Food and nutrition Miscellaneous

Dairy debates

In recent years, the health benefits of milk have come under scrutiny, with a growing body of research challenging the existing recommendations. The market for dairy alternatives is therefore on the rise, presenting important opportunities for manufacturers. But with dairy remaining a key component of the Western diet, how can the industry ensure new substitutes are up to scratch? Abi Millar investigates.

In years gone by, the idea that ‘milk is healthy’ was as close to a nutritional truism as you were likely to get. Considered an indispensable source of calcium, which in turn was key to bone development, dairy products were viewed as one of the pillars of a balanced diet. Think of the debacle that ensued in the 1970s when Margaret Thatcher promised to cut free school milk, earning her the famous ‘milk snatcher’ moniker.

Even today, Western nutritional orthodoxy remains in the pro-dairy camp. Since 2005, the US Department of Agriculture (USDA) has recommended three servings of dairy products a day. This is an increase on the historical ‘food pyramid’ recommendations, in which two servings a day were advised for adults. It brings the USA into line with the likes of Canada, Australia and France, which have had 3-a-Day programmes in place for years.

The USDA’s latest ‘tip sheet’, revised January 2016, says that low-fat or fat-free dairy foods are critical for providing ‘calcium, vitamin D, potassium, protein, and other nutrients needed for good health throughout life.’ It also suggests that: ‘Dairy foods are especially important to build the growing bones of kids and teens. Eat or drink low-fat or fat-free dairy foods with meals and snacks—for everyone’s benefit.’

Of course, the nutritional composition of milk is not in doubt – it does provide protein and various micronutrients. However, an increasing number of nutritionists now believe that its benefits have been oversold. Take the Harvard School of Public Health, which has a ‘healthy eating plate’ and ‘healthy eating pyramid’ of its own. Though similar in most respects to the USDA version, it omits a separate dairy category altogether.

The Harvard advice suggests that, while calcium is important, ‘milk isn’t the only, or even best, source’. It goes on to discuss the mixed health impacts: while calcium can indeed lower the risk of osteoporosis and colon cancer, a high intake is associated with an increased risk of prostate and possibly ovarian cancer. In addition, dairy products are often high in vitamin A, which ‘at high levels can paradoxically weaken bones’.

Bafflement and disappointment

Similarly, Public Health England has caused controversy with its latest ‘Eatwell’ guidelines, released at the start of 2016. These guidelines suggest that only 8% of a person’s total energy intake should come from dairy products, down from 15% in the previous guidance. This figure has angered the industry body Dairy UK, which claims the decision is ‘baffling and disappointing’. A Public Health England spokesperson has contended that the results were fully evidence-based.

We don’t have to look far to find studies that cast doubt on dairy’s benefits. For instance, a growing body of research has called into questions the links between milk and strong bones. One major US study, which tracked over 75,000 women for 12 years, found that participants who drank two or more glasses of milk a day had a greater risk of hip fracture than the rest of the cohort.

Then there are studies exploring the incidence of brittle bones in different cultures. It is now well established that regions with the highest dairy consumption also have the highest rates of bone fractures, with puzzlingly good bone health observed elsewhere. This relationship, acknowledged by the World Health Organization, has been christened ‘the calcium paradox’.

When approached by Ingredients Insight for comment, WHO said: “WHO does not provide recommendations on specific food commodities per se, such as dairy products.”

However, its recommendations for preventing osteoporosis cast some light on the conundrum. These state that while “calcium is one of the main bone-forming minerals and an appropriate supply to bone is essential at all stages of life”, requirements might vary between countries for dietary, genetic, lifestyle and geographic reasons. For instance, more calcium might be required in countries with a higher animal protein intake, to offset the negative impacts.

“To date, the accumulated data indicate that the adverse effect of protein, in particular animal (but not vegetable) protein, might outweigh the positive effect of calcium intake on calcium balance,” suggests the guidance.

Another key point of contention is the digestibility, or otherwise, of milk. It is only over the last few thousand years, since the dawn of agriculture, that some humans have developed an enzyme capable of digesting milk sugars past childhood.

Even now the enzyme (lactase) is only common in certain pockets of the world, with many ethnic groups (such as Asian and African populations) remaining predominantly lactose-intolerant. Because this applies to over 60% of the world’s population, it simply doesn’t make much sense to peg milk as an essential global superfood.

Alyssa Hamilton’s 2015 book ‘Got Milked?’ casts a damning eye over the dairy industry, arguing that its marketing strategies have pulled us into what she calls ‘the great dairy deception’. She claims that milk’s ‘privileged position in the North American diet’ is exclusionary, given high rates of lactose intolerance among non-white ethnic groups. She also gives short shrift to the idea that dairy comprises a food category in itself.

“Milk having special status as a calcium source makes as much sense as pumpkin seeds being a food group because they’re high in magnesium,” she said in an interview with Macleans.

