Dairy products have picked up a bad rap in recent years. (And really, when was the last time you saw a grown-up down a glass of milk?) That’s likely because of several reasons: Dairy can be fatty. In fact, the type of fat found in whole-fat dairy products is saturated fat, which increases your risk of cardiovascular disease by damaging arteries and increasing the “bad” LDL cholesterol that clogs them up. Too much saturated fat also causes weight gain.

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What’s more, some people have a tough time digesting dairy. And it can be tricky to separate smart nutrition advice from propaganda given the dairy industry’s funding of government programs and dairy research.But believe it or not, dairy does pack an undeniable punch of bone-healthy nutrients. The key is to make informed choices when choosing your dairy.

For the Bones:
Back in 2000, a pair of University of Alabama scientists gathered all of the studies that had looked at the relationship between dairy consumption and bone health since 1985. There were 46 of them in total. Altogether, these studies told a confusing story. More than half of the studies were inconclusive as to whether dairy products actually help our bones.But Dennis Savaiano, Ph.D., a professor of nutrition science at Purdue University, notes that making direct correlations between our adult dairy consumption and our bone health can be tricky. “The problem,” he says, “is that bone health is a lifelong process. We know that, for example, in early adolescents and children, children who avoid milk before puberty already have lower bone densities in the United States. We know that we can use dairy to maximize bone density in children.”

However, as adults, there’s not a lot we can do to change our bone mass. It’s already been established. What dairy can help us do is maintain the bone mass we already have. “You want to make sure you get enough calcium to try to limit the loss of calcium as you grow into old age,” recommends Savaiano.

Technically, notes Robert Heaney, M.D., a clinical endocrinologist specializing in nutrition at Creighton University, you could get that calcium from other sources besides dairy. But that doesn’t come easy. Adds Savaiano: “Dairy becomes really the only easy dietary approach to getting enough calcium.” For example, he says, “Three cups of broccoli equals about one cup of milk. It’s a lot of broccoli.”

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Lactose Woes:
You might be thinking, “Great, so dairy is good for bones. But I can’t eat dairy.” Not so fast. Your stomach can likely handle dairy products better than you think, says Dr. Heaney. “The milk sugar called lactose can’t be digested by the natural enzymes in a portion of the population,” he explains. “They lack that enzyme once they become adults. That’s true to a certain extent for all of us.” But, he says, most people can regain that lactose-digesting enzyme, called lactase.

“If you eat dairy on a regular basis,” he says, “the intestinal bacteria will develop the lactase that your own intestine lacks. That can happen over a period as short as two weeks.” Heaney recommends re-exposing yourself to milk slowly, by drinking just a little bit more every day. Though it may feel unpleasant at first, Heaney says the vast majority of people who try this tactic succeed in being able to comfortably consume dairy.

“The bacteria in your colon have a tremendous ability to adapt,” Savaiano says. “If you feed them milk, they learn to adapt sufficiently.” Savaiano himself sometimes has trouble with digesting certain foods, so he’s conscientious about his dairy. “What I do personally,” he says, “is I will have half a cup to a cup of milk, usually in the morning, usually over oatmeal. Then during the day I’ll have some other kind of dairy, usually hard cheese or yogurt. Then at dinner I’ll have another eight ounces of milk or so.”

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Yogurt can be a godsend for those who have trouble with dairy. “Yogurts are like taking a lactase pill with a glass of milk,” Savaiano says. “The bacteria in yogurt have a very high level of lactase. So when you eat yogurt, you’re eating an enzyme that helps digest it.” Greek yogurt, he adds, is lower in that sometimes-problematic milk sugar lactose, so can be even easier to digest. But, he adds, it’s also lower in calcium. Hard cheeses are also low in lactose.Despite the evidence that most people can build up a tolerance to dairy, a small percentage of people simply can’t. “They’ll have to resort to some other foods to make sure they get the nutrients that they need,” says Shivani Sahni, Ph.D., an assistant scientist at the Institute for Aging Research, a non-profit organization for gerontology and geriatric research, and an instructor at Harvard Medical School. Sahni recommends green leafy vegetables, such as collard greens and bok choy. “Beans and tofu also have some level of calcium,” she says.

Although calcium-fortified soy may sound like a good option, Heaney has this to say about the beverage: “The calcium that’s added to soy milk settles into the bottom of the carton and most people don’t get it at all. It takes a hardware store paint shaker to re-suspend that sludge at the bottom. Soy beverage is a good food, but it’s not a substitute for dairy.”

The Deal on Different Types of Dairy:
But before you reach for that pint of ice cream or half-and-half to bolster your bones, know that not all dairy is created equal. Case in point: “If you really look at the nutritional profile of these dairy foods, cream stands apart,” points out Sahni. “Cream has higher levels of saturated fatty acids and low levels of bone-specific nutrients like calcium and vitamin D.”

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Sahni recently completed a study that looked at the dietary questionnaires and bone mineral density charts of over 2,500 people. Sahni found that people who reported more milk and yogurt consumption had on average higher bone mineral density in their hips. But cheese and cream consumption didn’t seem to help bone mineral density. In fact, consuming cream correlated with lower bone mineral density at the neck of the femur bone, a part of the hip that’s susceptible to fracture.What’s more, since whole-fat dairy is higher in artery-damaging saturated fat, it’s important to go with non-fat or low-fat dairy choices. You’ll cut the fat without losing any calcium, which is a win-win in our book.

Meeting Those Calcium Requirements:
There’s no question that you can maintain bone health without dairy, but low- and non-fat milk products typically provide an easier path to bone-building calcium. It’s always a good idea to talk with your doctor if you believe you have a true milk allergy, but most people who have had trouble with milk products can ease back into eating them. Choose low-lactose products such as yogurt and hard cheese to make digestion easier. Go easy on cream-based dairy such as ice cream and creamy cheeses, since they’re not really going to do you any favors. And if you really can’t digest milk products, make sure you get enough calcium from other sources, such as green leafy vegetables and calcium-fortified orange juice.

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