MILK: Friend or Foe?

by Neil Nedley, M.D., taken from his book Proof Positive

It was an unusual conflict. The antagonists represented two groups that usually try to work together. On one side were members of the medical research community, and on the other was a major player in American big business. What exactly was going on? Scientific community members through their research publications were, in effect, taking to task the forces of the American Dairy Association. The clear contention of their medical research was that the Association was engaging in misleading advertising by using the slogan “Everybody needs milk.” When the Federal Trade Commission looked into the matter, they came to a surprising conclusion: they agreed solidly with the researchers and issued a “proposed complaint” citing that the slogan “Everybody needs milk” represented false, misleading, and deceptive advertising.1

This FTC judgment in 1974 called attention to a consistent strategy of the dairy industry: devise marketing slogans and approaches that impress people with the healthfulness and desirability of milk products. Some of these slogans, often accompanied by an attractive athlete or a beautiful person with a white rim at their upper lip, are summarized in Figure 1: Slogans of the American Dairy Industry.2

It is one thing to try to awaken a desire for a service or product—after all, that is the basis of most advertising that bombards us from day to day. But it is quite another thing to pass something off as health giving if it really is not. In view of this, the 1974 decision of the Federal Trade Commission raised a very important issue. Why would the government step into the fray and disallow a claim that most Americans accept? Whether it is today’s U.S. Department of Agriculture’s Food Guide Pyramid or the four food groups of yesteryear, the implication for decades has been that all Americans do indeed need milk. What, then, could have prompted the FTC to object to the dairy industry’s saying that “everybody needs milk”? The answer to the question forms the basis for this chapter. Immediately after the 1974 decision, the dairy industry changed their slogan to “Milk Has Something for Everybody.” Although no one challenged the accuracy of that slogan, the real question is: do you really want that “something”?

Some may feel that merely suggesting that there may be problems associated with milk and dairy products is almost un-American. This chapter is not promoting a new smear campaign. I am merely pointing out that a little-known FTC complaint against the dairy industry over 20 years ago eloquently argues that every American should become well acquainted with the medical facts regarding milk. After all, good health is not based on following our preconceived ideas or cultivated preferences—it is based on cooperating with the laws of health that govern us. It thus behooves every American to put sentiments aside and look seriously at why the U.S. government would reject the statement that “everybody needs milk.” We deserve to be able to make an intelligent decision regarding our personal use of milk and milk products.

The message that will emerge clearly in this chapter is that medical experts have known about health problems with milk for decades, but these concerns have not received much publicity. We need to recognize that it is very difficult for preventive medicine messages to be heard clearly when powerful commercial interests are putting millions of dollars behind promulgating a message of half-truths.

The Power of the Dairy Association

The magnitude of the dairy industry’s influence on the sale of their products and the political scene in the U.S. is enormous, as shown in Figure 2: Impact of the Dairy Industry in the U.S. Few of us are aware that 14 percent of the U.S. food budget is spent on dairy products,3 providing an average of more than one and a half pounds per day of these products per person.4 With such an immense sales volume, it is no wonder that the American Dairy Association is a powerful and well-financed organization. A large portion of their dairy revenue is strategically channeled into a huge advertising budget dedicated to a variety of milk promotionals.5 This is why you see so many dairy ads on television, radio, and in print. Furthermore, the ADA holds a considerable amount of political clout in Washington. Some attribute this to its patterns of political support that is secured by providing election campaign funds to as many as 15 percent of U.S. congressional representatives.6

Infants Need Their Mothers' Antibodies
Scientific research began turning up problems with milk as far back as 1930, when infant death rates were examined in relation to the use of cow’s milk. Prior to the discovery of antibiotics, researchers studied 20,000 infants in Chicago. One group of infants was fed human breast milk and the other group was fed boiled cow’s milk. The results are shown in Figure 3: High Infant Death Rates from Cow's Milk.7, 8

A pediatrician’s standard medical textbook today will state that in the current era of improved medical treatment, breast-feeding is unlikely to provide a survival benefit. However, it still acknowledges that there are situations where it can save infants’ lives. One textbook states, “Although little if any difference exists in mortality rates in formula-fed and breast-fed infants receiving good care, among the lower socioeconomic groups and those living in unsanitary conditions, the breast-fed infant is more likely to survive.”9 Regardless of living conditions and the available drugs, an infant’s immune system is compromised by feeding it cow’s milk rather than human milk. Studies today still favor breast feeding over infant formula or cow’s milk feeding.10, 11, 12 For instance, even in the era of antibiotics in the United States, infants fed formula or cow’s milk are 80 percent more likely to develop diarrhea and 70 percent more likely to develop ear infections when compared with infants who are exclusively breast fed.13

What is it about human breast milk that provides infants with such an advantage in terms of immunity? We probably still do not know all the answers, but several important factors are clear. They are listed in Figure 4: Known Advantages of Breast Feeding.

