All things Milk !

We are the generation that grew up on milk, and it is very rare to find an Indian household where milk is not consumed.We use it in our cereal , in chai, and the oh-so-fermented curd rice and buttermilk.We were taught about its benefits, and not consuming it in the 80's and 90's was frowned upon .

Now we live in a world of oat milk ,almond milk and many other plant milks . Are they really better than good old whole milk ? Or is skimmed milk better ?

If you know me or have worked with me you know my answer is always the same :It depends !!!

I am going to break down the complexities of milk consumption for you ...

The impact of dairy on a woman's health is highly nuanced and depends on a complex interplay of individual biology, a woman's life stage, and, crucially, the specific type of dairy product consumed.   

For a significant portion of the Indian population, dairy is a convenient and nutrient-dense food that provides vital components such as high-quality protein, calcium, and vitamins A, D, and B12.  Dairy serves as an accessible source to help address these nutritional gaps.  Convenience and accessibility of diary plays a very vital role in its consumption.

However, for many individuals, dairy consumption may lead to adverse effects. Despite being the world's largest producer and consumer of milk, three out of four Indians are estimated to be lactose intolerant, although many may be unaware of their condition. This high prevalence, particularly in Southern India, can lead to digestive discomfort. A deeper understanding shows that these effects are not universal. For example, traditional fermented dairy products such as curd (dahi) and buttermilk have been found to have anti-inflammatory effects and may support gut health, while the high saturated fat content in other dairy products may be pro-inflammatory. Similarly, the use of traditional fats like ghee in moderation is supported by both modern science and Ayurvedic tradition, with its benefits extending to skin, heart, and digestive health.   In other words one person may be able to handle Ghee and buttermilk while milk and curd might be raising their inflammatory markers.

Ultimately, the most important conclusion is that a single recommendation for all women is inappropriate and potentially misleading. The decision of whether to consume dairy, and in what form, should be based on an individual's unique health profile, specific dietary goals, and personal response to different dairy products. There are small nuances to understand in order to know if dairy works for an individual or should be replaced.

The Nutritional Profile of Dairy that we know of -

Dairy products are a cornerstone of many dietary patterns, primarily due to their rich and diverse nutritional content. The Indian Council of Medical Research (ICMR) and the National Institute of Nutrition (NIN) provide evidence-based dietary guidelines for Indians, recommending that most individuals consume 300 ml of milk or curd per day as part of a balanced diet.   

Milk and milk products provide a unique package of nutrients, including thirteen essential nutrients in every serving. These include calcium, which is fundamental for building and maintaining strong bones and teeth. Dairy is also a significant source of high-quality protein. This protein is vital for active women, helping them build and repair muscle tissue, supporting the immune system, and contributing to a feeling of fullness, which can aid in weight management.   

Furthermore, dairy provides potassium, zinc, selenium, choline, and various B vitamins like B12, riboflavin, and pantothenic acid. These nutrients contribute to a healthy immune system and energy conversion from food. The emphasis from these official bodies on dairy is particularly relevant given the high prevalence of certain micronutrient deficiencies in the Indian population. For example, studies suggest that more than 80% of Indians are at risk of deficiencies in calcium, vitamin A, B12, and folate. In particular, Indian women have been found to have a significantly lower intake of vitamins A, B1, B2, B3, B12, zinc, folate, and iron than their male counterparts. Iron deficiency anemia is also a common nutritional disorder in India, especially among pregnant women. Therefore, including dairy products can be an effective strategy to help address these specific and widespread nutrient gaps.   

Dairy and Women's Health: A Spectrum of Effects

The relationship between dairy consumption and a woman's health is complex, with effects ranging from clear benefits to potential harms. This section will explore the evidence across several critical health areas.

1. Bone Health: The Central Debate

The most widely known benefit of dairy is its role in bone health. Dairy foods provide nutrients that are vital for building and maintaining strong bones, a process that is especially important for women. During childhood and adolescence, a time when bone mass is rapidly being built, dairy consumption is linked to improved bone health. By adulthood, the goal shifts to promoting bone health and preventing the onset of osteoporosis. This is particularly critical in India, where a high prevalence of osteoporosis is linked to low calcium and vitamin D intake.   

