Science Makes the Case for Whole Milk, Teicholz Says

You don’t have to be part of the dairy sector to see how important whole milk is for children, best-selling author Nina Teicholz, Ph.D., said in the latest Dairy Defined Podcast.

That’s because nutrition science makes a compelling case for full-fat milk, underscoring the importance of getting whole milk back in schools, the goal of the Whole Milk for Healthy Kids Act, she said. 

Children who drink whole milk tend to be healthier, she said. “You need the fat in the milk to digest the vitamins that are in the milk, those are fat soluble vitamins. “I'm not a dairy advocate, but it turns out that the science supports the position of those of people in the industry who would prefer to see whole milk back in schools.”

Teicholz, author of “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet,” also discussed how food policy might be shaken up by Robert F. Kennedy Jr’s. confirmation as Health and Human Services Secretary. 

NMPF has a call to action supporting the Whole Milk for Healthy Kids Act for listeners who want to get involved on the advocacy page of our website, nmpf.org/take-action

Transcript

Alan Bjerga: Hello and welcome to the Dairy Defined podcast. Award-winning journalist, best-selling author, nutrition advocate, and recent Ph.D. Nina Teicholz is our guest today talking about her work with The Nutrition Coalition, a non-profit, non-partisan educational organization aiming to ensure the US Dietary Guidelines for Americans are evidence-based to reverse chronic diseases in America. This is very important work because we have a new administration, a recent report on the science behind the dietary guidelines, and a lot going on in the nutrition and policy worlds. So thanks for joining us today, Nina.

Nina Teicholz: Hi. Thanks for having me.

Alan Bjerga: You've been an outspoken critic of what you've characterized as weak science that's been used to vilify animal-sourced proteins and nutrients for some time now. Tell us about your journey from curious journalist to prominent critic.

Nina Teicholz: I was actually a vegetarian for 25 years and was completely avoiding red meat and most whole fat dairy products for reasons that I didn't really understand. It was just part of the zeitgeist and that's what you did, and I grew up in Berkeley, California, so that was especially what we did there. As a journalist, I also was not particularly interested in nutrition until I was assigned an article by Gourmet Magazine on trans fats, and that became a huge article for the magazine, led to a book contract on what I thought was going to be a book on trans fats. Nine years later, after really going down the rabbit hole, reading thousands of scientific studies, interviewing hundreds of researchers, and becoming very curious about all kinds of dietary fats... I mean, this is what we have obsessed about most in the American diet. Really it's low-fat, good fat, bad-fat. How much fat do we eat? That has been at the core of our dietary recommendations for 45 years.

So I just became really interested, and what I discovered was so surprising to me, really that we seemed to have gotten it completely wrong on which fats were healthy, on how much fat was healthy, and that became the subject of my book, The Big Fat Surprise. And I also became really interested in all the politics and influences, corporate ideological influences that suffuse the world of food politics, nutrition politics, and why we seem unable to have official recommendations or medical doctors recommending the best and most current science. I just became fascinated by why it is we could not get the science out there into our official policy.

Alan Bjerga: And frankly, part of why we ask you to come on this show is that you're not a dairy person, and not everything you say reflects the stated positions of the National Milk Producers Federation or the wider dairy community, but we all need to talk to one another and be honest about what we see going on from each of our communities. Your work has led you to advocate for the value of dairy and diets, but you're not a dairy advocate, you're looking at a broader framework. We're looking at a piece of legislation right now called the Whole Milk for Healthy Kids Act that in dairy we feel like we can get through Congress this year. We know why it's important to us. What makes it interesting and important to you?

Nina Teicholz: Well, I really approach everything from the view of science. What does the science say on this subject? And really the central theme of my book was that saturated fats, the kind found in dairy, the reason that whole milk is not allowed in schools that, it is illegal, is that it contains saturated fats. And these fats, which since 1961 really the American Heart Association started the first official policy anywhere in the world telling people to avoid saturated fats as the best way to prevent heart disease, we have in all those decades since believed that these are dangerous fats to be avoided, skim milk is better than whole milk. If you look at the evidence, it really was never strong. Clinical trials, many large clinical trials tested this hypothesis. They did not show that saturated fats had any effect on cardiovascular or total mortality, little to no effect on heart disease, and the data on children is nonexistent.

