TO YOUR GOOD HEALTH | DR. KEITH ROACH

Fat removed from milk mechanically, not chemically

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DEAR DR. ROACH: I’ve been told by a nutritionist that fat-free milk isn’t good for us and that it’s better to use whole milk even if restricting some fats from your diet, which we are doing. This person said that the process used to take fat out of milk is laced with many chemicals that make it harmful. I drink a cup a day along with other sources, for the calcium and vitamin D. Would you please clarify this for me? -- D.L.

ANSWER: I often read multiple opinions on health benefits and risks of foods, and sometimes one is completely opposite of another. When that happens, it’s usually because the science is unclear.

Milk contains protein, natural sugars and fat, along with natural calcium. The difference between whole, low-fat and fat-free has to do with the amount of milk fat, which is separated mechanically. Apart from vitamins A and D, chemicals are not added during the processing of milk.

Most experts believe, and most of the data supports, that large amounts of saturated fat contribute to the development of coronary heart disease. Milk contains about 65 percent saturated fat, and so avoiding excess fat makes sense. However, without fat, milk is sugar and a little protein, and sugar is being increasingly recognized itself as contributing to heart disease and other health problems.

My opinion is that milk, in any form, should be consumed in reasonable amounts, and that either skim or low-fat milk is probably less likely to contribute to heart disease than whole. At one cup a day, you should drink whatever milk you prefer.

DEAR DR. ROACH: I read your recent column about pancreatitis, which I have had twice. Both times, the cause was statins. Two percent of the population can get pancreatitis from statins.

I kept telling my physician that I don’t drink and don’t have a gallbladder, and therefore the problem had to be something else. She insisted that I drank or had gallstones.

Finally, our son called the company who makes Lipitor, and they confirmed that some people get pancreatitis from statins. Statins should be considered by every physician when there doesn’t seem to be another cause of pancreatitis. -- H.C.

ANSWER: Two percent of statin-treated patients getting pancreatitis sounded like a high number, so I looked up a recent review, which showed 204 cases of pancreatitis among participants in clinical trials on statins, but that was from among over 150,000 participants (a rate around 0.3 percent), and the group assigned to placebo had a higher incidence of pancreatitis than those taking statins. It is always important to consider drug treatment as a potential cause of any new side effect, but the risk for pancreatitis among statin users appears to be low.

DEAR DR. ROACH: I recently was diagnosed with osteoporosis of the spine (T score of -3). I am concerned about side effects of the medications available. I am in good health. What should I consider when selecting my option? Can medications be avoided and this be treated with vitamin D and calcium supplements? -- K.L.

ANSWER: A T-score of -3 means that your bone density is less than 0.3 percent of a healthy young woman’s, and this greatly increases your risk for developing a fracture. With a T score around -1, dietary and exercise changes are reasonable. However, with a T-score of -3, the standard of care would be to use specific medication in addition to ensuring adequate calcium and vitamin D. The choice of medication depends on your other medical issues, but might include a bisphosphonate, such as risedronate (Actonel) or denosumab (Prolia).

Health, Dr. Roach

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