Raw Milk, Asthma, and Lung Health

There are multiple peer-reviewed, scientific studies which correlate raw milk with improved lung health, both in childhood and adulthood.

Children Who Drink Raw Milk Have Less Asthma

Several large epidemiological studies of European children have found correlations between raw milk consumption and decreased rates of asthma.

PARSIFAL Study

The PARSIFAL study was designed to look at allergy risk factors in children. This large study of over 14,800 European children (from Austria, Germany, the Netherlands, Sweden, and Switzerland) investigated asthma and allergic diseases in relation to children’s exposure to different environments (farms, rural, suburban) and farm-fresh foods (such as raw dairy products, eggs, and vegetables). The PARSIFAL data relating to asthma and raw milk were published in December 2006 in the Journal of Clinical and Experimental Allergy [1].

The PARSIFAL study concluded that there is a "significant inverse association between farm [raw] milk consumption and childhood asthma." The study found that, regardless of which environment the children lived in, those children who drank raw milk had significantly lower rates of asthma than children who did not drink raw milk.

GABRIELA Study

The GABRIELA study was designed to investigate the genetic and environmental causes of asthma.  This study included over 8,000 European children (from Germany, Austria, and Switzerland), and was published in the Journal of Allergy and Clinical Immunology in August 2011 [2]. In this study, raw milk consumption was compared to consumption of boiled/pasteurized milk, and the level of exposure to raw milk in utero through school age was also accounted for. The study also looked into the children’s exposure to farm environments as a possible variable related to rates of asthma.

The GABRIELA study found that raw milk consumption is associated with significantly lower rates of asthma, and that this beneficial effect is independent of other farm exposures. It was found that early exposure to raw milk (at <1 year of age) and daily consumption of raw milk increased the beneficial effect in children who drank a mixture of raw milk and pasteurized milk. The consumption of only pasteurized milk “was not associated with any health outcome.”

PASTURE Study

The PASTURE study followed children from birth to age 6 years in order to gain a better understanding of the effects of raw milk consumption on asthma. This study of over 900 European children (from Germany, Austria, Switzerland, Finland, and France) was published in January 2016 in the Journal of Allergy and Clinical Immunology [3].

The PASTURE study concluded that, "Continuous farm [raw] milk consumption in childhood protects against asthma at school age." This study found that raw milk’s “beneficial effect on asthma increases over time. Recent consumption of farm milk seems to be more relevant than consumption in the first years of life, which extends the concept of early prevention to sustained prevention until school age and beyond.” 

It’s Not the “Farm Effect,” It’s the Raw Milk!

Some of the research correlating decreased asthma with raw milk consumption has been criticized as actually demonstrating that living on a farm is associated with decreased rates of asthma. However, several of the studies specifically analyzed the effects of living environments, and found that the beneficial effects of raw milk on asthma were indeed present even in children who did not live on farms.

Furthermore, a meta-analysis of eight health studies related to raw milk was published in the November 2019 issue of the Journal of Allergy and Clinical Immunology [4]. A meta-analysis is a quantitative statistical analysis which combines the results of multiple scientific studies, thereby allowing the researchers to derive overall conclusions about that body of research. The recent meta-analysis, written by a team of researchers from the Netherlands and Germany, concluded that when taken as a whole, the body of data from the previous studies shows that raw milk consumption in childhood has a protective effect on asthma “independent of other farm exposures and that children not living on a farm can theoretically profit from this effect.” 

Adults Who Drank Raw Milk in Childhood Have Better Lung Function

Agricultural Lung Health Study

There is evidence that raw milk’s beneficial impacts on lung health are not isolated to childhood. Evidence that raw milk has a beneficial effect on adult lung health is seen in the Agricultural Lung Health Study, which is part of the larger Agricultural Health Study that was designed to investigate how agricultural, lifestyle and genetic factors affect the health of farmers.  The Agricultural Lung Health Study data relating to lung health and raw milk were published in March 2018 in the journal Thorax [5].

This study investigated lung function in over 3,000 USA older adults, with a mean age of 63 years.   It was found that "raw milk consumption, particularly early in life, is associated with better pulmonary [lung] function in adulthood." This study found that childhood raw milk consumption was correlated with “higher forced expiratory volume” and higher “forced vital capacity”, leading the researchers to conclude that “the beneficial effect of raw milk is predominantly on lung growth.”

Low-Risk Raw Milk as a Therapeutic Tool

It is clear from all of this research that raw milk consumption is correlated with improved lung health.  Children who drink raw milk have lower rates of asthma, and childhood raw milk consumption leads to improved lung health that lasts into older adulthood. There is a growing body of evidence that raw milk is a low-risk food when it is produced carefully and intentionally [6, 7]. Thus, low-risk raw milk can be a powerful therapeutic tool for improving lung health.

References

[1] Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clinical and Experimental Allergy. 2007; 37(5):661-70. Waser M, Michels KB, Bieli C, Flöistrup H, Pershagen G, von Mutius E, Ege M, Riedler J, Schram-Bijkerk D, Brunekreef B, van Hage M, Lauener R, Braun-Fahrländer C; PARSIFAL study team. https://www.ncbi.nlm.nih.gov/pubmed/17456213

[2] The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study. Journal of Allergy and Clinical Immunology. 2011; 128 (4): 766-73. Loss G, Apprich S, Waser M, Kneifel W, Genuneit J, Büchele G, Weber J, Sozanska B, Danielewicz H, Horak E, Joost van Neerven RJ, Heederik D, Lorenzen PC, von Mutius E, Braun-Fahrländer C; GABRIELA study group. https://www.jacionline.org/article/S0091-6749(11)01234-6/fulltext

[3] ω-3 fatty acids contribute to the asthma-protective effect of unprocessed cow's milk. Journal of Allergy and Clinical Immunology. 2016; 137 (6): 1699-1706. Brick T, Schober Y, Böcking C, Pekkanen J, Genuneit J, Loss G, Dalphin JC, Riedler J, Lauener R, Nockher WA, Renz H, Vaarala O, Braun-Fahrländer C, von Mutius E, Ege MJ, Pfefferle PI; PASTURE study group. https://www.jacionline.org/article/S0091-6749(15)01731-5/fulltext

[4] The Beneficial Effect of Farm Milk Consumption on Asthma, Allergies, and Infections: From Meta-Analysis of Evidence to Clinical Trial. Journal of Allergy and Clinical Immunology: In Practcice, 2019. 8 (3): 878-889. Brick T, Hettinga K, Kirchner B, Pfaffl MW, Ege MJ. https://www.ncbi.nlm.nih.gov/pubmed/31770653

[5] Raw milk consumption and other early-life farm exposures and adult pulmonary function in the Agricultural Lung Health Study. Thorax, 2018; 73:279-282. Wyss AB, House JS, Hoppin JA, et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758444/

[6] Recent Trends in Unpasteurized Fluid Milk Outbreaks, Legalization, and Consumption in the United States. PLOS Currents. 2018; 10. Whitehead J, Lake B. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140832/#ref27

[7] Raw milk producers with high levels of hygiene and safety. Epidemiology and Infection, 2020; 148, e14, 1-7. Berge AC, Baars T. https://www.ncbi.nlm.nih.gov/pubmed/32000877

Build Immune System Strength With Whole Foods: Drink Raw Milk!

America invested $3 billion dollars and spent 13 years between 1990 and 2003 to figure out what makes us genetically human. The research project focused on discovery of the genes and genetic code that makes us what we are.  This work was funded by Congress and led by the Department of Energy and the National Institutes of Health. The findings were not quite as expected.  

Our parents gave us each about 20,000 genes that give us our basic structure and shape. That was the easy part.  That is our “hardware”. However, the “software” that runs our human machine gets a little tricky. It becomes very complicated and even inconvenient.

Rob Knight, founder of the Center for Microbiome Innovation and Professor of Pediatrics at the University of California San Diego, describes that,

“You’re more microbe than you are human.”

On a cellular level, we are only 43% human, with the balance of our cells being bacteria, viruses, and fungi. Genetically, our 20,000 human genes are vastly outnumbered by 2,000,000 to 20,000,000 microbial genes, which are mainly coming from bacteria. And most of these bacteria make their home in our gut.

At the cellular level, genetic information is shared between human cells and microbial cells. Genetic information is freely traded, exchanged and swapped around as an essential part of life and cellular function. The essential bacterial genetic information acts as “software” for the human cells, regulating the immune system, digestion, and manufacture of vital vitamins. This is how our human micro-biome functions.  

I like to say “we are Bacteriosapiens”.  What does this mean in real terms? How do we apply advanced science and use this information to better our lives? The bottom line is this:

We have great control over our optimal health.

