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Serving up health and fitness insights (daily, of course) with a side of irreverence.
28 Jan

The Definitive Guide to Dairy

I knew going in this was going to be a tricky one, because dairy, especially raw and/or fermented full-fat dairy, resides in a Primal gray area. The literature, the evolutionary reasoning, and the anecdotal reports all unanimously point to sugar, cereal grains and legumes, processed foods, and industrial vegetable oils as being net negatives on the human metabolic spectrum, but dairy is somewhat different. The other Neolithic foodstuffs we can rule out because the science condemning them is fairly concrete and they weren’t on the menu 20,000 years ago. Heck, they weren’t just off the menu; they were basically unrecognizable as food in the raw state. Dairy, on the other hand, is a relatively recent food chronologically, but it is most assuredly and obviously a viable nutritive source in its raw form. It’s full of highly bioavailable saturated fat, protein, and carbs – in equal portions. You could conceivably survive on milk alone (I wouldn’t recommend it, but you could technically do it; try doing the same with honey or raw millet). Milk is baby fuel. It’s literally meant to spur growth and enable a growing body. Our bodies definitely recognize dairy as food, even foreign bovine dairy. But is it good nutrition?

I don’t know. I’m not sure anyone really does, in fact, which is why I place dairy firmly in Primal limbo. And so, this Definitive Guide to Dairy may come across as being a bit less than definitive, but that’s only because I’m being honest: we simply don’t know whether dairy is suitable for regular human consumption. Whether you include or exclude it from your diet, the decision must be borne from a review of the available literature (Cordain v. Weston Price, for example) with an assessment of the potential risks and benefits, followed by a personal assessment of dairy’s effect on your body (try it, then strictly eliminate it, and note the differences). If you’ve been eating dairy your entire life, your body doesn’t know anything else. In that case, you’ll want to fully drop it for at least a month to get an accurate assessment. Remember – pre-Primal, you probably “felt fine” eating grains and sugar every day. You may have to take the same approach if you really want to figure out what dairy does to you.

You could listen to Dr. Loren Cordain and other strict paleos who adamantly oppose all forms of it. They offer a number of reasons why dairy doesn’t belong in the human diet – mainly lactose intolerance and casein intolerance. Yet, the truth is,  lactose (a form of sugar) and casein (a form of protein) are both found in human breast milk, so each of us – and certainly every one of our ancestors – was not only able to tolerate but to thrive for some time during infancy depending on both of these “questionable” molecules. That’s the main thing that makes eliminating dairy a little less clear cut than eliminating grains and legumes. But let’s look a little closer at the intolerance issue.

Lactose Intolerance

The widespread presence of lactose intolerants, who still make up a majority of the world’s inhabitants, is somewhat compelling evidence that maybe dairy isn’t the ideal food many assume it to be. Worldwide, we see that most people aren’t adapted to lactose consumption after age four, when many of us lose the ability to properly digest lactose (actually gene expression for the enzymes involved in lactose digestion are down-regulated). Nevertheless, it would appear that among many people, most of whom can trace ancestry back to herding cultures, some adaptation has taken place that allows them to continue to effectively digest lactose throughout their lives. I would never argue that a lactose intolerant person should drink milk; if it makes you feel like crap, don’t eat it! At the same time, though, if that same person were to complain about getting enough fat in his or her diet, and olive oil and coconut oil weren’t cutting it, I would suggest incorporating some cream, butter, or ghee. Little to (in the case of ghee) no lactose to speak of, and you’d be hard pressed to come up with a better all-purpose cooking fat. Lactose intolerance won’t kill you if you ignore it. It’s actually pretty impossible to ignore rumbling guts, explosive diarrhea, cramps, and bloating, so I doubt the truly lactose intolerant will miss it.

