From good fats to bad cholesterol, consumers and nutritionists alike have grappled with scientific evidence to determine what’s the best way to support cardiovascular health.
The general consensus informing the vast majority of dietary guidelines globally suggests that substituting saturated for unsaturated fats decreases LDL cholesterol, which in turn reduces the risk of heart disease and stroke.
The other common recommendation is to keep saturated fats – fatty meats and dairy such as butter, cheese, and cream – to about 10% of one’s daily calorie intake. The World Health Organization supports this approach and specifies that no more than 30% of energy should come from fats.
But research has evolved – and leading nutrition science experts believe there’s enough evidence to rethink dairy’s role in cardiovascular health – and thus its place in global dietary guidelines.
Why dairy was linked to CVD risk
Studies conducted pre-2016 showed a mixed picture on dairy’s impact on cardiovascular health.
Some high-quality research – such as observational studies and randomized controlled trials data – established a link between dairy and increased heart disease risk, influencing dietary recommendations since 2016. Even back then, no specific dairy product had been linked to a higher risk of cardiovascular disease (CVD).
And more recent meta analyses and cohort studies, including a large multinational, population-based one, have also failed to conclude that eating dairy raises the risk of heart disease.
In fact, evidence remains ‘too limited’ to definitively cast full-fat dairy as a heart disease risk factor, according to a new paper published in The American Journal of Clinical Nutrition.
The work summarizes the outcomes of a panel discussion between some of the world’s top nutrition science researchers, who met at a high-level closed workshop last year.
Is it right to categorize dairy by fat content?
Examining the evidence further, the panel concluded that bundling up dairy – from milk and yogurt to cheese – into a single dietary category ‘in not recommended’ because they are ‘very different foods’ irrespective of fat content.
“Indeed, the fat content of a low-fat cheese, which may vary from 5% to 25%, is much higher than the fat content of a low-fat milk, which typically ranges from 0% to 1%,” they observed. “Regular-fat and low-fat dairy foods may also be heterogeneous in terms of sugar content and additives.”
Epidemiological research on the fat content of dairy foods was also limited because different jurisdictions had different definitions of whole- and low-fat dairy.
Current recommendations promoting the consumption of low-fat in place of regular-fat dairy foods to limit SFA intake are . . . not evidence-based.
Such recommendations . . . may in fact be a distraction among other healthy eating recommendations, for which the evidence is much more convincing.
'Regular-fat and low-fat dairy foods and cardiovascular diseases: perspectives for future dietary recommendations'; Lamarche, B. et al
“In summary, most guidelines around the world propose that dairy foods can be part of a healthy dietary pattern. Many guidelines also recommend that low-fat dairy should be favored over regular-fat dairy.
“We suggest that there is currently insufficient evidence from epidemiology to support this ubiquitous recommendation to consume low-fat dairy foods in place of regular-fat dairy foods for CVD prevention.”
Does dairy raise ‘bad’ cholesterol?
As for dairy’s role in raising cholesterol, findings from randomized controlled trials suggest that dairy foods had ‘marginal effects on cardiometabolic risk, including on raising LDL cholesterol concentrations’, the authors pointed out.
Importantly, none of the trials considered the long-term effects of dairy and were limited cohort-wise. And so, the claim that replacing full-fat with low-fat dairy to avoid raising LDL cholesterol is not conclusively science-backed, according to the paper (see 'sources' below for more information).
Another reason why categorizing dairy foods by fat content is a flawed approach stems from dairy’s complex metabolic health impact.
“[D]airy fat and the dairy food matrix resulting from the processing of dairy food production have been shown to have several biological and signaling functions, to influence lipid and cholesterol metabolism, to alter digestion and the postprandial lipid response, as well as to modify gut signaling and gut homeostasis,” the authors explained.
“Studying this interplay of acting and counteracting biological mechanisms may provide insights into potential mechanisms that ultimately result in the relatively neutral effects that dairy food consumption has on cardiometabolic risk.
“We argue that categorizing dairy foods primarily based on their SFA content does not do justice to the diversity of these foods.”
Source:
Regular-fat and low-fat dairy foods and cardiovascular diseases: perspectives for future dietary recommendations
Lamarche, B., et al
The American Journal of Clinical Nutrition, Volume 121, Issue 5, 2025, Pages 956-964, ISSN 0002-9165