We are not narrowly driven by the genes our parents passed to us. Those genes are important, but they are only a sliver of the genetics that truly drive our human machine. How we live our lives has tremendous impact on our microbiome and therefore our health. Were we breast fed, were we born by C-Section, did we receive heavy antibiotics early on? That’s just for starters. What we were fed as children and how do we continue to eat today? Don’t get into a guilt trip. That’s all old history. You can start fixing it today.

According to Dr. Anahid Jewett PhD at UCLA:

The healthy gut biome needs two things to reduce inflammation and keep you healthy:

• A load of biodiverse bacteria

• The whole foods that feed them

It comes down to nurturing our beneficial bacteria!  How do we get good bacteria to hang out, colonize our bodies, and become our very best genetic friends? How do we get and keep our genetic software so our human cells can make good decisions and keep us healthy?  Beneficial bacteria don’t hang around very long if we don’t offer them breakfast, lunch and dinner.

What nourishes our beneficial bacteria?  Whole foods do. What is a whole food? A whole food is a food that is unprocessed and complete. Nothing taken away and nothing added. Whole foods grow right out of good healthy soils which are teaming with earthworms, fungi, and bacteria. Whole foods come right out of the cow or straight from a well-nourished animal.

Americans don’t eat many whole foods. Instead we eat the Standard American Diet (SAD). In doing so, we starve and deprive our beneficial bacteria! In fact, we Americans love our antibiotics, pharmaceutical drugs, preservatives, sugar rich foods, long shelf life foods and GMOs. Highly processed foods and chemicals are destructive to our gut biome and the bacterial diversity required for genomic health. So what does that leave us? Its leaves us with “hardware and no software to drive it”. We become genetically inept at the cellular level.  We develop a whole range of diseases, including allergies, leaky gut, autoimmune disorders, depression, autism, and more. It’s really SAD.   

Nourishing and healing our gut microbiome requires moving away from processed foods and pharmaceuticals, and instead moving towards whole foods.

Raw milk, raw cheese, raw butter, raw cream and raw kefir are whole gut biome superfoods. They seed the gut with diverse beneficial bacteria, while providing the enzymes, proteins, minerals, and good fats that bacteria love to eat. They are whole foods with biologically active elements and protein systems that protect the gut, and build and maintain our immune system. They are the first foods of life!  Add fresh or fermented vegetables, grass-fed beef, chicken, eggs, and other direct-from-the-farm foods to make your bacteriosapien thrive!

Follow-on studies to the Human Genome Project continue today, including the Human Microbiome Project and the American Gut Project. It has become quite the clash of titans. The current medical and food processing establishments find this information to be extremely inconvenient. If bacteria are critical to life, then what are we doing with all the antibiotics? Sugars grow candida yeast and disrupt normal healthy bacterial colonization. Preservatives kill off bacteria in foods to extend shelf life and cause damage to the gut bacterial colonies. So does the widely-used glyphosate Round-up!

In the recent Coronavirus Pandemic, we witnessed lack of resilience in our gut biomes and immune systems.

While some people were not affected by Coronavirus others became deathly ill or worse.  We don’t know exactly why there was such a difference in these outcomes and pathways. We have been given a big hint, though: in general, COVID19 illness seriously affected those with compromised immune systems and poor health status.

New threats will continue to emerge. Viruses and bacteria continually evolve and adapt. Our immune system and gut biome must dynamically do the same. We must be adaptive and resilient to be able to address the ever present and evolving threats that will come to visit us. Will your immune system and genomics be up to the new threat?  Vaccines are always late, come after the fact, and don’t have the most effective track record. A healthy adaptive resilient immune system is with you and working all the time.

There is a long list of studies that confirm the health benefits of raw milk. These benefits include significantly fewer colds (which are viral illnesses), less asthma, fewer ear infections, reduction of eczema, less allergies, and stronger general health. These findings confirm that:

Those who eat a whole food diet and consume raw dairy products have more adaptive and resilient immune systems.

Get to know your bacterial self. You are not alone. Give your new best friends breakfast, lunch, and dinner. They won’t ever let you down if you feed them well.

Drink your raw milk and eat your whole foods! Cherish your new bacterial friends. They are the healthy you!

Two Types of Raw Milk

My family has been drinking raw milk for over 18 years. I drank raw milk through both of my pregnancies and raised both of my kids on raw milk since they were weaned from breastmilk as toddlers. I have purposely chosen raw milk for my family because of its exceptional health benefits and animal welfare.

Studies performed in Europe have shown that children who drink raw milk have decreased rates of asthma, allergies, eczema, ear infections, fever, and respiratory infections. Nonetheless, when I tell people that my family drinks raw milk, I often hear responses such as:

“Raw milk is dangerous!”

“Doesn’t raw milk make people sick?”

“I heard that raw milk was bad for you.”

The reason for raw milk’s negative reputation is that there are two types of raw milk!  Raw milk that is intended for pasteurization is quite different than raw milk produced for direct human consumption.

Raw Milk Intended for Pasteurization

When my family drives past a nearby dairy that produces milk for pasteurization, we are struck by the horrendous smell and filthy living conditions.  The animal yard is completely covered with manure. The cows have no choice but to lie and stand in manure all day. It is disgusting to think that this operation is producing food for families.

Raw milk that is “intended for pasteurization” is typically sourced from Concentrated Animal Feeding Operations (CAFOs). This type of milk is actually defined under the Federal Grade A Pasteurized Milk Ordinance (PMO).  Such milk is being produced in conditions where animal health is often compromised and mastitis (udder infection) is common.  Antibiotics are often utilized in these herds, and hormones are used to stimulate higher levels of milk production. The animals are housed in an abundance of manure, and there is a corresponding high rate of pathogens.

This milk is intended to be pasteurized to kill pathogenic bacteria, and as such, it is often produced with little care towards preventing contamination with pathogens. Furthermore, this type of milk is generally commingled with milk from multiple dairies, which increases the risk of pathogenic exposure. Studies have shown that up to 33% of this type of milk tests positive for pathogens. This type of raw milk is clearly unsafe to consume. I would never feed this type of raw milk to my family.

Raw Milk Intended for Direct Human Consumption

When my family visits the dairy that produces the raw milk that we drink, we see a very different setting from the CAFO dairy. The cows at the raw milk dairy are happily grazing on lush pastures. The cows look clean and healthy. The milk is bottled on-farm, and we can see that the milk bottling room is clean and neat. There is a stark contrast between the CAFO dairy and this raw milk dairy.

Raw milk that is carefully and intentionally produced for direct human consumption is wholly different from raw milk being produced for pasteurization. Raw milk farmers carefully manage the cleanliness and hygiene of the farm from grass-to-glass, with much care to ensure that the animals are healthy and the milk is clean.

From the health of the herd, to cleanliness of the milking parlor, to the specific cleaning processes for the milk line, to ensuring rapid milk chilling, to regularly testing their milk, and everything in between, raw milk farmers are dedicated to taking their farm management to the next level in order to ensure that their raw milk is safe to consume.

Although there are no federal standards for raw milk, the Raw Milk Institute has established Common Standards for raw milk that is intended for direct human consumption.  This type of raw milk is tested often and held to rigorous standards to ensure that it is being produced in a way that discourages pathogen growth.

Where Do Pathogens in Milk Originate?

The four main pathogens in milk that can cause human illness are E coli 0157:H7, listeria mono, salmonella, and campylobacter. The two most common sources of pathogens in milk are manure and mastitis. It is estimated that one-third of CAFO dairy cows have mastitis, and the cows in CAFOs stand and lie in manure all day. Clearly, this type of dairy environment is primed for pathogen growth.

On the other hand, the raw milk dairy environment is carefully managed to prevent pathogens in the milk. These farmers manage the health of their herd to prevent mastitis. They ensure that the milk from any animals that are showing signs of mastitis is not used for direct human consumption. Raw milk farmers meticulously clean the udders before milking to ensure that no manure or other contaminants are present. They also rigorously and frequently clean their milking machines, milk lines, and milk tanks.

Take a look at the milk filters shown below.  Even with just a quick look, it is apparent that the milk being produced with the intent to be pasteurized is clearly not clean, whereas the milk filter from the intentionally-produced raw milk looks impeccable. (To be fair, there are some dairy farmers who produce milk for pasteurization that is much more hygienic than most others. However, that milk is still commingled with milk from other dairies, many of which are likely to not use hygienic practices.)

Comparison of Bacterial Test Standards for Two Types of Raw Milk

Okay, I’m gonna get technical here.  If reading about standards and looking at charts is not your thing, you can skip ahead to the last section. :)

Two important types of bacterial testing for milk are Standard Plate Count (SPC) and coliform count. The SPC is a measure of the total number of aerobic bacteria in the milk. High SPC numbers can indicate dirty milking equipment, poor milk chilling, and/or poor udder preparation.

