Milk-and-Dairy-Products-in-Human-Nutrition-FAO

Chapter 4 – Milk and dairy products as part of the diet 135
4.6 Dairy intake, weight gain and obesity development
The increasing incidence of overweight and obesity is a global public health concern
(WHO, 2011a). WHO (2012c) estimates indicate that more than 1.4 billion people
are overweight (body mass index [BMI] between 25 and 30 kg/m 2 ), 500 million of
whom are obese (BMI 30 kg/m 2 or more). Adult obesity rates continue to increase
and the WHO estimates that in many countries, including Argentina, Greece, the
United Kingdom and the United States, a large percentage of the population will
shift from the overweight category to the obese category between 2005 and 2015
(Dougkas et al., 2011). Obesity is associated with increased mortality and risk of
non-communicable chronic diseases such as CVD, diabetes, hypertension, certain
cancers and osteoporosis (Shetty and Schmidhuber, 2011).
4.6.1 Dietary patterns and the risk of obesity
The aetiology of obesity is complex and the assessment of dietary patterns related to
obesity has become increasingly popular in nutritional epidemiology (Jebb, 2007).
Excess energy consumed over a sustained period can lead to obesity. However,
certain dietary patterns are associated with a greater risk of obesity because of their
high energy content. A study of the dietary patterns of 15 890 Mexican adults found
that the patterns with the highest consumption of refined foods, sweets and animal
products were associated with being overweight or obese (Flores et al., 2010).
Sichieri (2002) reported that a “Western diet”, which included butter, margarine
and soda, was associated with an increased risk of obesity in adults living in Rio de
Janeiro. A cross-sectional study based in Mongolia (Dugee et al., 2009) concluded
that a traditional diet rich in whole milk, fats and oils, sugar and confectionery,
yoghurt, kumis (fermented mare milk), horse meat and refined wheat products was
associated with a greater risk of abdominal obesity than was a “healthy” diet with
greater intake of whole grains, mixed vegetables and fruits. The healthy diet also
included some dairy products, suggesting that consumption of moderate quantities
26 of yoghurt and kumis does not increase the risk of obesity (Dugee et al., 2009).
Using data from the Danish Diet Cancer and Health Study, Halkjaer et al., (2009)
reported that, of 21 food and beverage groups examined (including high-fat and
low-fat dairy products), only snack foods (chocolates, sweets, liquorice, fruit, gum,
toffee, pork rind, potato crisps and French fries) were significantly associated with
subsequent five-year differences in waist circumference. Romaguera et al., (2011)
analysed data from 48 631 men and women from five countries participating in the
European Prospective Investigation into Cancer and Nutrition (EPIC) study and
concluded that a dietary pattern characterized by a high consumption of fruits and
dairy products and a low consumption of soft drinks, white bread, processed meat
and margarine may help to prevent abdominal fat accumulation.
The recent expert consultation on fats and fatty acids (FAO and WHO, 2010)
reported that “a general recommendation is to follow a dietary pattern predominantly
based on whole foods (i.e. fruits and vegetables, whole grains, nuts, seeds,
26 Factor loading matrices were calculated for the three dietary patterns. The “traditional”
and “healthy” pattern had factor loading matrices of 0.519 and 0.225, respectively, for yoghurt
and kumis.