The first advantage of human milk is that it provides a child with the mother’s antibodies, and those antibodies are very protective when it comes to infectious illnesses.14 Conversely, cow’s milk or infant formula is devoid of these protective agents. Second, white blood cells called macrophages can be passed from mother to child through breast milk.15 These macrophages may be able to provide useful immune functions while in the child’s intestinal system. Third, breast milk contains a compound called lactoferrin. This agent tends to block the growth of E. Coli in the intestine.16 This is no small matter today when many are well aware of the deadly E. Coli strains that have claimed the lives of young children. Fourth, breast milk is usually sterile (except when a mother has a breast infection or widespread bodily infection). This can significantly decrease the child’s exposure to infectious agents. On the other hand, cow’s milk is described as being “regularly contaminated” as well as being a “good culture medium” (place to grow) for dangerous infectious agents,17 as we shall see.

Other Advantages of Breast Milk

Human milk is also different from many mammalian milks because of its relatively low content of phosphorous. As I point out in Chapter 7 on protein, phosphorus appears to make calcium absorption more difficult. Thus, a child will tend to absorb more calcium from Mom’s low phosphorus milk than from phosphorus-rich cow’s milk, as explained in Figure 5: Low Absorption of Calcium from Milk.18

Furthermore, high phosphorus intake presents other problems that human milk also avoids. Some of these benefits may further explain why breast-fed infants fare better in the face of infections.19 First, on a lower phosphorus diet children have more acidic colon contents, thus making it difficult for disease-producing germs to grow in the intestine. Secondly, newborns that are on a lower phosphorus breast milk regimen are less likely to come down with a severe complication of infection called metabolic acidosis.

Beyond the prevention of infection, breast milk has a number of additional benefits. The fat from breast milk is much more easily digested than the fat from cow’s milk.20 Although fat may get a bad rap on today’s commercials and talk shows, it is a critical ingredient for early childhood development. Cow’s milk is also deficient in Vitamins C and D, whereas breast milk generally gives sufficient quantities of these two essential nutrients.21

Lactose (Milk Sugar) Intolerance
American humanitarian aid backfired several years ago when our nation attempted to help certain South American countries. We distributed large quantities of powdered milk that resulted in widespread cases of cramping and diarrhea.22 Cow’s milk is rich in a simple sugar called lactose, or “milk sugar.” However, after infancy, many people lose their ability to digest lactose. They develop an insufficiency of the enzyme lactase that is needed to break down lactose into two simpler sugars so that it can be absorbed. The result is that undigested lactose travels to the large intestine where bacteria break this sugar down, producing anything from gas, to cramps, to diarrhea. Lactose intolerance appears to be the main factor in as many as a third of cases of recurrent abdominal pain in children.23

Well over half the world’s population is lactose-intolerant.24 Some races tend to lose the lactase enzyme earlier in life than others. As a rule, individuals of northwestern European descent maintain their ability to digest lactose better than most races, such that a greater proportion of them are able to drink milk into adulthood without untoward intestinal effects. The frequency of lactase deficiency among different races is listed in Figure 6: Lactase Deficiency in Adults.25, 26, 27

Broad Extent of Health Problems with Cow's Milk
The late Dr. Frank Oski was head of the Johns Hopkins Children’s Medical and Surgery Center for 10 years and professor of pediatrics and department chairman at Johns Hopkins University. He was editor and founder of the journal Contemporary Pediatrics and was a member of the editorial board for The European Journal of Pediatric Hematology and Oncology. He authored or co-authored 300 academic papers and 20 books, including the recently published The Practical Pediatrician. He was not only a credible scientist, but was also one of the most vocal advocates of the dangers of cow’s milk. Dr. Oski wrote the well-documented and very readable book, Don’t Drink Your Milk. Perhaps one of the greatest contributions of his book is its demonstration of the broad extent of health problems linked with milk drinking. From his book and other sources, I have drawn up a list of my 10 major concerns with the childhood health effects of cow’s milk. Six adult health concerns related to cow’s milk are listed and examined later in the chapter. The childhood concerns are listed in Figure 7: Major Childhood Health Concerns Related to Using Cow's Milk.

Milk Allergies
First on the list is allergies. Allergies and asthma are on a dramatic rise in America. Infants not exposed to cow’s milk develop far fewer allergies compared to those being fed cow’s milk.28 Human milk may help prevent the development of allergic diseases later in life by boosting an infant’s immune system.29

Not only is human milk beneficial to a child’s immune system, it also avoids what is probably the most common allergen in a child’s diet—namely, cow’s milk. Nelson’s Textbook of Pediatrics is quite clear on this relationship: “Most attention has focused on cow’s milk protein as the major cause of gastrointestinal food allergy in infants.”30 Allergies are common in children and food allergies are no exception. Estimates of the number of children affected are difficult to ascertain, since many may have minor symptoms that do not come to medical attention. However, one study in Sweden estimated that as many as 1 in every 70 children suffers from food allergy.31 Other statistics indicate an even more prevalent problem in certain age groups. Actual milk or casein (milk protein) allergies can manifest themselves in several ways. These symptoms include mouth ulcers, diarrhea or constipation,32 rectal bleeding, vomiting, recurrent attacks of nasal congestion, skin rash, and recurrent bronchitis.33, 34, 35, 36 One of the major treatments for childhood food allergies is a period of cow’s milk abstinence. If the allergy is due to cow’s milk, acute symptoms are usually gone within two days, while chronic problems may last a week or longer.37 For their child to get well, some mothers who are breast feeding may also need to eliminate cow’s milk from their own diets. Apparently, cow’s milk protein ingested by the mother can make its way into her own milk supply.38

The bane of many a young parent’s life is colic. “Colic” refers to episodes of extreme abdominal pain in infants. The attacks typically occur without warning and may last for hours; they are often accompanied by continuous crying.39 Infantile colic occurs in about 20 percent of all infants. Studies indicate that in about one-third of breast-fed infants with colic, the symptoms disappeared when the mother adopts a diet free of cow’s milk.40 This lends further evidence to the concept that at least some cases of colic are due to an allergic reaction to cow’s milk constituents.