I mean for this recommendation that was recently reviewed, I think it was in the 2020 Dietary Guidelines, they finally looked at saturated fats and the effect on children. This is something that I wrote about in my book. There are two clinical trials on children, both on highly unusual populations that cannot be generalized to children at large. One trial was on kids who had excessively high LDL cholesterol, which clearly meant they had some kind of genetic disorder, cannot be generalized to children on the whole. The other trial was, I think in Finland, and that trial simply showed that if you reduce saturated fats, gave them a low fat diet that they could survive. It didn't show that they benefited, and it didn't show that it prevented any kind of disease later in life. It just showed that they basically didn't suffer. But that's no reason to implement some kind of policy telling every child that they should only consume low fat milk. I mean that's really inadequate data. Taking whole milk out of schools was really never justified by the science, and that's where my group became involved in trying to submit... Well, we did submit scientific statements on this. And we just really feel that, in general, that policy should reflect the best and most current science.

And I think in this case, depriving children of whole milk actually there's evidence of harm. The studies that we have showed that children who drink whole milk grow up to be taller. Children who drink whole milk tend to be healthier. You need fat as children, you need the fat. You need the fat in the milk to digest the vitamins that are in the milk, those are fat soluble vitamins. I really responded to the lack of science here. So I'm not a dairy advocate, but it turns out that the science supports the position of those of people in the industry who would prefer to see whole milk back in schools.

Alan Bjerga: But at this point, you're pushing against two generations of consensus and conventional wisdom. How do you change that narrative?

Nina Teicholz: Well I think that we now have a unique opportunity with this administration and with the mandate to reverse chronic disease in America. And I am hoping that at US Department of Agriculture that there will be people appointed there who will bring a fresh approach to the Dietary Guidelines for America, because that's the federal policy that controls what is served in school lunches, largely. If that policy... If we are able to, let's say reexamine the cap on saturated fats, look at the evidence that has been ignored, and in some cases suppressed over the last 15, 20 years, I think that those caps on saturated fat could finally be lifted. They've never been evidence-based, and there's a huge amount of science now reexamining the evidence on saturated fats. There's like 23 systematic reviews and meta analyses on all the original clinical trials, and they all conclude the same thing, which is that we got it wrong on saturated fats. Some of these papers have authors that are former Dietary Guideline Committee members, people who participated in the guidelines at the highest level saying, "We got it wrong on saturated fats". So I think in this administration it is possible that that science will be recognized.

Alan Bjerga: So let's look at where we've come so far, taking a look at the scientific report. It takes incremental steps on full fat. It indicates the committee did find evidence that substituting higher fat dairy showed no association with cardiovascular disease morbidity. It found evidence of positive benefits for growth and bone health, specifically related to whole milk consumption in young kids. It comes down a little bit harder on butter. What are your thoughts on the work that's been going on so far, and how it fits into the framework you see developing?

Nina Teicholz: Saturated fats, as a whole, have been exonerated by the science. So trying to parse out the effects of whole milk versus butter, that really is... There's the same fatty acids in those foods, for the most part, and trying to separate out different foods containing saturated fats is based on weak science. Those are what we would call epidemiological findings, which show association but not causation. The clinical trials, which is the more rigorous evidence, really shows that saturated fats, as a whole from meat or dairy, have no effect on cardiovascular disease, or very minimal effects, and no effect on mortality. So I think that those recommendations are based on weak science.

There were some really problematic ways that this committee went about reviewing the science. For one, they used computer modeling to look at... They modeled diets. And they didn't publish their modeling assumptions, so that's a black box. Nobody can replicate it, nobody can know what went on. They put certain assumptions in there, such as we will say every food that has saturated fats in it we consider that unhealthy, so that it automatically downgrades any of those foods. And it's modeling. It doesn't reflect actual data. So that kind of modeling has never been used before, in any scientific report, because it's of such low quality. I mean if you look at the pyramid of evidence of science, up in the tip the most rigorous science are clinical trials. We have clinical trials. And then below that are these observation or epidemiological studies that only show associations, those are a weaker form of science. Not even on the pyramid of evidence, because it's such a weak form of data, is computer modeling. That's like in the basement. So I have no idea why they chose to do computer modeling to inform this scientific report.

I will say that I also went through the major systematic reviews conducted by this Dietary Guideline Advisory Committee, their key recommendations on the diet, so-called dietary patterns. There are three dietary patterns: vegetarian, US-style, Mediterranean. And they did systematic reviews on those dietary patterns to see if they had an association with any adverse health outcome. I went through all the clinical trials that they cited and found that fully 0% of those clinical trials supported their claims. So they listed say 15 clinical trials to show that if you follow a dietary pattern, you could avoid obesity or avoid weight gain. None of those trials supported that claim. There are problems with the systematic reviews as well.

