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Benefit-risk Assessment for Including Dairy Foods in the Diet
 

Benefit-risk Assessment for Including Dairy Foods in the Diet

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Uploaded with permission from Melissa Nickle...

Uploaded with permission from Melissa Nickle

Consumption of milk and milk products is an important component of a healthy diet. It is recommended by the Dietary Guidelines for Americans to consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. The benefits of milk and milk products outweigh the perceived risks. If milk is avoided in a diet, careful planning and monitoring is needed to assure adequate essential nutrients such as calcium, vitamin D, potassium, and magnesium. Calcium and vitamin D adequacy is critical to bone health, especially the prevention of osteoporosis.

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    Benefit-risk Assessment for Including Dairy Foods in the Diet Benefit-risk Assessment for Including Dairy Foods in the Diet Presentation Transcript

    • Benefit-risk Assessment for Including Dairy Foods in the Diet
      • Melissa Nickle
      • In conjunction with Kristen Nilsson Farley
      • Nutrition 577
      • December 2009
    • Abstract
      • Consumption of milk and milk products is an important component of a healthy diet. It is recommended by the Dietary Guidelines for Americans to consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. The benefits of milk and milk products outweigh the perceived risks. If milk is avoided in a diet, careful planning and monitoring is needed to assure adequate essential nutrients such as calcium, vitamin D, potassium, and magnesium. Calcium and vitamin D adequacy is critical to bone health, especially the prevention of osteoporosis.
    • Learning Objectives
      • Comprehend the background of the dietary guidelines and know what their recommendations are for milk and milk products
      • Become familiar with the health benefits of milk and milk products
      • Gain insight to the perceived risks of milk consumption
    • The 2005 Dietary Guidelines for Americans
      • Composed by scientific experts who were responsible for reviewing and analyzing the most current dietary and nutritional information and incorporating this into a scientific evidence based report 1 .
      • Advice to promote health and to reduce risk of major chronic diseases through diet and physical activity 1 .
      • A specific disease linked to poor diet and lack of physical activity is osteoporosis 1 .
      • The intent is to integrate knowledge regarding individual nutrients and food components into recommendations for a pattern of eating that can be adopted by the public 1 .
    • The 2005 Dietary Guidelines for Americans cont.
      • Recommends 3 cups per day of fat-free or low-fat milk or equivalent milk products 1 .
      • Documented intake levels of calcium, potassium, and magnesium are among the shortfall nutrients for adults and children 1 .
      • Dairy products provide a substantial portion of calcium, potassium, and magnesium 1 .
      • Indicates that low intakes of calcium tend to reflect low intakes of milk and milk products 1 .
      • Identifies milk and milk products as a major contributor of dietary potassium and lists dairy consumption, along with fruits and vegetables, as food groups to encourage 1 .
    • Benefits of Milk and Milk Products
      • Is fortified with vitamin D in the U.S. Vitamin D is important for optimal calcium absorption, and it can reduce the risk for bone loss 2 .
      • 3 cups of vitamin-D fortified milk contains 300IU’s of vitamin-D (75% of RDA) 3 .
      • Milk intake is especially important to bone health during childhood and adolescence 4 .
      • Studies specifically of milk and other milk products show a positive relationship between the intake of milk and milk products and bone mineral density in one or more skeletal sites 4 .
    • Benefits of Milk and Milk Products cont.
      • Most economical source of many key nutrients 4 .
      • Milk and milk products provide more than 70% of the calcium consumed by Americans 5 .
      • Contributes to essential nutrients, especially calcium, potassium, and magnesium 1 .
      Chart from National Dairy Council 6
    • Benefits of Milk and Milk Products cont.
      • Positively associated with bone health because of their calcium content. Bone mineral content is one-third calcium, and low calcium intake leads to increased bone remodeling and increased risk of hip fracture 7 .