Iron-Deficiency Anemia
Iron-deficiency anemia can also result from an intolerance to cow’s milk proteins.41, 42 In fact, when you look at all U.S. cases of severe iron deficiency in infants, as many as one- third of them have blood loss due to exposure to a protein in whole cow’s milk.43 Exposure to this protein results in sloughing off of the intestinal lining cells, causing small amounts of bleeding. When blood is lost, iron (a constituent of blood) is lost as well. Problems are compounded because cow’s milk does little to help replace iron loss. It has only about one fifth the amount of iron found in human milk.44

Lowered Intelligence

The prestigious American Academy of Pediatrics recently enunciated one of the most sobering messages regarding iron deficiency: “iron deficiency in early childhood may lead to long-term changes in behavior that may not be reversed even with iron supplementation sufficient to correct the anemia.”45 For example, premature infants who were raised on formula or cow’s milk have an eight to ten point lower IQ than breast-fed preemies.46, 47 Other factors besides iron deficiency are involved in cow’s milk-related intellectual impairment. Dr. Crook lists “learning difficulties” among the manifestations of milk allergy.48 Still another reason for lowered intelligence may be due in part to the lack of omega-3 fats in cow’s milk and cow’s milk-based formula.49, 50, 51 These fats appear to be necessary for optimal brain growth and development.

"Milk Sensitivities"
One of the most hotly contested areas in medicine is the domain of allergies and sensitivities. Regarding dairy foods, some physicians insist that there are forms of milk intolerance that are not true allergies, but still contribute to a broad range of physical ills. They refer to these disorders collectively as “milk sensitivities.” The problem with the alleged milk sensitivities is that they are believed to contribute to relatively common conditions, conditions that are often related to multiple factors. It can therefore be difficult to pinpoint milk as the guilty culprit. Some of the conditions found in the medical literature include chronic fatigue syndrome,52 tension headaches,53 musculoskeletal pain,54 hyperactivity,55 and even bedwetting.56 For reference purposes, this list of disorders along with two more is repeated in Figure 8: "Milk Sensitivity" Disorders.

I think the most constructive way to look at this area is to be open to the possibility that some of these common conditions may—in certain situations—be related, at least in part, to milk ingestion. By no means would I imply that milk is the sole cause or major cause of these problems. However, this information is in the medical literature, and a trial of a month without any dairy products is considered a worthwhile experiment for most people —particularly if they are having significant problems with their health.

Although many physicians may be skeptical of these milk sensitivity associations, I have had enough real-life experiences to cause me to be very open to the possibility that dairy food allergies can have a role in more conditions than we would normally imagine. For example, as an Internal Medicine specialist who usually deals with adults, I personally have seen a number of children, mostly boys, who were still bedwetting at eight or ten years old. Upon discontinuing the use of dairy products, their bedwetting ceased.

Another big concern in the area of milk sensitivity is its contribution to respiratory problems. I have already mentioned that a full-blown dairy food allergy can aggravate respiratory disorders, but now I am referring to individuals who have symptoms that cannot be explained by their immune system’s responses to cow’s milk. For some reason, dairy consumption seems related in some children to mucus production, coughs, and lung disorders. Nelson’s Textbook of Pediatricspoints out that X-ray lung abnormalities called “pulmonary infiltrates” have been related to cow’s milk.57 The text also lists a serious lung condition called “pulmonary hemosiderosis” as sometimes being reversed by removing dairy products from a child’s diet.58 It is interesting that some of the children with this rare lung disorder also have a chronic runny nose, recurrent ear infections, and chronically enlarged lymph tissue in their nose and throat.59 All of this raises a serious question: could a significant number of children with chronic ear, nose, and throat problems have dairy food sensitivity—even though they have not developed devastating lung problems? Many physicians would answer unequivocally, “yes.”

Early Atherosclerosis from Milk?
Evidence suggests that oxidized cholesterol has a role in beginning or worsening the artery-narrowing process called atherosclerosis. If foods containing cholesterol are exposed to air, the cholesterol can oxidize (combine with oxygen), which makes it more damaging to arteries. Whole milk and particularly powdered whole milk-based formulas meet these criteria, and provide an ideal setting for cholesterol oxidation. More information on cholesterol oxidation is presented in Chapter 3 on heart disease. Children may be getting an early start toward death from America’s leading killer by ingesting cow’s milk preparations. On the other hand, when a child consumes cholesterol from the mother’s breast milk, it flows directly from the nipple to the child’s mouth. There is considerably less opportunity for oxidation to occur. In fact, when comparisons are made between countries regarding heart disease and dietary items consumed, dairy products emerge as the most reliable food indicator for predicting the rate of heart disease.60, 61, 62, 63

