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Whole fat versus low or no-fat diary and heart disease


Question
Hello Tanya,

I am a 55 year old male having had a mild heart attack in 2003. I can do everything I did before, take my statins, Gemfybrozil, and blood pressure meds.
I also take a vitamin/mineral supplement, fish oil, and drink 4 ounces of milk with a tablespoon of brewer's yeast mornings and eves for a total of 8 ounces milk per day. 1% milk tastes o.k. to me but when I switched to skim milk, it tasted sort of like water diluted with powdered milk..sort of a strange flavor. My question is, would 1% milk be o.k. for a person with my health condition or should I strictly adhere to skim milk? On my 6 month physicals, my cholesterol and triglycerides have been within normal limits.

Thank you very much!

Mark E.

Answer
Dear Mark,

Unfortunately, I cannot give you a firm yes or no answer. The matter is complicated as it comes to scientific evidence. You might want to adhere to your doctor's advice or carefully experiment with your diary intake. Here are some facts.

A higher intake of dairy fat, which is mostly saturated fat (USDA National Nutrient Database for Standard Reference -- release 18), may be associated with an elevated risk of ischemic heart disease. Analyses of dietary data from the Nurses?Health Study showed that whole milk intake was associated with an increased risk of ischemic heart disease, whereas skim milk intake was associated with a lower risk (Am J Clin Nutr 1999;70:1001?8). Research on biomarkers of dairy fat intake suggested that a high intake of dairy fat is associated with a greater risk of ischemic heart disease.

However, several studies indicated that milk and milk products may not affect adversely blood lipids as would be predicted from its fat content and fat composition. Calcium, bioactive peptides and other components in whole milk may protect from . Conjugated linoleic acid (CLA) in whole milk have hypolipidaemic and antioxidative and thus antiatherosclerotic properties (British Journal of Nutrition (2000), 84:155-159). On the other hand, an inverse association between dairy consumption and hypertension was shown to be independent of dietary calcium suggesting that low-fat dairy products might be more beneficial for preventing hypertension (Hypertension. 2006;48:335). Blood pressure decreasing effects of dairy-rich diet were stronger compared with a diet rich in fruits and vegetables alone (Engl J Med. 1997; 336: 1117?124). On the other hand, those with higher low-fat dairy intake ate also more fruit and vegetable and less red meat. Their intake of whole grain and potassium, fiber, calcium, and vitamin D was higher (Hypertension. 2008;51:1073).

No wonder that there's no consensus regarding effects of different kinds of diary on cardio-vascular system. "Evidence from studies of the relationship between milk and possible vascular disease mechanisms is somewhat confused and the results of short-term feeding studies are inconsistent, " concluded researchers from University of Wales College of Medicine, Cardiff, UK (European Journal of Clinical Nutrition (2004) 58, 711?17)

Tanya Zilberter
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