Dispelling nutrition myths, ranting, and occasionally, raving


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A closer look at the full-fat dairy prevents T2 diabetes study

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Image by Roey Ahram on flickr. Used under a Creative Commons Licence

Findings of a study suggesting that full-fat dairy products might be protective against the development of T2 diabetes hit the news recently. Of course, you know me, I was curious if the research was sound.

One of the primary authors holds a patent for the use of trans-palmitoleic acid (one of the common fatty acids in dairy products) for the prevention and treatment of insulin resistance, type 2 diabetes, and related conditions. Right off the bat, there’s a red flag as it stands to benefit the author if he can support the assertion that high-fat dairy (or at least one fatty acid in dairy) can treat T2 diabetes.

I thought that it was interesting that they chose to use circulating fatty acid biomarkers as determination for consumption of full fat dairy products. This sounds like a better idea than the typical self-reported food frequency questionnaire. However, I wondered how accurate such a measure is. It seems that I wasn’t the only one with such a concern. When I searched to find out the accuracy of the use of such biomarkers I came across a letter to the editor expressing concern that some of the FA biomarkers used could also be attributed to fish consumption. Some of the FAs used in this study can also come from other meats, so may not all be attributable to dairy consumption. It seems that there are some additional limitations to use of biomarkers in research as lifestyle and disease state factors may affect metabolism and the resulting presence (or absence) of such biomarkers. Essentially, while the use of biomarkers may seem objective, they may not tell the full story. I also question how long biomarkers such of these remain present in the blood following consumption of dairy foods. Would they be indicative of long-term diet patterns or simply of having recently consumed high-fat dairy? Not being knowledgable in the area of biomarker research I can’t answer this question so it may or may not be worth raising.

Importantly, to account for potential confounding variables, the researchers used self-reported physical activity and food frequency questionnaires. Thus, there is always the potential that there might be another cause for the development (or prevention) of T2 diabetes in study participants.

There are also concerns regarding the actual study participants. The researchers used participants in the Nurses Health Study and the Health Professionals Follow-Up Study. These participants, health professionals, may not be reflective of the general population so generalization of the results to all Americans, or those in other countries is not necessarily possible.

I’m also not convinced that, while statistically significant (where is my personal statistician?*), the results hold any real-life meaning. The number of cases of T2 diabetes diagnosed in all study participants wasn’t huge so a 36-44% risk in reduction, while sounding massive, might not translate to a huge decrease in risk in actuality.

*After writing this, I had a friend with an advanced math degree offer to take a look at the original research for me (thanks Scott!). Here’s what he had to say:

My only concern with the data is the sample size of 3,333 which is not that large considering the amount of variables that they are accounting for. More variables the more likelihood of outliers that may not be actual outliers, but the sample size is so small it appears that way. However, they seemed to have introduced enough controls in their testing to reduce the risk.

What does all this mean? Basically, don’t go crazy on high-fat dairy products just yet. However, as you should only be eating a couple of servings of dairy a day anyway, you should go with foods that you enjoy. Why not have a variety of foods; maybe low-fat milk on your cereal, but full-fat yoghurt for a snack? Variety is the spice of life.

 

 


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Is skim milk healthier than whole milk?

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Last week Fooducate published a blog post answering (?) the question: Which is healthier for me: Skim or whole milk? Their response boiled down to “it depends”, can you afford the extra calories in whole milk or not? Which is certainly a part of the answer, but definitely not the whole (pardon the pun, you know I can’t resist) answer. So, what is the answer? Sadly, I don’t have the answer either, but I can give you a little bit more information than Fooducate did so that you can decide for yourself.

Fooducate mentions that lower fat milk options often have more sugar. This is not the case. Skim milk and whole milk both contain roughly 12 grams of sugar per cup (1, 2). When you get into chocolate milk and all of those bizarrely flavoured milks like Crispy Crunch or banana, yes, those will have more sugar than plain old white milk. This is the case regardless of fat content; it just so happens that most commercially available flavoured milks are low fat or skim. It can safely be said that white milk is better for you than chocolate. I’m not saying that you can’t ever have chocolate milk, it shouldn’t be considered a healthy dietary staple though. Treat chocolate milk like a liquid chocolate bar.

Fooducate focussed on macronutrients: fat, protein, and carbohydrate. What they fail to look at is micronutrients. When comparing fortified skim and whole milk they are very similar on the vitamin and mineral front. The difference lies in the bioavailability of these nutrients. Fat soluble vitamins (A, D, E, and K) need fat for your body to absorb them. If you’re having a glass of milk with a meal that contains another source of fat, awesome, you’ll get those vitamins. However, if you’re eating a bowl of SpecialK for breakfast topped with skim milk then you’re not going to be getting as many nutrients out of that milk (or that fortified cereal) as you would if you used whole or 2% milk. Just because the nutrients are on the label doesn’t mean your body’s able to utilize them.

I’m not saying that everyone should go whole hog and drink milk. Heck, you don’t even need milk to have a healthy diet. The type of milk you should consume really depends on your personal preference, what else you’re consuming milk with, your overall diet, and your personal goals.