Coliform count measures the amount of coliform bacteria present in the milk. Coliform counts measure the overall hygiene and cleanliness of the milk. High coliform counts generally indicate the presence of manure or other environmental contaminants on the udders or milking equipment. High coliform counts are likely to correspond to the presence of pathogens in the milk.

According to the PMO, pre-pasteurized milk is allowed to have up to 100,000 colony-forming units (cfu) of bacteria per mL in SPC testing. The PMO does not have a standard for how many coliforms are allowed in pre-pasteurized milk, but the state of California allows coliforms up to 750 cfu/mL of milk.

In comparison, the Raw Milk Institute Common Standards call for <5,000 cfu/mL for SPC testing, and <10 cfu/mL in coliform testing. As you can see in the chart below, intentionally-produced raw milk is measurably quite different from pre-pasteurized raw milk, and even meets stricter standards than pasteurized milk.

The Raw Milk Institute has been collecting monthly Standard Plate Count and Coliform Count data from its LISTED raw milk dairies since 2012.  This dataset of thousands of test results shows that raw milk farmers who have been properly trained can routinely meet the stringent standards set forth in the Common Standards.

Research on Raw Milk Safety

Researchers from Canada and Europe have studied the safety of raw milk intended for direct human consumption. They have found that carefully produced raw milk is a low-risk food which is fundamentally different from pre-pasteurized milk. 

The table below contrasts pathogen test data from pre-pasteurized milk vs. raw milk intended for direct human consumption.  As illustrated in the table, pathogen testing of pre-pasteurized milk samples has detected pathogens in up to 33% of samples.  In contrast, there were zero pathogens detected in thousands of milk samples from raw milk intended for direct human consumption. It is clear from this test data that pre-pasteurized milk is categorically different from raw milk intended for direct human consumption.

Data courtesy of the British Columbia Herdshare Association

Not All Raw Milk Is Dangerous!

It is clear that raw milk produced with the intention to be pasteurized is likely to contain dangerous pathogens. This type of raw milk is unsafe, and I would never feed it to my family. Unfortunately, this type of raw milk’s negative reputation has led many to believe that all raw milk is unsafe to consume.

It is important to note that there is no such thing as a perfectly safe food. An analysis of foodborne illnesses from 2009-2015 showed that the top food categories commonly linked to illnesses were chicken, pork, and seeded vegetables. Pasteurized milk is not perfectly safe, either, and is implicated in foodborne illnesses and outbreaks every year.  The CDC outbreak and illness data which is used to assert that raw milk is unsafe does not distinguish raw milk intended for pasteurization from raw milk that is carefully produced and intended for direct human consumption.

It is clear from the above-presented test data that intentionally-produced raw milk is a low-risk food. In my family, we purposely choose raw milk for its superior nutrition and significant health benefits over pasteurized milk.  Raw milk contains greater bioavailable nutrients than pasteurized milk, as well as a wide array of beneficial enzymes and probiotics which are known to have benefits on the immune system and gastrointestinal tract.   

FREE Raw Milk TRAINING: RAWMI Risk Management Training Video Series

The Raw Milk Institute (RAWMI) has trained hundreds of farmers through in-person workshops around the USA and Canada.  For those who cannot attend our training in-person, we have a free web version for you!

RAWMI’s Risk Management Training Workshop is now available to watch on Vimeo here. This 4.5 hour course is broken into 17 segments for easier viewing. There are direct links to each of the 17 segments towards the bottom of this post.

About the Training

This RAWMI training focuses on:

• benefits of raw milk,

• grass-to-glass identification of risks,

• development of a risk management plan, and

• lessons learned from other raw milk dairies.

It includes lots of practical tips for the production of safe raw milk. This training has been shown to reduce outbreaks and illnesses, increase safety, and lower insurance costs.

Links to Specific Segments

The overall training course is 4&1/2 hours long, but we have broken that down into 17 smaller segments so that you can easily find the sections you want to watch.  

WORKSHOP OVERVIEW: 

PART 1 – Introductions and About Raw Milk Institute  

PART 2 – Raw Milk History and Opposition 

PART 3 – Raw Milk Benefits 

PART 4 – Raw Milk Risks and RAWMI Method 

PART 5 – Introduction to Grass-to-Glass Risk Management   

PART 6 – Small-Scale and Large-Scale Raw Milk Production 

PART 7 – Risk Minimization: Grass, Pasture, and Water 

PART 8 – Risk Minimization: Animal Health and Biosecurity 

PART 9 – Risk Minimization: Milking and Udder Prep 

PART 10 – Risk Minimization: Management 

PART 11 – Q&A for Parts 1-10 

PART 12 – Risk Minimization: Management (cont.) 

PART 13 – Risk Minimization: Management (cont.) 

PART 14 – Risk Minimization: Glass, Bottling, and Inspections 

PART 15 – Raw Milk Testing 

PART16 – Why to Become RAWMI LISTED 

PART 17 – Conclusion and Final Q&A

What Attendees Have Said

Here is some of the feedback we received from attendees at this training: 

“Excellent presentation that every single person who dairies for themselves and their family should take and learn from. Thank you very much.”

“This has been excellent!  ONLINE was so helpful as it’s hard to travel and be away.”

“For me, the combination of technical information and anecdotes is very effective for explaining why the RAWMI methods are important and how they solve a raw milk producer challenges. I came away with practical solutions to increase the quality/value of our milk and farm. Thank you." 

“I left the Zoom meeting with a very clear understanding of what we are doing right and where we need to make changes. Beyond that, though, I left inspired to pursue excellence and cast a clear vision to everyone who is joining me in this endeavor.”  

“The information was also rich and informative. I learned a ton and the systematic way you presented it was easy to follow and comprehensive.” 

“I cannot wait to move forward with you in becoming RAWMI Listed. We will be making some changes as we form our RAMP plan. We have already adjusted our milk chilling and have seen an improvement in flavor and longevity.”  

“Thank you for all you do. I have no doubt history will look back at the RAWMI as having played a crucial role in reforming raw milk production, health, and nutrition.”

Bird Flu and Raw Milk: Where is the Evidence?

We are pleased to share with you this balanced analysis of the risks of H5N1 bird flu from raw milk, from medical microbiologist Peg Coleman. Peg serves on the Advisory Board for Raw Milk Institute and she will be presenting a free webinar about Milkborne Risk Analysis (including a discussion of H5N1 avian influenza and raw milk) on Thursday May 9 at 11am Pacific / 2pm ET.

Recent risk communications from CDC , FDA, and USDA regarding transmission of influenza A sub-type H5N1 (highly pathogenic avian influenza virus or HPAI) to humans via raw milk include no supporting evidence of viral transmission from raw milk to humans in the peer-reviewed literature. CDC and USDA reported that the HPAI strains recently isolated in the US lack the genetic markers for viruses adapted to infect humans. An extensive body of scientific evidence from the peer-reviewed literature introduced herein does not support the assumption by these US government agencies that HPAI transmits to humans via milkborne or foodborne routes and causes disease. Nor does the scientific evidence support the recommendation that consumers should avoid raw milk and raw milk products.

One Detected Case: Worker Contact with BOTH Dead Birds and Affected Cows?

In March of 2024, dead wild birds on a TX dairy farm and unusual symptoms in older dairy cows (decreased lactation, low appetite, other clinical signs) triggered sampling of affected cows (oropharyngaeal swabs) and their milk. On March 25th, Texas Animal Health Commission confirmed samples were positive for HPAI. A dairy worker on this farm with eye inflammation was also confirmed positive for HPAI, though it is unclear if the worker had contact with both the dead birds and the affected cows. Similarly, it is unclear if dead cats on affected dairy farms were infected by contact with dead birds, milk, or other sources of viral contamination. 

On April 9th, the World Health Organization (WHO) stated the following about the TX case. “This is the first human infection with [HPAI (H5N1)] acquired from contact with infected cattle and the second confirmed human case of influenza A(H5N1) detected in the country. No additional associated cases of human infection with influenza A(H5N1) have been identified. Since the virus has not acquired mutations that facilitate transmission among humans and based on available information, WHO assesses the public health risk to the general population posed by this virus to be low and for occupationally exposed persons, the risk of infection is considered low-to-moderate.” In addition, the American Association of Bovine Practitioners (AABP) now recommends a new name, Bovine Influenza A Virus (BIAV) because the virus is not highly pathogenic in dairy cows.

The WHO lists the following factual information about avian influenza: i) “Direct contact with infected animals (through handling, culling, slaughtering or processing) or indirect contact (through environments contaminated with bodily fluids from infected animals) represent a risk for human infection.“; ii) “animal influenza viruses are distinct from human influenza viruses and do not easily transmit to and among humans;” and iii) sustained person-to-person transmission is not demonstrated.

