Does Milk Really Do a Body Good?

Podcast Transcript

John Horton:

Hello, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

"Got milk?" is a wholesome, two-word slogan that powered a dairy industry advertising campaign for two decades. But some wonder if that's the question we should be asking ourselves. The real issue they say is whether we need milk. There's a long-running debate centered on whether dairy is truly necessary in our diet. There are undeniable benefits in consuming cow's milk and milk-based products of course. There are also studies questioning whether those positives outweigh the negatives.

It's a complicated issue, which is why we asked registered dietitian Julia Zumpano to join us and sort it out. She's one of the many trusted experts at Cleveland Clinic who pop into our weekly podcast to help us make healthier decisions. So now, let's find out whether milk really does our body good. Julia, welcome back to the podcast. I always look forward to our discussions because we learn so much.

Julia Zumpano:

Thank you so much, John, for having me. I also really enjoy being on the podcast.

John Horton:

Now, today, we're going to be talking about something which I never realized was a controversy, but apparently, it is, and that is, I guess, drinking milk. When did that become a troubled spot?

Julia Zumpano:

Well, I think it's just evolved over years of dietary trends and changes with the paleolithic diet or the ketogenic diet, and neither of those really include dairy as a foundational part. So, I think those have spiked this thought process around questioning whether dairy is really safe and intended for human consumption.

John Horton:

Well - and this is what we're going to talk about today, and obviously you are the perfect person to get into this topic with. So, let's start with some basics when it comes to milk and dairy products and what are the pros behind getting those recommended three servings a day.

Julia Zumpano:

So of course, we know dairy and milk as a source of calcium and protein. So those are probably the main nutrition sources that we get from milk and yogurt and dairy products. So, there's certainly benefit in that sense, especially if you struggle getting in protein or, of course, we know that calcium builds strong bones, but we're finding more and more nutrients are involved in that, like vitamin K2 and vitamin D, so it's not just calcium alone. So, I think we're finding more and more information that's leading us to think that, well, it's not just milk that's going to build those bones.

John Horton:

You had mentioned nutrients, and I thought I read somewhere where milk has 18 of the 22 essential nutrients that you're supposed to really focus on taking in?

Julia Zumpano:

It does. It is packed in nutrients for certain. So that's another great foundation and why we encourage, especially when we have young, growing children, we do encourage milk with young growing children as they're transitioning off with their formula or breast milk. We do encourage milk as being a foundational beverage because it meets so many nutrient needs.

John Horton:

OK. So, you're getting the calcium and the protein and all these vitamins and minerals. What does that do for our bodies?

Julia Zumpano:

Well, each nutrient and mineral and vitamin all offer different benefits to our body. So, we build muscle, and we build tissues and teeth and bones, and all of those structural components of our body are maintained and helped built through our consumption of these healthy vitamins, minerals, micronutrients, macronutrients - all of them play such a big role in our overall health in every way. So, from our head to our toe, really, they're all very, very essential.

John Horton:

And milk will help with that then, so it'll help with, if you drink milk - I know it's tied to stronger bones, stronger teeth. I thought I saw someplace where it's also linked to diabetes control?

Julia Zumpano:

In some studies, it has shown that regular consumption of dairy can help manage diabetes. We know milk is a source of carbohydrates if we utilize it that way and plan for carbohydrate consumption in the form of milk, we know you get calcium and protein from it. So, it's going to be beneficial that protein can slow down the rate of glucose in some cases. So, it can be - especially when compared in using other forms of carbohydrates like refined breads or flour or rice, refined grains, of course, baked goods or desserts or sweets - milk can certainly be more beneficial than some other carbohydrate sources.

John Horton:

Julia, that's a lot of check marks on the good side of the ledger for milk. So now, let's look at some of the potential cons or the drawbacks, reasons why you might have some caution about going overboard in a diary.

Julia Zumpano:

So oftentimes, we think about how we feel after we eat something or drink something, and there's a good portion of the population that is lactose intolerant. So that means that you cannot digest milk very well because you cannot break down the lactose in milk, and the lactose is the milk sugar. So, you lack the enzyme lactase to break down that lactose that's found in milk. So, some symptoms of lactose intolerance would be gas or bloating, indigestion, a very full feeling. So, most people know that right away if they're lactose intolerant.

