I love milk. I’ve been drinking it since I was a kid. I love nonfat milk in my cereal, especially, and as an adult have taken to organic, low fat chocolate on most if not all days (except when I’m on vacation, like right now). To get my three-a-day dairy as recommended by current Dietary Guidelines for Americans, I consume milk, eat cheddar, mozzarella, and other cheese, and yes–I do get calcium from broccoli and some leafy greens.
My husband and children drink lots of nonfat milk too, and they also get calcium from low fat or nonfat yogurt and beans, especially black beans and lentils.
As for vitamin D, we all take 1,000 IUs a day, smother ourselves with sunscreen, and we do eat some fatty fish (like salmon and tuna) and eggs to get vitamin D as well.
We all try to eat a healthful diet. We’re not perfect, but we try. And we’re also extremely active, and exercise in some way shape or form practically every day.
This morning I came across “Got Milk? You Don’t Need It!” by Mark Bittman in this morning’s New York Times (online). As a registered dietitian, I felt compelled to respond, and provide at least a partial counterpoint to his arguments. [In the interest of full disclosure, a year and a half ago, I worked as a spokesperson for the Got Milk? campaign. I've done some talks on behalf of the Dairy Industry. BUT I did all these things, representing the industry, because I was already a lover and consumer of milk and dairy products--it wasn't the other way around. Representing them was a true pleasure for me because I truly believed--and continue to believe--in the virtues of milk and dairy foods in the context of a healthy diet and lifestyle.]
As a lover of dairy–but even moreso, wearing my hats as a registered dietitian and health professional who wants to provide information to consumers to help them make their own decisions about what a healthy diet looks like for them as individuals–I wanted to a few moments to share my thoughts about the Bittman piece. The article struck a chord with me, and I’d be remiss not to voice my opinion as should you (if you have strong thoughts about it, one way or another). Whether you agree or disagree with my points below, I look forward to our conversation, so please share your thoughts below.
In Bittman’s article, he shared his experience with reflux and the fact that he is finding that a no-dairy diet dramatically helps his symptoms. I’m truly happy for him, because I imagine living with reflux is very difficult and challenging to say the least.
I agree with the point he makes about how water is the perfect beverage (I drink tons of it myself), and that certain people–those with milk allergy–cannot and should not have milk, since that’s a matter of life and death. (So far, we are on the same page.)
But I take issue with a few of Bittman’s points.
First and foremost, while lactose intolerance is prevalent in the US, studies support the idea that those with lactose intolerance can tolerate small amounts of dairy–milk, yogurt, and hard cheese. Having small amounts with meals can help with tolerance, and for those who have a problem digesting lactose, the sugar in milk, there are lactose-free dairy products that contain the same composite of nutrients found in dairy foods (namely calcium, and in the case of milk and many yogurts, vitamin D–not to mention several other key nutrients including protein, potassium, riboflavin..but I digress).
Bittman concedes that for those who like dairy, one or two servings a day is probably fine. I agree and disagree with this. While I encourage consumers to aim for three a day of dairy as recommended in current Dietary Guidelines for Americans, if you only consume one or two a day, it’s important to consume other foods rich in those nutrients, primarily calcium and vitamin D, to meet current needs (for adults, the current RDAs are 1,000 to 1,200 mg calcium and 600 to 800 IU vitamin D). In the case of calcium, that includes beans, leafy greens, fish with bones; calcium fortified foods including fortified soy beverages are also an option, though I believe the absorption of calcium from those foods may not be as high as it is from milk. Non-dairy foods rich in vitamin D include fatty fish (salmon, tuna, sardines, and mackerel); eggs, and even mushrooms, contain some too as does fortified margarine and ready-to-eat cereals. Children’s needs for calcium and vitamin D are lower than adults (see Institute of Medicine recommendations here), but it’s critical for growing bodies to meet their needs for these key nutrients during their bone-building years to lay the best foundation for strong, capable bones.
If you see, based on a look at your diet or those of your children, that you cannot meet current needs, I urge you to discuss supplementation with a physician and, ideally, a registered dietitian.
One of Bittman’s statements that I disagree with is, “You don’t need milk, or large amounts of calcium, for bone integrity.” As it is, many Americans fall short on both calcium and vitamin D. Milk is a great vehicle for these nutrients, and even though this was not mentioned in the article, while dairy foods ARE a big source of saturated fat in the American diet, low- and non-fat dairy foods provide little fat and saturated fat to the diet and are loaded with key nutrients that optimize bone health and can help prevent osteomalacia (softening of the bones) and eventual osteoporosis. However, these nutrients can’t work their magic alone…an overall healthful dietary pattern that includes plenty of foods, namely fruits, veggies, beans, nuts and seeds, fish and lean meats, and in my opinion, low fat dairy if you like it and can tolerate it, plus exercise (on that point, Bittman and I agree) not only optimize not only bone health, but overall health as well. (Let’s not forget the other elements of a healthy life–love, laughter, and purpose.)
One other point I take issue is with the blanket statement in which Bittman says you can get Vitamin D from sunshine. Yes, of course that’s true–but most experts agree that relying on the sun for vitamin D ups skin cancer risk. In my opinion, it’s best to look first at food to get the vitamin D you need. The problem is that there are few food sources naturally rich in vitamin D, and many of us don’t consume nearly enough fatty fish to meet our vitamin D needs. If we don’t eat enough fish and also exclude dairy from our diet, as many vegetarians and those with lactose intolerance do, it’s very hard to get enough. Fortified foods are a backup option, as are supplements.
There’s no one diet that fits all. I hope you take the advice in Bittman’s article with a grain of salt, think about your own current diet, food preferences, health status, and lifestyle and decide what’s best for you. If you like and enjoy dairy foods and don’t have any apparent adverse health effects from doing so, there’s no reason to exclude dairy from your diet. I’ll continue to do it–not overdo it–and feed it to my children, again in the context of an overall healthful dietary pattern and lifestyle. What about you?
Do you do dairy? Why or why not? Do you think Bittman is on to something or is missing the boat?