Is skim milk better for cholesterol?

Not in the trials that have tested it. A network meta-analysis of 19 randomized trials in 1427 adults, at low certainty, found no harm to LDL cholesterol from either low-fat or full-fat dairy diets over 12 to 52 weeks. The only trial that put skimmed and whole milk head to head, half a liter a day for 3 weeks in 18 healthy adults, found no significant difference in total or LDL cholesterol. Milk fat is still saturated fat, and swapping it for a plant oil is where the LDL drop shows up.

Unsettled. Switching from whole to skim milk has not been shown to lower LDL cholesterol. The head to head trial found no significant difference, but it was tiny and short. Two meta-analyses of dairy trials found LDL unchanged with low-fat and with whole-fat dairy alike.

What the trials found

Skim against whole, directly

Eighteen healthy adults with normal cholesterol drank 17 fl oz (0.5 liters) a day of whole milk (3.5% fat) or skim milk (0.1% fat) on top of their usual diet, for two periods of 3 weeks each, and 17 finished. There were no significant differences between the two milks in total cholesterol, LDL, triglycerides, insulin or glucose. This is the only randomized trial we found that compares the two drinks, and it is far too small and short to settle the question on its own.

Dairy trials pooled

The network meta-analysis behind the lead pooled 19 trials in 1427 adults, mostly with overweight, obesity or metabolic syndrome, eating high-dairy diets for 12 to 52 weeks. Certainty was low, only one arm used full-fat dairy against seven low-fat arms, and 12 of the 19 trials were at least partly funded by the National Dairy Council or industry. An older meta-analysis of 20 trials in 1677 healthy adults, with searches up to April 2013, found extra dairy changed LDL by +1.36 mg/dL, with a 95% interval from -2.38 to 5.09, and the results were similar for low-fat and whole-fat dairy. The authors call most of those trials small and of modest quality.

Single trials point the same way. In 72 adults with metabolic syndrome, 3.3 servings a day of full-fat milk, yogurt and cheese for 12 weeks did not change fasting cholesterol against a low-dairy diet or a low-fat dairy one, though lipids were an exploratory outcome there. In 27 postmenopausal women with abdominal obesity, 3.2 servings a day of 2% milk for 6 weeks inside a prudent diet did not change LDL. In 180 healthy volunteers, advice to raise or cut dairy for 1 month, with the cutting group dropping dairy fat by 77%, did not change LDL or HDL. That last trial relied on self-reported intake.

Where an LDL drop does show up

Removing milk fat on its own has not moved LDL in these trials. When it is replaced by unsaturated plant fat, the numbers move. In 20 adults with high blood lipids, a diet whose fat came from rapeseed oil lowered LDL by 17% from baseline over 3 weeks, while the same diet with dairy fat changed nothing. Across a network meta-analysis of 54 trials, swapping butter for safflower, sunflower, rapeseed, olive or several other oils, or even beef fat, lowered LDL by 8.9 to 16 mg/dL (0.23 to 0.42 mmol/L) per 10% of energy exchanged. That evidence is about butter and solid fats, which matters when whole milk and cream supply a lot of your daily fat.

Changing the drink altogether moved LDL in one small pilot. Thirty-three young women drank 20 fl oz (600 ml) a day of oat drink or semi-skim milk for 4 weeks, and the oat drink lowered LDL by 15 mg/dL (0.4 mmol/L), with a 95% interval from -23 to -7.7 mg/dL (-0.6 to -0.2 mmol/L). The trial was open-label and short.

The reason milk fat is not off the hook is the long-term evidence on saturated fat as a whole. A Cochrane review of 11 trials in 53,300 people, of whom 8% had a cardiovascular event, found that cutting saturated fat lowered combined cardiovascular events by 21%, a risk ratio of 0.79 with a 95% interval from 0.66 to 0.93, on moderate-quality evidence. Skim milk carries almost none of that fat, and whole milk carries some. No trial has tested the milk swap against heart attacks or strokes.

Who should be careful

Young children are the clearest case where skim milk is the wrong default. The Dietary Guidelines for Americans 2025-2030 say full-fat dairy is important for children to meet energy needs and support brain development. A systematic review of 29 studies in children aged 2 to 18, mostly observational and with only 1 randomized trial, found whole-fat dairy mostly not linked to higher cardiometabolic risk.

