For many of us, cow’s milk is the first thing we remember drinking, and we’ve always been told it’s a healthy choice: It’s packed with calcium and fortified with vitamin D, both of which are essential for building (and keeping) strong bones. And despite the saturated fat, milk is a great source of protein that can keep you fuller longer—and thus might help with weight loss. The United States Department of Agriculture (USDA) recommends adults have three cups of dairy (including milk, yogurt and cheeses) per day for these reasons.
Yet as you’ve probably heard, the nutritional tide can sometimes seem like it is turning on milk, leading some to wonder whether adults should be drinking it at all.
Here are the facts:
Is milk healthy?
First, there is some evidence to suggest that milk, on its own, may not be as helpful for your bones as originally thought. For example, a 2011 review published in the Journal of Bone and Mineral Research found that drinking milk didn’t reduce the risk of fractures in women.
And a 2014 study in The BMJ suggested that women who drink a lot of milk may actually have a higher fracture risk and a higher risk of death compared to those who drink less. To reach their findings, researchers looked at data from more than 61,000 women (and about 45,300 men) who had filled out a series of food frequency questionnaires over two decades. In the end, drinking three or more glasses of milk per day was associated with a higher incidence of hip fracture for women (but not men) and an increased risk of death from any cause (for both men and women), compared to those who had less than one glass per day.
This of course made splashy headlines: too much milk can kill? But that’s an oversimplification. The study found an association, yes, but it doesn’t prove that milk’s the problem. “It may be that people who drink more milk differ in other ways from their counterparts… These other differences, rather than milk per se, might actually account for the health outcomes observed,” David Katz, MD, the founding director of Yale University’s Yale-Griffin Prevention Research Center, explained in an editorial for U.S. News &World Report. Even the study’s authors recommended “cautious interpretation” of their results.
And it’s important to note these are just two studies in a sea of dietary research showing that consuming milk and dairy is one of the easiest and fastest ways to get to the recommended daily amount of 1,000 mg of calcium, a nutrient that is without a doubt essential for bone health.
So, I shouldn’t skip it?
Unless you are lactose intolerant, you don’t have to cut out dairy. The bottom line is that milk can be a part of a healthy diet, Dr. Katz wrote in The Huffington Post. For example, the Mediterranean diet allows for modest amounts of dairy, and that diet has time and again been associated with better heart health and even brain benefits. But you don’t need dairy for a diet to be healthy.
“You could survive without dairy, but there’s no overall consensus that cow milk is bad for you,” Lisa R. Young, PhD, RD, adjunct professor of nutrition at New York University and author of The Portion Teller Plan ($12, amazon.com) explained to Health.
Translation: there’s no reason to stop now if you like it, and you’re not overdoing it.
More than calcium, Young sees dairy as an ideal opportunity to get protein into your breakfast with a glass of milk or a Greek yogurt. (Particularly if you’re not eating eggs, beans, or meat for breakfast.) Other sources of protein, like nut butter, are nutritious, but can be difficult to portion control, she adds.
This protein boost isn’t enough to suggest adding more dairy to your diet, necessarily. But the protein does seem to be what makes modest amounts of milk and milk products so helpful when it comes to shedding pounds. That’s because, “fat-free milk and yogurt is one of lowest calorie sources of protein. It offers a lot of bang for your buck,” Young says.
Staying on the dairy train? Young recommends going for fat-free or low-fat versions. Guidelines still suggest limiting intake of saturated fat, a recommendation Young gives her clients. If you’re going to have yogurt, for example, stir in walnuts for extra protein, healthy fats, and staying power. “I’d rather you save the saturated fat for the occasional piece of cake,” she says. So, as long as you’re filling up on things like fruits and veggies, milk (and cake) fit in, too.
What if I’m lactose-intolerant?
You’re not alone. About 65% of people lose the ability to digest lactose, the sugar found in milk and dairy. If you’re skipping milk and dairy for any reason—you’re lactose intolerant, you’re vegan, or you don’t like the taste—that’s completely fine, too. There are other foods that will get the job done, as long as you plan out your diet to get the recommended 1,000 mg of calcium per day.
Go for foods like dark leafy greens, tofu, and almonds. And, aim to fill your diet with vitamin D foods, since milk is normally fortified with D. Look for sources like salmon, fortified OJ, and whole eggs, Young says.
What about milk alternatives?
Almond, soy or rice milk are not necessarily even trades, Young says.
Many are fortified with calcium and vitamin D, making them comparable to milk. But the downside is that many don’t come close in terms of protein, even when protein is added during processing. For example, almond milk typically contains just 1 gram of protein per cup, compared to 8 grams in regular milk. But some versions add pea protein to the mix to boost it to 5 grams. So just keep that in mind.
You also have to watch the sugar content, since some sweetened alternative milks can contain a couple teaspoons or more of added sweet stuff, Young says. If you do go this route, make sure to buy unsweetened milk, Young says.