And let me just add one other point, which is that a paper came out recently in the American Journal of Clinical Nutrition, which is quite a well-read and respected journal, by a group of methodologists mainly from Ottawa in Canada, where they tried to replicate the systematic reviews from the last set of Guidelines. They selected eight systematic reviews, they tried to replicate them, they analyzed how they had been conducted, and their conclusion was that they were, "of critically low quality", and that they were a subpar. Which means that these reviews that are being conducted by USDA, that's a team at USDA that does these reviews, they really are not reliable. Which is confirmed by my own back of the envelope analysis that zero clinical trials supported their claims. I mean there's something going wrong with that methodological process that they use at USDA to review the science. And let me just add one more thing, which is that the National Academy of Sciences in a congressionally mandated report back in 2017 came to the same conclusion. That's a very authoritative report. And said, "Methodology needs to be improved. It's lacking in rigor. It's not systematic. It doesn't follow any recognized methodology that we know of". So I think there are big questions about the systematic reviews that are used to support our National Dietary Guidelines.

Alan Bjerga: So that's all very detailed, but it's not without pushback. You just cited in a recent Nutrition Coalition call to action, USDA and Health and Human Services staff responded to some of your criticisms of the Dietary Guidelines process with a paper that was titled "Addressing Misinformation about the Dietary Guidelines". Why is this happening?

Nina Teicholz: Well I guess it's a little bit of a badge of honor to be called a misinformer in today's world, but yeah. So let me just tell you about that. So a really important paper published in a journal of the National Academy of Sciences was by me and three or four former Dietary Guideline Committee members. Again, people who'd written the guidelines. And I would say that's the most serious critique of the Dietary Guidelines and its process and its recommendations published to date. That came out I think in 2022. And we said things like the science on low carbohydrate diets has been ignored and suppressed. The committee came to the conclusion in 2015 that dietary cholesterol had no relationship to your blood cholesterol. We got it wrong when we told people to have egg white omelets and avoid shellfish. But that conclusion was never conveyed to the American people, so people are still confused about eggs. We reviewed the confusing science on the low fat diet. The Dietary Guideline committee no longer tells anybody to eat a low fat diet, but the way they formulate their meals is a de facto low fat diet. So there are all these bizarre contradictions in the Guidelines, information not conveyed, confused information.

And so that obviously did not please people at USDA and HHS, and so some of the staff members there they co-wrote an article calling our... They didn't actually cite our paper, because I guess they didn't want anybody reading it. But they took all of our points and responded to them and called that misinformation, or disinformation. I can't remember. Misinformation?

So they're aware of these criticisms, and I guess now they're sort of adopting what I think is some of the strategies used by other public health agencies recently just trying to stonewall critics, and trying to... Well this has been going on for some time really, the kind of tactics that have been used against me, which is either to ignore what I'm saying or to kind attack me in ad hominem ways. Yeah. I mean there's just a real effort to try to sideline any critics. I mean I haven't been de-platformed yet, but I've been disinvited from conferences, I've had attempted retractions against my papers. So there's clearly an effort to try to suppress this kind of science from coming out.

Alan Bjerga: Needless to say, nutrition policy in the US is in an interesting moment. We're seeing what could be a pretty significant inflection point right now with the confirmation of Robert F. Kennedy Jr. as Secretary of Health and Human Services. How might RFK shape food policy, and what are some of the challenges that'll be coming in his path?

Nina Teicholz: Robert F. Kennedy Jr. has been given a mandate by Trump to reverse chronic disease in America. Bobby Kennedy is the head of now HHS. HHS can do many things, but it does not have control over the Dietary Guidelines. I mean that they will have some input on the Guidelines that are coming out, the next iteration of the Guidelines, but really the main home of the Guidelines is at USDA. And that's also where the nutrition assistance programs are, school lunches, SNAP, feeding programs for the elderly, women and infant children. All those programs are housed at USDA. So really the changes have to happen at USDA, which is not going to be Bobby's agency. So I think he'll probably have some influence there, but those changes will ultimately rely on the leaders at USDA, who as far as I can see are mainly Trump appointees. I mean I happen to know that there's a lot of support for changing our nutrition policy in various ways, in ways that I consider to be good. I know there's support for bringing whole milk back to schools, and I think that that will be supported by Bobby Kennedy. But really his whole locus of control is going to be about drugs, healthcare, all of the domain of HHS. And the action on food and dietary policy is going to happen at USDA.