If your LDL is already high, the trial that matters most here is the one in 20 adults with high blood lipids, and it compared dairy fat with rapeseed oil, not skim with whole milk. Nobody has tested skim against whole milk in people with high LDL or with familial hypercholesterolemia. Saturated fat limits still apply to whole milk: both WHO and the US guidelines put saturated fat at or below 10% of daily energy.

We found no evidence on skim milk and cholesterol in pregnancy or alongside cholesterol-lowering medicines, so this page cannot say anything specific about either.

Not for everyone. For children, full-fat dairy is the current US advice. For adults with high LDL or on cholesterol-lowering medicine, milk choice is one small piece of saturated fat intake, and it is worth discussing with the person treating you.

What expert bodies say

They disagree, openly. The American Heart Association's 2021 dietary guidance lists low-fat or fat-free dairy products among healthy protein sources. The Dietary Guidelines for Americans 2025-2030 say to include full-fat dairy with no added sugars, which reverses the previous edition. Both the US guidelines and WHO, in a strong recommendation, keep saturated fat at or below 10% of total energy for adults and children. The randomized dairy trials above, which found no LDL change from full-fat dairy, fit the newer advice. The saturated fat limit, which whole milk counts against, fits the older one.

How we searched

What would change this answer

• A larger, longer trial of skim against whole milk with LDL as the outcome. One is registered (NCT07087184), a crossover trial still recruiting. Until it reports, the direct evidence is one 3-week trial in 18 people.
• A trial in people with high LDL or familial hypercholesterolemia, who are the ones most often told to switch.
• Any trial of the milk swap that runs longer than a year or counts cardiovascular events. None of the dairy trials here does.
• Dairy trials without industry funding. Most of the pooled ones had some.

What a glass of skim milk contains is on the skim milk page. Milk in general is on its own cholesterol page, and how fats move cholesterol is on the dietary fat page.

Sources

1. ev-skmc-01 · Randomized controlled trial(s) · randomized controlled crossover trial · n = 18
   There were no significant differences between whole milk and skimmed milk in effects on total and LDL cholesterol, triacylglycerol, insulin, and glucose concentrations.
   
   Who: healthy adults; 0.5 L/day of whole milk (3.5% fat) or skim milk (0.1% fat) added to habitual diet, 2 x 3 weeks; 17 completed
   Effect: no significant difference in total or LDL cholesterol, triacylglycerol, insulin or glucose; HDL higher on whole milk (P < 0.05)
   Certainty: The only RCT found that compares skim and whole milk head to head; very small, short, normocholesterolemic adults; no_pmc.
   Eur J Clin Nutr, 2018 · checked 2026-10-07 · we read the abstract
2. ev-skmc-02 · Meta-analysis or systematic review · systematic review and network meta-analysis of RCTs, GRADE · n = 1427
   We observed no detrimental effects of a high-dairy (irrespective of fat content), low-fat dairy, or full-fat dairy diet over a control group (low in dairy) on LDL cholesterol, HDL cholesterol, and triglycerides (low certainty)
   
   Who: adults, mostly with overweight, obesity or metabolic syndrome, in RCTs of high-dairy diets (mostly 3 or more servings a day) vs low-dairy control, 12 to 51.6 weeks
   Effect: no detrimental effect of low-fat or full-fat dairy on LDL, HDL or triglycerides vs control (low certainty); full-fat dairy HDL MD +10 mg/dL (1.2 to 19; metric: 0.26 mmol/L, 0.03 to 0.49)
   Certainty: Low certainty; 7 low-fat arms, 1 full-fat arm; 12 of 19 trials at least partly funded by the National Dairy Council or industry. Not in PubMed corpus; passport from Europe PMC REST.
   Advances in Nutrition, 2023, Effects of Dairy Intake on Markers of Cardiometabolic Health in Adults: A Systematic Review with Network Meta-Analysis · checked 2026-10-07 · we read the fulltext
3. ev-skmc-03 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs · n = 1677
   Results were similar for studies with low-fat and whole-fat dairy interventions.
   
   Who: healthy adults randomized to increased dairy food for more than one month; median 26 weeks; mean +3.6 servings/day
   Effect: LDL +1.36 mg/dL (95% CI -2.38 to 5.09), HDL +0.45 mg/dL (-2.13 to 3.04), weight +1.3 lb (0.75 to 1.9; metric: 0.59 kg, 0.34 to 0.84); low-fat and whole-fat subgroups similar
   Certainty: Most trials small and of modest quality (authors); search to April 2013.
   PLoS One, 2013 · checked 2026-10-07 · we read the abstract
4. ev-skmc-04 · Randomized controlled trial(s) · randomized controlled trial, exploratory endpoints (NCT02663544) · n = 72
   In men and women with metabolic syndrome, a diet rich in full-fat dairy had no effects on fasting lipid profile or blood pressure compared with diets limited in dairy or rich in low-fat dairy.
   
