IDF bulletin advocates revised approach to lactose in dairy

Milk, cheese, yogurt, and other cultured/fermented dairy products are composed of complex structures and are important sources of several key nutrients. As part of their nutrient-rich package, dairy foods also contain naturally occurring sugar, lactose. According to the International Dairy Federation, it is important to consider dairy products in a unique way, giving credit to the important nutritional properties of their intrinsic lactose content.

While excessive intake of added/free sugars is linked to non-communicable diseases, there is no evidence linking naturally occurring sugars (such as lactose from dairy products) with chronic disease risk. Rather, lactose, as a naturally occurring sugar in milk, is associated with some specific health properties such as enhancing intestinal calcium absorption in infancy and possibly in the elderly. In addition, recent studies have shown that unabsorbed lactose could have prebiotic-like effects in the digestive tract.

Despite this scientific evidence, in some countries, lactose naturally present in milk or milk products is considered as an added/free sugars by health organisations or authoritative bodies. Additionally, despite the distinction made between “naturally occurring” and “added/free sugars”, some policies have been proposed to evaluate the health benefits of foods by looking at the total amount of sugars, including lactose.

In view of the important need to raise awareness of the benefits of lactose and identifying a lack of evidence-based information about the important role of dairy, including lactose, as part of a healthy diet, the IDF is publishing its bulletin 509/2021: Lactose, an important nutrient: Advocating a revised policy approach for dairy and its intrinsic sugar. The bulletin provides in-depth detail on topics introduced by the IDF position paper on lactose issued in September 2020.

IDF director general, Caroline Emond, said: “Dairy products have long been recognised as an important part of a balanced diet, and there is a wealth of scientific evidence that supports the beneficial effects of milk and other dairy products on nutrition and health. Their consumption is recommended in t dietary guidelines worldwide and is associated with health benefits. There is no justification to discourage consumption of naturally occurring lactose in dairy in public health policies. We hope that this IDF bulletin will help national authorities take the uniqueness of lactose into consideration when designing and promoting domestic nutrition policies, especially those recommending reduction in consumption of sugar.”

According to the World Health Organisation (WHO), the term “free sugars” refers to all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus the sugars that are naturally present in honey, syrups, and fruit juices. This definition does not include naturally occurring sugars such as lactose in dairy and fructose in fruit. Naturally occurring sugars were intentionally excluded from the WHO recommendations due to no reported evidence of adverse effects.

The implementation of various dietary strategies or food polices aimed at improving health locally or regionally, often focus on the total sugar content when evaluating the healthiness of foods, without differentiating between added/free and naturally occurring sugars. The IDF states it is important that the intent of the policy is considered, and coherence is considered with other policies such as dietary guidelines. If this is not done, it risks unduly penalising nutrient dense nutritious foods such as dairy which contain intrinsic sugars and impact negatively on the nutrition and health of those who count of milk and dairy food for their protein, vitamins and minerals intake.

Developed by the experts from the IDF Action Team on Lactose, under the umbrella of the Standing Committee Nutrition and Health, the Federation’s bulletin summarises the scientific evidence on lactose naturally present in milk and other dairy foods and its nutritional and health properties based on the science available and outlines the key role that milk and dairy products play in healthy diets.

IDF Action Team leader, Maretha Vermaak, registered dietician, said: “Owing to the natural lactose content of dairy, milk products could be unfairly classified as ‘high in sugar’ according to certain policy or regulatory proposals should a ‘total sugar approach be taken. The review in this bulletin provides evidence-based information to IDF members about the important contribution of dairy, including lactose, to a healthy, balanced diet. The review underscores that policy measures aimed at lowering the intakes of nutrients of concern (such as sugar) should not be defined at the expense of the consumption of core, nutrient-dense foods such as milk, milk-based products, cheese, and yoghurt.”

Foods are a complex matrix of nutrients, which interact in a multitude of ways to influence health outcomes. Nutrition is not only about nutrients but also about having a balanced diet. Therefore, when measures are implemented to fight NCDs, the IDF states that thoughtful consideration should be given to not impede the promotion of the consumption of nutritious and healthy foods. Dairy products have long been recognised as an important part of a balanced diet and this should be taken into account when defining policy measures intended to lower intakes of nutrients of concern, without discouraging the consumption of nutrient-dense core foods such as milk, milk-based products, cheese, and yoghurt.

Bulletin 509/2021 is now available to download free of charge from the IDF website.

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