The recently released 2015–2020 Dietary Guidelines for Americans, jointly published by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture (USDA), recommend including dairy sources such as milk, yogurt, and cheese regularly in the diet, though they stress that these sources should be fat-free or low-fat. But are these recommendations best for those with diabetes? We decided to ask some of the nation’s top diabetes experts to find out. Although experts may differ on the recommendations for fat content of dairy, most agree that incorporating some form of dairy on a regular basis may be beneficial for diabetes management.
Dairy and Its Role in Diabetes Management
“In my counseling sessions, I recommend dairy in general,” explains Toby Smithson, RDN, CDE, author of Diabetes Meal Planning and Nutrition for Dummies, who is based in Hilton Head, South Carolina. She points out that “two out of every three people with diabetes have high blood pressure, which may be reduced by eating foods rich in potassium, magnesium, and calcium. Dairy foods contain all three of these substances.” Consuming dairy may not help not only with diabetes management, but also with preventing the development of the disease. Data from the Nurses Health Study II appeared in an article published in the American Journal of Clinical Nutrition that suggested diets rich in dairy may have a protective effect against the development of type 2 diabetes. “High dairy intake is associated with a lower incidence of type 2 diabetes, especially when started at an early age of adolescence,” explains Smithson. A review of research published in September 2017 in the journal Nutrients concluded that the consumption of dairy and dairy products offers protective benefits against type 2 diabetes. As the research indicates, including dairy as part of a well-balanced diet can be beneficial at preventing and managing diabetes, but the question remains as to what type of dairy is the best choice. “There is emerging research that full-fat dairy may have a protective effect on preventing type 2 diabetes, yet that research is not conclusive and does not necessarily apply once diabetes has already developed,” explains Lori Zanini, RD, CDE, creator of For The Love of Diabetes, who is based in Los Angeles. For those at risk of developing type 2 diabetes, consuming full-fat dairy warrants some consideration, especially when it comes to weight management. A study published in February 2016 in the American Journal of Clinical Nutrition looked at the role of full-fat diary on weight management over the span of almost two decades. Women consuming more than 3.1 servings of full-fat dairy per day showed the lowest amount of weight gain. The most likely explanation for such findings may be due to the impact fat has on hunger and satiety. “Fat-free products do not promote the same levels of satiety as their fat-containing versions, since fat takes longer to digest,” explains Zanini. Although full-fat dairy products may be more filling, they are typically richer in calories as well. “I don’t encourage my clients with diabetes to consume full-fat dairy exclusively as this is often a source of excess calories,” explains Zanini, adding, “the excess fat in the diet can also interfere with the insulin response.” RELATED: The Best and Worst Foods to Eat in a Type 2 Diabetes Diet
Diabetes and Dairy: No One-Size-Fits-All Recommendation
Providing a standard recommendation on dairy for people with diabetes can be challenging. Depending on the individual’s health needs and goals, the best form of dairy will vary. “I typically encourage low-fat versions, but also promote variety and honoring the personal preference of the client,” adds Zanini. “I recommend 2 percent Greek yogurt if using in baking, but 0 percent if eating daily for breakfast.” For Smithson, dairy recommendations are also individualized. “I recommend dairy based on my client’s preferences and do not hesitate recommending full-fat dairy to people with diabetes that are in target range for their weight.” Both experts agree that the focus should be on encouraging individuals to consume a variety of dairy products without putting too much emphasis on fat content. “When people believe they have to eat only fat-free or low-fat dairy products, it can take away from the enjoyment of eating and may cause people to feel less satisfied and overeat as a result,” explains Zanini. Still, when it comes to diabetes and dairy choices, some options can be much more beneficial than others. Our experts weighed in on the best and worst choices.
The Best Dairy Choices to Make When You Have Diabetes
Greek Yogurt
“Fermented dairy products like yogurt are always great choices due to their natural source of probiotics, which has a positive effect on intestinal health and is linked to improved glucose and insulin levels in the body,” explains Zanini. A review published in October 2017 in European Medical Journal noted that probiotics have been able to lower fasting glucose and insulin levels in a preclinical setting as well as in human trials. “Greek yogurt provides the perfect combination of carbohydrate and protein,” adds Smithson. Enjoy it alone, topped with nuts, or mixed into smoothies. You can even use plain Greek yogurt as an ingredient in baked goods to cut down on added fats.
String Cheese
“Cheese can be a good option to balance out a meal or snack by adding good sources of protein and a little fat,” explains Zanini. “With minimal carbohydrates (just one gram per ounce), cheese won’t spike blood glucose readings,” adds Smithson.
Grass-Fed Dairy
“The source of the dairy, and not just the fat content, should also be taken into consideration,” points out Zanini who adds “dairy from grass-fed cows will provide products that are higher in alpha-linolenic acid, a type of omega-3 fatty acid with many health benefits.” Look for grass-fed yogurt and cheese options in your local grocery store.
The Dairy Choices to Limit When You Have Diabetes
Fat-Free Milk
“I typically encourage my clients to avoid fat-free milk since this is actually often used to treat hypoglycemia due to its quick absorption rate in the body and quicker blood sugar response,” explains Zanini, who recommends unsweetened almond milk as a better alternative. Smithson adds that how you consume this beverage also has an impact on blood glucose levels. She notes that milk is often paired with carb-containing foods, such as cereal or cookies, and together that combination may raise blood sugar readings.
Sweetened Dairy Products
Chocolate milk, ice cream, and yogurts with added sugar do not have to be off limits, but extra attention needs to be taken when including them into a diabetes meal plan. “Sweetened options can be included, but you need to account for the extra carbohydrates these food contain,” explains Smithson. “Enjoy them infrequently and in moderation,” added Zanini.
