Yogurt

Uses of Yogurt

Yogurt provides a dietary source of calcium and protein, as well as folic acid, magnesium, and zinc. There is limited clinical information regarding its benefits in lipid regulation and cardiovascular disease. Despite debate regarding the role of exogenous calcium in the prevention of osteoporosis, yogurt remains a recommended source of calcium. It is commonly used as a source of probiotics.

Yogurt Dosing

In addition to its widespread use as a food, yogurt has been studied in clinical trials in amounts of 100 to 200 g/day.

Contraindications

The use of yogurt containing live cultures (probiotic) is not advised in patients at risk for opportunistic infections or in those with badly damaged GI tracts.

Pregnancy/Lactation

Generally recognized as safe when used as a food.

Yogurt Interactions

None well documented.

Yogurt Adverse Reactions

Yogurt is not associated with any clinically important adverse events.

Toxicology

No data.

Yogurt is the general term for a fermented, slightly acidic milk product that contains essentially no alcohol. Most commonly, it is fermented by the addition of live cultures of Streptococcus thermophilus or Lactobacillus bulgaricus to heated whole or skimmed cow's milk. 1

Yogurt to which cultures of Lactobacillus acidophilus are added is termed acidophilus milk.

Yogurt Uses and Pharmacology

Yogurt provides a dietary source of protein, calcium, folic acid, 2 magnesium, potassium, and zinc ions. 3 , 4 Most authorities consider yogurt, either pasteurized or live culture, to be a viable option as a source of dietary calcium and protein in lactose-intolerant people; however, controversy still exists. 4 , 5 , 6 , 7 , 8 , 9 , 10 Yogurt increases zinc bioavailability with no effect on iron bioavailability. 7 , 11

Osteoporosis

In a randomized, open-label trial with 29 menopausal women, the addition of yogurt to the diet significantly reduced N-telopeptide excretion, a marker of bone resorption. 12 Despite the debate that exists regarding the role of exogenous calcium in the prevention of osteoporosis, yogurt remains a recommended source of calcium. 7 , 13

Cancer

Yogurt has a protective effect against some cancers in laboratory experiments, but convincing human data are not available. Both cultured and pasteurized yogurts are considered active. 3 , 14 , 15

Conflicting epidemiological data exist concerning the role of dairy products, including yogurt, when treating patients with increased risk of prostate cancer. 16 , 17

Cardiovascular and lipid-lowering effects

Yogurt enhanced the effects of a moderate, energy-restricted diet in 38 obese people. Fat loss was augmented and central adiposity reduced in a randomized, open-label trial. Enhanced calcium intake was proposed as the mechanism for this effect. 18 Older metabolic studies have demonstrated a cholesterol-lowering effect. 19 , 20

Epidemiological studies suggest yogurt has a protective effect against coronary heart disease and elevated blood pressure. 21 , 22

Yogurt as a probiotic

Yogurt to which live cultures have been added, commonly called probiotic, is widely available. Uses of yogurt as a probiotic include treatment of antibiotic-associated diarrhea, acute/infectious diarrhea, vaginosis, immunity/allergy, and respiratory and urinary tract infections. For a discussion specifically on such cultured yogurts, see the Probiotics monograph.

Dosage

In addition to its widespread use as a food, yogurt has been studied in clinical trials in amounts of 100 to 200 g/day. 5 , 6 , 11 , 18 , 22

Pregnancy/Lactation

Generally recognized as safe when used as a food.

Interactions

None well documented. Yogurt does not affect iron bioavailability. 7 , 11

Adverse Reactions

The use of yogurt as a probiotic is considered relatively safe, but caution is advised in patients at risk for opportunistic infections and in those with badly damaged GI tracts. 22

Toxicology

No data.

