This post will make much more sense if you read my latest On Nutrition column, “Why butter isn’t back: not all saturated fat is created equal,” first. I’ll wait for you.
Welcome back. The “is full-fat dairy a healthy choice” question has been niggling at me for some time, for several reasons, including:
- The partial reversal on the “is saturated fat bad for you” question that began several years ago.
- Some random research papers that crossed my path suggesting that the saturated fat in dairy might not be the same as saturated fat in meat.
- A scientific literature review I did in 2012 looking at whether potential replacements for trans fats in restaurants and food manufacturing were better, worse or the same. (This included some detailed research on the various types of saturated fats, and the effects they have on blood cholesterol.)
- The fact that, although the Dietary Guidelines Advisory Committee still recommends limiting saturated fat to no more than 10 percent of total calories, they acknowledge that not all saturated fats affect our bodies equally.
- The fact that several of my patients have mentioned that they get hungry sooner after eating nonfat plain Greek yogurt than they do after eating full-fat plain Greek yogurt, even when they eat a smaller portion of the full-fat yogurt. (In fact, one of my patients – and she knows who she is – gave me hell after I posted an “after” photo of my refrigerator clean-out and a huge Costco-sized tub of nonfat Fage was in plain sight. I have since switched to full-fat Fage, even though Costco doesn’t carry it and I end up spending more.)
Serendipity Strikes
A few months ago, I was thrilled to be assigned to investigate the full-fat dairy question for an upcoming issue in one of the publications I write for. Well, when it rains, it pours, because last month I was at the Honoring The Harvest summit in Chicago, sponsored by the National Dairy Council (disclosure: my travel expenses were paid for), and one of the presentations was on precisely this topic. While I had seen references to milk fat globule membranes (MFGM) in some of the research papers I had pulled off of PubMed, I hadn’t had a chance to read them yet. Thankfully, I got a quick immersion into what they were, and why they may be important, by Mickey Rubin. I mean, the National Dairy Council is pointing out that butter shouldn’t be back on the table (in large quantities, anyway)? Too interesting for words.
Except that I did use words, and quickly pushed aside the next planned column in my Seattle Times editorial calendar to make way for this timely topic. After a successful pitch to yet another publication, I will soon (read: this month) have a chance to write about it at much more length (2,500 words vs. about 550 in The Seattle Times). I can’t wait, because I’m a geek that way.
Public Health vs. Personal Health
As I pointed out in my Times column, for now some of the best general advice is to choose the form of dairy that suits you, whether it be lower fat or higher fat, with four caveats:
- Still aim to get most of your fat from polyunsaturated and monounsaturated sources that have been shown to specifically benefit health (while most dairy fat may be fine, it still has not been show to have the same level of health benefits).
- If you have a specific health reason why you need to reduce fat (this is the public health vs. personal health part), stick to lower-fat forms of dairy.
- Don’t go hog-wild with skim milk. When I have a new patient who drinks a lot of skim milk, or has it for breakfast with cold cereal (another food I’m not a fan of, nutritionally speaking), I work with them to wean off of it, often transitioning to plain yogurt or to kefir, both of which have the additional benefit of being fermented foods (plus, yogurt has more protein).
- Don’t go hog-wild with cheese. Cheese is lovely, but it is a calorie-dense food. If you are in the habit of coming home from work and going at the cheese and crackers because you are starving and it feels like you will expire before dinner is on the table, you can easily eat so many calories that when dinner is on the table, you’re not hungry anymore. (I know whereof I speak, and so do many of my patients!)
In My Kitchen
What kind of dairy do I use? We use full-fat plain yogurt (Nancy’s “regular” yogurt, Fage Greek yogurt, and occasionally Ellenos “crack treat” yogurt), full-fat kefir (for smoothies or overnight oats), full-fat buttermilk from a local dairy, and at least a few kinds of cheese. I use whole milk in my coffee, when I make steel-cut oatmeal, and in other cooking applications. I never drink milk straight. Our cottage cheese (which we buy mostly for our dog, because he loves it almost more than he loves us) is 2%, because that’s what Costco carries (and about half of our trips to Costco are because the dog is out of cottage cheese…sigh).
Now, about that butter. I am not anti-butter. I love butter…but I don’t eat it every day, and I don’t slather it. How much do I love butter? Next to skin care products from French pharmacies, butter is my favorite souvenir to bring back from Paris each year. No, I’m not kidding. We keep it in our hotel or apartment fridge until it’s time to got to the airport, then we keep it in our checked luggage so it stays nice and cold, then as soon as we get home we double-wrap it and put it in the freezer. It keeps nicely. We don’t use butter every day, and olive oil is our main cooking fat. Butter has its place in my life, but I know I get better nutrition from other fat sources (olive oil, olives, nuts, seeds, avocados).
About That Bulletproof Coffee
I specifically mentioned bulletproof coffee in my column because I’ve had quite a number of patients ask me if it’s a good idea to put a hunk of butter in their coffee. I bet you can guess my answer. Some people make bulletproof coffee with MCT (medium-chain triglyceride) oil or coconut oil, but there’s no solid research to support that practice, either.
But Wait, The Jury’s Still Out
Incidentally, the research study I mentioned that compared the effects of butter vs. cheese on LDL (“bad”) cholesterol (“Potential role of milk fat globule membrane in modulating plasma lipoproteins, gene expression, and cholesterol metabolism in humans: a randomized study“) presents a just slightly different picture from another study that was released June 29 (“Is Butter Back? A Systematic Review and Meta-Analysis of Butter Consumption and Risk of Cardiovascular Disease, Diabetes, and Total Mortality“), which found that butter “has a relatively small or neutral association” with overall mortality. The authors also said that much more research needs to be done to clarify the issue (clearly).
The reason I point this out is that some studies on food and health look at what are considered “intermediate markers of health,” such as cholesterol levels, blood sugar, body weight, blood pressure and so on, while others look at actual chronic diseases, such as cardiovascular disease, type 2 diabetes, and so on. It’s more practical to look at the intermediate markers, and easier to try to tease out cause-and-effect, but the question on everyone’s mind is, of course, “Is eating food X going to increase my risk of disease Y?” Good questions, with no easy answers.
One Final Thought
If you made it all the way to the end of this post (which is twice as long as the column it’s about…yikes!), please read Marion Nestle’s excellent post on her Food Politics blog, “No, butter is not back (eat in moderation, please).”
