Did you drink milk today? BMC Medical Research found that consuming sugar-sweetened or artificially sweetened beverages instead of milk increases the risk of frailty in older women!

Attention, people who don't like to drink milk

Older women at greater risk of frailty when consuming sugary or artificially sweetened beverages instead of milk

On weekdays, these sugary drinks are loved by many people because of their sweet taste. However, long-term and excessive intake of sugar and artificial sweeteners may have adverse effects on the body, such as blood sugar fluctuations, weakened immune system, etc., thereby increasing the risk of physical weakness in elderly women.

This is a finding from a 30-year health study published in BMC Medicine that observed more than 80,000 people (all women over 60 years old). The study also found that replacing milk, yogurt and cheese with red meat or eggs would increase the risk of frailty, while replacing milk with orange juice would reduce the risk of frailty.

This may be because, although red meat and eggs are both nutritious foods, long-term and large-scale intake may lead to health problems. The high fat and cholesterol in red meat may increase the risk of cardiovascular disease, and the high protein in eggs may also burden the kidneys. Orange juice is recommended because it is rich in vitamin C and other minerals. Moderate intake of orange juice can enhance immunity and has certain benefits for the health of elderly women.

Therefore, when total energy intake remains stable, a decrease in one food will inevitably lead to an increase in another food. When choosing a beverage to replace milk, its nutritional value and potential health risks should be carefully considered. Maintaining a balanced and varied diet is key to maintaining our health, and a large body of evidence shows that a better diversified and balanced diet can reduce the risk of frailty. So, what is the relationship between specific dietary factors, such as dairy products, and frailty?

Frailty increases the risk of falls, disability, hospitalization, and death. Studies have found that dairy products contain a variety of nutrients that may prevent frailty , such as magnesium, potassium, and calcium. These nutrients may affect the development of frailty by slowing down the rate of bone loss through their effects on muscle contraction and metabolism.

The 2024 National Nutrition Week uses the slogan "Healthy China, Nutrition First" and proposes the communication theme of "Milk and soybeans add nutrition, less oil is healthier". It focuses on the key contents of the balanced diet guidelines of the "Dietary Guidelines for Chinese Residents (2022)" and advocates the use of milk and soybean foods as sources of high-quality protein, calcium and B vitamins, thereby improving the quality of diet.

The original balanced diet guidelines suggest that a balanced diet should have a variety of foods, with an average daily intake of more than 12 types of food and a weekly intake of more than 25 types of food, with a reasonable combination of three meals a day. Eat more fruits and vegetables, milk, whole grains, and soybeans, less salt and oil, and control sugar and limit alcohol.

Common liquid milks include cow's milk, goat's milk, and horse's milk, among which cow's milk is the most consumed. It is not difficult to make dairy products a necessity in the diet. For example, drink a glass of milk (200-250ml) for breakfast and a glass of yogurt (100-125ml) for lunch. For children, they can eat 2-3 slices of cheese for breakfast and drink a bottle of milk or yogurt during breaks.

So, did you drink milk today?

To prevent weakness, which is better, milk, yogurt or cheese?

Let's take a look at some scientific research results on their weak correlation.

Yogurt: can reduce the number of attacks of weakness.

Compared with milk, yogurt has a moderate protective effect on frailty in elderly women, and women who consume 5 or more servings of yogurt per week have a relatively low body mass index (BMI). In the Framingham Study subproject in the United States, it was found that more yogurt intake was associated with fewer episodes of frailty, while the intake of high-fat dairy products (including whole milk, ice cream, cheese/ricotta and other cheeses) increased the risk of frailty.

Milk: May reduce the risk of frailty.

In a Spanish study of 1,871 older adults followed for 3.5 years, those who consumed more than seven servings of low-fat milk per week had a 43% lower risk of frailty compared with those who consumed less than one serving of low-fat milk per week; consumption of cheese, whole milk, whole-fat yogurt, or low-fat yogurt was not associated with the incidence of frailty.

Cheese: mixed results on increased or decreased risk of frailty.

The study found that when older women have a higher cheese intake, their risk of frailty increases accordingly, which is contrary to the conclusion of European studies. This is mainly because factors such as cheese consumption type, lifestyle and dietary patterns vary in different regions. For example, in the United States, cheese is often used as an ingredient in foods such as pizza, hamburgers or pasta, rather than eaten alone. Therefore, in this study, the association between cheese and frailty may be due to the combined influence of mixed dishes in these typical Western dietary patterns.

The high saturated fat content of cheese may partially explain its adverse association with frailty, while also counteracting possible beneficial effects of nutrients in dairy products such as calcium, magnesium, and vitamin D. High saturated fat intake may lead to increased LDL levels and influence frailty through its pro-inflammatory effects.

The nutritional content of different dairy products such as fresh milk (sterilized milk), room temperature milk (sterilized milk), yogurt, milk powder or cheese is not much different, so there is no need to worry about which one is better. As long as it is palatable and can enter our stomach and be converted into absorbable nutrients, that is the most important thing. If you are not allergic to dairy products, it is better to eat a variety of dairy products every day. Among them, liquid milk should be selected with a short shelf life, yogurt should be selected with less added sugar, and cheese should be selected with low salt content.

Read labels and avoid sugar traps, as sugar can increase the risk of weakness.

When buying dairy products, you should read the labels more. On the outer packaging of dairy products on the market, there will be corresponding food label information, including food ingredients, applicable groups and consumption methods, nutritional composition table and related nutritional information, etc. Therefore, you should pay attention to these contents when buying dairy products, so as to help you compare and choose the dairy products that are suitable for you.

