Wednesday, October 8, 2014

The Nutrition Debate #251: High-fat dairy ‘good’; low-fat dairy ‘bad’

Good news from Sweden, via Vienna, the site of this year’s European Association for the Study of Diabetes 2014 meeting. This paper was presented by an epidemiologist from the Lund University Diabetes Center in Malmö, Sweden. According to Medscape Medical News, who reported on it here, “people who consume a large amount of high-fat dairy products… have a 23% lower risk of developing type 2 diabetes than those who consume lower levels…” That’s good news for full-fat yoghurt, cheese, cream and whole-fat milk fans. My Swedish relatives, and people the world over, should be rejoicing.

Admittedly, the portion size spread was large (>8 vs. <1), but that still accounted for 20% of the 26,930 Swedish people aged 45 to 74 years included in the study. Swedes do love their yoghurt with fruit and coffee and bread for breakfast. What interested me most about this study, though, was that both the Swedish scientists and the Medscape writer reporting on it were both open to the findings. The Medscape banner was, “Big Intake of High-Fat Dairy May Be Protective for Diabetes.” That has got to get the attention of skeptics, which is to say, the mainstream medical establishment. That in itself is news.

Of course, I am probably being naïve. A large cohort of the Swedish population is already eating LCHF (low-carb, high-fat). Andreas Eenfeldt, MD, The Diet Doctor, reported on that some time ago. And he was among the first to herald the decision of the Swedish Government to change its official dietary recommendations in this post. So, the Swedish scientists who initiated this study, declaring themselves to have “no relevant financial relationships,” were like the camel who stuck his nose into the tent. Their aim was, “to clarify the risk for type 2 diabetes associated with the intake of the main dietary [saturated] fat sources – namely, meat, fish and dairy. I added “saturated” because PUFAs (polyunsaturated fatty acids from vegetable and seed oils) have become the main dietary fat source for most Americans (86% vs. 14%, according to this 2008 USDA report, “Dietary Assessment of Major Trends in U.S. Food Consumption, 1970-2005,” page 12 and table 6).

In the cloak of pure, unbiased science, to the extent that is possible, they accepted certain tenets of “perceived wisdom” while opening the crack in the “growing body of evidence supporting the need to shift the focus of dietary advice away from nutrients like total or saturated fat to the differential healthfulness of food sources like dairy products or meat.”  The hazard ratios (HRs), after 14 years of follow-up, were striking. Most impressive was that high-fat fermented milk [yoghurt] consumption …reduced the risk of developing diabetes by 20%. The portion size here was just 180ml, or 6oz (3/4 cup!).

As usual, the scientists raised more questions than they answered, looking for new grant money, obviously. One of them said, “To place the observed beneficial association with high-fat dairy in context, it is important to tease out if the higher risk of no association of low-fat dairy products with diabetes was because low-fat products have extra added sugar instead, which we know from other research to be detrimental” (emphasis added by me). She also noted that, “Other beneficial health effects might be due to other beneficial compounds in dairy, such as probiotics [present in fermented foods like cheese and yoghurt] and other nonfat nutrients such as vitamins and minerals.”

Medscape also noted that while “previous epidemiological studies have indicated a high intake of dairy products is associated with a decreased risk of developing type 2 diabetes,” the Swedish scientists said, ‘but it has been suggested that mainly low-fat dairy lies behind the observations.’” However, Medscape concludes, “The findings presented here suggest only high-fat content is protective.” “In comparison with high-fat dairy products, a large intake of low-fat dairy was associated with increased risk for type 2 diabetes, but this association disappeared after additional adjustment for protein.”

Another interesting finding reported by Medscape was that “molecules with odd numbers of carbon atoms (15 and 17), which are found in dairy products such as yoghurt, cheese and milk, appeared to have a protective effect. This contrasts with evidence suggesting that even-chain saturated fatty acids, as found in alcohol and margarine [demonizing one by association with the other] are associated with a greater risk for type 2 diabetes.” More studies (money) needed here too.

“The results in relation to intake of meat and meat products were found to be in line with previous findings,” Medscape reported. “An increased risk for diabetes was found for meat and meat products regardless of fat content.” The camel’s nose knows not to go any further. But Swedes and Europeans in general love dairy and eat far less meat than Americans.

The Medscape article doesn’t mention any finding with respect to the other source of dietary saturated fat: fish. Fish is sacred to Scandinavians in general, and salmon is 29% palmitic acid, an even chained saturated fat. The last time we visited Sweden, in every home we visited the gracious host served salmon with a crème fraiche and caviar topping, with aquavit and a beer chaser, of course. Yum, yum. And full-fat yoghurt and fruit and coffee (no bread for me) for breakfast. Real food.

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