January 2019 Health Bulletin

Rethinking full fat and low fat dairy – which is better?

Recommendations to replace full fat dairy products with low fat and non-fat milk options have been in place for 4 decades. But does the evidence really support that we are better off consuming low fat dairy produce compared with full fat ones? Many people, including nutritionists and cardiologists are now posing these questions.

The Prospective Urban Rural Epidemiology Study (PURE)1 was a study of 136,384 people, aged 35 to 70 years in 21 countries across 5 continents. The study found consistently, across regions, that people who had at least 2 servings of dairy/day were less likely to have a cardiac event or die, and that full fat dairy products were associated with a lower risk of adverse outcomes. The problem with this study is that a number of factors, such as socio-economic status, may have influenced the findings.

However, recent review of studies that have looked at this issue (meta-analysis) concluded that both total dairy intake and low fat dairy intake were associated with lower rates of diabetes, and hearts disease2. In essence, dairy is good for you and full fat dairy may not be bad.

Full fat dairy products contain important nutritional and anti-inflammatory components: vitamins (A, B6, B12, D and K), minerals (calcium, iodine, magnesium, potassium, phosphorus and zinc), fats and proteins. These are diminished/ lost in low fat/nonfat products. Full fat milk also contains in the order of 80 mg/110 g dietary cholesterol. The theory was that by lowering the fat, and therefore, lowering the cholesterol content, of dairy products people would be at lower risk of cardiovascular disease.

There does not appear to be an adverse effect of full fat milk on heart disease risk and fermented yoghurts and cheeses have health values as probiotics for gut and non-gut health. In addition, not all dairy has the same effect. Some studies have shown that whereas high butter consumption might increase cholesterol, an equivalent amount of mature cheese has a neutral or even cholesterol-lowering effect3. It is also important to carefully read the ingredients of low fat dairy items. Reduction in fat content results in a loss of flavour. To manage this, sugars, including high fructose corn syrup, are added to items such as yoghurt. Consequently, these can be seen as unhealthy options as not only has the nutritional value of the full fat been lost but it has been replaced with unhealthy sugars.

Lordan and colleagues, in their paper published in 20183 concluded as follows: “Therefore, consumers can continue to moderately consume full-fat dairy products as part of a healthy and balanced lifestyle, however fermented dairy products would be preferential for optimum nutrient intake and potential cardiovascular health benefits. The authors suggest that less emphasis is needed on the impact of milk and dairy product consumption on serum cholesterol levels but more emphasis should be placed on inflammatory biomarkers to elucidate the cardioprotective mechanisms of dairy products.”


  1. Dehghan M, Mente A, Rangarajan S, Sheridan P, Mohan V, Iqbal R, Gupta R, Lear S, Wentzel-Viljoen E, Avezum A, Lopez-Jaramillo P, Mony P, Varma RP, Kumar R, Chifamba J, Alhabib KF, Mohammadifard N, Oguz A, Lanas F, Rozanska D, Bostrom KB, Yusoff K, Tsolkile LP, Dans A, Yusufali A, Orlandini A, Poirier P, Khatib R, Hu B, Wei L, Yin L, Deeraili A, Yeates K, Yusuf R, Ismail N, Mozaffarian D, Teo K, Anand SS, Yusuf S, Prospective Urban Rural Epidemiology study i. Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study. Lancet 2018; 392:2288-2297
  2. Soedamah-Muthu SS, de Goede J. Dairy Consumption and Cardiometabolic Diseases: Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Curr Nutr Rep 2018; 7:171-182
  3. Lordan R, Tsoupras A, Mitra B, Zabetakis I. Dairy Fats and Cardiovascular Disease: Do We Really Need to be Concerned? Foods 2018; 7

Information provided might not be relevant to a particular person's circumstances and should always be discussed with that person's own healthcare provider.