John Horton:

Yeah. There are some estimates to what, 70 percent of the world's population maybe have some form of lactose intolerance?

Julia Zumpano:

Yeah, I would not be surprised by that. There's a large population of people who cannot digest milk in some way or another, so they have some type of negative GI effect from consuming milk or dairy.

John Horton:

Now, how does that play into even that perception that milk is not good? I mean, if so, many people just have trouble processing it, just taking it in and having their bodies handle it, I take it some people view that as a sign that maybe it's not the best thing to be consuming a lot of.

Julia Zumpano:

Of course, and I often recommend that my patients look at signs like that. If your body's telling you something's not working for you, I would cut it out for a little bit and figure out why. So, I do think it's very important to listen to those signs. So, if you don't tolerate dairy well, it's probably best to cut it out because you can gain those other vitamins and minerals that are found in dairy from so many other foods. So, it's not like you're going to be missing a big chunk of nutrition as long as you replace that dairy with other sources of those vitamins and minerals. So, I think it's important to look at that and look at what your body's telling you.

In some cases, there are certain types of dairies that create that negative reaction more than others. So that's also a way that we can still include a little bit of dairy back in by forcing what the effects are and certain types of dairies. So, for instance, milk and ice cream tend to create lactose intolerant effect more, but some people can tolerate small amounts of cheese or yogurt or kefir, and some of those products now are found to be lactose-free or lactose-reduced. So, some of those products can also help overcome some of those negative side effects and symptoms.

John Horton:

Speaking of the negative side effects, and I know when I was looking things up for this, I was shocked at some of the things that were connected to consuming large quantities of milk. And one of the things that just blew my mind was, I saw studies showing there's an elevated risk of hip fractures later in life. If you drink a lot of milk, that just seems the opposite of what you would think. So, what's happening there?

Julia Zumpano:

There are several studies that did indicate along the lines of that, and the National Institute of Health did a big review and it looked at the amount. So, we found that a large consumption of dairy did, in turn, allude to some of that increased risk factor hip fracture risk, looking at greater than 200 grams a day of milk consumption. But there was insignificant or insufficient evidence to deduce that there was an association between milk consumption and the risk of hip fracture at this point. But we do know that we want to look at how much dairy we were consuming and really keep it at no more than three servings a day, if not a little less than that.

John Horton:

OK. Well, that's good advice. Let's roll through some of the other items that just seem to pop up in the anti-milk side. I saw where there's associated cancer risks, prostate and endometrial — this is why I'm not a doctor — that can be tied to a lot of milk consumption. Is that true?

Julia Zumpano:

When we look at cancer risks, we're really looking at the hormones and some of the antibiotics and things that are placed in the dairy cows. So, it's really what's being spilled into the milk. So, we have this overconsumption of hormones and additives and things that the cows are treated with that are spilling into the dairy products that are leading to this increased cancer risk. So absolutely, you should be very aware of that. When you have the opportunity to buy organically raised dairy products, that would be ideally the way you want to go. If you don't have the opportunity to choose organically raised or are making sure it doesn't have these hormones added, you really want to decrease your consumption of milk and dairy products.

John Horton:

Perfect. So, moving along, I also saw where milk has been tied in with heart disease. What's the explanation there?

Julia Zumpano:

Milk can contain a large amount of saturated fat. So, when you look at whole milk or even 2% milk, it contains a substantial amount of saturated fat. And when you're consuming that throughout the day in large amounts, it really, really adds up. So, we know that saturated fat can increase your level of LDL or “bad” cholesterol, so that's really the culprit there. And another large contributor to increasing your LDL is cheese, and we lump cheese into that dairy consumption. So we really want to be mindful of how much dairy we're taking, and specifically, in whole milk, dairy products and cheese and even other dairy products like butter or cream — those are extremely high in saturated fat and certainly can contribute to increased levels of bad cholesterol, and that, in turn, leads to more plaque buildup in the lining of your artery. So that's really what we're trying to avoid.

John Horton:

And then, one of the other things that came up was acne and skin issues. How does milk or dairy contribute to that?

Julia Zumpano:

So, I don't know if we know the exact mechanism of how that can contribute, but we do know that there have been populations and people who suffer from acne, and once they reduce their dairy intake, their acne improves, and maybe they have a source of dairy and they start breaking out. So, it could be with just the oil buildup in your skin. It could be with mucus production; it could be due to hormones and milk. It could be due to a variety of reasons, but we know that there is an association there. So, if you struggle with acne, it would be a very easy quick test to cut dairy out of your diet for a couple of weeks and see if your acne clears up and then, you know are someone who is sensitive to that.