Animal Contact is the Only Demonstrated Transmission Source

Of all the transmission sources reported in surveillance systems by CDC and other government agencies (animal contact, environmental, foodborne, person-to-person, and waterborne), the only demonstrated transmission source for HPAI transmission to humans is animal contact. In light of the body of evidence on HPAI transmission to humans by direct animal contact, not by foodborne transmission, risk communications to avoid consumption of raw milk and raw milk products do not appear to be based on scientific evidence, but on other factors.

An earlier risk assessment conducted by FDA and USDA (2010) determined that HPAI “is not considered to be a foodborne pathogen although virus had been isolated from poultry muscle and the interior of eggs”. This is consistent with current facts compiled by the WHO about avian influenza transmission to date: i) “Direct contact with infected animals (through handling, culling, slaughtering or processing) or indirect contact (through environments contaminated with bodily fluids from infected animals) represent a risk for human infection.“; ii) “animal influenza viruses are distinct from human influenza viruses and do not easily transmit to and among humans;” and iii) “sustained person-to-person transmission is not demonstrated”. Although HPAI was detected in milk from ill cows in TX, as in poultry muscle and eggs, no evidence supports foodborne transmission of HPAI to humans.

Antiviral Properties of Raw Milk

While no evidence supports milkborne or foodborne transmission of HPAI to humans, evidence does exist that demonstrates a multitude of well-characterized mechanistic factors that inactivate viruses and prevent foodborne illness. Key studies in the peer-reviewed literature are cited in brackets, with full references appended.

First, consider peer-reviewed studies demonstrating antiviral properties of a suite of bioactive components of raw mammalian milks, including bovine milk [4,5,7-9,12-14,16,17,19]. Multiple researchers note that some of the antiviral components of milk are likely function synergistically, meaning effects are greater in combination than independently, an observation particularly relevant in complex gut ecosystems of humans that include innate and adaptive immune systems. Many of these bioactive components of raw milk are also sensitive to heat and may be absent, inactive, or present in lower concentrations in pasteurized milks. Considering the extensive literature on antiviral activity in milk, clinical researchers [3] applied deep scientific knowledge to recommend that infants not be deprived of raw breastmilk due to the presence of viruses. The benefits of feeding raw breastmilk including its antiviral components to infants outweighs the very small risk of infection, from their perspective as clinical researchers, one associated with the Italian Association of Human Milk Banks.

Defense Against Pathogens in the Human Digestive Tract

Next, consider the gauntlet of defenses against foodborne pathogens in the human digestive tract [1,6,18]. These defenses include physical (stomach acidity, peristalsis), chemical (digestive enzymes), and cellular (innate and adaptive immune system, microbiota) factors that, acting simultaneously or sequentially, inactivate pathogens, including viruses, and/or suppress infectivity and virulence of ingested pathogens. Researchers [11] note that HPAI is an enveloped virus, susceptible to disruption and degradation in stomach acids, unlike the 16 viruses known to be transmitted to human by the oral route [6]. Further, FDA and USDA determined in 2010 that HPAI “is not considered to be a foodborne pathogen” even though virus was isolated from poultry muscle and the interior of eggs.

Host chemical and cellular defenses include:  complement; defensins; enzymes; interferons; interleukins; pattern recognition receptors (Toll-like receptors 3, 4, and 7; NOD-like receptors; RIG-1 receptors); and an array of host cells (dendritic cells, B cells, intestinal epithelial cells, macrophages, monocytes, natural killer cells, T cells) and cells of the gut-associated microbes or microbiota. Also, the gut microbiota include not only commensal (non-pathogenic) bacteria, but also commensal viruses that can modulate infectivity and virulence of pathogens [10].

CDC Data on Transmission Sources

Now, consider that the microbial ecology of raw milks including antiviral activity as described briefly above aligns with recent CDC data for all transmission sources from 2005 to 2020 [15]. This CDC dataset included 3,807 milkborne illnesses (2,111 associated with pasteurized milk) linked to bacterial pathogens, but lacks any viral illness associated with milk, raw or pasteurized. The predominant virus in this CDC dataset was norovirus, associated with 8,199 illnesses from leafy greens reported over this 16-year period. No norovirus illnesses or any other viral illnesses were reported in milk.

What is known about HPAI transmission to humans is that it is rare, requiring prolonged direct contact with infected, sick, and dead animals, generally birds, now dairy cows, that can lead to mild flu-like symptoms or eye inflammation, some progressing to fatal infections, according to WHO. Again, HPAI in humans is linked to transmission via animal contact, not by foods.

It seems that occupational exposure resulted in infection of a farm worker handling ill cows, with developed of one symptom in the worker, eye redness (conjunctivitis), consistent with transmission by animal contact. HPAI has been detected in dairy cows in Texas, Kansas, New Mexico and Michigan as of April 2. The dairy animals and rare humans affected have recovered.

Cross-disciplinary evidence demonstrates that raw milk from healthy cows is not inherently dangerous, consistent with the CDC evidence of trends for 2005-2020 [15] and evidence of benefits and risks [2]. There is no scientific evidence that HPAI in raw milk causes human disease.

Please consider the references below and pose questions in the comments. You may be interested to learn more about these recent peer-reviewed publications.

• Trends in burdens of disease by transmission source (usa, 2005–2020) and hazard identification for foods: focus on milkborne disease.
  Journal of Epidemiology and Global Health.

• Suppression of pathogens in properly refrigerated raw milk.
  PLOS ONE

• Lessons identified from applications of the Risk Analysis Quality Test Release 1.0.
  Risk Analysis

This article was originally published on Peg Coleman’s website here: https://www.colemanscientific.org/blog/2024/4/7/where-is-the-evidence

References

1.           Buchanan RL, Havelaar AH, Smith MA, Whiting RC, Julien E. The key events dose-response framework: its potential for application to foodborne pathogenic microorganisms. Critical Reviews in Food Science and Nutrition. 2009 Sep 22;49(8):718-28.

2.           Dietert RR, Coleman ME, North DW, Stephenson MM. Nourishing the human holobiont to reduce the risk of non-communicable diseases: a cow’s milk evidence map example. Applied Microbiology. 2021 Dec 30;2(1):25-52.

3.           Francese R, Peila C, Donalisio M, Lamberti C, Cirrincione S, Colombi N, Tonetto P, Cavallarin L, Bertino E, Moro GE, Coscia A. Viruses and human milk: transmission or protection?. Advances in Nutrition. 2023 Aug 20.

4.           Gallo V, Giansanti F, Arienzo A, Antonini G. Antiviral properties of whey proteins and their activity against SARS-CoV-2 infection. Journal of Functional Foods. 2022 Feb 1;89:104932.

5.           Gallo V, Arienzo A, Tomassetti F, Antonini G. Milk bioactive compounds and gut microbiota modulation: the role of whey proteins and milk oligosaccharides. Foods. 2024 Mar 16;13(6):907.

6.           Lockhart A, Mucida D, Parsa R. Immunity to enteric viruses. Immunity. 2022 May 10;55(5):800-18.

7.           Kaplan M, Şahutoğlu AS, Sarıtaş S, Duman H, Arslan A, Pekdemir B, Karav S. Role of milk glycome in prevention, treatment, and recovery of COVID-19. Frontiers in Nutrition. 2022 Nov 8;9:1033779.

8.           Oda H, Kolawole AO, Mirabelli C, Wakabayashi H, Tanaka M, Yamauchi K, Abe F, Wobus CE. Antiviral effects of bovine lactoferrin on human norovirus. Biochemistry and Cell Biology. 2021;99(1):166-72.

9.           Panon G, Tache S, Labie C. Antiviral substances in raw bovine milk active against bovine rotavirus and coronavirus. Journal of Food Protection. 1987 Oct 1;50(10):862-7.

10.         Pavia G, Marascio N, Matera G, Quirino A. Does the human gut virome contribute to host health or disease?. Viruses. 2023 Nov 17;15(11):2271.

11.         Sangsiriwut K, Uiprasertkul M, Payungporn S, Auewarakul P, Ungchusak K, Chantratita W, Puthavathana P. Complete Genomic Sequences of Highly Pathogenic H5N1 Avian Influenza Viruses Obtained Directly from Human Autopsy Specimens. Microbiol Resour Announc. 2018. 7(22):e01498-18. doi: 10.1128/MRA.01498-18. PMID: 30533850; PMCID: PMC6284082.

12.         Santos I, Silva M, Grácio M, Pedroso L, Lima A. Milk antiviral proteins and derived peptides against zoonoses. International Journal of Molecular Sciences. 2024. 25(3):1842.

13.         Schlusselhuber M, Godard J, Sebban M, Bernay B, Garon D, Seguin V, Oulyadi H, Desmasures N. Characterization of milkisin, a novel lipopeptide with antimicrobial properties produced by Pseudomonas sp. UCMA 17988 isolated from bovine raw milk. Frontiers in Microbiology. 2018. 9:355822.

