For decades, the public has been told to avoid whole milk and other foods containing full-fat dairy products because such fare will clog arteries and promote cardiovascular disease. A trip around the grocery store will show many food products labeled as low-fat or fat-free. Even today, the American Heart Association warns us about this on their website and recommends that we substitute fat-free (skim or “light”) milk and low-fat yogurt or cheese in place of full-fat equivalents. Despite the embrace of low-fat dietary practices, obesity has become an epidemic. In fact, the obesity rate among children has doubled in the last two decades alone, which brings about an increased risk for poor health in adulthood. So is a low-fat diet still a solid recommendation?

A July 2021 randomized controlled trial published in The American Journal of Clinical Nutrition compared the impact of low-fat vs. full-fat dairy foods on fasting lipid blood levels and blood pressure in 72 men and women with metabolic syndrome—a cluster of conditions (high blood pressure, abnormal blood lipid levels, high fasting blood sugar, and excessive waist circumference) that occur together and increase the risk of heart disease, stroke, and type 2 diabetes. Study participants began by limiting their dairy intake to less than three servings a week of non-fat milk for four weeks. Then, they were assigned to one of three diets: no-change, continue to limit dairy to less than three servings of non-fat milk a week; switching to 3.3 servings of low-fat milk, cheese, or yogurt a week; or switching to 3.3 servings of full-fat milk, cheese, or yogurt a week. After twelve weeks, the researchers did not observe a difference in blood lipid readings or blood pressure levels between the three groups.

On the other hand, a meta review of previous studies did find that restricting carbs can improve blood pressure and blood lipid levels. However, this does not mean one should consume as much fat as possible in their diet. Not all fats are the same, and studies have shown that increased consumption of saturated fats and trans fats can be detrimental to one’s health. Trans fats are used to prolong shelf life in highly processed foods and should be avoided. Saturated fats are found in dark poultry meat; fatty cuts of beef, pork, and lamb; high-fat dairy products; lard; and tropical oils (coconut and palm, for example). Health experts recommend limiting saturated fat consumption to less than 5-6% of total calories per day, which may explain why the full-fat dairy group did not experience any increase in blood lipid or blood pressure compared with the low-fat dairy group in the study noted above.

On the other hand, monounsaturated fats (nuts, avocado, olive oil, peanut butter) and polyunsaturated fats (such as omega-3 fatty acids) have been shown to promote good health and reduce the risk for cardiovascular disease.

If one desires a diet featuring healthy fats, low-carbs, and fewer unhealthy fats, a good option to consider is the Mediterranean diet. This eating pattern focuses on eating fruits, vegetables, nuts, fish, olive oil, and whole grains while avoiding red and processed meats, dairy, saturated fats, and refined sugars. Not only has the Mediterranean diet been observed to lower the risk for heart disease but it also helps to reduce inflammation in the body, which has been associated with an increased risk for chronic musculoskeletal pain. That’s why doctors of chiropractic may encourage patients to engage in healthier dietary practices in order to aid in the healing process and to reduce the risk for recurrence.