John Horton:

So, your answers are all these, it makes you realize that there's no just concrete yes or no answer, which is what we're always looking for, I guess.

Julia Zumpano:

I think that's so important. That is really the key take-home message here is that whether it's milk or grains or meat, there's not one answer that fits all. Everybody needs to find their personalized individual plan of what serves their body and what does not. And things that play a role in that are past medical history, family history, genetics, how you digest and absorb certain foods, how you tolerate them, even what your ancestors ate. All of those things play a role. And then, we want to really pay attention to clues that our body is giving us when we don't react well to a food — and we want to really pay attention to that. Because when we don't react to a food well over time, over and over again, it creates negative outcomes like inflammation, which can then lead to disease.

So, we don't want to ignore some of those signs that our body's giving us. So just really pay attention and make the decision based on your personal reaction to a food versus maybe what studies say or trends say, or what might be out in the media world. So, it's very important to find an individual and nutrition plan, and registered dietitians are great resources to help you find that. So, meeting with a registered dietitian can really be helpful in that journey.

John Horton:

We've gone over a lot of the good and the bad with milk. What advice would you give somebody just wondering how they might be able to fit dairy into their diet in ways in which they can do it that would give you the benefit, but then reduce the risk or the chance of something bad happening?

Julia Zumpano:

Sure. So, I would start to suggest using more lower-fat versions of dairy. So even the 2 percent, 1 percent skim sources of dairy, whether it be milk or yogurt or cheese. And if you do react to lactose, choose the lactose-free versions of that dairy, and then again, keeping in mind of consumption.

So, a lot of times, if we do have symptoms or side effects, we see those being greater with greater consumption. So, keep your consumption low and find out what your personal threshold is of that consumption. Certainly, yogurt can play a nice role. There's a lot of probiotics and healthy bacteria that's found in yogurt that can feed our gut in a healthy way.

So if you are going to consume dairy, I usually recommend starting with yogurt, especially if you can find a lactose-free version, so that can actually feed the healthy gut, give you the nutrients and vitamins and things that you're looking for from dairy, and can be easily lower in fat and provide protein, too. So that's typically what I recommend if you still want to include dairy in your diet on a regular basis.

John Horton:

And to bring up something you mentioned before, people should look for organic milk or milk that is free of growth hormones.

Julia Zumpano:

Correct. Organic milk does avoid those hormones added and added and things to the dairy that we're trying to avoid, and sometimes, it's not organic, but it will say “sourced from cows that were not provided those hormones.”

John Horton:

OK. So, look for that on the containers when you're And then, I'd be remiss if I didn't ask you about all the milk alternatives that are out there because now, I mean, there's almond milk, cashew milk, and all that. Are those good options for people?

Julia Zumpano:

I actually think those are great options for people. They're typically vitamin- and mineral-fortified, so they're going to get a similar profile, depending on the kind that you're choosing, to what might you get from a glass of milk. So, they're calcium-fortified, sometimes they even have more calcium than milk. Again, vitamin mineral fortified. What you might lack in some of those is protein. So, a lot of the milk alternatives do not contain protein. Some do but most don't. Soy milk will have some protein, and most of it is much lower in calories. As long as you're choosing the unsweetened versions, which of course, is what I recommend, the unsweetened versions of the milk alternative are going to save you a lot of calories, the hormones, the saturated fat. So, you really should consider those alternatives. I really recommend those often to my patients.

John Horton:

You've given us a ton to think about. So, before we go, anything else you'd like to add?

Julia Zumpano:

Reinforcing what I said before is taking a personalized approach to dairy consumption or a consumption of food. So really being aware of how your body's reacting and taking steps toward improving your personal health and diet, toward what's best for you.

John Horton:

Great advice as always, Julia. So, thank you so much for joining us, and I look forward to having you back.

Julia Zumpano:

Thank you so much for having me.

John Horton:

Milk is packed with the protein, vitamins and nutrients that you need, which is why it's a recommended part of a healthy diet. But it is by no means a perfect food. So, keep that in mind when you're making mealtime choices. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.