Take a look at the ingredient list: "white sugar", "fructose syrup", "honey", "jam" and other ingredients in the ingredient list are all incarnations of sugar. Dairy products with added ingredients such as jam may taste better and have a richer taste, which invisibly leads to excessive sugar intake, so "sugar control" is the key. You can try to choose dairy products where sugar is ranked later in the ingredient list. The later it is ranked, the lower the sugar content.

Second, look at the nutrition facts table: or it is better to choose sugar-free dairy products. Sugar-free does not mean completely sugar-free. We can refer to the carbohydrate content. For example, yogurt is not zero sugar in theory, because the milk as the raw material itself contains about 5% lactose. Therefore, in the nutrition facts table, the carbohydrate content in 100 grams (g) of yogurt is 5-7g, which means that there is almost no additional sugar added; 9.5-12g is the general amount added; if it exceeds 12g, then you should pay attention.

The above picture shows the nutritional composition of a commercially available yogurt, in which the carbohydrate content is as high as 14.0g/100g. After removing the basic 5g carbohydrates in every 100g of milk, according to the known carbohydrate amount in the nutritional composition table, every box (205g) of this yogurt consumed is equivalent to an additional intake of about 16-18g of "sugar". If you drink a few more boxes because of the sour and sweet taste, the sugar intake will be even higher.

The white sugar in the picture below is about 16g!

Also, a warm reminder: not all products with the word "乳" in their names are dairy products. For example, milk drinks are not dairy products; they are drinks with added sugar .

Milk beverage: It is essentially a beverage, not milk.

Generally, water is the first ingredient in the list, and various sugars and flavorings are added. The nutritional value is greatly reduced. It is not recommended to drink more, and it cannot be used as a nutritional supplement for dairy products. Therefore, you must read the ingredient list before buying, and don't be confused by the name.

So it is recommended that when buying dairy products:

The first step is to look at the product type: milk drinks are not dairy products.

The second step is to look at the ingredient list . There are sugar-free related keywords: white sugar, high fructose corn syrup, honey, jam, etc. The fewer these keywords, the better.

The third step is to look at the nutritional information table . The recommended weight for carbohydrates is 4-7 grams.

Does the more dairy products you drink, the better the effect of improving weakness?

Fresh milk can be processed into various dairy products, including liquid milk, milk powder, yogurt, cheese and condensed milk. Compared with liquid milk, yogurt, cheese and milk powder have different protein concentrations. Protein plays a significant role in preventing weakness, sarcopenia, fractures, etc., and their different flavors can enrich the diet, so they are deeply loved by people.

A recent randomized controlled trial among hospitalized elderly people showed that compared with the control group, the overall intake of calcium and protein was insufficient, but the diet supplemented with dairy products, whether milk, yogurt or cheese, for 2 years reduced the risk of any type of fracture by 33%, including a 46% reduction in the risk of hip fractures and an 11% reduction in the risk of falls. However, some scholars have found based on population studies that when analyzing the increase in milk intake per serving/day, the risk of frailty in elderly women with higher milk intake is slightly higher. In other words, the more dairy products, the better it is in improving frailty.

The Chinese Dietary Guidelines encourage people to eat a variety of dairy products, but different groups of people have different recommended intakes of dairy products. For example, fresh milk, milk powder, cheese and other dairy products can be converted according to the protein ratio with fresh milk and interchangeable, and can be consumed in moderation. For example, an 18-year-old adult chooses dry cheese as his dairy product today. After converting according to the recommended daily intake of liquid milk, he needs to eat at least 30g of dry cheese to reach the recommended daily intake of dairy products.

Calculated according to the protein ratio with fresh milk: 300ml milk = 300ml yogurt = 37.5g milk powder = 30g cheese.

Therefore, we cannot simply equate the amount of dairy product intake with the degree of physical weakness. Everyone should reasonably control the daily intake of dairy products according to their own health conditions and nutritional needs. For example, the recommended daily intake of liquid milk for a two-year-old baby is 500 grams (1 gram ≈ 1 milliliter), and the recommended daily intake of liquid milk for teenagers, adults, and the elderly is 300 grams. This is to achieve the purpose of maintaining good health.

Summarize

Dairy products contain a variety of nutrients that may prevent frailty and slow the rate of bone loss, which may affect the progression of frailty.

In terms of improving weakness, the more dairy products you drink, the better. A moderate amount is fine. You can choose milk, yogurt, etc.

Learn to read the ingredient list. Milk drinks are not dairy products but drinks with added sugar. Sugary drinks put older women at a greater risk of weakness.

References:

[1] Struijk, Ellen A, et al. Specific dairy foods and risk of frailty in older women: a prospective cohort study. BMC Med. 2024 Feb 29;22(1):89.

[2] O'Caoimh R, Sezgin D, et al. Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies. Age Ageing. 2021;50(1):96–104.

[3] Cruz-Jentoft AJ, Dawson Hughes B, et al. Nutritional strategies for maintaining muscle mass and strength from middle age to later life: a narrative review. Maturitas. 2020;132:57–64.

[4] Struijk EA, Fung TT, et al. Protein intake and risk of frailty among older women in the Nurses'Health Study. J Cachexia Sarcopenia Muscle. 2022;13(3):1752–61

[5] Iuliano S, Poon S, et al. Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomized controlled trial. BMJ. 2021;375:n2364.

Written by: Li Caihong, Urumqi First People's Hospital (Urumqi Children's Hospital)