However, the evidence on dairy's long-term effects on bone health is not without contradiction. A 12-year Harvard study of 78,000 women found that those who drank milk two or more times a day had a higher incidence of hip fractures than those who rarely drank milk. This finding is supported by a Swedish observational study that similarly linked higher milk intake to a greater incidence of bone fractures. A large Harvard cohort study that followed 96,000 men and women for over two decades also found no association between greater milk intake during the teenage years in girls and a lower risk of hip fractures later in life. An analysis in the    

British Medical Journal concluded that most studies fail to show a link between dairy intake and fractures.   

The existence of conflicting findings in the scientific literature is not a sign of poor research, but rather an indication of the complex nature of the subject. A recent Finnish study provides a compelling explanation for some of these contradictions, suggesting that the type of dairy consumed may be critical. This long-term study of aging women found that liquid dairy consumption was linked to a reduced risk of osteoporotic fractures, while cheese intake was specifically associated with a reduced risk of hip fractures. This suggests that the benefits of dairy may not be universal for all bone types and may be tied to the specific product consumed.   

2. Hormonal and Endocrine System Effects

Dairy's effect on the hormonal system is a particularly contentious area of debate. Dairy products naturally contain small amounts of hormones, such as estrogen and progesterone, from lactating cows. While these amounts are generally considered unlikely to drastically alter hormone levels on their own, dairy can influence important hormone systems indirectly, leading to a variety of effects.   

For some women, a link exists between dairy and skin health. Research suggests that dairy, particularly low-fat and sweetened varieties, can influence inflammation and oil production in the skin, potentially triggering acne flare-ups. One mechanism proposed for this is insulin-like growth factor 1 (IGF-1), a hormone found in milk that can also be stimulated by milk consumption and is associated with increased sebum production and heightened hormonal activity.   

The connection between dairy and conditions like Polycystic Ovary Syndrome (PCOS) is similarly complex. For women with PCOS, a condition closely tied to insulin resistance, certain dairy products can worsen symptoms because high-insulin-spiking foods increase androgen production. This stands in contrast to research that suggests full-fat dairy, in moderation, may support ovulation and reproductive hormone function. This dual nature of dairy is further highlighted by studies that link high dairy protein intake to lower antral follicle counts, a marker of accelerated ovarian aging and reduced ovarian reserve, which has implications for fertility. Higher consumption of dairy has also been associated with a higher risk of sporadic anovulation, a failure of ovulation that prevents conception.   

Concerns also exist regarding a potential link between dairy and certain cancers. Studies have associated high-fat dairy, including cheese, with an increased risk of breast cancer. For example, a 2017 study found that women who consumed the most American, cheddar, and cream cheeses had a 53% higher risk for breast cancer. Conversely, the same study noted that yogurt was associated with a lower risk. Among women with a prior breast cancer diagnosis, those who consumed one or more servings of high-fat dairy daily had a 49% higher breast cancer mortality rate.   

The "hero vs. villain" narrative surrounding dairy's hormonal effects is a reflection of the fact that dairy is a complex food that interacts with the body's intricate signaling systems. It's not just about the hormones contained within the milk but about how the milk's components, such as IGF-1 and protein, can directly influence human hormonal pathways. This complexity explains why dairy can be beneficial for some women's health goals while simultaneously being detrimental to others.

3. Digestive and Inflammatory Responses

A common reason for avoiding dairy is digestive discomfort, which can be due to two distinct conditions: lactose intolerance and a milk allergy. Lactose intolerance is a particularly relevant concern in the Indian context. While India is the world’s largest producer of milk, an estimated three out of four Indians are lactose intolerant, although many may not be aware of their condition. The prevalence of lactose intolerance varies significantly across the country, with studies showing it affects up to 66.6% of healthy volunteers in South India, compared to 27.4% in North India. This regional difference is attributed to genetic and historical dietary habits, as North Indians have a long history of consuming dairy products well beyond infancy, leading to a genetic trait called lactase persistence. The resulting symptoms—such as bloating, gas, stomach pain, and diarrhea—are caused by the undigested sugars and represent a digestive issue. A milk allergy, on the other hand, is an immune-system-based response to dairy protein (casein) that can trigger a direct inflammatory reaction ranging from mild to life-threatening.   