14.         Singh P, Hernandez‐Rauda R, Peña‐Rodas O. Preventative and therapeutic potential of animal milk components against COVID‐19: A comprehensive review. Food Science & Nutrition. 2023. 11(6):2547-79.

15.         Stephenson MM, Coleman ME, Azzolina NA. Trends in burdens of disease by transmission source (USA, 2005–2020) and hazard identification for foods: focus on milkborne disease. Journal of Epidemiology and Global Health. 2024 Mar 28:1-30.

16.         Tache S, Benkaddour M, Corpet DE. Rotavirus inhibitor and recovery in raw bovine milk. Journal of Food Protection. 1995 Apr 1;58(4):434-8.

17.         Taha SH, Mehrez MA, Sitohy MZ, Abou Dawood AG, Abd-El Hamid MM, Kilany WH. Effectiveness of esterified whey proteins fractions against Egyptian Lethal Avian Influenza A (H5N1). Virology Journal. 2010 Dec;7:1-4.

18.         Wan T, Wang Y, He K, Zhu S. Microbial sensing in the intestine. Protein & Cell. 2023 Nov 1;14(11):824-60.

19.         Wang X, Yue L, Dang L, Yang J, Chen Z, Wang X, Shu J, Li Z. Role of sialylated glycans on bovine lactoferrin against influenza virus. Glycoconjugate Journal. 2021 Dec 1:1-8.

Avian Flu and Raw Milk: A Common Sense Approach

Breaking News!  There is a concern among dairymen and biosecurity experts about a multistate outbreak of avian flu that is affecting cattle in Texas, Kansas, Michigan, New Mexico, and Idaho. Various Federal and state government agencies are using this cow illness outbreak as a stage to warn consumers against drinking raw milk. 

According to the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS), in cattle this illness causes decreased lactation and low appetite, but the cattle generally recover without dying. Cows who have contracted this illness have recovered “with little to no associated mortality,” according to the USDA.

The press and media information released by the USDA and others warns against drinking raw milk from affected cows. They further state that pasteurization protects consumers from the illness.  

Raw Milk and Breastmilk are Very Similar

As a premed-trained dairy farmer who is a 12-year member of the UC Davis International Milk Genomics Consortium (IMGC), I have studied viral infections in cows and the immunologic and biomechanics of antibody creation.  Based on what is known about antibodies and raw milk, there are deep flaws in the warnings about consuming raw milk related to avian flu.  

Dr David Dallas PhD is an IMGC researcher who studies milk genomics. At the 2023 IMGC Symposium, Dr Dallas reported that raw milk from cows and goats is “qualitatively similar” to human breast milk.  However, “quantitatively” bovine raw milk and human breast milk have “different levels” of various milk components.  

This is why raw milk from cows and goats is so well-digested and compatible by human consumers. We can thus compare human mammals with bovine mammals in how mothers protect their babies. 

Mammals Protect Their Young Through Antibodies in Raw Milk

In 2004, the state of California Veterinarian visited our dairy to perform tuberculosis testing of our cows. He told me something I will never forget: “Mammals protect their young.”  

What he meant was that, in general, when a mother becomes infected by a virus or bacterial infection, she will produce antibodies in her raw milk that will provide her young with protection from the illness.  This is part of why breastfed babies are known to have stronger immune systems than babies raised on formula.  Antibodies in raw milk are one way that Nature assures the strength and survival of the next generation.  

The CDC readily acknowledges that mothers should continue to breastfeed their infants because “flu is not spread to infants through breast milk.” They know that breastmilk contains “antibodies and other immunological factors that can help protect her infant from flu.” Similarly, studies performed at the UC Davis dairy lab during COVID found that exposing a cow to coronavirus resulted in antibodies to coronavirus in her raw milk.  

These studies were a further confirmation of what doctors and the owners of Alta Dena dairy knew way back in the 1960’s: cows that have been exposed to illnesses create antibodies to the illnesses which are then passed through their raw milk.  Decades ago, Alta Dena dairy would purposely make immune milk for certain consumers and doctors by intentionally exposing cows to specific illnesses. This raw milk was used to help heal sick people.  Now the FDA does not allow this practice and threatens anyone who uses it with criminal charges. They consider it to be equivalent to creating a new drug without oversight, which is a crime in the USA under the Food Drug and Cosmetic Act.  

Further back in history, it was observed that the milk maidens of the 1700-1800s did not catch smallpox because of their exposure to cowpox by being around dairy animals and drinking raw milk.

Common Sense Approach to Avian Flu in Cattle

The warnings against raw milk related to avian flu are clearly fearmongering.  The FDA acknowledges that “there is limited information available about the transmission of bird flu in raw, unpasteurized milk.” Then they go on to use the same fearmongering tactics they’ve been using for decades against raw milk, despite the fact that there is now ample evidence that raw milk can be carefully produced as a low-risk food.  

Conscientious raw milk producers already monitor their herds for illness and ensure that raw milk from unhealthy animals is not used for direct human consumption. Additionally, biosecurity measures such as maintaining a closed herd and quarantining any new animals are implemented.   

These are common sense measures that are already recommended by the Raw Milk Institute and used by diligent raw milk farmers. We have no reason to suspect that any further measures are necessary in the current Avian flu outbreak in cattle.  Mammalian milk is uniquely designed to protect and strengthen the immune system, and those systems will continue on as new threats arise.

Allergies and Raw Milk

Modern Lifestyles and Allergies

Although allergies were rare prior to the 1800’s [1], they are a common affliction in our modern lifestyles.  As people have moved further from their agricultural roots, allergies have become more prevalent.  Several studies have found that exposure to diverse bacteria and potential allergens in the environment makes a big difference in preventing the development of allergies.

For instance, in a study looking at allergies and asthma in northern Europe, allergy prevalence was much higher in Finnish people as compared to Russians, even though they lived in geoclimatically similar areas [2]. 27% of Finnish school children demonstrated allergic sensitization to pollen, as compared to only 2% of their Russian counterparts. In unraveling the causes for this disparity, the study found a striking result: “the epidemic of allergy and asthma results from reduced exposure to natural environments with rich microbiota, changed diet and sedentary lifestyle.” Basically, exposure to environments with high bacterial and microbial diversity is associated with lower rates of asthma and allergies.   

North Karelia in Finland and Pitkäranta region in the Republic of Karelia in Russia. The dashed lines are Finnish borders before 1944. Haahtela, et al, 2015.

Several other studies have found similar results, and have concluded that living in a farm environment provides protection from asthma and allergies. Contact with farm animals was found to be associated with lower rates of allergies [3], as was “exposure to stables and farm milk” [4]. Although several studies identified that consumption of raw milk (aka “farm milk”) was an integral part of the farm environment, it was argued that allergy protection was from the farm environment and not from raw milk consumption.  However, further research has revealed that raw milk is indeed a key factor in protecting against allergies and asthma.

Children Who Drink Raw Milk Have Less Allergies

Several large epidemiological studies of European children have found correlations between raw milk consumption and decreased rates of allergies.

PARSIFAL Study

The PARSIFAL study was designed to look at allergy risk factors in children. This large study of over 14,800 European children (from Austria, Germany, the Netherlands, Sweden, and Switzerland) investigated allergic diseases in relation to children’s exposure to different environments (farms, rural, suburban) and farm-fresh foods (such as raw dairy products, eggs, and vegetables). The PARSIFAL data relating to allergies and raw milk were published in December 2006 in the Journal of Clinical and Experimental Allergy [5].

The PARSIFAL study concluded that there is a “significant inverse association between farm [raw] milk consumption and childhood asthma, rhinoconjunctivitis, sensitization to pollen, a mix of food allergens, and horse dander." The study found that, regardless of which environment the children lived in, those children who drank raw milk had significantly lower rates of allergies and asthma than children who did not drink raw milk. These effects were “most pronounced in children drinking farm milk since their first year of life.”

GABRIELA Study

The GABRIELA study was designed to investigate the genetic and environmental causes of asthma and allergies.  This study included over 8,000 European children (from Germany, Austria, and Switzerland), and was published in the Journal of Allergy and Clinical Immunology in August 2011 [6]. In this study, raw milk consumption was compared to consumption of boiled/pasteurized milk, and the level of exposure to raw milk in utero through school age was also accounted for. The study also looked into the children’s exposure to farm environments as a possible variable related to rates of asthma and allergies.

The GABRIELA study found that raw milk consumption is associated with significantly lower rates of allergies and asthma, and that this beneficial effect is independent of other farm exposures. It was found that early exposure to raw milk (at <1 year of age) and daily consumption of raw milk increased the beneficial effect in children who drank a mixture of raw milk and pasteurized milk. The consumption of only pasteurized milk “was not associated with any health outcome.”