Casein Intolerance

Casein is the primary protein in dairy. It shares structural similarities with gluten, a highly problematic grain protein that can shred the intestinal lining and lead to severe auto-immune issues. Bad, bad stuff, and a big reason why grains are so unhealthy. (And if you’re still not convinced that grains are unhealthy read this (PDF).) Now, paleo opponents of dairy say casein wreaks similar havoc on our guts, and it’s true that gluten intolerance goes hand-in-hand with casein intolerance. But is casein a primary cause of leaky gut, or does it slip in only after gluten has opened the floodgates? Once a floodgate is opened, any protein can enter and cause issues. And after all, casein is the primary protein in human breast milk…

Cancer

Cordain thinks milk leads to cancer, citing a fairly impressive array of studies that seem to suggest a link between milk consumption and various types of the disease. He fingers betacellulin, one of milk’s epidermal growth factors, as the causal agent. In the fetus and suckling newborn, betacellulin helps with growth and tissue differentiation. It’s completely essential for growing infants. In adults, Cordain says it passes cleanly into the gut, completely intact and free to enter circulation, where it can bind to receptors and enhance cancer cell growth. What Cordain doesn’t mention is conjugated linoleic acid (CLA), which is also found in milk fat (especially raw, grass-fed milk, which is never included in any study) and has been shown to possess anti-cancer effects by inhibiting breast cancer cell growth and reducing the activation of insulin-like growth factor receptors (the same receptors Cordain identifies as sensitive to betacellulin). The studies Cordain cites as support of the milk-cancer connection are interesting, but their messages are muddled. As Chris Masterjohn points out, milk proteins mostly appear harmful only when separated from their natural fat. Low fat and skim milk appear to have associations with certain cancers (like prostate), while whole milk appears protective (of colorectal cancer) or neutral. It would be nice to see researchers take a good, long look at full-fat, pastured dairy’s effects on cancer rates. Conventional milk consumption probably isn’t advisable, but the jury’s still out on whether raw, pastured, whole milk is also problematic. We need more data.

Insulin Response

Milk is highly insulinogenic, more than most carbohydrate sources. We’re all aware of the dangers of chronically elevated insulin levels, but that’s also what makes milk such a popular post-workout recovery drink. If you’re insulin sensitive following a tough strength training session, milk’s insulin response can be an effective way to shuttle in protein and glycogen. I don’t do it myself, because I like to fast post-workout (and I don’t like the taste of regular milk) but some people swear by it. This is just speculation, but perhaps the potentially negative effects of milk are negated by the post-workout internal environment (starved muscles, depleted glycogen, insulin-sensitive tissue). Or perhaps those powerlifters are slowly but surely eroding their gut lining. To be on the safe side, maybe limit your milk drinking to immediately post-workout if you’re going to drink it at all.

There isn’t a whole lot of consensus on the subject. People with whom I normally agree on everything regarding nutrition have completely different takes on dairy. Some MDA forum goers report no ill effects, while others complain of joint pain and clogged sinuses from consuming even a single ounce of dairy. More than any other food, dairy seems to be entirely subjective. There is no “one size fits all” approach to it. To be on the safe side and to go “full Primal,” you would technically eliminate it completely, but that may be unnecessary for a relatively large number of people.

In a strange way, this entire blog is just a detailed, science-based map of my own personal journey augmented with anecdotes and experiments from others on similar, but slightly divergent, paths. Much of what I write is founded in science but based on my experiences, and this particular post is no different. When things are gray and murky and the science is unclear and far from definitive, I generally go with anecdote and personal, n=1 experimentation. Personally (and, in a way, this entire blog is just a detailed map of my own personal journey), regular dairy doesn’t generally agree with me. I don’t buy or drink milk. Having said that, I’m a big fan of heavy cream in my coffee and butter in my eggs (and on my steaks and vegetables). I like a nice thick yogurt sauce on lamb, and occasionally either Greek yogurt or fresh whipped cream with berries for dessert. I even have a bit of artisan cheese once in a while. It works for me. I don’t get cramps or gas, and I don’t get leaky gut symptoms from casein alone (gluten is another thing altogether). I’d say, on average, I consume at least one dairy item each day (usually butter), but that’s not a hard and fast rule.

As I mentioned in my book, I think there’s a continuum, a cascading scale of suitability when it comes to dairy. It’s not all created equal.

Raw, fermented, full-fat dairy is probably best.

Tons of traditional, fairly disease-free groups lived with dairy (just as tons of traditional, fairly disease-free groups lived without it), and they all included some form of fermented or cultured product. Cultured butter, yogurt, kefir, clotted milk, cheese – these are traditional ways of increasing shelf life, improving digestibility, and incorporating beneficial probiotics into the gut. Fermentation takes care of most of the lactose, and some posit that it may even positively alter the structure, function, and safety of casein.

