Studies show that milk is part of cardioprotective eating patterns

Nine out of 10 Canadians have at least one risk factor for heart disease, stroke, or vascular cognitive impairment,[1] and23 percent of adults report that they have been diagnosed with hypertension or take anti-hypertensive medication.[2] In addition to drug treatment, there are also lifestyle interventions, such as changes in eating habits, that can help manage high blood pressure and other risk factors for heart disease.[3]

Research shows that both the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) eating patterns can help reduce heart disease risk and manage high blood pressure levels.[4],[5] Milk and dairy foods play a role in both the Mediterranean and the DASH eating patterns.

In the Mediterranean eating pattern, dairy foods are recommended in moderate portions and can be enjoyed daily.[6]This includes milk and fresh (non-fermented) cheese, as well as fermented dairy foods such as cheese, yogurt and kefir. The whole Mediterranean eating pattern includes:

• Whole grains
• Fruits and vegetables
• Beans and nuts
• Herbs and spices
• Healthy fats such as olive oil
• Fish and seafood
• Dairy
• Eggs and poultry
• Reduced intake of meat and sweets[7]

A study published in the American Journal of Clinical Nutrition looked at the effect of a Mediterranean eating pattern supplemented with additional dairy foods to see the impact on cardiovascular risk factors.[8] The randomized, controlled study compared a Mediterranean eating pattern with 3–4 daily servings of dairy to a low-fat diet for eight weeks. Researchers found that the Mediterranean eating pattern with dairy resulted in significantly lower blood pressure, higher HDL “good” cholesterol, and lower triglycerides compared to the low-fat diet. They concluded that the Mediterranean eating pattern with dairy was “appropriate for an improvement in cardiovascular risk factors in a population at risk of cardiovascular disease.”

In addition to antihypertensive drug treatment, changes in dietary patterns can also help manage hypertension.[9] The most well-researched eating pattern for preventing and controlling high blood pressure is DASH.

The blood pressure-lowering effect of DASH was first documented in a clinical trial over 25 years ago, where a dietary pattern rich in fruits, vegetables, and low-fat dairy products was seen to reduce systolic and diastolic blood pressure more than a typical American diet.[10] The experimental diet had reduced amounts of saturated fat, total fat, and cholesterol, but was rich in potassium, magnesium, calcium, fibre and protein. The synergy of these nutrients led to blood pressure reduction.

Today’s DASH eating pattern is based on this original research. The DASH eating pattern includes:

• 2-3 servings of milk and milk products daily
• 4-5 servings of fruits daily
• 4-5 serving of vegetables daily
• 6-8 servings of grains daily
• 4-5 servings of protein from beans, nuts and seeds weekly
• Less than 6 servings of fish, poultry and meat daily[11]

It’s also lower in salt, sugar, fat and red meat compared to the typical North American diet. The combination of foods in the DASH eating pattern can decrease systolic blood pressure by about six to 11 mm Hg in both hypertensive and normotensive people.[12]

Milk is an important part of DASH because it’s a source of protein, and contains minerals including calcium, potassium and magnesium, which help lower blood pressure levels. One serving of dairy is equal to a cup or milk or yogurt, or 1.5 ounces of cheese, and DASH recommends 2-3 servings daily.[13]

While the original DASH studies focused on low-fat milk as part of the eating pattern, one study found that a higher-fat DASH eating pattern, which replaced low-fat milk products with full-fat milk products, was able to lower blood pressure as much as the standard DASH eating pattern.[14] Using higher fat milk products also lowered triglyceride levels and did not adversely impact blood cholesterol levels. So, your patients can choose whichever dairy products they prefer.

Studies support the inclusion of dairy foods for cardiovascular health and lowering blood pressure levels, so you can feel confident making this recommendation to your patients. It’s definitely time to celebrate milk as part of a balanced and nutritious diet. For more information, visit Milk.org.

Sidebar content:

Milk is a convenient source of nutrition since it provides 15 essential nutrients in just one glass:

• Protein
• Vitamin A[15]
• Vitamin B12
• Vitamin B6
• Riboflavin
• Niacin
• Thiamine
• Pantothenic acid
• Vitamin D
• Calcium
• Magnesium
• Phosphorus
• Potassium
• Zinc
• Selenium

By: Cara Rosenbloom, RD

Cara Rosenbloom RD is a registered dietitian, journalist and author in Toronto.

[1] Heart & Stroke. Connected by the Numbers. https://www.heartandstroke.ca/articles/connected-by-the-numbers
[2] Statistics Canada. https://www150.statcan.gc.ca/n1/pub/82-625-x/2021001/article/00001-eng.htm
[3] Filippou C et al. (2020). Advances in nutrition. 11(5), 1150–1160. doi.org/10.1093/advances/nmaa041
[4] Mediterranean Diet. Oldways. https://oldwayspt.org/traditional-diets/mediterranean-diet
[5] Filippou C et al. (2021). Clin Nutr. 2021;40(5):3191 doi: 10.1016/j.clnu.2021.01.030.
[6] Mediterranean Diet Pyramid. Oldways. https://oldwayspt.org/resources/oldways-mediterranean-diet-pyramid
[7] Mediterranean Diet Pyramid. Oldways. https://oldwayspt.org/resources/oldways-mediterranean-diet-pyramid
[8] Wade A et al. (2018). Am J Clin Nutr. 108(6):1166–1182. doi.org/10.1093/ajcn/nqy207
[9] Filippou C et al. (2020). Advances in nutrition. 11(5), 1150–1160. doi.org/10.1093/advances/nmaa041
[10] Appel L et al. (1997). N Engl J Med. 336(16):1117-1124. doi: 10.1056/NEJM199704173361601
[11] US National Heart, Lung and Blood Institute. DASH Eating Plan https://www.nhlbi.nih.gov/education/dash-eating-plan
[12] Challa, H. DASH Diet to Stop Hypertension. May 2021. (book). https://www.ncbi.nlm.nih.gov/books/NBK482514/
[13] US National Heart, Lung and Blood Institute. Following the Dash Eating Plan. https://www.nhlbi.nih.gov/education/dash/following-dash
[14] Chiu S et al. (2016). Am J Clin Nutr. 103:341-347. doi.10.3945/ajcn.115.123281