Buttermilk vs. Milk — Health Impact and Nutrition Comparison

Calories

Low-fat milk and low-fat buttermilk are both low-calorie foods.

Milk is only a little higher in calories when compared to low-fat buttermilk. A 100g of milk contains 42 calories, whereas buttermilk has 40.

Protein and Fats

Milk and buttermilk are very similar in their fat and protein contents as well; however, milk is a little higher in both.

They are also very alike in protein and fat compositions. Both contain appreciable amounts of all essential amino acids.

In milk and buttermilk, the predominant fat type is saturated fatty acids, followed by monounsaturated and then polyunsaturated fatty acids.

Buttermilk is lower in cholesterol.

Carbohydrates

Milk is also a little higher in carbohydrates. Both do not contain dietary fiber. Most of the sugars are made up of lactose.

Cardiovascular Health

A study concluded that dairy consumption was associated with lower mortality risk and major cardiovascular disease events (6).

Another research summarised that while full-fat dairy products did not increase heart disease risk, they did not decrease it either (7).

Regarding the concerns about high calcium intake, one study found that a high intake of milk, and therefore calcium, does not increase the risk of acute myocardial infarctions (8).

Several peptides found in milk and buttermilk inhibit angiotensin-converting enzyme (ACE), so these peptides require special attention (9.10.11). These biopeptides may reduce arterial blood pressure by inhibiting the action of the ACE; ACE-inhibitor medications (Captopril, Lisinopril, etc.) also work by activating this similar mechanism; according to ESC’s (European Society of Cardiology) guidelines, these drugs are considered the drugs of first-line (first choice) in the treatment of hypertension (12).

Milk polar lipids, found in buttermilk, can improve cardiometabolic health by lowering several lipid cardiovascular markers, mainly through reducing cholesterol absorption from the intestines (13). Consumption of buttermilk reduces levels of cholesterol and triglycerides in the blood (14).

Diabetes

Milk and buttermilk are both low glycemic index foods.

Higher intake of whole fat, but not low-fat, dairy has been associated with a decreased risk of metabolic syndrome and most of its component factors, as well as a lower risk of diabetes and hypertension (15).

Another study found a neutral or a moderate inverse correlation between dairy consumption and the risk of type 2 diabetes mellitus (16.17).

Fermented dairy products, such as buttermilk, were linked to lower fasting plasma glucose and hemoglobin A1C. Overall, there is a strong and relatively consistent body of accumulating evidence indicating that dairy products may significantly reduce the risk of type 2 diabetes and likely in a dose-response manner (18).

Cancer

Studies have shown an inverse association between milk consumption and colorectal and bladder cancer risk. However, due to the high calcium levels, milk may also increase the risk of prostate cancer (19).

The intake of fermented dairy products, such as buttermilk, has significantly decreased the risk of bladder cancer, colorectal cancer, and esophageal cancer (20).

Buttermilk is a rich source of a compound called milk fat globule membrane that has been studied to have selective antiproliferative effects on cancer cells (21).

Bone health

Milk (and milk products) can contribute significantly to the daily intake of several of the "milk minerals," particularly calcium and phosphorus. A variety of milk minerals' have been shown to have key roles in bone metabolism and bone mass. However, the evidence for bone benefits from increased mineral intake is mostly based on data from human trials that used diverse forms of the mineral, not simply milk-based versions (22).

Preventing bone loss is a major concern for women during the menopause and post-menopausal stages. According to endocrinology guidelines, up to 20% of bone loss can occur throughout these stages, and osteoporosis affects nearly one in every ten women over the age of 60 worldwide (23). 

Other hormones that influence bone health include vitamin D and calcium. Calcium absorption is aided by vitamin D. Without enough vitamin D and calcium, bones may not grow properly as a child and may lose mass, become weak, and easily break as an adult. Even if you consume enough calcium, your body will not absorb it if you do not consume enough vitamin D.

Lactose Intolerance

Section reviewed by gastroenterologist Arpi Gasparyan

Lactose intolerance is a disorder during which the sugar lactose does not get absorbed or digested through the intestines. Symptoms may appear within a few hours of consuming lactose-containing foods and include bloating, gas, diarrhea, nausea, and abdominal pain.

The primary sugar found in both milk and buttermilk is lactose. Therefore, people with lactose intolerance should refrain from using these products. Milk is higher in sugars and, consequently, lactose compared to buttermilk.

Diabetes

In contrast to the studies mentioned above, one research found that high dairy consumption may be associated with lower insulin sensitivity and, therefore, greater insulin resistance, potentially increasing the risk of type 2 diabetes (24).

Cancer

Several studies have concluded that milk consumption has no association with an increased breast cancer risk. However, one study found high milk intake to be linked to an elevated risk of breast cancer (25).

High consumption of whole milk may also increase the risk of prostate and ovarian cancer (26).