Juvenile Diabetes and Cow's Milk

Cow’s milk may trigger diabetes in genetically susceptible children. A growing number of scientific papers suggest this relationship. Researchers have now uncovered cow’s milk proteins that resemble proteins found on the surface of the beta cells of the pancreas. The technical names of two of the implicated milk proteins are ABBOS (a fraction of bovine serum albumin),64 and beta casein.65 The research suggests that a genetically susceptible child may begin to make antibodies against one of these or other milk proteins. Those antibodies may then attack look-alike proteins on the beta cells of the pancreas. Beta cells are the insulin factories of the body. If the immune system destroys them, diabetes results. Dr. Karjalainem, an author of one of the studies, said, “We may have uncovered a wonderful strategy to prevent Type I diabetes. If we are right, it may be the beginning of the end of this terrible disease.” Of course, that would mean eliminating cow’s milk from the diets of all susceptible individuals.

Acne and Milk

Acne is a well-known major concern of adolescence. Although for years, mothers have dispensed free dietary advice to their children to control this problem, most physicians have moved to a medication approach and rarely, if ever, advocate dietary change. Nonetheless, research indicates that diet plays some role. Certain fats (with medium chain lengths of 8 to 14 carbons) are identified by Nelson’s text as a “minor provocatory factor.”66 The same source mentions that fat may have a role in the formation of blackheads.

Although most people do not think of milk as a high fat food, about 50 percent of the calories in whole milk come from fat.67 Many cheeses are higher than that; some, like cream cheeses, approach 90 percent of their calories from fat.68 (Of note, 15 to 20 percent of the fat calories in dairy products are generally from the implicated medium chain fats of 8 to 14 carbons in chain length).69 Whether it is because of this fat connection or for other reasons, Dr. Frank Oski reported that acne often clears up when milk is discontinued.70

Oski seemed to favor an explanation apart from fat for the diet-acne link. Significant portions of milk cows are pregnant and thus give off progesterone in their milk. Oski’s argument was that the progesterone is converted into male sex hormones (androgens) which in turn increase acne.71

Rheumatoid Arthritis, Dental Decay, and Infectious Diseases
Some cases of the crippling form of joint disease known as juvenile rheumatoid arthritis may be related to dairy use.72 Other reports implicate milk products as a risk factor for some forms of dental decay.73 Infectious diseases, however, are some of the greatest risks to a child’s health that can result from dairy foods. We will take a further look at this subject later in the chapter.

Adult Dairy Food Diseases
Having looked at my major concerns with the health effects of milk in children, we shall now look in detail at serious dairy-linked diseases that are usually manifest in adulthood. The six conditions that I am most concerned about are listed in Figure 9: Major Adult Health Concerns Related to Using Cow's Milk.

Coronary Artery Disease

Most individuals who are either trying to prevent or reverse coronary artery disease have the impression that skim milk and one percent fat milk are good options. However, the program in a 1990 study that gave the very best resultsin treating heart disease with lifestyle changes essentially removed milk from the diet.74 The same concerns previously mentioned in the chapter regarding oxidation of cholesterol are even more worrisome for adults than they are for children. In children, the issue is usually the prevention of an early beginning of atherosclerosis. In adults, many times the issue takes on life and death proportions as they are seeking to keep arteries open that may already be significantly blocked.

Furthermore, in Chapter 7 that deals with protein issues, we learn that one of the very worst proteins that raises blood cholesterol levels is casein, a common milk protein.75 All levels of cow’s milk, including skim and one percent milk, contain both casein and cholesterol. Two percent and whole milk are worse than either skim or one percent milk because they have more cholesterol and are higher in saturated fat, which increases the blood cholesterol.

One patient, Norman Mayo, age 61 from Seattle, recently made headlines when he announced that he was taking the dairy industry to court for not putting a warning label on milk informing the consumer about the increased risk of heart disease and stroke. He stated that he drank whole milk his entire life because he believed it was a healthy practice. Now he has clogged arteries and has already suffered a stroke. After he knew about his artery blockages, he learned about the artery-damaging effects of dairy products from his health advisors.

The Link between Dairy Foods and Cancer

Dr. David Rose and colleagues at the American Health Foundation examined the international death rates from a variety of cancers.76 They found that the more milk and meat eaten in a country, the greater the risk of breast cancer. Prostate and ovarian cancer risks were also associated with milk use. La Vecchia and coworkers in Italy have shown that prostate cancer risk increases in a “dose response” fashion with milk drinking. Thus, the more milk a person uses the greater the risk of this fatal cancer. Specifically, those who used one to two glasses of milk per day increased their risk by 20 percent. However, when milk intake exceeded two glasses per day, prostate cancer risk jumped 400 percent.77 A study in Spain added yet another cancer to the list of dairy-related malignancies. Researchers there found that milk products tended to triple the risk of cancer of the rectum.78

These are not isolated international studies. There is a growing body of research—right here in America—that tends to implicate milk along with other animal products in increasing cancer risk. For example, a fascinating U.S. study compared state-by-state data on dairy food use with the risk of breast cancer. The more milk a state consumed the greater the risk their populace had of dying from breast cancer.79

