1.
PRESCOUTER
Evidence for Dairy Benefits in
Mediterranean Diets?
Date: March 21 2017
15:24 CDT
Rachel Murkett, PhD
Project Architect
PreScouter, Inc.
Vishal Kothari
Research Scholar
Auburn University
Your personal research team

2.
Inquiry
“Evidence for Dairy Benefits in Mediterranean Diets?”
The goal is to:
1. Answer: Is there evidence for dairy benefits in the Mediterranean Diet?
2. Identify evidence to support benefit for dairy (or not if there is evidence to the contrary) in
Mediterranean Diet.
3. What is the Consensus/Conclusion

3.
Key Findings
There is evidence to support the notion that dairy products are beneficial in the
mediterranean diet, provided that dairy products with a low fat content or
fermented dairy foods are used.
The traditional Mediterranean diet is characterized by high consumption of vegetables, fruits and nuts,
legumes, and unprocessed cereals; compared with low consumption of meat and meat products. The
inclusion of dairy products in the diet has been a long-standing, controversial issue. There are clinical
studies that endorse the use of dairy products including in the context of the mediterranean diet.
Particularly, the PREDIMED study, which demonstrated that the consumption of low fat dairy products or
fermented dairy products with traditional Mediterranean diet were beneficial in disease conditions.
It is commonly believed that high consumption of whole milk dairy products has adverse effects on health.
A possible mechanism for this could be the presence of medium and long chain saturated fatty acids in
whole milk, which increase serum low-density lipoprotein cholesterol and are atherogenic. However, there
is increasing evidence suggesting the contrary; a beneficial effect of dairy products on cardiovascular risk
factors.
So, we can conclude that a moderate amount of low fat or fermented dairy products is safe and healthy
along with the Mediterranean diet. Though, further evidence for benefits of dairy products after long term
usage with mediterranean diet is required.

4.
Benefits of Low-Fat Dairy in a Mediterranean Diet
Researchers working out of the University of Navarra in Spain assessed the relationship between low-fat
dairy product intake and blood pressure in an observational follow-up study conducted in a large
population at high cardiovascular risk participating in the PREDIMED study, a trial to test the effects of the
Mediterranean diet on cardiovascular outcomes.
They have shown a unique benefit of low-fat dairy products when they are consumed within the context of
a Mediterranean Diet. In their study of more than 2,000 older adults—60% of them with high blood
pressure—the Spanish researchers found that high intake of low-fat dairy products within the context of
a Mediterranean Diet (the equivalent of 2.5 cups of low-fat milk per day) did a better job of lowering high
blood pressure than did the absence of these foods.
From a biological point of view, protection against hypertension by low-fat dairy products has been
attributed to their nutrient composition. Dairy products are good sources of K, Mg, Ca, peptides with an
inhibitory effect on angiotensin-I converting enzyme activity and opioid-like peptides. All these
mechanisms add biological plausibility to the hypothesis of a specific protection against hypertension
provided by low fat dairy products.

5.
Benefits of fermented or whole fat dairy products
Fermented dairy foods such as yoghurt and cheese are commonly found in the Mediterranean diet.
Recent analyses from large population studies from various countries list yoghurt and other fermented
dairy products as the food most negatively associated with the risk of weight gain which is a problem that
may lead to cardiovascular diseases. In additions, dietary trials suggests that cheese and yogurt may not
have the same effect on raising LDL-cholesterol levels as butter with the same saturated fat content.
Although, the use of whole dairy product is believed to be detrimental to the health, recent research
proposes that dairy products, rich in saturated fats, may not be a negative factor. A prospective
population-based cohort study was studied in relation to dairy consumption among rural men for central
obesity. In this study a high intake of dairy fat was associated with a lower risk of developing central
obesity and a low intake of dairy fat was associated with a higher risk of central obesity. A separate and
more recent meta-analysis of 16 relevant studies in the European Journal of Nutrition echoes the weight-
gain link. One likely explanation is that the full-fat version provides more satiety, but it is also possible that
some of the fatty acids in milk products have an additional effect on weight regulation.
However, use of whole fat dairy products with Mediterranean diet is yet to be explored. Further studies
would be needed to investigate fermented and whole fat dairy products in the specific context of the
Mediterranean diet. .

6.
Suggested Next Steps
The Mediterranean diet has long been one of the healthiest diets known to reduced various disease
related complications. Although dairy products with Mediterranean diet is not recommended previously,
many recent studies support the use of dairy products to offer added benefits. However, it is very
important to select the type of dairy products with Mediterranean diets. There is evidence for the
beneficial effects of low fat or fermented dairy products to alleviate or protect various disease conditions.
However, studies of the Mediterranean diet with full fat dairy products have not been completed. It is also
very important to keep in mind that in low fat dairy products, fat should not be replaced with high sugar
which is known to increase the adiposity.

7.
References
1.Toledo E et al. Low-fat dairy products and blood pressure: follow-up of 2290 older persons at high
cardiovascular risk participating in the PREDIMED study. Br J Nutr. 2009 Jan;101(1):59-67.
2.McGrane MM et al. Dairy Consumption, Blood Pressure, and Risk of Hypertension: An Evidence-Based
Review of Recent Literature. Curr Cardiovasc Risk Rep. 2011 Aug 1;5(4):287-298
3.Trichopoulou A, Martínez-González MA, Tong TY, Forouhi NG, Khandelwal S, Prabhakaran D,
Mozaffarian D, de Lorgeril M. Definitions and potential health benefits of the Mediterranean diet: views
from experts around the world. BMC Med. 2014 Jul 24;12:112.
4.Tapsell, L. C. (2015). Fermented dairy food and CVD risk. The British Journal of Nutrition: an
international journal of nutritional science, 113 (Suppl. S2), s131-s135.
5.Holmberg S, Thelin A. High dairy fat intake related to less central obesity: a male cohort study with 12
years' follow-up. Scand J Prim Health Care. 2013 Jun;31(2):89-94.

8.
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