It’s Not the “Farm Effect,” It’s the Raw Milk!

The above-referenced studies specifically analyzed the effects of living environments, and found that the beneficial effects of raw milk on allergies and asthma were indeed present even in children who did not live on farms. Furthermore, a recent meta-analysis of eight health studies related to raw milk was published in the November 2019 issue of the Journal of Allergy and Clinical Immunology [7]. A meta-analysis is a quantitative statistical analysis which combines the results of multiple scientific studies, thereby allowing the researchers to derive overall conclusions about that body of research.

The recent meta-analysis, written by a team of researchers from the Netherlands and Germany, concluded that when taken as a whole, the body of data from the previous studies shows that raw milk consumption in childhood has a protective effect on allergies and asthma “independent of other farm exposures and that children not living on a farm can theoretically profit from this effect.” 

Why Does Raw Milk Protect Against Allergies and Asthma?

Although it was originally postulated that raw milk’s bacterial content was responsible for its allergy-protective effects, research has not found this to be the case.  For instance, the GABRIELA study found that, “Contrary to our expectations, we did not observe an association between total viable bacterial counts in milk and investigated health outcomes” [6].

More recent research has investigated whether the whey proteins in raw milk could be responsible for the beneficial effect on allergies. A study published in the June 2020 Food and Function Journal “aimed at achieving a better understanding of the underlying mechanism between heat damage to whey proteins and allergy development” [8]. In this study, “raw cow’s milk was heated for 30 min at 50, 60, 65, 70, 75, or 80 °C [122, 140, 149, 158, 167, or 176 °F]… The allergy-protective effect of differently heated milk samples were tested in a murine OVA-induced food allergy model.” 

Heat treatment at 65 °C or higher destroyed allergy-protective capacity of raw milk in murine OVA-induced food allergy model. Abbring, Xiong, et al, 2020.

This study found that allergy protection ceases when raw milk is heated to 149 °F, which is the same temperature at which the whey proteins are denatured.  It was concluded that the whey protein in raw milk provides protection from allergies, asthma, and inflammation.  When heated above 149 °F, these properties are dramatically reduced or eliminated. This finding is an important confirmation of the unique beneficial properties of whole, unprocessed raw milk. 

Low-Risk Raw Milk as a Therapeutic Tool Against Allergies

The research is clear that raw milk consumption is correlated with protection from allergies and asthma. Although a living environment that is rich in bacterial diversity is helpful, it has been demonstrated that the allergy-protective benefits of raw milk are present in both rural and urban environments.  The immunologically active whey proteins are likely the cause of this protective effect.  There is a growing body of evidence that raw milk is a low-risk food when it is produced carefully and intentionally [9, 10]. Thus, low-risk raw milk can be a powerful therapeutic tool for allergy and asthma protection.

References

[1] Hay Fever and Paroxysmal Sneezing: Their Etiology and Treatment. 1887. Mackenzie M. https://archive.org/details/b20406757/page/n7/mode/2up

[2] Hunt for the origin of allergy – comparing the Finnish and Russian Karelia. Clinical and Experimental Allergy. 2015; (45) 891– 901. Haahtela T, Laatikainen T, Alenius H, Auvinen P, Fyhrquist N, Hanski I, von Hertzen L, Jousilahti P, Kosunen T U, Markelova O, Mäkelä M J, Pantelejev V, Uhanov M, Zilber E, Vartiainen E. https://onlinelibrary.wiley.com/doi/full/10.1111/cea.12527

[3] Farming exposure in childhood, exposure to markers of infections and the development of atopy in rural subjects. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology vol. 34,8 (2004): 1178-83. Radon K, Windstetter D, Eckart J, Dressel H, Leitritz L, Reichert J, Schmid M, Praml G, Schosser M, von Mutius E, Nowak D. https://pubmed.ncbi.nlm.nih.gov/15298556/

[4] Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet. 2001;358(9288):1129-1133. Riedler J, Braun-Fahrländer C, Eder W, Schreuer M, Waser M, Maisch S, Carr D, Schierl R, Nowak D, von Mutius E; ALEX Study Team. https://pubmed.ncbi.nlm.nih.gov/11597666/

[5] Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clinical and Experimental Allergy. 2007; 37(5):661-70. Waser M, Michels KB, Bieli C, Flöistrup H, Pershagen G, von Mutius E, Ege M, Riedler J, Schram-Bijkerk D, Brunekreef B, van Hage M, Lauener R, Braun-Fahrländer C; PARSIFAL study team. https://www.ncbi.nlm.nih.gov/pubmed/17456213

[6] The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study. Journal of Allergy and Clinical Immunology. 2011; 128 (4): 766-73. Loss G, Apprich S, Waser M, Kneifel W, Genuneit J, Büchele G, Weber J, Sozanska B, Danielewicz H, Horak E, Joost van Neerven RJ, Heederik D, Lorenzen PC, von Mutius E, Braun-Fahrländer C; GABRIELA study group. https://www.jacionline.org/article/S0091-6749(11)01234-6/fulltext

[7] The Beneficial Effect of Farm Milk Consumption on Asthma, Allergies, and Infections: From Meta-Analysis of Evidence to Clinical Trial. Journal of Allergy and Clinical Immunology: In Practcice, 2019. 8 (3): 878-889. Brick T, Hettinga K, Kirchner B, Pfaffl MW, Ege MJ. https://www.ncbi.nlm.nih.gov/pubmed/31770653

[8] Loss of allergy-protective capacity of raw cow's milk after heat treatment coincides with loss of immunologically active whey proteins. Food and Function. 2020 Jun 24;11(6):4982-4993. Abbring S, Xiong L, Diks MAP, Baars T, Garssen J, Hettinga K, van Esch BCAM. https://pubmed.ncbi.nlm.nih.gov/32515464/

[9] Recent Trends in Unpasteurized Fluid Milk Outbreaks, Legalization, and Consumption in the United States. PLOS Currents. 2018; 10. Whitehead J, Lake B. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140832/#ref27

[10] Raw milk producers with high levels of hygiene and safety. Epidemiology and Infection, 2020; 148, e14, 1-7. Berge AC, Baars T. https://www.ncbi.nlm.nih.gov/pubmed/32000877 

Raw Milk and Lactose Intolerance

People choose to drink raw milk for many different reasons. Some are seeking to support local farms and connect with the places from which their food originates.  Others want to make sure that animal welfare is a high priority in the production of their food. Some people choose raw milk for its delicious, rich flavor.  And still others seek out raw milk in order to address specific health conditions, such as asthma, allergies, and eczema.

Lactose intolerance and maldigestion of pasteurized milk are significant factors for many people who choose raw milk. Nonetheless, when researching the peer-reviewed literature, many would conclude that raw milk cannot help with lactose intolerance. Raw milk detractors often cite a study by Stanford University in their assertion that raw milk does not help with lactose intolerance. However, many people who have been diagnosed as “lactose intolerant” have reported that they can actually drink raw milk with no digestive problems. Let’s dig deep into all of this to better understand the disconnect.

The Stanford Study

The Stanford study, titled “Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study,” assessed the effects of raw milk, pasteurized milk, and soy milk in 16 adults. The people participating in this study were confirmed to have “true lactose malabsorption” through the use of a Hydrogen Breath Test (HBT). Over a course of several weeks, the participants in the study consumed successively greater amounts of raw milk, pasteurized milk, and soy milk in an 8-day milk phase for each type of milk as shown in the figure below.  This study found that there was no improvement in lactose intolerance symptoms with the consumption of raw milk compared to pasteurized milk.

Milk dosage protocol and outcome measures for each 8-day milk phase: full amount of milk was consumed in 1 sitting on each day. Mummah, et al 2014.

Although the Stanford study has often been cited as proving that raw milk does not help with lactose intolerance, there are some significant problems with this study. The sample size of 16 participants is quite small, and this makes is very difficult to make any sweeping conclusions based on the results of the study.  The sample size becomes even more problematic when it is considered that 383 people initially signed up to participate in the study.

The 383 people who volunteered for this study considered themselves to be lactose intolerant. This means that they had experienced digestive symptoms such as diarrhea, abdominal cramping, audible bowel sounds, and/or flatulence as a result of consuming milk products. However, only 27 people were qualified to participate through the use of the Hydrogen Breath Test. Of these 27 people, 16 people chose to participate in the study. Out of the initial group of 383 volunteer participants, only 4% actually participated in the study. This means that 96% of the original volunteers were excluded from this study!

This calls into question the use of the Hydrogen Breath Test as an appropriate measure of lactose intolerance.  Although the HBT is used to characterize the clinical definition of lactose malabsorption, it is clearly not a sufficient test for identifying people who experience digestive symptoms as a result of consuming milk products. The study even mentioned that, “Many people with lactose malabsorption [as diagnosed through results of the HBT] do not report clinical lactose intolerance. Conversely, many individuals with perceived lactose intolerance do not experience malabsorption [as confirmed with HBT].” The Hydrogen Breath Test is clearly not a sufficient test for identifying people who experience digestive symptoms from the consumption of milk products.

