Guidelines Dietary - Eat For Health

Other conditionsThe traditional nutritional rationale for the inclusion of dairy foods such as milk, cheese and yoghurt is their highcalcium content and the positive relationship between calcium and bone mass. 8• Bone mineral density: Recent evidence suggests that consumption of dairy foods (particularly milk) isassociated with improved bone mineral density (Grade C; Evidence Report, Section 5.1) 590,593-598 but this iscontradicted by evidence suggesting that less than one serve of milk per day during adult life is not associatedwith risk of osteoporotic or hip fracture (Grade C; Evidence Report, Section 5.2). 599,600Guideline 22.5.3 How consuming milk, yoghurt, cheese and/or alternatives, mostly reduced fat,may improve health outcomesThere is a range of bioactive substances in milk products that may have a contributing role in health outcomes.The mechanism by which milk, yoghurt and cheese consumption (especially milk) affect blood pressure 601 mightbe due to calcium modulating endothelial function. 602 Calcium from foods may be preferable to calcium fromsome supplements. A recent meta-analysis of the effect of calcium supplementation on myocardial infarction andcardiovascular events 603 suggested that calcium supplements, without co-administered vitamin D, were associatedwith an increased risk of myocardial infarction. The same group has more recently reported a similar effect fromcalcium supplements with vitamin D. 604 However, the effect of an equivalent dose of calcium from milk, yoghurtand cheese products has a much smaller effect than calcium supplements on the proposed risk factor, namelyraised serum calcium levels. 605There may be a negative association between calcium and blood pressure although this is variable, depending onother dietary factors, and it has been suggested that calcium supplementation may lower blood pressure only inpeople with a relatively high salt intake. 606Several reasons have been suggested for the lack of an association between a low consumption of milk andincreased risk of osteoporotic fracture of the hip. For example, it has been suggested that women who consumedhigher quantities of milk chose to do so because they were known to be at an elevated risk of osteoporosis or thatmilk intake during childhood was more important. 607A randomised controlled trial of children who were overweight found that 200ml of milk per day combined withnutrition education was associated with a reduced consumption of sugar-sweetened drinks and increased leanbody mass. 6082.5.4 Practical considerations: enjoy milk, yoghurt, cheese and/or alternatives,mostly reduced fatConsuming at least two and a half serves of milk, cheese, yoghurt and/or alternatives, mostly reduced fat, isrecommended for Australian adults, while the recommended food group intakes for children and adolescentsdepend on age and sex (see Tables 2.14 and 2.15). 9 Varieties of cheese that are lower in salt are also preferable(see Section 3.2).The companion resources provide more detailed information on the recommended number of serves and servesizes of milk, yoghurt, cheese and/or alternatives required for different omnivore population groups. Discussion ofdietary patterns and the environment is included in Appendix G.58EAT FOR HEALTH – australian dietary guidelinesNational Health and Medical Research Council