Neurologic Diseases
One very devastating neurologic disease is called Amyotrophic Lateral Sclerosis (ALS). It is commonly know by a less imposing name: Lou Gehrig’s disease (after the famous baseball player who contracted this illness). ALS tends to cause progressive paralysis. The average victim dies within three years of the diagnosis.80 Although the disease can rarely be inherited, most of the cases are not. There is some concern from population studies that some cases of ALS may be caused from an infectious agent transmitted through dairy products.81

Multiple Sclerosis (MS) is another potentially disabling neurologic disease. This condition strikes the tissue (called myelin) that insulates nerve cells in the brain, eye nerves, and spinal cord. The disease appears to be due to an immune system abnormality that causes inflammation and destruction of the myelin tissue.82 One study reported in the prestigious British medical journal, Lancet, suggested that MS might have a relationship to dairy consumption.83

Allergies and Digestive Problems
Dairy foods may have a role in a whole host of other diseases that strike in adulthood. We have already observed that childhood allergy is often related to milk products; these items can cause adult allergic manifestations as well. Lactose intolerance has already been addressed to some extent. We learned that a significant portion of abdominal problems in children results from malabsorption of milk sugar. Lactose intolerance also poses problems for millions of adults. Often they do not realize that milk is either a contributing cause or the sole cause of their intestinal problems.

Milk use is also being linked to a growing number of diseases that we have yet not touched on in this chapter. Perhaps those that are the most worrisome are the growing number of serious infectious diseases. We will look at these next.

Contaminants in Cow's Milk

So far, we have been looking at problems related to hypothetically pure, unadulterated cow’s milk. Frankly, as a former milk drinker, I view this list of problems as quite sobering. However, pure cow’s milk does not really exist, because whatever a cow is exposed to tends to show up in her milk. For example, what comes with our breakfast milk today is the cow’s lunch yesterday. This explains why milk can taste so different at times; when cows eat different foods, the milk takes on a different taste. In a sample of milk from processing plants in five states, over one-third of the milk samples contained flavors of the feed recently eaten by the cow.84 This included the taste of wild garlic or wild onion, corn, oats, rye, and bitterweed. The sobering message is that whatever is in the cow’s blood at the time tends to show up in the milk. Unfortunately, more than flavor is passed in this manner. Bacteria, hormones, pesticides, and other contaminants can find their way into milk.

Infectious Agents in Milk

Infectious agents can be very effectively transmitted through milk. These agents include both bacteria and viruses. Many consumers believe that drinking pasteurized milk eliminates all potential disease-bearing agents. This is far from the case, although pasteurized milk is safer to drink than raw milk. However, pasteurization does not sterilize the milk. Sterilization would require a minimum of 212 degrees Fahrenheit for a period of time. Pasteurization heats milk to only 161 degrees Fahrenheit for a scant 15 seconds;85 therefore, it merely reduces the number of potentially infectious germs, but does not eliminate them.

Government agricultural standards bear witness to the expectation that milk will be contaminated with microorganisms after the pasteurization process. Current U.S. Public Health Service regulations are stated in Figure 10: Bacteria in Milk "Limited" to 20,000.

In plain English, this regulation means that a glass of milk can have nearly five million bacteria in it and still be acceptable. The coliforms are of even more concern. These bacteria are germs that come from the cow’s stool. Milking, especially automated, can be messy in spite of precautions; it is not uncommon for milk to be contaminated. We see that our government allows up to 10 coliform bacteria from stool per milliliter after pasteurization. Granted, ten bacteria do not sound like much. However, ten per milliliter translates to nearly 2500 per 8-ounce glass.

Just as bacteria survive the pasteurization process, so do many viruses. Some of the classic research looked at the survival of the foot and mouth disease virus after pasteurization.86, 87 Other viruses have been cited as being pasteurization-resistant. These include the maloney leukemia virus, the rous sarcoma virus, the rauscher leukemia virus, and the bovine papilloma virus.88 These disease-causing viruses could be destroyed by boiling, but not simply by pasteurizing.

A number of epidemics have occurred as a result of infectious agents getting into the commercial dairy supply. There was a recent outbreak of Salmonella from a nationally distributed ice cream brand. Over two thousand cases—and several fatalities—were verified in Minnesota, South Dakota, and Wisconsin.89 Food poisoning can also occur from cheese. In 1989, a Salmonella outbreak sickened at least 164 people in Minnesota, Wisconsin, Michigan, and New York. The infection was traced to contaminated mozzarella cheese.90 What was striking about this case and others is the relatively few bacteria that are needed to produce infection. In the mozzarella outbreak, unopened blocks of the contaminated cheese were analyzed. They found less than two salmonella organisms per one ounce serving of cheese. These and other reports suggest that dairy products with seemingly insignificant levels of contamination may play a greater role in disease outbreaks than previously recognized.A whole host of infectious diseases have been traced to milk use. These include relatively common infectious agents like salmonella or strep,91 or they can include rarer diseases. One such illness is brucellosis, a sometimes chronic and unrecognized disease that can cause headache, fatigue, weakness, and muscle aches as well as more familiar infection signs like fever and sweating.92

