EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

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Guideline 2

The 1995 National Nutrition Survey^45 included a category called ‘milk products and dishes’ which included items

such as milks, yoghurts, cheese, cream, ice-cream and milk-based custards, as well as milk substitutes such as

soy drinks and soy cheeses. On the day of the survey, 93% of subjects consumed foods from this category, the

average intake being 322g for adult men and 258g for adult women. Older men consumed less of these foods

than younger men, but consumption remained relatively stable in women across age groups.

To meet recommended food group intakes for adults^9 consumption of milk, yoghurt and cheese products would

need to approximately double overall, with a halving of higher fat varieties and a four-fold increase in reduced

fat varieties of milk, cheese and yoghurt. Alternatives such as calcium-enriched soy or other drinks could be

substituted for these dairy foods.

Pregnant and breastfeeding women

Milk, yoghurt and cheese product intake during pregnancy and lactation have benefits for both women and

their babies. Reduced fat milk, yoghurt and cheese products are recommended during pregnancy and while

breastfeeding.428,572

Pregnant women are advised to avoid consuming unpasteurised dairy products and soft, semi-soft and surface-

ripened cheeses (e.g. brie, camembert, ricotta, fetta and blue cheeses) due to risk of listeriosis.349,609

Infants

Cow’s milk should not be given as a drink to infants (under 12 months of age). However cow’s milk may be served

in small quantities as custards, with cereals or as yoghurt. Any milk given to infants (as a drink) should be breast

milk or infant formula.

Milk given to infants and toddlers should be pasteurised. As children under 2 years are growing rapidly and have

relatively high energy (kilojoule) needs, reduced fat milks are not recommended as a main milk food for this age,

but are suitable after 2 years of age.

For further information, see the Infant Feeding Guidelines.^351

Children and adolescents

Milk is an important source of calcium and protein for growing children and adolescents. The decreased intake of

milk and milk products among adolescent girls is of concern, and can lead to low calcium intake in this group.^45

Diets restricting intake of milk and milk products (or calcium-fortified alternatives) are not generally suitable for

growing children and adolescents. Suspected lactose intolerance and allergy in children and adolescents should

be confirmed by a medical practitioner.

Older people

For older Australians, milk is a good source of protein, calcium and energy (kilojoules). All milks, including whole

milk, are good choices for older people whose appetite is reduced or who have lost weight, unless medically

advised otherwise.

People with lactose intolerance

The rate of lactose intolerance is relatively high in many Asian communities compared with Caucasians. High rates of

lactose intolerance have been described among Aboriginal and Torres Strait Islander groups.610,611 lactose-intolerant

adults and children often avoid milk and milk products, however up to 250ml of milk may be well tolerated if broken

up throughout the day and consumed with other foods.^612 Cheese contains little lactose and the lactose in yoghurt is

partially broken down by bacteria that thicken the yoghurt, so should be well tolerated. lactose-free dairy products

and calcium-fortified beverages are also available.

People with vegetarian or vegan dietary patterns

The 2003 edition of the dietary guidelines addressed vegetarian and vegan diets and their influence on calcium

needs because of the relatively high oxalate and phytate content in some plants. However, lacto-ovo vegetarians

appear to have calcium intakes similar to those of omnivores. Those who follow a vegan or vegetarian diet

and avoid milk products, should consume alternative calcium-fortified products and seek advice from a health

professional about whether they need to take supplements.^36