EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

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Guideline 2

Other conditions

The traditional nutritional rationale for the inclusion of dairy foods such as milk, cheese and yoghurt is their high

calcium content and the positive relationship between calcium and bone mass.^8

•   Bone mineral density: Recent evidence suggests that consumption of dairy foods (particularly milk) is

associated with improved bone mineral density (Grade C; Evidence Report, Section 5.1)590,593-598 but this is

contradicted by evidence suggesting that less than one serve of milk per day during adult life is not associated

with risk of osteoporotic or hip fracture (Grade C; Evidence Report, Section 5.2).599,600

2.5.3 How consuming milk, yoghurt, cheese and/or alternatives, mostly reduced fat,

may improve health outcomes

There is a range of bioactive substances in milk products that may have a contributing role in health outcomes.

The mechanism by which milk, yoghurt and cheese consumption (especially milk) affect blood pressure^601 might

be due to calcium modulating endothelial function.^602 Calcium from foods may be preferable to calcium from

some supplements. A recent meta-analysis of the effect of calcium supplementation on myocardial infarction and

cardiovascular events^603 suggested that calcium supplements, without co-administered vitamin D, were associated

with an increased risk of myocardial infarction. The same group has more recently reported a similar effect from

calcium supplements with vitamin D.^604 However, the effect of an equivalent dose of calcium from milk, yoghurt

and cheese products has a much smaller effect than calcium supplements on the proposed risk factor, namely

raised serum calcium levels.^605

There may be a negative association between calcium and blood pressure although this is variable, depending on

other dietary factors, and it has been suggested that calcium supplementation may lower blood pressure only in

people with a relatively high salt intake.^606

Several reasons have been suggested for the lack of an association between a low consumption of milk and

increased risk of osteoporotic fracture of the hip. For example, it has been suggested that women who consumed

higher quantities of milk chose to do so because they were known to be at an elevated risk of osteoporosis or that

milk intake during childhood was more important.^607

A randomised controlled trial of children who were overweight found that 200ml of milk per day combined with

nutrition education was associated with a reduced consumption of sugar-sweetened drinks and increased lean

body mass.^608

2.5.4 Practical considerations: enjoy milk, yoghurt, cheese and/or alternatives,

mostly reduced fat

Consuming at least two and a half serves of milk, cheese, yoghurt and/or alternatives, mostly reduced fat, is

recommended for Australian adults, while the recommended food group intakes for children and adolescents

depend on age and sex (see Tables 2.14 and 2.15).^9 Varieties of cheese that are lower in salt are also preferable

(see Section 3.2).

The companion resources provide more detailed information on the recommended number of serves and serve

sizes of milk, yoghurt, cheese and/or alternatives required for different omnivore population groups. Discussion of

dietary patterns and the environment is included in Appendix G.