© University of Reading 2013 www.reading.ac.uk

Milk and dairy products: dietary partners for life?

Ian GivensProfessor of Food Chain Nutrition

University of Reading. UK

Humans are unusual creatures!

We are the only species to consume milk of another species

Most of us can continue to consume milk beyond infancy

2

Lactase persistence provided a survival/selective advantage

Nature, 1 August 2013

3

0

10

20

30

40

50

60

Milk production trends in Indiaand China

4

India

China

Milk

pro

duction (

Mt)

135

EU

Dairy products and health: what are we trying to do?

5

Mechanisms?

© University of Reading 2008 www.reading.ac.uk

Childhood and young adults

Bone mass changes with age

Age (years)7

Calcium intake in females vs. RNI in UK

NDNS 08/09 + 09/10

9

Childhood milk intake and fracture occurrence in women >=50 years

Recent studies of UK iodine status

1. Bath et al. 2008; 2. Rayman et al. 2008; 3. Lampropoulou et al 2012 4.Kibirige et al. 2004; 5.Barnett et al. 2002; 6. Bath et al. 2010; 7. Pearce et al 2010

Recent UK studies have shown sub-optimal status in:

Women of childbearing age1-3

Pregnant women4-7

10

Milk intake and 24h iodine excretion

11

Bath et al. (2013)

Milk, dairy foods and iodine intake

Rose et al., 2001; Henderson et al., 2003.

0

0.2

0.4

0.6

0.8

1

1.2

1.4

0

5

10

15

20

25

30

35

40

Bre

ad

Me

at

& P

ou

ltry

Fis

h

Milk

an

d D

air

y

Eg

gs

Fru

it &

Nu

ts

Su

ga

rs &

Fa

ts

Po

tato

es &

Ve

ge

tab

les

Be

ve

rag

es

Iod

ine c

on

cen

tratio

n (m

g/k

g)P

erc

en

tag

e c

on

trib

uti

on

(%

)

Percentage contribution (%) Iodine content (mg/kg)

12

Effect of type of retail winter milkon iodine concentration

13

Iodin

e (

µg/L

)

Conventional vs. organic (P<0.001)

Conventional vs. UHT (P<0.05)

Payling et al. (2015)

Milk has been beaten by soft drinks

Astrup et al., 2010

14

How often do you drink soft drinks?% drinking daily, 15 year olds

Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat

Maersk et al., 2011

15

Ch

an

ge i

n v

iscera

l a

dip

ose t

issu

e (

%)

47 subjects drank 1 L of 1 of 4 test drinks daily for 6 months

/200g/d

Milk and T2DM: Meta-analysis ofcohort studies

Whole milk

Low fat milk

Aune et al., 2013

© University of Reading 2008 www.reading.ac.uk

Middle and Older Age

Increasing and ageing population

18

EU 2050EU 2010

Ageing issues

19

Meta-analysis of prospective cohort studies: milk and cardio-metabolic disease

20

Givens et al., 2014

*in high vs low

consumers

RR

Soedamah-Muthu et al., 2012

RR

Dairy consumption and hypertensionMeta-analysis of prospective studies

RR for HTN 0.97 (95% CI, 0.95–0.99) / 200 g/d RR for HTN 0.96 (95% CI, 0.93–0.99) / 200 g/d

Total dairy Low fat dairy

Similar reduction in risk from total and low fat dairy

Dairy intake, systolic blood pressure and augmentation index (AIx)

10.4 mmHg lower

0 284 426 625

Livingstone et al., 2013

1.8 % lower

0 – 296 96 – 307 307 – 440 440- 698

22

Fekete et al., 2015

Effect of milk proteins on vascular health

23

Milk proteins and Blood Pressure and Arterial Stiffness

Lactotripeptides reduce SBP P<0.001

Dairy products, saturated fatsand CVD

What about saturated fats?

24

Q: Do milks and dairy foods with reduced saturated fats provide any additional advantage…….?

Ca soap (CS) of oleic acid study

g/100g DM

Replacing saturated fat in milk fat

25

Kliem et al., 2013

Effect of replacing saturated fattyacids in milk and dairy products on risk markers for CVD

26

September 2013 3 years

Changes in total and LDL-cholafter consumption of ~80 g/d fat (~36g/d SFA)as cheese or butter

Hjerpsted et al. Am J Clin Nutr 2011;94:1479–84.

Cheese vs butter

And finally….

Sarcopenia

Young muscle18-25 years

Sarcopenic70 years +

29

Protein from:

Milk and dairy products: Dietary partner for life?

• For most people milk yes, and milk much misunderstood but:

• We don’t know everything………

• …..what are the differential effects of butter, cheese, yogurt,

milk etc.?

• …..is fat-reduced milk ‘healthier’ than full fat?

• …. is saturated fat-reduced milk/dairy better than normal?

• There are lingering issues around prostate and breast cancer

• Replacement of milk by sugar sweetened drinks is a major

concern especially for children

• On balance there are major benefits across all life phases so…….

• Nutrition and health must be included in any debate about

sustainable/environmental food production and ….

• Don’t ignore the food vehicle.30

31

THANK YOU

32

London Road Campus Henley Business School University of Reading Malaysia

THANK YOU