The world of nutrition science is constantly evolving, and as a wellness entrepreneur and podcast host, I have to make sure I’m up to date with all the latest developments that are out there.
That means not subscribing to a particular diet and being open to challenging my beliefs as new data comes out.
Dairy is a perfect example of this.
Buckle up, because in these next few newsletters, I’m rehashing the dairy conversation and sharing my personal take on it based on the latest research.
This week, we’re examining the link between dairy and inflammation based on the results from one of the largest review papers on clinical evidence to date.
A quick note before we get started! I’m going to be focusing primarily on the health properties of dairy today and not the environmental impact or animal-welfare aspects. Those are topics we’ll save for a different newsletter.
Let’s jump in!
My N of 1 Experience with Dairy
Growing up, I was vegetarian. Dairy was a major source of protein and a popular dietary staple in Indian culture. When I hit puberty, I started getting terrible cystic acne. I tried everything, including Accutane, to try and get it under control, but nothing worked.
Then, one day when I was at a summer camp, the keynote speaker, an animal rights advocate, stated that dairy was inflammatory to the gut and could be a potential trigger of acne. She suggested going vegan for a month to see if it helped. I took her advice, and after 30 days, my skin totally cleared up. It was like a miracle, and I was over the moon!
After my experience, I started preaching the gospel that dairy was inflammatory and harmful to everyone. But as I got into the world of Functional Medicine, I started to see there was more to the dairy conversation than what the vegan and plant-based communities were saying. And perhaps, for some people, the right kind of dairy might even have an anti-inflammatory effect.
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In this next section, we’re going to discuss what the research actually says about the link between dairy and inflammation and why it led me to add high-quality dairy back into my diet. Plus, I’m also sharing the specific dairy products I can eat without any acne trouble.
Is Dairy Really Inflammatory? Here’s What the Research Says
One of the best reviews on dairy to date comes from a 2017 paper. Researchers analyzed 52 human studies on dairy and inflammation and assigned inflammatory scores based on the changes in biomarkers measured (1).
After crunching all of the data, the overall report indicated that dairy had anti-inflammatory activity for almost everyone!
Digging Deeper into Dairy: Anti-Inflammatory for Almost Everyone
- Who benefited the most from dairy? Healthy individuals and even those with metabolic disease. Dairy’s anti-inflammatory properties were most significant for healthy individuals and, fascinatingly, even those with metabolic disease (e.g., obesity, type 2 diabetes, cardiovascular disease). This effect is likely due to dairy’s rich profile of bioavailable protein, healthy fats, vitamins A and E, carotenoids, and micronutrients like iodine, zinc, and selenium that support antioxidant activity and an anti-inflammatory state (2). For those with metabolic disease, consuming dairy was especially beneficial by supplying essential nutrients that combat underlying, chronic inflammation.
- Who benefited the least? People with dairy allergies. Not surprisingly, dairy consumption in those with diagnosed milk allergies (not lactose intolerance) had the worst inflammatory outcomes. This subset of individuals would be better off avoiding dairy and opting for clean plant-based alternatives, like almond milk, instead.An estimated 68 percent of the world population is lactose intolerant. If you fall under that umbrella but do not have a diagnosed allergy, fermented dairy products tend to be tolerated better because they contain bacteria that aid in lactose absorption (3). See below for more on the interaction between fermented dairy and inflammation.
- Needs more research: people with gastrointestinal disorders. In the review, dairy had a pro-inflammatory effect on people with GI conditions, but the result was not significant. Research on dairy intake and GI issues is conflicted, with some studies showing no link and others showing a pro-inflammatory effect (4).The impact of dairy on inflammation in GI disorders is highly individualized. Some factors to consider are the source (fermented vs unfermented), the quality of the source, and how well the person tolerates dairy.This, by the way, is the category I fell into as a teenager suffering from acne. I had a history of gastrointestinal symptoms, most likely caused by the overuse of antibiotics as a child. Low-quality industrialized dairy, in particular, was a big trigger for me. Even today, if I consume conventional dairy products (which rarely happens), I notice tiny blemishes on my skin within 24 hours.Speaking of dairy quality, let’s look at what the study found concerning the effects of fermented dairy and fat content on inflammation.