   Who: men and women with metabolic syndrome; limited dairy, or 3.3 servings/day of low-fat or full-fat milk, yogurt and cheese for 12 weeks
   Effect: no intervention effect on total, LDL or HDL cholesterol or triglycerides (P > 0.1)
   Certainty: Lipids were exploratory outcomes; dairy mix, not milk alone.
   Am J Clin Nutr, 2021 · checked 2026-10-07 · we read the abstract
5. ev-skmc-05 · Randomized controlled trial(s) · randomized crossover trial · n = 27
   These data suggest that short-term consumption of low fat milk in the context of a prudent NCEP diet has no favorable nor deleterious effect on cardiometabolic risk factors associated with MetS in postmenopausal women with abdominal obesity.
   
   Who: postmenopausal women with abdominal obesity; NCEP diet with 3.2 servings/day of 2% fat milk vs NCEP diet without dairy, 2 x 6 weeks
   Effect: no significant effect on LDL-C, triglycerides or LDL size; HDL fall similar on both diets (between-diet P >= 0.07)
   Certainty: Reduced-fat (2%) milk inside a prudent diet with saturated fat held at 10% of energy; short.
   Nutr J, 2015 · checked 2026-10-07 · we read the abstract
6. ev-skmc-06 · Randomized controlled trial(s) · randomized controlled trial · n = 180
   In healthy volunteers, dietary advice to change dairy intake for 1 month did not have a clinically significant effect on cardio-metabolic risk factors.
   
   Who: healthy volunteers randomized to increase, reduce or not change dairy intake for 1 month; reduced group cut dairy fat by 77%
   Effect: no significant change in LDL or HDL cholesterol or triglycerides; standardized mean differences below 0.2
   Certainty: Advice-based, self-reported intake, only 1 month.
   Eur J Prev Cardiol, 2014 · checked 2026-10-07 · we read the abstract
7. ev-skmc-07 · Randomized controlled trial(s) · randomized controlled crossover trial · n = 20
   The RO diet, but not the DF diet, reduced the levels of serum cholesterol (-17%), triglycerides (-20%) and low-density lipoprotein cholesterol (-17%), cholesterol/high-density lipoprotein (HDL) cholesterol ratio (-21%), apolipoprotein (apo) B/apo A-I ratio (-4%) and factor VII coagulant activity (FVIIc) (-5%) from baseline.
   
   Who: free-living hyperlipidemic adults; isocaloric diets differing only in fat source (dairy fat vs rapeseed oil), 2 x 3 weeks
   Effect: rapeseed oil diet: total cholesterol -17%, triglycerides -20%, LDL -17% from baseline; dairy fat diet no change (between-diet P = 0.05 to < 0.0001)
   Certainty: Compares dairy fat with a plant oil, not skim with whole milk; shows what removing milk fat can do when it is replaced by unsaturated fat.
   J Intern Med, 2011 · checked 2026-10-07 · we read the abstract
8. ev-skmc-08 · Meta-analysis or systematic review · systematic review and network meta-analysis of RCTs · n = 54 trials
   Safflower, sunflower, rapeseed, flaxseed, corn, olive, soybean, palm, and coconut oil as well beef fat were more effective in reducing LDL-C (-0.42 to -0.23 mmol/l) as compared with butter.
   
   Who: adults in randomized trials of at least 3 weeks comparing oils and solid fats, per 10% isocaloric exchange
   Effect: LDL -16 to -8.9 mg/dL (-0.42 to -0.23 mmol/L) for safflower, sunflower, rapeseed, flaxseed, corn, olive, soybean, palm, coconut oil and beef fat vs butter
   Certainty: About butter, not liquid milk; relevant when whole milk or cream supplies a lot of daily fat.
   J Lipid Res, 2018 · checked 2026-10-07 · we read the abstract
9. ev-skmc-09 · Randomized controlled trial(s) · open-label pilot randomized controlled trial (NCT06764173) · n = 33
   In conclusion, these results indicate that replacing cow’s milk with oat drink may lead to modest reductions in total and LDL‑cholesterol over four weeks in healthy young women under real-world conditions.
   