Another significant problem with the Stanford study is that the length of the 8-day milk phases may have been too short.  Specifically, the study authors found that “the reduced H2 production observed for raw milk on day 8 vs day 1 suggests a degree of adaptation to raw milk… In contrast to raw milk, no adaptation was observed for pasteurized milk.” The participants had decreased levels of hydrogen in the HBT by the end of the 8-day raw milk phase, and this finding warrants further study to determine whether this trend would have continued over a longer period of time and resulted in a reduction of lactose intolerance symptoms.

Mummah, et al 2014

Overall, the Stanford study fell far short of actually answering the question of whether raw milk can be well-tolerated by people who describe themselves as “lactose-intolerant.” 96% of the volunteers who considered themselves to be lactose intolerant were excluded from this study. Furthermore, the study did not continue long enough to determine if the positive trend in hydrogen production from drinking raw milk would have continued and resulted in reduction of lactose intolerance symptoms.

First-Hand Accounts About Raw Milk and Lactose Intolerance

There have been numerous first-hand reports of improvements in lactose intolerance from the consumption of raw milk. For instance, lactose intolerance runs in my husband's family, coming through his father.  My husband and his siblings all developed digestive problems from consuming milk and other dairy products at around 18-20 years old. Prior to trying raw milk, my husband could only tolerate pasteurized milk products if he took lactase enzyme pills whenever he consumed dairy. However, my husband has been able to drink raw milk in moderate amounts (such as 1-2 glasses per day) with no problems, and raw milk consumption also corresponded with an increased ability to tolerate pasteurized dairy in cheese and ice cream.  My father-in-law was also able to consume raw milk without digestive problems and reported that it also increased his ability to consume pasteurized cheese and ice cream.  

Here are a few more first-hand accounts about raw milk consumption and lactose intolerance.

“I am lactose intolerant. I was diagnosed around the age of 12. I missed so much school due to upset stomach & went off of dairy fully for over 10 years. I can drink raw milk with no issues - I can have cups of it with no bad side effects. In fact - I can even have pasteurized dairy now with little to no problems. It has helped my gut health so much - I notice when I don’t consume it because my digestion gets weird.

“When I first started drinking it I was terrified but after the first cup my body craved it for the first month. It was all I wanted. I could have easily drank half a gallon a day if I didn’t limit myself. That’s tapered off now though.”       ~Bethanie N.

“I had IBS and had to take everything out of my diet and slowly add things back in to see what was bothering me. It was processed dairy. Found raw dairy and now that's all I consume most days. Raw milk, cheese, yogurt, butter. IBS gone, hemorrhoids gone, arthritis gone, inflammation gone, sinus problems gone. Feel like a new woman.” ~Patricia W.

“My kids were all lactose intolerant, but when I switched to raw A2, they all saw a huge difference in response. No more issues. One of my kiddos was at the point of needing her tonsils removed, but they shrunk down to normal size, and her sleep apnea went away.” ~mother of four children

Surveys About Raw Milk and Lactose Intolerance

There have been several raw milk surveys which collected data about lactose intolerance. In a 2007 survey of Michigan raw milk drinkers, 155 people participating in the survey had been diagnosed with lactose intolerance by a healthcare professional. Out of these 155 people, 118 reported that they did not have lactose intolerance symptoms from consuming raw milk.  Thus, 76% of the survey respondents who had been diagnosed with lactose intolerance were able to consume raw milk with no digestive issues.

In a 2011 survey of 56 Michigan raw milk drinkers, “eleven individuals claimed that they experienced symptoms of lactose intolerance when drinking processed milks but had no ill side effects from drinking raw milk.”

In a 2014 survey of 153 Maryland raw milk drinkers, “Fifty-nine respondents claimed no discomfort after drinking raw milk but discomfort from drinking pasteurized milk.

Raw Milk and Lactase

Pasteurization inactivates enzymes and also denatures proteins, and consequently pasteurized milk induces digestive discomfort in many people. Lactase is the enzyme responsible for breaking down lactose into digestible form. Raw milk facilitates the production of lactase enzyme in the intestinal tract, and thus it makes sense that so many people have reported improvements in lactose intolerance from drinking raw milk.

Ancient populations who relied on dairy products adapted over time by developing lactase persistence genes. These genes allow people to digest lactose into adulthood, and they have been found in various indigenous populations in Africa, Europe, Asia, and the Middle East. Overall, around 35% of adults worldwide have lactase persistence genes.

Although it has been widely argued that only people who have lactase persistence genes can consume milk, there are currently many populations around the globe who subsist largely on dairy yet who do not have lactase persistence genes.  For instance, despite the fact that an estimated 95% of Mongolians do not have the lactase persistence gene, their diet relies very heavily on raw milk, cheese, and other milk products.

Furthermore, archaeological evidence shows that humans were consuming raw milk for thousands of years before the widespread appearance of the lactase-persistence gene. Raw milk allowed humans to thrive in conditions where survival would have been difficult. Scientists now believe that lactase-persistence genes were spread through natural selection. This means that the reproductive capacity and/or survivability of ancient raw milk drinkers was substantially increased compared to non-milk-drinking populations.

Large Body of Evidence for Raw Milk and Lactose Intolerance Benefits

First-hand accounts and surveys show that there are many people whose lactose intolerance symptoms are improved by drinking raw milk. Additionally, many worldwide raw milk-drinking populations do not have lactase persistence genes. Furthermore, the archaeological record shows that humans were consuming raw milk for thousands of years before the appearance of lactase persistence genes. This large body of evidence cannot be negated by one small study. The Stanford study should clearly not be seen as the final word on raw milk and lactose intolerance.

Raw Milk Reduces Respiratory Infections and Fevers

A study of 983 European infants looked at consumption of raw milk, pasteurized milk, and ultra-high temperature pasteurized milk alongside occurrence of respiratory tract infections, rhinitis (runny nose), otitis (ear infections), and fever. This study was published in January 2015 in the Journal of Allergy and Clinical Immunology [1].

Every week from age 8 weeks to 53 weeks, the infants’ health outcomes and dairy consumption were tracked. “The main finding of this analysis was an inverse association between consumption of unprocessed [raw] cow's milk and rhinitis, RTI [respiratory tract infection], and otitis.” There was also an inverse association between raw milk and fevers.

In layman’s terms, an “inverse association” means that as one increases, the other decreases. This study thus found that, as raw milk consumption increased, the incidence of runny nose, respiratory tract infections, fevers, and ear infections decreased. The researchers concluded that, “The protective effects of raw cow's milk on infections were comparable to those of breast-feeding, suggesting similar anti-infective properties of bovine and human milk.”

Additionally, C-reactive proteins were measured in the infants at 12 months old. C-reactive proteins are a measure of inflammation in the body. The study found that “raw farm milk consumption was inversely associated with C-reactive protein levels at 12 months.” The researchers concluded that consumption of raw milk led to a “sustained anti-inflammatory effect” in the body.

It is clear from this research that raw milk consumption is correlated with improved resistance to respiratory tract infections, ear infections, fevers, and overall inflammation.

References

[1] Consumption of unprocessed cow's milk protects infants from common respiratory infections. Journal of Allergy and Clinical Immunology. 2015; 135 (1): 56-62. Loss G, Depner M, Ulfman LH, Joost van Neerven RJ, Hose AJ, Genuneit J, Karvonen M, Hyvärinen A, Kaulek V, Roduit C, Weber J, Lauener R, Pfefferle PI, Pekkanen J, Vaarala O, Dalphin JC, Riedler J, Braun-Fahrländer C, von Mutius E, Ege MJ; PASTURE study group. https://www.jacionline.org/article/S0091-6749%2814%2901274-3/fulltext

New Raw Milk Research From the 2023 IMGC Symposium

A Farmer’s Takeaways from the 2023 Symposium of the International Milk Genomics Consortium (IMGC)

“If you are the smartest person in the room, you are in the wrong room.”

Introduction

Well…I was in the right room at IMGC with a huge opportunity to learn and grow. Just like all prior years.

The 20th International Milk Genomics Consortium (IMGC) Symposium was held on September 6-8 2023. This was the 12th year that I have attended the IMGC Symposium. For the last several years, the Raw Milk Institute has been an official Bronze Level Sponsor of the conference. These conferences have taken me all over the world, including Cork Ireland, Quebec Canada, Aarhus Demark (twice), Sydney Australia, and UC Davis in California several times. I am nearly always the only farmer in the room filled with dairy processing scientists, PhD students, dairy science professors and university professors, and other milk researchers.

