Dairy has a complicated reputation.
You’ve probably heard dairy talked up as a health-promoting food group, rich in calcium to keep bones strong. But dairy is outright eliminated in fad diets that also claim to be healthy. Some dairy foods, like cheese and ice cream, are rich in saturated fat, the type many experts still advise limiting. And some people – particularly vegans – argue that, given high levels of lactose intolerance in certain populations, humans aren’t meant to consume dairy at all.
All this confusion can (very understandably) leave you wondering whether dairy foods like milk and cheese and yogurt are good or bad for you.
To answer that question (and more), INSIDER turned to registered dietitian Georgie Fear, author of “Lean Habits for Lifelong Weight Loss,” and Dr. Caroline Apovian, director of nutrition and weight management at Boston Medical Center.
Here’s what you need to know about dairy’s place in your diet.
Do I need dairy to get calcium?
Calcium is a mineral that’s needed to maintain strong bones, as you’ve probably heard before. It’s also required for muscle, nerve, and blood vessel function and the release of certain hormones and enzymes. Adults ages 19 through 50 need 1,000 milligrams of calcium per day, according to the US National Institutes of Health (NIH), and dairy is a great source of the mineral.
A cup of plain low-fat yogurt, for example, has 448 milligrams.
Apovian explained that, while there are other sources of calcium, dairy is the most convenient and concentrated natural source.
Aren’t there other foods high in calcium?
Though many non-dairy foods naturally contain calcium (including some leafy greens, root vegetables, beans, nuts, seeds, and fish eaten with the bones still in them), it’s tough for these foods to compete with dairy in terms of sheer calcium concentration.
“[To get] the amount in calcium in one serving of milk you’d have to eat buckets of some of the vegetables that are touted as high calcium,” Fear said.
For example: A cup of 2% milk has 350 mg of calcium. You’d need 7 cups of kale or 12 cups of spinach to get that amount from raw leafy greens. Or you could get it by eating a whole can of sardines – a prospect that’s probably not appealing unless you’re a sardine devotee.
Some plant-based calcium sources have another drawback. Fear said that some of these foods also contain oxalates – natural compounds that bind to calcium and inhibit our bodies from absorbing it. The calcium in dairy, on the other hand, is more easily absorbed by our bodies.
This doesn’t mean non-dairy calcium sources aren’t worth eating. They have plenty of nutritional merits. They just aren’t the most concentrated sources of calcium. So if you can’t or don’t eat dairy, you may need to consume calcium-fortified foods.
How do I get enough calcium if I can’t or don’t eat dairy?
“If somebody does not [consume dairy] due to an allergy or just a preference, the best way to get calcium is through calcium-added foods or supplements,” Fear said. “If you don’t have any fortified sources it is pretty difficult to get enough calcium to maintain optimal bone density.”
Foods that are often fortified with calcium include soy milk, almond milk, tofu, breakfast cereals, and even orange juice. Check the nutrition facts to know for sure if a product’s been fortified.
On a related note: Your body also needs vitamin D in order to absorb calcium, Apovian said – so make sure you’re getting enough of that nutrient, too.
Is dairy a good source of protein?
“Dairy as a protein source can be really convenient, especially for breakfast,” Fear said. “Many people find putting together a smoothie or having Greek yogurt or cottage cheese is more appealing to them than chewing on a pork chop at eight in the morning. So dairy is often one of our go-to protein sources – even more so if you cut out meat.”
What is lactose intolerance, and does it mean you can’t have any dairy?
People with lactose intolerance have trouble digesting lactose, the natural sugar present in milk. More specifically, their bodies don’t make the enzyme lactase, which breaks down lactose. It’s rare to be born lactose intolerant. Instead, most people with lactose intolerance become that way as adults since the body’s lactase production slows down after infancy, according to the NIH.
Worldwide, about 65% of adults are lactose intolerant, the NIH adds. But that’s a general figure – rates vary dramatically between populations.
For example, more than 90% of people of East Asian descent are lactose intolerant, but less than 5% of people of Northern European descent are lactose intolerant. The condition is far less common in populations with that have long depended on milk as a food source, the NIH explains.
