DRAFT Australian Dietary Guidelines - Eat For Health

2.5.3 How drinking milk and eating yoghurt, cheese
and/or alternatives may improve health outcomes
Two proposed mechanisms link the consumption of milk, yoghurt and cheese products with a
reduction in cardiovascular risk. Firstly, the consumption of milk, yoghurt and cheese products has
been linked to an increase in the levels of high density lipoprotein (HDL) cholesterol [410, 411].
Secondly, there is evidence of an inverse relationship between milk, yoghurt and cheese
consumption (especially milk) and blood pressure [412] which might be mediated by calcium
modulation of endothelial function [413]. 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 [414] suggested that calcium supplements, without coadministered
vitamin D, were associated with an increased risk of myocardial infarction. The same
group have more recently reported a similar effect from calcium supplements with vitamin D
[415]. 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 [416].
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 [417].
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 [418].
A randomized control trial of overweight children found that 200mL of milk per day combined
with nutrition education reduced consumption of sugar-sweetened drinks and increased lean body
mass [419].
2.5.4 Practical considerations: Milk, yoghurt, cheese
and/or alternatives
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 [10]. Varieties of cheese which are lower in
salt are also preferable (see Section 4.4).
The Australian Guide to Healthy Eating provides detailed information on number of serves and serve
sizes of milk, yoghurt, cheese and/or alternatives required for different population groups (see
tables 2.7 and 2.8 below).
DRAFT Australian Dietary Guidelines- December 2011 65