Influence and investment

It seems unlikely that we’ll see a consensus on these issues any time soon. The dairy industry wields a considerable influence, and has invested heavily in public health campaigns.

For instance, the UK’s Dairy All-Party Parliamentary Group recently released a report which intends ‘to put dairy back on the daily menu’. This calls for a 3-a-Day dairy programme ‘to remind consumers of the unique nutritional value of dairy products’.

As the foreword explains: “The dairy industry has long played an important role in helping to feed the people of the UK. At a time when it needs strong support and tangible solutions to help weather the storm of volatility, it is disheartening to hear negative or misleading messages about the benefits of milk and dairy products.”

However, it seems clear that dairy products are no longer viewed as a unilateral good. Overall milk consumption is falling, with the average American now drinking around 40% less than they did in 1970, even though sales of yogurt and cheese have risen.

This has driven the dairy industry to take a change of tack. Many milk companies have been pushing chocolate milk, for instance, which contains added protein and is being marketed as recovery fuel for fitness buffs. This enables them to tap into a growing market of sports supplements and protein shakes. (The UK report points to the electrolytes present in milk, dubbing it ‘nature’s own sport’s drink’.)

Other companies have created lactose-free milks suitable for those with an intolerance. Rather than taking the lactose out, which would be impracticable, manufacturers add the lactase in. Through the addition of this enzyme, the lactose is hydrolysed into glucose and galactose, simple sugars the body can absorb, eliminating gastrointestinal symptoms.

Meanwhile, the market for non-dairy milk substitutes is growing. According to a new report by BCC Research, the global milk-alternatives market is expected to increase from $5.8bn in 2014 to $10.9bn in 2019, reflecting a CAGR of 13.3%. This market can be divided into four categories: soy milk, almond milk, rice milk and others (such as coconut milk, oat milk and hemp milk) deemed to be ‘in their budding stage’.

Almond power

For many years, soy milk was the undisputed market leader, to the point at which the USDA guidelines use fortified soy interchangeably with dairy. However, in recent years the market for soy milk has stabilised somewhat, fuelled in part by worries over its phytoestrogen content, and in part by the gamut of newer options.

While it is still by far the largest category worldwide, reflecting its popularity in Asia, many ‘health food’ proponents in Western countries have moved on.

Today, it faces a rival in the form of almond milk, which now accounts for 4% of US milk sales, up from 0.5% just five years ago. In October 2015, the British retailer Waitrose confirmed that almond milk had overtaken soy milk as its customers’ preferred alternative to dairy.

Reporting this news, the Guardian pointed out that while ‘almonds are one of the healthiest foods you can eat’, it may be disingenuous to expect the same benefits from almond milk. Many brands boast an almond content of just 2%, which means consumers are only getting around a seventh of the protein of cow’s milk. They also contain added sugar, along with various stabilisers and emulsifiers, and may be lacking in vitamins and minerals.

Helen Bond, spokesperson for the British Dietetic Association, told the Guardian: “Dairy is a really great source of a readily available form of calcium, so you need to look for plant-based milk that is fortified with calcium, essential for maintaining bones as we get older.”

The race is on, then, for a non-dairy substitute that can truly offer the same benefits as milk. Ripple Foods, a California-based startup, is working on precisely that – a sustainably-produced substitute based on pea protein, which contains as much protein as cow’s milk while supplying 45% of a person’s daily calcium needs. Having amassed $15 million in venture capital funding during 2015, the founders believe their product could revolutionise the industry.

“We’re going after the alternative dairy market,” one of the founders, Neil Renninger, told the Wall Street Journal. “Right now there aren’t any real quality products out there in the alternative dairy space.”

Dairy substitutes are clearly an important market segment, with a growing number of food entrepreneurs and technologists seeking to capitalise on demand. However, it pays to remember that many foods offer similar nutritional benefits, without competing directly with dairy products.

For instance, calcium from plant-based foods tends to be well absorbed by the body, without being mitigated by calcium-leaching animal protein. Leafy greens are a particularly good source of the mineral, with one cup of cooked kale containing the same amount of absorbable calcium as one cup of cow’s milk.

AJ Lanou, writing in the American Journal of Clinical Nutrition in 2009, suggests that: “Instead of drinking milk, individuals should focus on bone building through exercise, spending time in the sunshine to promote vitamin D production, eating lots of fruit and vegetables, and getting calcium from plant sources.”

It seems clear that, for even the staunchest defender of dairy products, milk is not a panacea, but should form part of a balanced diet and healthy lifestyle if its putative benefits are to be realised. As the debate rumbles on, and consumption patterns change, food manufacturers should watch this space – there may be important marketing opportunities in store both for dairy products and for the growing array of alternatives.

This article appears in the 2016 vol 1 edition of Ingredients Insight

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