If you’relactose intolerant, eating dairy may give you abdominal pain, bloating, gas, nausea, and diarrhoea. But you may not need to eliminate all dairy. Lactose intolerance can vary in severity, Apovian explained, and some people can eat lower-lactose items like cheese with no unpleasant symptoms.
Plus, many grocery stores also carry lactose-free versions of dairy products.
“If someone has difficulty digesting lactose, these products are my first recommendation, because you get all the calcium, you get all the protein, you get everything that was in the original milk,” Fear said.
But some people are so severely lactose intolerant they can’t eat any dairy.
“If you’re very lactose intolerant and you can’t have any dairy you need to find other foods that are high in calcium,” Apovian said. (That’s when those fortified foods come in handy.)
Isn’t the fat in dairy bad?
Full-fat dairy is a source of saturated fat. This is a type of fat that many experts (including those at the American Heart Association) still advise limiting because it can raise levels of unhealthy cholesterol.
But dairy isn’t alone in containing this type of fat. It’s also in some meats and plant foods like coconut oil.
“I do recommend moderating total saturated fat intake, so that may influence somebody’s dairy intake,” Fear said. “If they eat lots of sour cream or cream in their coffee, for example, I do recommend switching to a lower fat alternative as a means of moderating saturated fat – not because there’s anything inherently evil about dairy. I would advise the same [thing] if they were consuming lots of bacon.”
The most current Dietary Guidelines for Americans recommends limiting saturated fat intake to less than 10% of your daily calories. That’s roughly 22 grams per day if you’re on a 2,000 calorie diet.
Moderating saturated fat intake is only part of the picture, though. The food you eat in its place matters too. Replacing saturated fat with soda, for example, is not a big improvement. But replacing saturated fat with healthier polyunsaturated fats, like the kind found in nuts, has been shown to reduce the risk of heart disease.
Does dairy really make acne worse?
There is some research suggesting that diet can influence acne.
First, a few studies have shown that people who low-glycemic foods – ones that don’t cause huge spikes in blood sugar –can improve their acne symptoms, according to the American Academy of Dermatology (AAD). (Foods like vegetables, nuts, whole grains tend to be low-glycemic, while choices like white pasta sugary drinks are usually high-glycemic.)
Another handful of studies has found consuming milk products may aggravate acne, the AAD says. The link seems to be stronger with skim milk compared with dairy foods like cheese or yogurt.
But the evidence is still preliminary, and for now, the AAD doesn’t recommend any dietary changes as a way to treat acne. Other proven acne fighters, like prescription medications,drugstore products, and birth control pills, may be a better choice for you.
Still, Fear said those with acne, if they want to, could try going two weeks without dairy to see if it improves their skin, as long as they make sure to get enough calcium from other sources during that time.
Is dairy good or bad for me?
The idea that whole food groups can be classified as “good” or “bad” is an alluring one. Unfortunately, it’s not very accurate.
First, it’s tough to make sweeping claims about dairy because dairy foods can be really different from one another. They run the gamut from sugar-loaded ice cream to salty cheese and they may not have the same effects on your body.
Second, no one eats dairy in isolation – the rest of your diet matters, too. You can include dairy in a diet high in nutrient-packed vegetables, but you can also include dairy in a diet high in 32-ounce slushies.
“The vast majority of foods really aren’t comfortably described as ‘good’ or ‘bad’ – they fill a place in an overall diet,” Fear said. “You can build an adequate healthy diet with or without dairy. The addition of dairy is not going to wreck a good diet, and it’s also not going to redeem a terrible diet.”
Given all this complexity, though, the ultimate takeaway is surprisingly simple.
“If someone is currently consuming milk, enjoying it, and not having any digestive issues, then I would say there’s no reason to cut it back,” Fear said. “And if someone doesn’t like dairy or doesn’t want to consume it for ethical reasons or just didn’t grow up consuming dairy, I don’t push them to add it in. I would just make sure that they attain enough calcium and protein from other sources.”
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