Heart disease and blood pressure

The Australian Dietary Guidelines recognise the importance of including milk, cheese and yoghurt as part of a healthy, balanced diet. They acknowledge that these foods can protect us against heart disease and stroke and can reduce our risk of high blood pressure.

Heart disease in Australia

One in six Australians has heart disease, which is the leading cause of death in Australia.¹ Cardiovascular disease (CVD) is a term used to describe all diseases of the heart and blood vessels. Coronary heart disease (which includes heart attacks and angina) and stroke are common forms of CVD. In terms of lives lost and health spending, CVD is still considered to be Australia’s most costly disease.²

Risk factors for heart disease

There are a number of risk factors associated with developing CVD.³ Some risk factors such as increasing age, male gender and family history of premature CVD cannot be changed. Other risk factors which can be addressed include excess weight, physical inactivity, an unhealthy diet, smoking and excessive alcohol consumption.

High blood pressure (hypertension) and high blood cholesterol are two other major risk factors for CVD. It is estimated that one in three Australian adults has either hypertension (blood pressure ≥ 140/90mmHg)⁴ or high cholesterol (total blood cholesterol ≥5.5mmol/L).⁵ The good news is these risk factors can also be addressed through a healthy lifestyle.

Evidence for dairy and improved heart health

Dairy foods have long been known for their role in bone health. However, the Australian Dietary Guidelines recognise the importance of including milk, cheese and yoghurt to reduce heart disease risk. Milk, cheese and yoghurt are also recognised for reducing the risk of stroke, hypertension and type 2 diabetes.⁶

In a recently published meta-analysis, consumption of dairy foods was associated with a 12% reduced risk of CVD and 13% reduced risk of stroke.⁷ These findings were based on 22 studies with over 900,000 participants.

However, most Australians aren't consuming enough milk, cheese and yoghurt in their diet and are missing out on the health benefits. Approximately nine in 10 Australian adults need to increase their dairy food intake to align to the Australian Dietary Guidelines.⁸

Dairy linked to a reduced risk of hypertension

A number of studies have shown consuming three daily serves of milk, cheese and yoghurt is linked to a reduced risk of hypertension. The DASH (Dietary Approaches to Stop Hypertension) diet is widely recommended for prevention and management of hypertension. This diet is characterised by a high intake of fruits and vegetables, high in reduced-fat dairy and reduced sodium intake. Evidence has shown consumption of the DASH diet is favourable for heart health, including CVD and stroke.⁹, ¹⁰, ¹¹ While the DASH diet focuses on low or no-fat dairy, a new randomised controlled trial has also found similar reductions in blood pressure can occur with regular-fat dairy.¹² These findings don’t just apply to adults. In a recent study of adolescents, it was found that consumption of both regular and reduced-fat dairy was significantly associated with reductions in blood pressure.¹³

The National Heart Foundation of Australia has also removed their restriction for healthy Australians on eating full-fat milk, cheese and yoghurt. Based on their review of the evidence, they concluded that this type of dairy had a neutral effect on heart disease risk and stroke.¹⁴

Cheese is not associated with increased cholesterol

The fat in dairy products has a reputation for being bad for heart health and cholesterol levels. This is why some health professionals recommend limiting dairy in the diet, particularly regular or higher-fat dairy, such as cheese. However, studies show that people who regularly consume milk, yoghurt and cheese (including regular-fat varieties) are less likely to have heart disease than those who don’t. Danish researchers compared the effect of cheese and butter on cholesterol levels and found cheese did not increase low-density lipoprotein (LDL) or total cholesterol. In this study, participants ate about 140g of cheese a day, which is much higher than the Australian Dietary Guidelines serve recommendations.¹⁵ A more recent meta-analysis of randomised controlled trials also supported these findings – where consumption of hard cheese lowered total cholesterol by five per cent, compared to butter.¹⁶

The dairy matrix and heart health

The exact reason the dairy food group can help to prevent and manage heart health is still being explored. Research suggests the unique combination of minerals and proteins in these foods play a major role. Milk, cheese and yoghurt contain several essential nutrients and bioactive substances (such as casein and whey) which may play a role in reducing risk of cardiovascular disease. For example, calcium and potassium particularly from dairy (as opposed to other sources) may be beneficial to those with high blood pressure. In addition, the high calcium content of cheese may increase faecal fat excretion, which may be favourable for cholesterol levels.¹⁷ It is thought that dairy food components may act synergistically. Therefore, it is important to consider the entire food matrix as opposed to isolated nutrients.

Heart health resources

Heart health fact sheets
Download the Cardiovascular health fact sheet
Download the Managing Your Blood Pressure fact sheet

Heart health infographics
Download the Health benefits of dairy foods infographics
Download the Cheese consumption and health infographics

Hearth health white paper
Download the It's ok to recommend cheese white paper