With millions of Americans lactose intolerant, should dairy remain as an independent, recommended food group?

By Elizabeth Crawford

- Last updated on GMT

Source: Getty /  Prostock-Studio
Source: Getty / Prostock-Studio

Related tags Dairy Lactose intolerance Non-Dairy Dietary guidelines Dietary guidelines advisory committee

Likely fighting an uphill battle, some nutrition experts, health care providers and professional athletes want the 2020 Dietary Guidelines for Americans to demote dairy from its long-held position as a standalone and recommended food group to a discretionary option or alternative protein source.

At an Aug. 11 public meeting, they argued that the inclusion of dairy as a food group is “outdated,”“a clear form of dietary racism”​ and a contributor to multiple chronic diet-related diseases, while simultaneously not offering nutritional benefits that cannot also be met through balanced consumption of other food groups.

Their pleas to the US Department of Agriculture and Health and Human Services Department go against recently published recommendations by the dietary guidelines advisory committee, which maintained dairy as an independent food group. As such, the DGAC recommended in a report published earlier this summer that the upcoming Dietary Guidelines for Americans, which is updated every five year, include that Americans 9 years and older consume three servings of dairy day, and infants as young as 6 months consume yogurt and cheese among their first complementary foods. The committee added that an ideal, healthy dietary pattern for all ages includes low-fat and fat-free dairy along with legumes, whole grains, fruits and vegetables.

Dairy industry stakeholders lauded the committee’s recommendations and argued that dairy should retain its status as an independent food group due to its unique combination of core nutrients, including many which are nutrients of concern.

Daily dairy recommendation runs counter to a third of Americans qualifying as lactose intolerant

While dairy may be a nutritionally dense, protein-packed option with a long-track record of offering health benefits, such as bone support, for some Americans, it also makes millions ​of Americans ​sick, argued proponents for dropping it as a recommended food group.

“Thirty-six percent of Americans are lactose intolerant, meaning they experience symptoms ranging in severity such as difficulty breathing, diarrhea, bloating, itchy skin rashes and gastrointestinal distress every time they consume dairy,”​ argued Dotsie Bausch, a US Olympian and representative for Swith4Good, a coalition of athletes, trainers, nutritionists and influencers advocating for a dairy-free lifestyle. “This is over a third of the American population or 118 million people, for whom dairy does far more harm than good.”

The majority of those who are lactose intolerant are people of color with up to 80% of Black Americans, 95% of Asian Americans, 80-100% of Native Americans and up to 80% of Hispanic and Latinx unable to handle dairy, said NBA champion John Salley, who represented the Physicians Committee for Responsible Medicine.

“Racial health disparities also plague America and the dietary guidelines advisory committee suggestion the dietary guidelines recommend three servings of dairy a day would take a disproportionate toll on the health of Black Americans and other communities of color,”​ he said at the meeting, explaining, “Heart disease, prostate cancer, breast cancer and asthma take the lives of Black Americans at a disproportionate rate, and milk, cheese, yogurt – all dairy products – increase the risk of these conditions.”

Rather than strong-arming Americans who cannot tolerate dairy to eat it, Salley recommended USDA and HHS follow the Canadian government’s lead and “demote dairy products to a food group as an optional protein source.”

In 2019, Canada unveiled sweeping changes to its dietary guidance, including lumping dairy with other proteins, which together should account for a quarter of the plate. The director general of Health Canada’s office of nutrition policy and promotion said at the time that the decision was based on only on scientific research not funded by industry, and was an attempt to course-correct after “kowtowing to the meat and dairy industries”​ for years.

Alleging that the US government and dairy industry enjoyed a “deeply embedded”​ relationship similar to that of the commodity and Canadian government, Bausch said she has “little confidence” ​that dairy will be dropped in the 2020 Dietary Guidelines.

However, she argued, “the updated guidelines must include … extensive education on lactose intolerance and what it is and the symptoms and risks of consuming dairy,”​ because most people who suffer a negative reaction from dairy “have no idea dairy is making them so sick.”

Martica Heaner, a professor in the public health department at Hunter College, nutritionist and exercise physiologist reiterated the need for the updated guidelines to “include warnings about the hazards of dairy products and remove dairy entirely as a recommended food group,” ​instead positioning it along side processed meats, sweets and “junk food.”

Likewise, Jamie Kane, an internal medicine physician and diplomat of the American Board of Obesity Medicine, echoed these concerns and recommendations, noting he is “not sure there were any convincing arguments as to why dairy is recommended as a fixture in the American diet.”

‘Dairy is associated with many beneficial health outcomes’

During the meeting, dairy advocates touted the category as offering “unmatched health and nutritional benefits,”​ including as a top source of calcium, vitamin D and potassium that is affordable and accessible to most Americans.

“Dairy is associated with many beneficial health outcomes for adults, including reduced risk of hip fractures, decreased risk of cardiovascular disease, favorable outcomes related to body weight and risk of obesity and lower risk of colorectal cancer,”​ Miquela Hanselman of the National Milk Producers Federation said at the meeting.

Hanselman, along with representatives from the National Dairy Council and the International Dairy Foods Association all lauded the DGAC for recommending dairy as a standalone food group of which most Americans should consume three servings a day.

They also lamented the low compliance rate – about 88% -- of Americans who currently meet this standard and sought additional suggestions from the dietary guidelines to help increase consumption.

In addition, they recommended the government consider newer science on milk fats at all levels​, which is an area where Hanselman said the DGAC “did fall short.”

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