The bacteria that cause Q fever (another sometimes-chronic illness that often eludes diagnosis) can also be transmitted in cow’s milk.93 Although unfamiliar to most consumers, yersinia enterocolitica is a fairly common infectious agent that causes abdominal pain, fever, and diarrhea.94 It has the dubious distinction of mimicking appendicitis, and is doubtless the cause of many unnecessary surgeries each year. Yersinia is generally destroyed by pasteurization. However, documented cases demonstrate that if there are sufficient numbers of this germ in the raw milk, some yersinia can survive pasteurization and later multiply during refrigeration.95 The list of organisms that can contaminate raw and even pasteurized milk is quite extensive. I provide more information in Chapter 10, “Animal Diseases and Human Health Risk,” including information on other relatively common and dangerous infectious agents such as Listeria96 and Campylobacter.97

There is also a growing list of other diseases that we are now becoming aware of having a link to infection and to dairy foods specifically. The chapter on animal diseases provides further information. For example, mycobacterium paratuberculosis transmitted through dairy foods may be a cause of Crohn’s disease, an often incurable, debilitating disease of the bowel.98 Evidence indicates that mycobacterium paratuberculosis is not destroyed by the most common form of pasteurization, which attains 161 degrees Fahrenheit for 15 seconds.99

In view of such pervasive problems with infection, those who plan to continue drinking milk should seriously consider sterilizing their milk. Boiling is the simplest way to sterilize dairy beverages. Some people do not like the taste of boiled milk, but this sterilization process definitely decreases the risk of transmissible diseases.

However, even boiling may not prevent all risk. One of the most feared animal-related diseases is Creutzfeldt Jakob disease (CJD). One of the ways that this condition is believed to be transmitted to humans is through prions from cattle with “mad cow” disease. These prions are not living organisms and can withstand temperatures far higher than the boiling point of water. In Chapter 10 on animal diseases, I point out the evidence that dangerous prions can enter human breast milk if a woman is suffering with CJD. Although it is felt unlikely to be contaminating dairy sources in the U.S. at the present time, some have still raised concerns that some of the American milk supply could be tainted with prions.

Beyond Bacteria and Viruses-Other Milk Contaminants

As damaging to human health as bacteria and viruses are, other contaminants can be just as damaging. Let us look at the antibiotic contamination problem.

Antibiotics in Milk
Antibiotics are commonly found in milk today. These drugs come from a variety of sources. Since the early 1950s antibiotics such as penicillin and tetracycline have been added to livestock feed to prevent infection and boost growth.100 Antibiotics are also utilized to treat sick cows. Although milk from animals undergoing drug treatment is discarded for a period of time, drugs can still be present in a cow’s milk even after it has finished a course of antibiotics.

Two major concerns have arisen about the use of antibiotics as they relate to dairy products. First, there are worries that widespread antibiotic use in livestock is favoring the rise of organisms that are resistant to the common antibiotics. Second, there are legitimate fears that human exposure to antibiotic residues in milk products will result in illness.

Increasing resistance to antibiotics among microbes has been recognized for some time. Many diseases like pneumonia, gonorrhea, or salmonella that formerly were easily treated with certain antibiotics have now become resistant to those drugs.101 Some blame this problem of growing resistance on indiscriminate use of antibiotics in both the human population as well as in livestock. Research suggests that the livestock connection is very likely a factor in this process.

The likelihood of any carton of milk having one or more drug residues is fairly high. Milk from many cows in a “milkshed” area is pooled; thus, milk that reaches the consumer has constituents that may have come from literally hundreds of cows. Researchers at Rutgers University found that a significant portion of milk samples showed more than one drug residue.102 The presence of these antibiotic residues in milk is emerging as a factor favoring the development of antibiotic resistance.

In another Rutgers study, staphylococcus aureus (a cause of serious skin and bone infections) was exposed to small doses of six antibiotics. The study employed some antibiotics that are commonly used in the livestock industry, including erythromycin, tetracycline, and ampicillin. The drugs were used in amounts small enough to be legally sold in commercial milk (i.e., they were below the cut-off for what the FDA considers a “safe” dose). These drugs were used singly or in combinations of three drugs. (The rationale for using a combination of drugs was their knowledge of the frequency of multiple drugs finding their way into the milk supply). After two weeks, actual measurement showed that the drug-exposed staphylococcus aureus samples were rapidly developing antibiotic resistance. When compared to staph germs that were not exposed to antibiotics, those subjected to residues of a single drug developed resistance six times as fast. However, those exposed to three antibiotics developed resistance over 27 times as fast.103 This research suggests that milk should be free of all antibiotics if we want to reduce the rapid development of resistant bacteria.

A summary list of the various known contaminants in milk is shown in Figure 11: What is Coming with Milk for Breakfast?.

Although I have tried to differentiate between conditions that are related to milk itself and other conditions due to contaminants in the dairy supply, such a division is very tenuous. The problem is that milk is so pervasively contaminated that it is often merely conjecture as to whether problems are related to milk itself or to the ever-present contaminants. For example, although I have presented cancer risk as being due to milk itself, evidence suggests that at least some of the milk-cancer link may be related to contaminants.

One study dealing with lung cancer provides a good illustration of this possibility. Researchers found increased risk from drinking full fat milk but not from the low fat variety. Although the pure dairy fat itself could be the culprit, another interpretation is that contaminants in milk fat are the factors most responsible for increasing risk. The idea that contaminants are involved is not at all far-fetched. Many of the most worrisome poisons are fat-soluble toxins that reside in the fat portion of milk.