The link between dairy and systemic inflammation is also a subject of conflicting research. While the saturated fats found in high-fat dairy are generally considered pro-inflammatory, some studies have surprisingly shown a link between dairy consumption and a decreased risk for inflammation. This apparent contradiction suggests that other components of dairy may be at play.   

A key factor in this debate is the type of dairy consumed. Fermented dairy products like curd and buttermilk are rich in probiotics, which are beneficial bacteria. Research has indicated that these fermented products may reduce inflammatory markers and help to minimize inflammation by nourishing a healthy gut microbiome. This connection between the gut and the rest of the body explains why fermented dairy is often viewed as beneficial for those with concerns about inflammation and why an individualized approach is so important.   

Dairy Across the Female Lifespan

A woman's nutritional needs, and therefore her relationship with dairy, changes significantly throughout her life. From puberty to pregnancy and into menopause, dairy can play a different but critical role.

Adolescence and Peak Bone Mass

Adolescence is a pivotal period for bone health. Our Indian diet has a lot of diary which has some amount of calcium. Peak bone mass is typically reached between the ages of 25 and 30, and the amount of bone mass accrued during these years is a major predictor of osteoporosis risk later in life. Though there are other sources of foods and vegetables that can provide way more calcium than diary, it is rare for most Indians to add it to their everyday diet.

There is a theory that dairy consumption is linked to early puberty in girls. Oxytocin is injected in cattle , and consuming such milk is resulting in the spurt in growth hormones in young adolescents. A more comprehensive analysis indicates that this trend is seen more prominent in children eating more animal proteins and those who are obese or are of the TOFI category. Research suggests that while animal protein intake has been associated with earlier menarche, yogurt consumption has been found to have a protective effect against early puberty in some studies, further illustrating the complexity of how specific food types can impact development.   

Pregnancy and Lactation

During pregnancy and lactation, a woman's body requires a greater intake of specific nutrients to support the growth and development of her baby. Dairy products provide essential nutrients like calcium, iodine, and protein, which are crucial during this time. Calcium helps build the baby's bones and teeth, while iodine is necessary for proper growth and brain development. This is particularly important for Indian women, as surveys show a large percentage of pregnant women have less than half of the recommended intake for iron, calcium, and folic acid. In fact, iron deficiency anemia is a major public health concern in India, with 87% of pregnant women suffering from it.   

A critical safety consideration for pregnant and breastfeeding women is the risk of listeriosis, an infection caused by Listeria bacteria. This infection can lead to severe health complications, including miscarriage or stillbirth. To mitigate this risk, it is essential to avoid unpasteurized dairy products, which include raw milk and certain soft cheeses like brie, camembert, and chèvre (unless cooked until steaming hot). Care to be taken that the milk isn't injected with oxytocin or any synthetic hormone which can have adverse effect on the hormonal health of the baby and the mother.   

Menopause and Beyond

The menopausal transition is characterized by significant hormonal changes, most notably a decline in estrogen. This drop in estrogen accelerates bone loss and can lead to sarcopenia, the gradual loss of muscle mass. Dairy foods are particularly beneficial during this life stage due to their high-quality protein and bone-building nutrients, which can help preserve muscle and maintain bone strength.   

Weight management is another common concern for women during and after menopause. Contrary to the misconception that dairy contributes to weight gain, studies suggest that including dairy foods, especially yogurt, may help with weight management during this time. The protein and calcium in these foods can increase feelings of fullness and support lean muscle mass.   

