When the new dietary guidelines are released at the end of this month, the Trump administration is expected to reverse long-standing advice on whole milk and its full-fat allies in the dairy sector.
For decades, the American public has been advised to opt for fat-free or low-fat dairy options, largely due to concerns about limiting saturated fat intake in these foods.
Although the public doesn’t necessarily follow this advice — cheese is the main source of saturated fat in our diet — Health Secretary Robert F. Kennedy has promised to end the “attack on whole milk, cheese, and yogurt” and give these foods new prominence in the upcoming guidelines.
So, what’s the argument for ditching skim milk and other low-fat alternatives?
Richard Bruno, professor of human nutrition at Ohio State University, says the nutrition field has been wrestling with this issue for many years.
“There has been a lot of controversy,” says Bruno, author of numerous studies on the topic.
Opinions have evolved in recent years as researchers began to discover that “saturated fat from dairy doesn’t seem to be behaving the way we thought it should, based on historical evidence linking saturated fat to heart disease,” he says.
As dairy is such a broad category — and fat content varies widely among foods like milk, yogurt, and cheese — it’s hard to make blanket statements. However, Bruno and other experts in the field say that when you look at the data, the justification for a general recommendation to favor skim milk and low-fat dairy quickly disappears.
“If we’re saying low-fat is better than high-fat, we should have studies that demonstrate that clearly and concisely, because guidelines should be evidence-based,” says Benoît Lamarche, director of the Nutrition, Health, and Society Center in Quebec and professor at Laval University.
That’s why Lamarche gathered nutrition leaders last year, including several who worked on dietary guidelines, to review the evidence on dairy fat and its link to cardiometabolic health.
Their conclusion?
“The evidence shows they have the same effect, but it’s low-quality and there are few studies that have looked at this,” he says.
Lamarche says the argument against full-fat dairy is largely “circumstantial.”
Previous research showed that people at higher risk of heart disease tended to have a dietary pattern that included more full-fat dairy, but there were other factors — and foods in their diet — that could explain that finding.
“We don’t have rigorous, robust evidence pitting the two types of dairy against each other and their effects on health,” he says. “We need to stop distracting people with this recommendation.”
Some recent studies have even signaled that high-fat dairy consumption isn’t just neutral but may offer benefits beyond low-fat options in some cases, at least when part of a healthy dietary pattern.
A small study found that participants following the “DASH” diet — developed by National Institutes of Health (NIH) scientists to reduce hypertension — and substituting high-fat dairy had blood pressure improvements comparable to those who consumed low-fat dairy and better blood lipid levels, a risk factor for heart disease.
Another study tracking 18 adults in Europe for three weeks found that drinking whole milk outperformed skim milk in boosting HDL, or “good” cholesterol.
Bruno says the hypothesis is that certain bioactive components in the milk fat membrane, like phospholipids, “mitigate any putative risks that would be associated with that higher saturated fat intake.”
The key, he says, seems to be the form in which the milk fat is provided.
For example, research shows that butter — also dairy-derived but mainly fat and water — has the predicted negative effects on cholesterol; however, that’s not true when people consume the same amount of saturated fat in the form of cheese, which contains calcium, protein, minerals, and other components.
In fact, Lamarche notes there is strong evidence from observational studies that cheese is associated with a lower stroke risk.
“Is this real or could it be confounded by something else?” he asks. “We don’t know, but the data are quite consistent on this.”
Similarly, there is a well-documented link between yogurt and type 2 diabetes prevention, leading the Food and Drug Administration (FDA) to issue a qualified health claim for these products (though, of course, the yogurt universe spans everything from full-fat Greek yogurt to sugary skim varieties).
While some recent studies examining high-fat dairy are promising, Bruno believes it’s “premature to have a one-size-fits-all recommendation that consumers should prefer whole-fat over skim foods.”
Even when it comes to milk, the evidence is sparse in both directions, and Lamarche argues that U.S. and Canadian guidelines should remain agnostic on the issue for now, until more precise data emerge.
In its reports, the scientific advisory committee providing guidance to the federal government on the 2025 dietary guidelines decided not to change existing recommendations supporting skim milk because it “could not draw a conclusion on the relationship between consumption of milk with different fat contents” — advice that Kennedy may well ignore, given his public comments disparaging the scientific report.
Frank Hu, chair of the nutrition department at Harvard T.H. Chan School of Public Health, agrees there are no clear answers yet, meaning there’s no reason to start promoting full-fat dairy as superior, especially since a glass of whole milk with cheese contains more calories and saturated fat.
In his view, however, the much bigger problem is that Americans are mainly consuming dairy in the form of pizza, burgers, sandwiches, and other foods “loaded with sodium, refined starch, and processed meats.”
In that context, it probably doesn’t make much difference whether the cheese you eat is low- or high-fat. On the other hand, it’s relatively easy “to incorporate a moderate amount of dairy into your overall diet, whether full-fat or low-fat,” he says.
“If you’re replacing your carbs, especially refined carbs and sugar, with dairy, even some full-fat, that’s probably a good thing.”
Source: npr.org by Will Stone