Bibliography

1. Meydani SN , Ha WK . Immunologic effects of yogurt . Am J Clin Nutr . 2000;71:861-872.
2. Forssén MA , Jägerstad MI , Wigertz K , Witthöft CM . Folates and dairy products: a critical update . Am J Clin Nutr . 2000;19:100S-110S.
3. Perdigón G , de Moreno de LeBlanc A , Valdez J , Rachid M . Role of yoghurt in the prevention of colon cancer . Eur J Clin Nutr . 2002;56:S65-S68.
4. Yogurt an excellent source of calcium and protein . AORN Journal . 2001;74:729.
5. Shermak MA , Saavedra JM , Jackson TL , Huang SS , Bayless TM , Perman JA . Effect of yogurt on symptoms and kinetics of hydrogen production in lactose-malabsorbing children . Am J Clin Nutr . 1995;62:1003-1006.
6. Arrigoni E , Marteau P , Briet F , Pochart P , Rambaud JC , Messing B . Tolerance and absorption of lactose from milk and yogurt during short-bowel syndrome in humans . Am J Clin Nutr . 1994;60:926-929.
7. Murray TM . Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada . CMAJ . 1996;155:935-939.
8. Lin MY , Yen CL , Chen SH . Management of lactose maldigestion by consuming milk containing lactobacilli . Dig Dis Sci . 1998;43:133-137.
9. Saltzman JR , Russell RM , Golner B , Barakat S , Dallal GE , Goldin BR . A randomized trial of Lactobacillus acidophilus BG2FO4 to treat lactose intolerance . Am J Clin Nutr . 1999;69:140-146.
10. Pelletier X , Laure-Boussuge S , Donazzolo Y . Hydrogen excretion upon ingestion of dairy products in lactose-intolerant male subjects: importance of the live flora . Eur J Clin Nutr . 2001;55:509-512.
11. Rosado JL , Diaz M , González K , Griffin I , Abrams SA , Preciado R . The addition of milk or yogurt to a plant-based diet increases zinc bioavailability but does not affect iron bioavailability in women . J Nutr . 2005;135:465-468.
12. Heaney RP , Rafferty K , Dowell MS . Effect of yogurt on a urinary marker of bone resorption in postmenopausal women . J Am Diet Assoc . 2002;102:1672-1674.
13. Weinsier RL , Krumdieck CL . Dairy foods and bone health: examination of the evidence . Am J Clin Nutr . 2000;72:681-689.
14. Le MG , Moulton LH , Hill C , Kramar A . Consumption of dairy produce and alcohol in a case-control study of breast cancer . J Natl Cancer Inst . 1986;77:633-636.
15. Kampman E , van 't Veer P , Hiddink GJ , van Aken-Schneijder P , Kok FJ , Hermus RJ . Fermented dairy products, dietary calcium and colon cancer: a case-control study in The Netherlands . Int J Cancer . 1994;59:170-176.
16. Kesse E , Bertrais S , Astorg P , et al. Dairy products, calcium and phosphorus intake, and the risk of prostate cancer: results of the French prospective SU.VI.MAX study . Br J Nutr . 2006;95:539-545.
17. Hedlund TE , Maroni PD , Ferucci PG , et al. Long-term dietary habits affect soy isoflavone metabolism and accumulation in prostatic fluid in caucasian men . J Nutr . 2005;135:1400-1406.
18. Zemel MB , Richards J , Mathis S , Milstead A , Gebhardt L , Silva E . Dairy augmentation of total and central fat loss in obese subjects . Int J Obes . 2005;29:391-397.
19. Hepner G , Fried R , St Jeor S , Fusetti L , Morin R . Hypocholesterolemic effect of yogurt and milk . Am J Clin Nutr . 1979;32:19-24.
20. Thakur CP , Jha AN . Influence of milk, yoghurt and calcium on cholesterol-induced atherosclerosis in rabbits . Atherosclerosis . 1981;39:211-215.
21. Massey LK . Dairy food consumption, blood pressure and stroke . J Nutr . 2001;131:1875-1878.
22. Tavani A , Gallus S , Negri E , La Vecchia C . Milk, dairy products, and coronary heart disease . J Epidemiol Community Health . 2002;56:471-472.

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