Is Dairy Recommended in Other Countries' Nutrition Guidelines?
Yes, dairy is recommended in the majority of countries worldwide, with 75% of countries including dairy in their food-based dietary guidelines, though the emphasis varies significantly by region. 1
Global Patterns of Dairy Recommendations
Regional Variation in Dairy Emphasis
The inclusion of dairy in national dietary guidelines shows marked geographic differences:
Strong emphasis regions: North America, the Near East, and Europe show dairy as a separate food group in nearly all countries (100%, 100%, and 85% respectively), with most having specific key messages about dairy (100%, 75%, and 82% respectively) 1
Moderate emphasis regions: Africa, Asia Pacific, and Latin America show dairy as a separate food group less frequently (50%, 60%, and 38% respectively), with fewer key messages about dairy (57%, 53%, and 30% respectively) 1
Countries without dairy representation: Only 3 countries (Sierra Leone, Vietnam, and Belize) have no visual representation of dairy in any food group 1
How Dairy is Presented in Guidelines
In food guides, dairy appears as its own food group in 64% of countries, is grouped with protein foods in 31% of countries, and in China specifically, dairy and soy are grouped together 1
Specific Recommendations When Provided
Frequency and Quantity
Among countries with dairy messages:
Daily consumption: Over half (27 of 51 countries) recommend dairy consumption "daily" 1
Quantitative recommendations: 14% of countries (n=13, predominantly in Europe) provide specific serving sizes, recommending a mean of 2.4 servings per day (mode = 2) 1
Volume specifications: Three countries recommend 500 mL per day 1
Product Types and Modifications
Product variety: 51% of countries with dairy messages include milk products, yogurt, or cheese in addition to fluid milk 1
Low-fat emphasis: Half of countries' dairy messages (29% of all countries, n=26) include mention of "low fat" 1
Dairy alternatives: 11% (10 countries across various regions) include nondairy alternatives to milk such as soymilk or other calcium-rich foods 1
Calcium-focused messaging: Six countries frame their dairy message around calcium content 1
Health Evidence Supporting Dairy Recommendations
Metabolic and Cardiovascular Benefits
Dairy consumption shows protective effects against type 2 diabetes, with total dairy intake associated with an 11% risk reduction (RR: 0.89; 95% CI: 0.84-0.94), whole milk with 13% reduction (RR: 0.87; 95% CI: 0.78-0.96), and yogurt with 17% reduction (RR: 0.83; 95% CI: 0.70-0.98) 1
Consuming 200-300 mL/day of milk and dairy foods does not increase cardiovascular disease risk 1
Cheese intake is inversely associated with coronary heart disease (RR: 0.96; 95% CI: 0.93-0.98 per 20g higher intake/day) 1
Dairy intake shows inverse association with hypertension and stroke risk 1
Growth and Development
Both meat and milk are effective in reducing childhood stunting 1
Milk has specific growth-promoting effects on young children across all income levels, possibly via IGF-I stimulatory mechanisms 1
Moderate maternal milk intake during pregnancy is positively associated with birth weight, length, and bone mineral content during childhood 2
Bone Health Considerations
Dairy consumption shows positive effects on bone mineral density, with increases of 0.6-1.0% at the total hip and 0.7-1.8% in whole body after 1 year of increasing calcium intake to >800 mg/day 1
However, these increases are unlikely to lead to clinically significant reduction in fracture risk 1
Important Clinical Caveats
Lactose Intolerance Context
The lower emphasis on dairy in Asia, Africa, and Latin America correlates with lactose intolerance prevalence:
Approximately 70% of the world's population has relative or absolute absence of lactase, particularly in Asia, Africa, and South America 1
Patients consuming less than 280 mL of milk daily typically do not require lactase supplementation, as this amount is generally tolerated even with lactose intolerance 3, 4
Many lactose-intolerant patients can tolerate yogurt and hard cheeses, which contain lower lactose levels or beneficial bacteria 3, 4, 5
Practical Implications
The variation in dairy recommendations reflects:
- Cultural dietary patterns and food availability 1
- Regional lactose tolerance patterns 1
- Different approaches to meeting calcium and protein requirements 6
Countries without separate dairy groups typically include dairy products in general protein groups as alternative protein sources, leaving flexibility for populations where lactose intolerance is prevalent 1