A healthy diet that includes whole-fat dairy is associated with less risk of cardiovascular disease and mortality no matter what region of the world a person lives in or their income level, concludes a new study recently published in the European Heart Journal.

That research, the product of a collaboration between scientists around the world, sought to evaluate what effects healthy and unhealthy eating patterns had on cardiovascular function in people from all continents and backgrounds. They developed a novel diet evaluation score called PURE and aimed to compare it to other diet pattern scores like the Mediterranean, EAT-Lancet Planetary diet, and Dietary Approaches to Stop Hypertension (DASH). All of these programs include a greater emphasis on fruit, vegetables, legumes, nuts, and fish, but they differ in their approach to fats and consumption of dairy, the team’s paper stated. They studied whole-fat dairy and included it in the PURE diet because it is one of the dietary factors that, though previously thought to elevate the risk of cardiovascular disease, more recently has been shown to have a neutral or protective effect.

The evaluation included diet information from more than 147,000 people from 21 countries on five continents who enrolled in an ongoing, large-scale study between 2003 and 2018. Diet scores were associated with patients who had experienced different vascular conditions.

The PURE diet allowed for more variety of diet than the other diet scores mentioned, the team said. This was mostly in the area of animal products. But they found that a higher PURE diet score was associated with a lower risk of mortality, major cardiovascular disease (CVD), myocardial infarction, stroke, or death by CVD or other cause. This was true across geographic regions and in countries grouped by income level. The highest diet scores were found in North America, Europe, the Middle East, and South America and were associated with higher income. South and Southeast Asia, Africa, and China had less healthy eating patterns when compared to PURE standards.

Guidelines must match

In addition to supporting the idea that a healthy diet is made up of a variety of foods rather than restricting oneself to certain categories, this study highlights the ability of whole-fat dairy to be a valuable part of a beneficial diet and one that even protects against heart concerns.

“In populations globally and especially in disadvantaged populations, moderate amounts of whole-fat dairy are not harmful and can be beneficial,” the authors state among their conclusions.

They also write, “Animal foods such as dairy products and meats are a major source of saturated fats, which have been presumed to adversely affect blood lipids and increase CVD and mortality. However, recent data suggest that the effects on lipids and blood pressure [BP] are much more modest than previously thought.

“While higher intake of saturated fats is associated with slightly higher LDL cholesterol, it does not increase the atherogenic particles such as small dense LDL or Apo B. Further, recent reviews of observational studies and our findings in PURE showed that dairy foods, especially whole-fat dairy, may be protective against risk of hypertension and metabolic syndrome,” they continue.

The study specifically points to the value of a healthy, high-scoring diet that includes whole-fat dairy for lower income regions where less healthy diets are more frequently consumed. The benefits of eating a diet that scored higher on the PURE scale were even stronger in places like South Asia, China, and Africa, the researchers found. “These findings suggest that an inadequate level of consumption of key healthy foods is a larger problem than overconsumption of some nutrients or foods (such as saturated fats or whole-fat dairy and meats) for mortality and CVD risk around the world,” the paper says.

So, dietary guidelines targeting saturated fat in many populations of the world may not be warranted, the authors add. And although the U.S. is among the countries fortunate enough to have some of the healthier diets of the world, Americans can benefit from this science, too.