Types of Dairy, Fat Content, and Their Effects on Inflammation
- Fermented dairy was the most anti-inflammatory. Both fermented and unfermented dairy had reported anti-inflammatory activity in consumers, but only fermented dairy (e.g., yogurt, cheese, and kefir) was significant. This is consistent with mounds of research showing that fermented dairy supports healthy gut flora that create anti-inflammatory metabolites (5,6).
- Both high-fat and low-fat dairy were anti-inflammatory. Low-fat dairy displayed greater anti-inflammatory activity than high-fat dairy, but the difference was insignificant.
High-fat dairy contains conjugated linoleic acid (CLA), a fatty acid that has been shown to neutralize the effects of saturated fat and is linked to a lower risk of obesity, heart disease, and cancer (7).
What about the Saturated Fat in Full-Fat Dairy?
Another potential mechanism for why saturated fat in dairy is not linked to inflammation is because it’s enclosed by milk fat globule membrane (MFGM), an outer casing that protects against elevated cholesterol levels.
I was first made aware of this from a conversation I had with my dear friend Max Lugavere. In this clip, he says the reason butter raises cholesterol is due to the churning process, which disrupts MFGM. This explains why butter, and not other dairy sources, is associated with high cholesterol and an increased risk for heart disease (8).
The Debate about Saturated Fat and Heart Disease
If you’re getting enough saturated fat in your diet from other sources, you want to be careful not to overdo it, especially if you believe or adhere to the notion that saturated fat causes heart disease. I say “believe or adhere” because it’s a hotly debated area with many nuances. I’ll be having cardiologist Dr. Michael Twyman on the podcast soon to talk through this debate and the research that’s out there.
With that being said, some of the smartest people I know aren’t worried about saturated fat from whole foods in the context of a clean diet. They do, however, minimize concentrated sources of added saturated fat in the form of things like butter, MCT, and coconut oil.
Tying It All Together: My Story and Why Dairy Quality Matters
Around 2014, I noticed many of my friends were starting to add high-quality dairy back into their diets. And when I met my business partner, Dr. Mark Hyman, he was also starting to publicly change his tune on dairy.
I started by introducing European cheeses from goats and sheep and noticed I wasn’t getting the blemishes I typically would with conventional American dairy products.
Once I started my gut-healing journey, I noticed I could also tolerate goat kefir and grass-fed Greek yogurt, which is a reminder that our gut health determines our ability to tolerate certain foods. Quality matters, too, and I’ve found I do much better with grass-fed a2 dairy sources.
(Note: a1 and a2 are two types of casein, a protein found in milk. Factory-farmed dairy cows make a1 milk, while heirloom cows, goats, and sheep produce a2 milk.)
Last year, I introduced grass-fed a2 whey protein into my diet as a protein source and tolerated it really well. Interestingly, just two years prior to that, I tried adding whey protein that wasn’t grass-fed into my diet and immediately noticed a strong reaction of bloating and pimples.
This is just my N of 1 experience, but my story matches the anecdotes of a lot of my friends who have had similar experiences, and we’ve all come to the same conclusion: the quality of dairy matters in our ability to tolerate it, and modern-day dairy is much more problematic than a2, grass-fed sources.
Dairy has been villainized for being inflammatory (heck, I used to believe it), and although that might be true for some, is it really fair to say that dairy is inflammatory for all? Based on the findings of this 2017 study and my own personal experience, I don’t think it is.
Stay tuned for next week’s newsletter. We’re going to talk about the link between dairy and bone health to see if the claim “dairy builds strong bones” has any truth behind it.