The impact of dairy on menopause is not entirely straightforward, however. A prospective study found that a higher intake of low-fat dairy was associated with a 23% lower risk of early menopause. This finding suggests a potential protective effect. At the same time, other sources raise concerns that the naturally occurring hormones in dairy may influence a woman's hormone levels and potentially exacerbate some menopausal symptoms. This dynamic relationship means that the benefits and potential harms of dairy shift across a woman's lifespan, arguing against a one-size-fits-all dietary rule.   

Dairy and Traditional Indian Foods: A Deeper Look

Understanding the nuances of dairy goes beyond simply deciding to consume it or not. The type of dairy, its processing, and the available alternatives are all critical factors in making an informed health decision.

A1 vs. A2 Milk

A more recent development in the dairy landscape is the distinction between A1 and A2 milk, which refers to a single amino acid difference in their beta-casein protein. During digestion, A1 beta-casein can break down into a peptide called beta-casomorphin-7 (BCM-7), while A2 beta-casein does not.   

While research is still ongoing, some studies suggest that A1 milk may be associated with digestive discomfort, including bloating, gas, and abdominal pain, due to the release of BCM-7. In contrast, A2 milk is often perceived as easier to digest and less likely to trigger digestive symptoms. For individuals who experience digestive issues after consuming regular dairy, A2 milk may be a worthwhile alternative to explore. However, the evidence is not yet conclusive, and the link between A1 milk and more serious health conditions is still considered weak.   

Ghee and Paneer: Traditional Indian Staples

Ghee, or clarified butter, is a cornerstone of Indian cuisine, celebrated for its rich flavor and its role in traditional rituals and Ayurvedic medicine. Modern research has explored ghee's therapeutic benefits, including its anti-inflammatory effects and its ability to support heart and digestive health in moderation. Ghee is also an excellent source of fat-soluble vitamins like A, D, E, and K. However, due to its high concentration of saturated fats, it is recommended to consume ghee in moderation to avoid potential risks like increased cholesterol and weight gain.   

Paneer, or Indian cottage cheese, is a vegetarian staple known for its protein content. It is also a rich source of calcium, making it a key part of many Indian diets. However, similar to ghee, overconsumption of paneer can lead to health risks, including a spike in cholesterol and blood sugar, and may contribute to weight gain.   

Traditional Indian Alternatives to Dairy

For women who choose to avoid dairy, it is crucial to proactively seek out other sources of key nutrients. Fortunately, traditional Indian cuisine offers a wealth of plant-based foods rich in calcium and other essential minerals.

• Ragi (Finger Millet): This is one of the richest plant-based sources of calcium, providing over 350 mg per 100 grams. It's a staple in Indian diets and can be used to make dishes like dosa and rotis. However, it contains compounds like phytates that can inhibit calcium absorption, so proper preparation is important.   

  
  

• Sesame Seeds (Til): These seeds are a powerhouse, with just one tablespoon containing about 90 mg of calcium. They are often used in chutneys and sweets.   

  
  

• Amaranth Leaves (Rajgira): These greens provide 215 mg of calcium per 100 grams and are considered easier to absorb than spinach.   

  
  

• Legumes: Traditional Indian legumes like rajma (kidney beans) and moth beans are also good sources of calcium and protein for those who do not consume dairy.   

  
  

• Tofu: Calcium-set tofu is a significant source of calcium.   

  
  

• Leafy Greens: Besides amaranth, other greens such as kale, cabbage, and broccoli are excellent sources of calcium, though some like spinach contain oxalates that can reduce absorption.   

  
  

Synthesis and Conclusion

The question of whether dairy is beneficial or harmful is not one that can be answered with a simple "yes" or "no." The analysis shows that both sides of the debate have valid points, and the seemingly contradictory evidence can be reconciled by considering the context of each study and the specific circumstances of the individual.

The primary factors that determine dairy's effects in the Indian context are:

• Cultural and Culinary Role: Dairy is a sacred and central part of Indian life, with traditional products like curd, paneer, and ghee serving as staples.   

