Written by Courtney Human RD(SA) 22/06/23

This month Midline Dieticians is joining the dairy debate. While working as a clinical dietitian I have found that one reoccurring proud fact that majority of patients tell me is that of course they are having full cream milk and not skimmed milk. Alternatively, that they have proudly cut out dairy completely.

 Naturally, the next question I ask is why? Which seems like a shock to patients because in their minds either cutting out dairy is the new norm or how didn’t I know that lower fat milk options is the enemy of all people. While on the contrary, sharing this extremist mindset, sits most dietitians including my less informed self that full fat dairy was the enemy of all people. Hence, this blog post.

So let me first start with possible reasons that come up for choosing full cream milk or simply avoiding low fat or fat free milk. Often the first famous line of full cream milkers is that fat free or low-fat milk is being watered down having lower protein and nutrient value with added sugar. Or that full cream milk is less processed. Or simply the taste of low fat or fat free milk is not up to standard with the rich creamy flavour and texture of full cream milk- this is a fair point.

So, let’s dive deeper and do some myth busting with this visual to comparing dairy milk varieties per 1 cup serving.

Firstly, the only thing full cream milk has that low fat or fat free milk does not, is a higher fat content allowing for higher vitamin A content too. The lower fat milk options have slightly more calcium due to fortification.

The protein and “sugar” contents are equal throughout milk. But to clarify the only ‘sugar’ found in milk is lactose being the carbohydrate representative. One thing our country deserves credit for is dairy regulations that are tight enough that no “Hullets” is being added to your lower fat milk options (what a relief).

Secondly, in South Africa all milk whether full cream or not is homogenized so we don’t have an unappetizing thick layer sitting on top and pasteurized so potentially harmful bacteria is removed. Unfortunately, no one gets that completely ala natural stuff unless you are pouring straight from the cow’s udder into your glass.

Finally, it is that 3.4% butter fat in full cream milk VS only 0.5-1.5% butter fat in low fat milk that explains the creamy taste that can’t be beaten. You are probably thinking now comparison aside she’s going to tell us what to choose.

Before we discuss this topic let’s boost dairy’s ego first as a food group by honouring its unique package. It contains essential macro nutrients being complex fat, carbohydrates and high-quality protein and micronutrients of calcium, potassium, magnesium, zinc, phosphorous, vitamin A, vit B12 and B2. Not to mention a protective effect on high blood pressure proposed by bioactive peptides and those live bacterial cultures found in fermented dairy like certain cheese, yoghurt and amazi boosting gut health.

I gave all the credit to fruit and vegetables last month, but dairy is quite the overachiever too.

So back to the topic I’ve been avoiding as I’m not going to lie latest studies have confused dietitians too. I wish we were all 1–2-year-old children because then the answer is simple- full cream dairy is the answer. The controversy comes in with the milk fat which is two thirds saturated fat always believed to increase bad cholesterol and subsequent risk of heart disease. But newer research shows no effect or beneficial health effects due to the composition of dairy as a whole matrix not just looking at the saturated fat content alone.

So, the rule of thumb of lower fat dairy for all went out the window for us dietitians because now if you fall within a healthy body mass index (BMI) of 18.5-24.9kg/m² without any chronic disease like hypertension, diabetes, high cholesterol etc. then full cream dairy is for you too. Yay! For those select few within our chronic disease, obese ridden South African population. Apologies for putting it bluntly, but hence lower fat dairy options are the song most South African dietitians are still singing when addressing the general public.

But I think overall it all comes down to how much dairy contributes to your diet. If you are having little dairy as it is, then opting for full cream over low fat probably won’t make much of a difference. Whereas if you are as obsessed with cheese (as I am ) that it could be your whole diet and portion control doesn’t exist then maybe low fat or fat free is the better choice for you. Typically, in cases of weight loss a lower fat option is selected as a means of lowering calorie intake. But if you are someone who struggles with heart burn or a sensitive stomach then maybe you should join us low fat or fat free milkers too, before excluding dairy as a whole.

If you are cutting out dairy completely ask yourself why? If it is a moral decision or specific medical diagnosis you are excused. If it is to follow a social media trend or due to the fat content which is 3.4% maybe you don’t realize this is nothing compared to a hamburger containing 30% fat, bar of chocolate having 20-30% fat, or boerewors containing 32% fat. Are we focusing on the real saturated and trans-fat culprits or using full fat dairy as a scape goat. There are much higher saturated fat contents in commonly consumed snacks or food items that are energy dense and nutrient poor to focus on removing before targeting nutrient dense dairy products.

As dietitians I think the song we should be singing louder is irrespective of your choice make dairy a regular feature in your diet. The recommended intake is 3 servings of dairy daily, which most of us diary-holics even struggle to reach. Keep an eye out on our Instagram page to see what a dairy serving looks like. All dairy irrespective of the fat content is a nutrient-rich food that can compensate for nutrient-poor foods and snacks so let dairy as a whole be one of the heroes and not enemies of our holistic nutrition journey. Now go drink a glass of milk, spoon in that yogurt, eat a piece of cheese and have a nice (dairy-filled) day!