People with both type 1 and type 2 diabetes often ask about drinking milk and eating dairy products.
We took those questions to Joanna Mitri, M.D., endocrinologist in the Adult Diabetes section of the Joslin clinic and the Associate Director of the Lipid Clinic, and Veronica Salsberg, M.S., R.D., L.D.N.., clinical research dietitian at Joslin.
Speaking of Diabetes: Can you clarify what is meant by dairy foods, and are there certain ones that are better for people with diabetes?
Veronica Salsberg: Dairy foods are foods that are made from the milk from animals such as cows, goats, and sheep. Most commonly, it refers to cow’s milk products. Dairy foods include milk, yogurt, and cheese Dairy foods do not include alternative dairy products or alternative milks such as soy milk, nut milks, or coconut milk.
Dairy foods can be a good choice for people with diabetes. They are an excellent source of protein, calcium, vitamin D, phosphorus, and some B vitamins. A serving of milk or yogurt does contain carbohydrates (about 12-15 grams per serving) in the form of lactose, the naturally-occurring sugar in milk. However, the glycemic index of milk and yogurt is low, meaning that these carbohydrates are digested more slowly and cause a gradual rise in blood glucose. Cheese generally contains little to no carbohydrates.
It is best to limit sweetened or flavored yogurts because those will also contain added sugars, which can cause blood sugar to rise more rapidly. Same goes for flavored milks and ice cream. You can naturally sweeten plain yogurt by adding your own fruit! Greek yogurt especially can be a great choice for people with diabetes because it contains more protein than traditional yogurt, which can help keep you feeling fuller, longer.
SOD: The Joslin Nutrition guideline states that saturated fat in dairy may be okay. Why is that?
Joanna Mitri: In a detailed literature review that we recently conducted, we found that there is not enough evidence that consumption of high fat dairy increases the risk of cardiometabolic or heart disease. Therefore, the guidelines state that saturated fat from dairy foods (milk, yogurt, cheese) may be acceptable within total calorie intake as long as the total amount of saturated fat is less than 10% of the daily calories.
The type or quality of fat is also important. Some of the fatty acids in dairy foods may have a beneficial effect on cardiometabolic disease. Patients with elevated cholesterol levels and at high risk for heart disease can incorporate dairy fat in their diet as long as they do not exceed their saturated fat allowance. There is no evidence showing that incorporating dairy fat in your diet, will increase your risk of cardiovascular disease. Similarly, there is no strong evidence that saturated fat in dairy decreases your risk of coronary heart disease. Overall, it is the quality, quantity and dietary pattern that is more important than a particular food nutrient.
SOD: So, does that mean it is okay to drink whole milk, use butter and eat ice cream? How do you know how much is too much? Are there some choices that are better than others?