Alan Bjerga: One of the challenges about food policy in general is there's a lot of emotion about it. Everyone has their personal experiences, and inevitably that becomes part of the debate. How do you deal with that in your work?

Nina Teicholz: Well I think food is passionate, and you think about it's almost like a religion for people in the sense that you eat three times a day, right? Most people. So you are confirming your beliefs three times a day. You go to church maybe once a week, or synagogue or wherever you pray. You pray once a week, but you eat three times a day. That is confirming your beliefs three times a day. You give food to your children and you are hopefully giving the food that you hope will make them healthy. So you are constantly reaffirming your beliefs about food, and it makes it very deeply felt. And there's an additional set of passions that come from people who believe in animal rights who don't want any kind of animal foods because they think that's harmful to animals. There's another group of people who really feel like, due to climate change, we should not be eating any animal products to save the planet. So there's all of these passions that converge on animal foods. All of these influence, obviously, the debate around food.

I really try very hard in my work to stay focused on what the science says. What does the science say is a healthy diet, and let us make that diet sustainable. What does the science say about how humans can be healthy? I mean given the crippling load of chronic diseases that we are suffering under, that mission alone is enough. We cannot survive as a people if we are so unhealthy we are unable to staff our... We're unable to recruit people for the military. Our kids are getting sick in schools. I think 38% of kids now have pre-diabetes, which is an astonishing number. So if cows cause climate change, for instance, then we have to decide... Every American should decide, "Do I want to balance my climate budget based on my... Do I want to give up my health to do that? Or would I rather take one less flight overseas a year?" I mean that's the decision of every single American to make on their own. It should not be imposed on us from above. But I really try to keep my focus on the science of nutrition, what makes people healthy. That's a single scientific question, and that's enough. If we can just do that, and then we deal with the other consequences, I think that will be a victory for our country.

Alan Bjerga: Just last year, you earned a Ph.D. in nutrition science from the University of Reading. You've already established yourself in the public sphere in the world of ideas. Why a Ph.D.?

Nina Teicholz: I got a Ph.D. because I didn't want to be called anymore just a journalist. I felt like I have read so many scientific papers, I have researched in this field for 20 years, and yet the average medical doctor who doesn't read science papers at all, that's not part really of their curriculum on... Nutrition isn't even part of their curriculum. The average medical doctor could dismiss me as being just a journalist, and I think that's unfair, or I felt like that was unfair. It was complicated for me because I don't actually have a tremendous amount of respect for credentials. I know many credentialed people who are saying things that I know are not science-based, and I've written articles criticizing the scientists at Harvard, the scientists at Stanford, I mean very senior elite scientists. So my respect for credentials is not particularly high, but I felt like I needed one just to level that playing field so that I could have conversations where I'm not just a journalist. And so I'm happy to have done that.

Alan Bjerga: We've been speaking with Nina Teicholz, Ph.D. and founder of the Nutrition Coalition. And, by the way, author of a highly influential book called The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. Nina, is there anything that we've missed that you'd like to add?

Nina Teicholz: Yeah. Maybe I would just say that my book is still, even though it was published 10 years ago, I still think it is relevant for people to read today because there is no other book that tells the story of how we got into this mess. What were the politics? Where did it all begin? How did we get the idea that meat and dairy were bad for health? It was an idea that has an origin at a single point in time, we didn't always believe this. Why did this clearly non-evidence based policy survive for so many decades? And we still have not reformed our official policy to reflect the science. So really all the factors and the politics, the corporate interests, the I would say non-rigorous university scientists who are really leading the charge here, I would say that's all true still. So for anybody who wants to understand the background story, I think that's worth reading still. And that's not to plug my book, I just think that many people really need to understand why is it okay to drink whole milk? They kind of understand the scientific reasons, but other people really need to understand how did we get it so wrong? And so if you have that kind of curiosity, I would recommend it to you.

Alan Bjerga: Nina Teicholz, thank you so much for your time.

Nina Teicholz: Thank you.

Alan Bjerga: And that's it for today's podcast. The Nutrition Coalition has a website if you'd like to visit it. It's at nutritioncoalition.us. That's one word. NMPF of course has its own call to action asking lawmakers to sponsor the Whole Milk for Healthy Kids Act. Just go to nmpf.org and click on our advocacy toolbar. For more of these podcasts, all you have to do is go to our website or go to Apple Podcasts, Spotify, and Amazon Music and search under the podcast name Dairy Defined. Thank you for joining us.