Whole-FatorReduced-FatDairyProductIntake, Adiposity,andCardiometabolicHealthinChildren: ASystematicReview

Abstract

Dietaryguidelinescommonlyrecommendthatchildrenaged >2yconsumereduced-fatdairyproductsratherthanregular-orwhole-fatdairy.In adults,moststudieshavenotfoundtheconsumptionofwhole-fatdairyproductstobeassociatedwithincreasedcardiometabolicoradiposityrisk. Associationsinchildrencoulddifferduetogrowthanddevelopment.Wesystematicallyreviewedtheliteratureinindexed,peer-reviewedjournals tosummarizepediatricstudies(childrenagedfrom2to18y)assessingassociationsbetweenwhole-andreduced-fatdairyintakeandmeasuresof adiposity as well as biomarkers of cardiometabolic disease risk, including the serum lipid profile, blood pressure, low-grade chronic inflammation, oxidative stress, and measures of glucose homeostasis. For the purposes of this review, a “whole-fat”dairy product was defined as a product with thenaturalfatcontent,whereasa“reduced-fat”dairyproductwasdefinedasaproductwithsomeorallofthefatremoved(including“low-fat”and “skim”versions).Atotalof29journalarticlesmetourcriteriaforinclusion.ThemajoritywereconductedintheUnitedStatesandwereprospective orcross-sectionalobservationalstudies,withonly1randomizedcontrolledtrial.Studieswereconsistentinreportingthatwhole-fatdairyproducts were not associated with increased measures of weight gain or adiposity. Most evidence indicated that consumption of whole-fat dairy was not associatedwithincreasedcardiometabolicrisk,althoughachangefromwhole-fattoreduced-fatdairyimprovedoutcomesforsomeriskfactorsin 1study.Takenasawhole,thelimitedliteratureinthisfieldisnotconsistentwithdietaryguidelinesrecommendingthatchildrenconsumepreferably reduced-fat dairy products. High-quality randomized controlled trials in children that directly compare the effects of whole-fat compared with reduced-fat dairy intake on measures of adiposity or biomarkers of cardiometabolic disease risk are needed to provide better quality evidence in thisar