Over 12 years, I have made some great friends and created some important collaborations and alliances. I am approached by PhDs, especially after I speak at the microphone after a particularly engaging presentation that begs questions. They say things like, “Keep on asking those great questions!”  I am the only one that can ask those questions because everyone else would potentially lose their NIH or industry grants if they dared to asked those kinds of questions.

Time and interest are ushering in a new generation of open-minded PhD researchers, many of whom are women. They all want to talk about raw milk and its bioactive elements. Raw milk is truly a miracle of nature.  Being an event sponsor has allowed greater access to insider information about all things milk.  Below are my main takeaways from three intensive days of meetings, interactions, meals and dinner parties, and presentations in Cork Ireland at the University of Cork.

Raw Milk Institute was a Bronze Level Sponsor of the 2023 IMGC Symposium

Raw Milk Nourishes, Protects, and Directs

Raw milk is incredibly complex and perfectly designed to nourish, protect, and direct. We all know that raw milk is designed as the first food of life for babies to thrive and grow, yet as researchers continue to study raw milk, they discover many more benefits.

For instance, raw milk serves as a delivery system for immune-bioactive proteins. Peptides (which are chains of amino acid proteins) are protective of the baby by not allowing pathogens to cause illness. These functional proteins serve many roles, including protection of the baby.

Other specialized-proteins in breastmilk include natural mRNA, which provide the genetic information to direct cellular metabolic processes in the baby.  Breastmilk also contains stem cells for repair of damaged cells or tissues.

Raw milk also contains everything needed for its digestion. Raw milk has proteases, peptidases (for digesting proteins), lipases (for digesting fats), and bacteria that make lactase (for digesting lactose).

Additionally, when people drink milk, over time there are changes in the composition of the gut bacteria that make milk digestion easier. Lactase-producing bacteria found in the gut become the probiotic and as they feed on lactose, that becomes their selected prebiotic (food that bacteria chose to digest or eat). Over time the populations of these lactose-loving probiotic bacteria increase when they are fed lactose from dairy products.

The various milk proteins, immunoglobins, enzymes, fats and sugars are “qualitatively similar” between human breastmilk and cow milk. However, they are “quantitatively different” and appear at different levels and amounts in cow milk versus human milk. The same would be true for other bovine milks. The similarities are why humans can drink raw milk from cows, goats, and other animals. 

Milk’s Benefits Can’t Be Extracted

Many raw milk researchers are focused on finding ways to extract beneficial elements from raw milk. However, these elements are designed to work together with the full complement of many different macro- and micro- nutrients, enzymes, probiotics, etc in whole raw milk.

New products made with bio-actives extracted from raw milk will likely be met with suspicion, as well they should. The health benefits from whole, raw milk are the result of a complex interplay of bio-actives. Outside of the whole food matrix, those bio-actives are incomplete and not as effective as in their natural state.

Milk Fat is Essential to Its Beneficial Properties

Butterfat in milk is an essential part of milk’s overall beneficial properties. This fat is known to benefit brain development, immune system development, intestinal development, and the composition of the gut microbiota.

Butter fat globules are three-layer thick capsules that come in different sizes. The three-layered capsules are used by the gut as fiber; they also provide butyrate and butyric acids which are highly beneficial and healing to the lower gut. 60% of the bioactive elements found in raw milk are “carried on or inside” the fat globule. This says so much about skim milk, which has lost much of its beneficial value with the removal of the fat.

Researchers discovered that the fat globules in the milk are smaller in cows fed a high energy diet with high stress levels, such as cows being kept in concentrated animal feeding operations (CAFOs). The smaller fat globules in the milk do not contain bacteria inside that could ride through the stomach to the lower gut.

In contrast, the fat globules are larger in cows fed a low energy diet and under low stress levels (such as cows in pasture-based operations).  These larger fat globules carry bacteria inside of them. It is thought that the fat cell may act as a protective carrier vessel to carry bacteria though the stomach acid environment into the lower gut where they may be beneficial.

Pasteurization Damages and Denatures Milk

Pasteurization damages milk such that it becomes oxidated, highly allergenic, and hard to digest. It is a common protocol to pasteurize milk up to 3 or 4 times to achieve longer shelf life and assure that the milk is completely dead, with no regard for the essential and beneficial bio-actives that are destroyed in the process. 

Raw milk contains everything it needs to digest itself. Raw milk contains enzymes and bacteria that help create more enzymes to digest raw milk and all the sub elements. Milk maldigestion has been over simplified. It is not just lactose; it is the proteins and fats that also need help with digestion.

After pasteurization the bioactive elements needed for milk to digest itself are missing! Fats, proteins, and sugars all need digesting, but their enzymes and digestive bacteria are denatured or dead.  Without active enzymes, digestion of fat (via lipase) and proteins (via protease) is inhibited. This results in maldigestion in some consumers. 

Whereas raw milk helps to build immune system strength, pasteurized milk does not build up the immune system. Heat denatures the functional proteins and does not allow cellular direction. This can result in cellular confusion and chaos.

Raw whey proteins are highly anti-inflammatory and have many health benefits. The raw whey health benefit findings are consistent with other researchers in the Netherlands, including Dr. Ton Baars’ research on whey proteins showing that they stabilize MAST cells, control histamine release, and reduce allergies.

However, all whey is required to be pasteurized in the USA as per the Food and Drug Administration (FDA) and Pasteurized Milk Ordinance. Whey proteins are destroyed by processing and are highly sensitive to heat. One researcher has been frustrated in trying to extract the beneficial components from pasteurized whey. The heating of whey makes the components “sticky” such that they plug up the ultrafiltration micropores. Therefore, ultra filtration cannot be used to extract whey components from pasteurized whey.

New Pasteurization Technologies Cause Less Damage Than Traditional Heat Pasteurization

As an alternative to heat-based pasteurization, researchers are studying other methods such as high pressure (HPP), ultrafiltration, and ultraviolet (UV) light. These methods are effective at inactivating bacteria and less harmful to milk than heat-based pasteurization. For instance, both high pressure processing and ultraviolet processing preserve some of the bioactive milk proteins better than heat-based pasteurization.

Nonetheless, milk processors in the USA are resisting the use of these new technologies. In some other countries, UV and HPP are being successfully used, but in the USA the FDA continues to represent processors’ interests and thereby block the ability to innovate with these alternatives to heat processing. This failure to innovate with HPP, UV or Ultrafiltration is creating a loss of consumer interest in pasteurized milk as people continue to suffer from maldigestion when consuming pasteurized milk.

In Studies, 20,000+ Kids Drank Raw Milk With NO Milk-Related Illnesses

The pioneering PARSIFAL and GABRIELA studies of more than 55,000 kids in Europe really set the international high bar for studies on raw milk. The overall findings included reduced rates of asthma, eczema, respiratory illnesses, fevers, allergies, and ear infections in children who drank raw milk.

At the symposium, it was emphasized that during all of those studies and over twenty years of research, there was never a “red flag event.” A red flag event would be a reported illness from raw milk consumption. The studies included data from more than 20,000 children who drank raw milk, and there was not a single red flag event!

Yet, at the end of each of the peer reviewed and journal published articles, there is a disclaimer that says something such as, “even though there are health benefits to consuming raw milk, the researchers can not recommend raw milk because of the risks of raw milk consumption.” This disclaimer was included because peer review and journal publication political pressures demanded it, despite the fact that there was no basis in the research data.

Dr. Markus Ege MD and Mark McAfee, in Cork Ireland at the IMGC symposium 2023

Raw Milk Provides Sustainability for Farmers and Superb Nutrition for Consumers

Farmers have been denied fair markets for their dairy products for more than a century. All of the value-added efforts are happening after products leave the farm. Milk processors continue to ensure that farmers are paid low prices for their milk, resulting in the loss of thousands of family farms. However, raw milk provides a pathway to sustainability and life satisfaction for dairy farmers.

Raw milk presents a unique farmstead product that brings all the added value back to the farmer with an incentive to work on quality. By selling directly to consumers, raw milk farmers are able to obtain greater financial rewards for their work, while consumers benefit from the improved flavor and nutrition. It’s a win-win for farmers and consumers!

Raw milk that is carefully and intentionally produced for direct human consumption is a low-risk food. This type of raw milk is wholly different from raw milk being produced in unhygienic conditions. Raw milk intended for direct human consumption is produced in sanitary conditions, with much care to ensure that the animals are healthy and that the milk is clean. This type of raw milk is tested often and held to rigorous standards to ensure that it is being produced in a way that discourages pathogen growth.

By combining nature’s blueprints, the bio-actives found in whole raw milk, standards for good production practices and modern testing systems, RAWMI Listed farmers are nourishing consumers safely. Congrats to all of the RAWMI Listed pioneers!