   Who: healthy women aged 18 to 40 who habitually drink cow's milk; 600 mL/day oat drink vs 600 mL/day semi-skim milk for 4 weeks; 32 completed
   Effect: oat drink vs semi-skim milk: total cholesterol -12 mg/dL (-0.3 mmol/L), LDL -15 mg/dL (95% CI -23 to -7.7; p = 0.002; metric: -0.4 mmol/L, -0.6 to -0.2); no HDL or triglyceride difference
   Certainty: Pilot, open-label, small; shows that even lower-fat milk is not the most cholesterol-lowering drink.
   Nutr J, 2026 · checked 2026-10-07 · we read the abstract
10. ev-skmc-10 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = 53,300
    The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21% (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.66 to 0.93, 11 trials, 53,300 participants of whom 8% had a cardiovascular event, I² = 65%, GRADE moderate-quality evidence).
    
    Who: adults with or without cardiovascular disease in trials of at least 24 months reducing saturated fat
    Effect: combined cardiovascular events RR 0.79 (95% CI 0.66 to 0.93); 11 trials; moderate-quality evidence
    Certainty: About saturated fat from all sources; whole milk is one source, skim milk has almost none.
    Cochrane Database Syst Rev, 2020 · checked 2026-10-07 · we read the abstract
11. ev-skmc-11 · Observational data · systematic review, mostly prospective and cross-sectional observational studies · n = 29 articles
    Most evidence indicated that consumption of whole-fat dairy was not associated with increased cardiometabolic risk, although a change from whole-fat to reduced-fat dairy improved outcomes for some risk factors in 1 study.
    
    Who: children aged 2 to 18 years; whole-fat vs reduced-fat (low-fat and skim) dairy
    Effect: whole-fat dairy not associated with more adiposity; mostly not with cardiometabolic risk; a switch to reduced-fat improved some risk factors in 1 study
    Certainty: Mostly observational, no pooled numbers; questions the default advice to give children skim milk.
    Adv Nutr, 2020 · checked 2026-10-07 · we read the abstract
12. ev-skmc-12 · Position of an expert body · scientific statement of the American Heart Association · n = —
    choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms)
    
    Who: general population, cardiovascular prevention
    Effect: low-fat or fat-free dairy recommended
    Certainty: Disagrees with DGA 2025-2030 (full-fat dairy). Not in corpus; quote read twice via Europe PMC REST (EXT_ID and DOI queries); ahajournals.org returned 403.
    Circulation, 2021, 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association · checked 2026-10-07 · we read the abstract
13. ev-skmc-13 · Position of an expert body · national dietary guideline · n = —
    When consuming dairy, include full-fat dairy with no added sugars.
    
    Who: general US population
    Effect: recommends including full-fat dairy without added sugars
    Certainty: Reverses DGA 2020-2025 (low-fat or fat-free dairy) and disagrees with AHA 2021.
    Dietary Guidelines for Americans, 2025-2030 (HHS, USDA), January 2026 · checked 2026-10-07 · we read the section
14. ev-skmc-14 · Position of an expert body · national dietary guideline · n = —
    Full-fat dairy products are important for children to help meet energy needs and support brain development.
    
    Who: infants and toddlers, children
    Effect: full-fat dairy advised for children; whole milk from 12 months when formula stops
    Certainty: Skim milk as a default drink for young children runs against this; the UK NHS also advises against skim milk under 5 (nhs.uk not in trust.json, not carded).
    Dietary Guidelines for Americans, 2025-2030 (HHS, USDA), January 2026 · checked 2026-10-07 · we read the section
15. ev-skmc-15 · Position of an expert body · national dietary guideline · n = —
    In general, saturated fat consumption should not exceed 10% of total daily calories.
    
    Who: general US population
    Effect: saturated fat no more than 10% of total daily calories
    Certainty: The limit that whole milk counts against and skim milk barely touches.
    Dietary Guidelines for Americans, 2025-2030 (HHS, USDA), January 2026 · checked 2026-10-07 · we read the section
16. ev-skmc-16 · Position of an expert body · WHO guideline · n = —
    WHO recommends that adults and children reduce saturated fatty acid intake to 10% of total energy intake (strong recommendation).
    
    Who: adults and children
    Effect: SFA at most 10% of total energy (strong recommendation)
    Certainty: General limit on saturated fat; skim milk carries almost none.
    WHO, 2023, Saturated fatty acid and trans-fatty acid intake for adults and children: WHO guideline · checked 2026-10-07 · we read the section