a sustainable choice.

Lactose maldigestion: how yogurt can help? A lecture from Lorenzo Morelli 

Yogurt swaps to improve nutrition – A lecture from Azmina Govindji