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Ask JJ: Skim Milk

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Dear JJ: My dietitian recently recommended to meet my calcium needs (I'm a 59-year-old woman), I should have two glasses of skim milk daily. In your books, you don't recommend milk. So why is my dietitian suggesting it and you don't?

I can't speak for your dietitian, but I can explain why milk -- especially skim milk -- doesn't belong in a healthy diet. Lactose intolerance affects about 75 percent of the world's population, but that's hardly the only reason to wipe off that milk mustache.

"Despite what those milk-mustachioed celebrities in those 'Got Milk?' ads have been telling us for years, humans have no nutritional requirement for milk, and it may be doing us more harm than good because of all the sugar even plain non-fat milk contains," notes a 2013 study by Harvard pediatrician Dr. David Ludwig published in the Journal of the American Medical Association Pediatrics.

Let's start with the better bones myth. If you look at countries with the highest milk consumption, they also tend to have the highest levels of osteoporosis.

One of the largest and longest studies of women's health, the Nurses' Health Study, looked at 77,761 nurses over 12 years. Turns out those who consumed the most milk had the highest risk of bone fractures. Researchers concluded that study data didn't support the hypothesis that higher consumption of milk or other food sources of calcium protected against hip or forearm fractures.

Milk doesn't do any favors for your skin either. One study showed those who drank more milk as teenagers had higher rates of severe teenage acne than those who drank less. Skim milk ranked worse than full-fat milk. Researchers concluded lactose, hormones, and bioactive molecules in the milk could have been culprits.

Then there's fat loss. Studies also show if you drink more skim milk, you gain weight.

One particular study at Harvard's School of Public Health found children who drink three servings of skim or 1 percent milk each day (as opposed to higher fat dairy products) were more prone to becoming overweight than children who drank fewer such servings each day. The weight gain was only associated with skim and one percent milk rather than with full-fat dairy products.

That makes sense when you consider skim milk is higher in lactose (sugar), as Dr. Ludwig noted, which raises insulin. Among this master hormone's jobs is to store things -- namely, fat.

"It appears that it is not just the anabolic or sex hormones in milk that causes problem but milk's ability to stimulate insulin production," writes Dr. Mark Hyman. "It actually may be the lactose or milk sugar in milk that acts more like a soft drink than an egg. Drinking a glass of milk can spike insulin levels 300 percent. Not only does that cause pimples, but it also may contribute to prediabetes."

I'm not entirely anti-dairy, but be aware for many people it creates food intolerances. If you can handle dairy, opt for quality, filling, full-fat sources like no-sugar-added Greek yogurt.

Even then, eat it sparingly. Over-eating even quality cheese, yogurt, or raw unpasteurized milk (if your state allows it) becomes easy, exacerbating food intolerances and increasing your caloric intake.

If you're intolerant or otherwise avoid diary, numerous alternatives exist that provide the satisfaction of cow's milk without its numerous problems. Unsweetened coconut milk and no-sugar-added ice cream are among the growing array of dairy-free foods that provide flavor without dairy or sugar impact.

As more dairy-free options appear on grocery shelves, are you trading in the cow for coconut, almond, or other milks? Share your favorite below.