      • Vegans who exclude dairy products in their diets have reduced bone mineral density and increased incidence of fracture 8 .
      • Also, lowers the risk of developing insulin resistance syndrome by 21% 9 .
    • Perceived Risks of Milk and Milk Products
      • Protein-induced calciuria associated with bone loss
        • Milk adds 8g of protein/cup, however overall calcium retention is unaffected by protein amount or type 10-12 .
      • Presence of steroid hormones
        • 17 β -estradiol is very low in whole milk (1.4 ± 0.2 pg/mL) and would be even lower in skim milk since it is based on fat value 13 .
      • Prostate Cancer
        • Some epidemiologic studies have shown a relation between dairy consumption and prostate cancer risk 14 , yet more recent studies have shown no relation or a reduction of risk with consumption 15,16 .
    • Conclusion
      • The current guidelines are made to ensure adequate calcium intake and are grounded in strong science.
      • Calcium intake is currently insufficient in the US, where osteoporosis is a major and rapidly growing public health problem 17 .
      • It is possible to consume adequate dietary calcium without dairy products, however doing so requires nutrient knowledge, planning, and monitoring.
      • Milk is an inexpensive source of high-quality, essential nutrients 17 .
    • Conclusion cont.
      • Milk is fortified with vitamin D and is currently the only significant food source of vitamin D. Vitamin D is critical for the absorption of calcium and particularly important during the winter months 17 .
      • American Cancer Society advises to consume recommended levels of calcium primarily through food sources such as low-fat or non-fat dairy products 18 .
    • References
      • U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2005. 6th Edition, Washington, DC: U.S. Government Printing Office, January 2005.
      • Holick MF. Vitamin D. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, eds. Modern Nutrition in Health and Disease, 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2006.
      • U.S. Department of Agriculture, Agricultural Research Service. USDA Nutrient Database for Standard Reference, Release 22, 2009.
      • Weaver CM. Should dairy be recommended as part of a healthy vegetarian diet? Point. Am J Clin Nutr 2009; 89(suppl):1634S-7S.
      • Hiza, HAB. Bente L, Fungwe. Nutrient Content of the U. S. Food Supply, 2005. (Home Economics Research Report No. 58). U.S. Department of Agriculture, Center for Nutrition Policy and Promotion.
      • National Dairy Council. http://www.nationaldairycouncil.org/NR/rdonlyres/BF4E114A-E9D5-4BD1-9858-E712E6B4ECA7/0/ImproveDietQualitywithDairyFINAL102209.pdf
      • Kalkwarf HJ, Khoury JC, Lanphear BP. Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women. Am J Clin Nutr 2003; 77:257-65.
      • Appleby P, Roaddam A, Allen N, Key T. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 2007; 61:1400-6.
      • Elwood PC, Pickering JE, Fehily AM, Hughes J, Ness AR. Milk drinking, ischaemic heart disease and stroke. I. Evidence from cohort studies. Eur J Clin Nutr 2004; 58:711-7.
    • References
      • Kerstetter JE, O’Brien KO, Caseria DM, Wall DE, Insogna KL. The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. J Clin Endocrinol Metab 2005;90:26-31.
      • Roughead ZK, Johnson LK, Lykken GI, Hunt JR. Controlled high meat diets do not affect calcium retention or indices of bone status in healthy postmenopausal women. J Nutr 2003; 133:1020-6.
      • Spence LA, Lipscomb ER, Cadogan J, et al. The effect of soy protein and soy isoflavones on calcium metabolism and renal handling in postmenopausal women: a randomized crossover study. Am J Clin Nutr 2005; 81:916-22.
      • Pape-Zambito DA, Magliaro AL, Kensinger RS. Concentrations of 17 β -Estradiol in Holstein whole milk. J Dairy Sci 2007; 90:3308-13.
      • Wu K. Hu FB, Willett WC, Giovannuci E. Dietary patterns and risk of prostate cancer. Cancer Res 2006; 15:167-71.
      • Park Y, Mitrou PN, Kipnis V, Hollenbeck A, Schatzkin A, Leitzmann MF. Calcium, dairy foods, and rick of incident and fatal prostate cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol 2007; 166:1270-9.
      • Neuhouser ML, Barnett MJ, Kristall AR, et al. (n-6) PUFA increase and dairy foods decrease prostate cancer risk in heavy smokers. J Nutr 2007; 137:1821-7.
      • Goldberg JP, Folta SC, Must A. Milk: can a ‘good’ food be so bad? Pediatrics 2002; 110:826-832.
      • Kushi LH, Byers T, Doyle C, et al. CA Cancer J. Clin 2006; 56:254-262.