  
  

• Individual Biology and Genetics: The high prevalence of lactose intolerance, particularly in certain regions, means that a "one-size-fits-all" approach is inappropriate.   

  
  

• Nutrient Deficiencies: For many Indian women, dairy can be a vital and accessible source of key nutrients like calcium, protein, and B12, which are often lacking in their diets.   

  
  

• Traditional Knowledge: Ayurvedic principles offer a framework for integrating dairy into the diet in a mindful way, often recommending specific preparations to aid digestion and enhance benefits.   

  
  

The most profound realization from this review is that a woman's dietary choices must be deeply personal. The framework for making a decision should not be based on broad advice, but on a process of self-assessment and informed choice. A woman should consider her own body's signals, her current health goals, and the specific composition of the dairy products or alternatives she chooses to consume.

The following table provides a summary of the benefits and potential concerns of dairy consumption across different health areas, as discussed in this report.

Table 2: Summary of Dairy Health Effects

Health Area	Potential Benefits	Potential Harms or Mixed Evidence
Bone Health	Primary source of calcium and vitamin D; helps address widespread deficiencies and reduce osteoporosis risk in Indian women.	Some observational studies link high milk consumption to increased fracture risk; research findings are mixed and may depend on population and dairy type (e.g., liquid vs. cheese).
Hormonal Health	Some research suggests full-fat dairy may support ovulation; low-fat dairy may be linked to a lower risk of early menopause.	Can increase IGF-1 and androgen levels, potentially worsening acne and PCOS symptoms ; high-fat dairy linked to increased risk of breast and ovarian cancers.
Digestive Health	Fermented dairy (curd, buttermilk) may improve gut health and reduce inflammation due to probiotics.	High prevalence of lactose intolerance in India (3 out of 4 Indians affected); causes bloating, gas, and diarrhea.
Weight Management	High-quality protein helps with satiety and muscle preservation; studies suggest dairy, especially yogurt, can aid in weight management during menopause.	High-fat, sweetened dairy products can contribute to excess calories, saturated fat, and weight gain, which is a risk factor for chronic inflammation.
Sourcing & Type	A2 milk may be easier to digest for those sensitive to A1 protein; ghee provides essential fat-soluble vitamins and has anti-inflammatory properties.	Overconsumption of ghee and paneer, while traditional, can lead to increased cholesterol and fat intake ; some studies on A1 milk and chronic diseases are inconclusive.

Practical Recommendations

The following recommendations are offered to help women make informed decisions about dairy consumption.

• For Nutrient Deficiencies: For women with a documented deficiency in calcium, vitamin D, or B12, dairy products can be a simple and effective dietary source. Incorporating 300 ml of milk or curd per day, as recommended by Indian guidelines, can help address these common nutritional gaps.   

  
  

• For Digestive Issues: Given the high prevalence of lactose intolerance in India, a woman experiencing symptoms such as bloating, gas, or stomach pain after consuming dairy may benefit from a simple approach. Trying lactose-free milk or choosing products like hard cheeses or aged cheeses, which are naturally lower in lactose, can be effective. Alternatively, traditional fermented products like curd and buttermilk, which are often easier to digest, are excellent choices.   

  
  

• For Hormonal or Skin Concerns: For those with hormone-related conditions like acne or PCOS, considering a temporary removal of dairy from the diet for a period of three to four weeks is a useful diagnostic tool. If symptoms improve, a woman can selectively reintroduce small servings of full-fat, unsweetened, or fermented dairy, such as curd or buttermilk, to assess her body's specific response.   

  
  

• For Plant-Based Diets: It is crucial to understand that not all dairy alternatives are nutritionally equal. A woman who chooses a plant-based diet should ensure her diet is rich in a variety of traditional non-dairy calcium sources. She can incorporate ragi (finger millet), sesame seeds, amaranth (rajgira), and legumes to meet her daily nutrient requirements.   

  
  

The ultimate conclusion is that there is no universal "right" answer. The most effective approach for any woman is to use her body's responses as a guide and to make choices that are both evidence-based and aligned with her individual health and wellness goals.