Another example that illustrates the difficulty in distinguishing the effects of contaminants from the effects of unadulterated milk comes from the area of allergy. Although many cases of cow’s milk allergy seem to be related to milk proteins, contaminants may also be part of the problem. The common finding of respiratory problems following milk drinking (such as more mucus production, cough, or infections) may sometimes be due to antibiotic residues in the milk. A person may be allergic to penicillin, erythromycin, or some other drug that is present in low amounts in milk. There is not enough drug there to cause a serious generalized allergic reaction, but the small amount present is sufficient to produce the annoying respiratory symptoms.

If Dairy Foods are Out, Where Do We Get Our Calcium?
Americans are rightly afraid of osteoporosis, a condition that refers literally to a thinning of the bones. The disease affects all races and both sexes, causing approximately 70 percent of all fractures in Americans over 45.104 The dairy industry has been quick to capitalize on these concerns. They advertise milk, cheese, and other dairy products as food items to help strengthen bones because of their calcium content. However, despite what most Americans “know,” more calcium is not what is needed for improving the bone health of Americans—or anyone else for that matter.

In Chapter 7 on protein, I deal with the true nutritional culprit related to osteoporosis. The real villain is excess consumption of protein, not inadequate calcium intake. I present the full argument there, but let me review the key concepts briefly here. First, studies on population groups (epidemiology) show that the more animal protein in the diet, the greater the risk of osteoporosis. One of the classic groups studied is the Eskimo. Despite their high consumption of up to 2500 mg of calcium per day, they have rampant osteoporosis. Second, actual human experiments have shown a similar relationship. Increasing the protein in the diet of someone who consumes liberal amounts of calcium—as much as 1400 mg per day—can actually result in a loss of calcium from their body on a daily basis. Third, there seems to be a number of biochemical factors that account for the calcium-depleting effect of meat in particular. These include effects of the higher protein content itself, as well as problems with the excess phosphorus and sulfur that is found in meat.

It is important also to note that in Chapter 7 previously referred to, I provide tables listing food sources that supply liberal amounts of calcium while avoiding problems of excess protein, sulfur, and phosphorus. Among the real stars are the green leafy vegetables.

The Pro-Dairy Side
The National Dairy Council recently published a book promoting dairy foods from the scientific standpoint.105 The book was written by two of its employees and a paid consultant. Most of the benefits claimed by dairy can be easily boiled down to one mineral—calcium. Other benefits mentioned include the consumption of Vitamin D, which is added to milk as a supplement. Vitamin D can easily be obtained by moderate exposure to sunlight and is thus not a necessary constituent of the human diet. If Vitamin D-supplemented dairy food is eliminated from the diet and customary sunlight exposure is not possible, I recommend supplementing the diet with 400 International Units of Vitamin D a day.106 Vitamin D is actually more important in preventing osteoporosis than a high intake of calcium.

Most of the remainder of the so-called “positive” dairy research does not control for other dietary or lifestyle factors. For instance, a recent study suggested that middle aged men who were milk drinkers had a slightly less risk for developing a stroke later in life. However, the study did not separate out (control for) other factors that are known to decrease the risk of stroke, such as daily exercise and eating several serving of fruits and vegetables a day.107 Even the study’s author himself stated, “There’s something else in milk [calcium], or in the lifestyles of milk-drinkers, that’s offering protection. These factors are difficult to identify, but milk drinkers [in this study] tended to be leaner and more physically active and to consume foods that were more likely to be healthy.” He then added that it would be “...inappropriate to recommend that milk consumption be increased to reduce the risk of stroke.”

Thus, although these studies are widely touted by the dairy industry and the news media as advocating the liberal use of milk, they really do not give reliable information about milk. The latest scientific book put out by the National Dairy Council in partnership with the National Dairy Promotion and Research Board that endeavors “to provide a balanced review” of milk is completely silent about the many concerns expressed about milk in this chapter, with the exception of lactose intolerance.108

School Milk and Politics

With all the problems associated with dairy products, it seems prudent for our country to avoid giving messages that appear to recommend the free use of milk. Unfortunately, current legislation (probably due in part to dairy industry influence) requires public schools to provide a wide range of dairy products. The complexity of the issue is illustrated in Figure 12: Government Inconsistency Regarding Milk.109

It seems that the government is caught in a conflict of interest. On the one hand it widely promotes the recommendation of bringing our national fat consumption to 30 percent or below, and to especially reducing saturated fat in the diet. On the other hand, older USDA regulations help dump excess dairy products (high in fat and especially high in saturated fat) into our school lunch program. It has been argued that instead of the health of children solely determining the goals of school lunch programs, powerful commercial interests such as the dairy industry are altering the priorities. A public watchdog organization for food and health has pointed out that the USDA regulations have put Americans in an unacceptable position; their statement is quoted in Figure 13: Dairy Economic Interests Versus Good Nutrition.110

My Own Experience with Milk

A number of years ago I went through an experience that persuaded me to discontinue my use of milk. Beginning in my teen years, I experienced repeated respiratory tract infections. I would get over one infection, then a week later I would come down with another. All during college and medical school my mother would tell me I needed to see a specialist to find out what was wrong with my immune system. I finally went through the immune system blood tests but nothing was abnormal. I was tempted to conclude that I was a sickly person and would always have upper respiratory tract infections. Then I learned during my specialty training in Internal Medicine about some of the complications of milk that I have been describing in this chapter. I decided to discontinue using milk, which was rather difficult since I was accustomed to using it in quantity. I experimented with several of the soy, rice, and nut milks on the market and found them acceptable. Even the soy ice creams were good and free of animal products. When I stopped using milk, my respiratory infections went away and I did not come down with another cold for many years.

Ellen White cautioned years ago, “...if other foods to supply the needed elements cannot be obtained, milk and eggs should not be wholly discarded. Great care should be taken, however, to obtain milk from healthy cows and eggs from healthy fowls, that are well fed and well cared for...”111

Of course, even healthy-appearing cows may be sick for days before manifesting any symptoms. All during the time of their unrecognized illness, people could still be drinking their milk. White gave advice to deal with this possibility: “If milk is used, it should be thoroughly sterilized; with this precaution, there is less danger of contracting disease from its use.”112

She also wisely wrote, “Let the diet reform be progressive. Let the people be taught how to prepare food without the use of milk or butter. Tell them the time will soon come when there will be no safety in using eggs, milk, cream, or butter, because disease in animals is increasing in proportion to the increase of wickedness among men.”113 Since most of the world population does well without the use of dairy foods, I believe that Americans can do so as well. My own personal experience, my work with patients, and medical research all point in the same direction—that a decision to give up the use of dairy foods will likely bring us significant health benefits.

I could wish that the news media were more objective in reporting the problems with dairy products. Since they are not, I believe it is my responsibility as a physician to let people know the dangers associated with them. When we look at the overall picture, I can honestly recommend that cow’s milk should be reserved for baby cows. Their calves need a high-powered source of energy to start walking the day they are born.

The American Academy of Pediatrics now recommends that no one under the age of twelve months be fed cow’s milk.114 They add, “the American Academy of Pediatrics recommends that infants be fed breast milk for the first 6 to 12 months.” Clearly, children develop best on their own mother’s milk. Consequently, I commend and appreciate the movement in our country among professionals and lay people alike advocating breast-feeding. Perhaps the time has come to publicize a new slogan for milk that, contrary to the American dairy industry slogans in Figure 1: Slogans of the American Dairy Industry, has an honest scientific basis. A slogan such as shown in Figure 14: Cow's Milk is for Cows! would be fitting.

Cow's Milk Alternatives are Now Available
For children that are weaned—and adults as well—there are now an abundance of milk-like products on the market that are suitable to use on breakfast cereals. Health food stores usually have a liberal supply of soy milk products of several brands and flavors, and other plant-based milk alternatives such as oat, potato, rice, and almond milks. With their popularity growing and more Americans realizing the dangers of dairy foods, these items are now being stocked in regular grocery chains. Not only have many consumers been surprised to see these products on the aisles of their local supermarket, but they also have been amazed at how nutritious and satisfying some of these beverages are. A comparison of the nutrients in cow’s milk with various soy milk products is shown in Figure 15: Nutrition Comparisons of Various Milk Products.

Several observations of the data in the figure are in order. First, the high content of phosphorus in cow’s milk causes a rather poor absorption rate of calcium, at 25 percent, or about 75 mg per cup. Second, this amount is equal to the amount of highly absorbable calcium in human breast milk, which substantiates that the nursing infant will absorb as much calcium from mother’s milk as one who is on cow’s milk. Notice also the desirably low content of phosphorus in mother’s milk. Third, protein levels of soy milk products are generally similar to that of cow’s milk, and calcium levels for the fortified soy milks are also similar to that of cow’s milk. Fourth, the phosphorus level of fortified West Soy Plus is slightly lower than that of whole milk, which would suggest that the absorbable levels of calcium would be similar. Instasoy, another milk alternative, has slightly higher levels of protein and calcium, with a slightly lower content of phosphorus. A listing of quantities of B12 and other nutrients in various brands of milk alternatives and cereals is found in Appendix IX.

The culmination of my extensive research on the subject of milk is that there is absolutely no reason why any adult human should feel that they need the milk of another species for health. All the nutrients we need can be obtained without resorting to dairy foods—and we can avoid a host of problems by shunning this harmful group of foods. Dr. Oski made a simple but forceful observation regarding the uniqueness of a full-grown mammal that consumes a food meant strictly for babies. His statement appears in Figure 16: Do Mammals Drink Milk?.115

I challenge you now. Take a bold step and determine to do something that will likely make a significant difference for your health and for the health of your family. Determine that by your influence and example you will help others to break free of a disease-bearing product line—even if you feel perfectly healthy today. Make a choice to cease putting money into the coffers of an industry that is telling half-truths at the expense of the health of the American public. Visit your local grocery store or health food store, pick up a sample of several soy, nut, or other plant-based milk alternatives, and embark on a new habit of dairy-free living. You will be surprised at how tasty today’s alternatives are, and you will know that you are following a course calculated to improve your own health, and the health of others around you.


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