Raw, high-fat dairy is next.

Raw butter and cream are minimally processed sources of good saturated fat. They’re free of most lactose and casein, and let’s face it: butter and cream just make everything taste better. If it’s essentially just pure, raw animal fat from grass-fed animals, without offensive levels of milk proteins and sugars, what’s not to enjoy? Ghee is another good choice, and though it technically isn’t raw, it is pure animal fat without a trace of lactose or casein.

Then raw milk.

I don’t advise regular consumption of raw milk, mind you, but if you can tolerate it (no stomach upset, no bloating, no gas, no intestinal issues) an occasional glass is probably OK as a sensible vice. Some farms will even supplement their raw milk with colostrum (the extra rich, “first run” milk that provides even more vitamins and nutrients), resulting in a lower-carb, higher-fat, higher-protein product. Look for that stuff if you’re thinking of buying raw milk.

Organic, hormone and antibiotic-free dairy (full fat, of course).

Bottom line: don’t consume non-organic dairy if you can help it. Avoid homogenized milk if you can, and try not to purchase pasteurized milk (organic or not) on a regular basis. If you’re out getting coffee or something, the regular half and half or heavy cream are fine, and Kerrygold makes a great pastured, pasteurized butter that’s available nationwide.

Other things to consider:

A2 Milk versus A1 Milk

Milk proteins are made up of different beta-caseins, which vary between cow breeds. There are two main categories of beta-casein: A1 and A2, each with different effects. A1 cows (Holsteins and Friesians) produce A1 beta-caseins, which release an opioid-like chemical upon digestion. This chemical, called beta-casomorphin-7 (BCM7), is a protein fragment that figures into the joint pains, digestive issues, and leaky gut symptoms that detractors typically blame on just casein. A2 cows (Jerseys and Gurnseys), on the other hand, produce A2 beta-casein, which has been vindicated. Raw, pastured milk tends to come from Jersey and Gurnsey cows; Holsteins and Friesians produce far more milk and so are used by conventional, factory dairy farmers. The Masai, for example, have A2 cattle.

Goat

Goat dairy is another option, with more fat (that’s never homogenized, even when pasteurized), less casein, less lactose, and fewer digestive issues. Structurally and nutritionally, goat milk is one of the closer corollaries to human breast milk, making it arguably more suitable for human consumption than cow’s milk.

In the end, is there a definitive stamp of Primal approval, or Primal disapproval? I just can’t go either way. Sometimes, the correct path is to admit that you simply don’t know. You can read all the blogs you want, pour over every comment, follow every link, and pontificate about every hunter-gatherer group on the planet, but if you don’t try things out for yourself – either by trying certain dairy products or by eliminating them and noting the effects – it’s all just speculation and hearsay. In the murky, milky world of dairy, it’s up to you to decide your ideal path.

Tell me about your experiences. Is dairy part of your Primal eating strategy? If so, what (butter, milk, yogurt, cheese, etc.) and how much?

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You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I was looking at this article and thought it would be interesting to share…I had no idea that milk could be so bad!

    Pranay wrote on February 18th, 2012
  2. I was curious to see what Hildegard Von Bingen had to say about dairy, and this is what I came up with on the net:

    http://germanfood.about.com/od/introtogermanfood/a/Hildegard_von_Bingen.htm

    Health and Nutrition from the Middle Ages by Hildegard von Bingen
    Germany’s First Nutritionist

    Saint Hildegard von Bingen lived from 1098 to 1179 in Germany. She joined a Benedictine convent in Disibodenberg and became the Abbess at the age of 35. St. Hildegard had visions all her life, which helped her see God’s wisdom and be seen as a prophet. She wrote down what God told and showed her through these visions and published many volumes on science, medicine and theology.

    Healthy Drinks – beer, spelt coffee, fruit juice thinned with mountain spring water, fennel, rose hip or sage teas, wine, goat milk.

    panda wrote on March 3rd, 2012
  3. Oh, and I forgot to include this from Von Bingen’s recommendations:

    Butter and cream from the cow are good, but milk and cheese are better from the goat.

    panda wrote on March 3rd, 2012
  4. DR Earth Store; King St; newtown sydney.australia….

    sell unhomogenised-unpastuised bottled in good old glass milk……

    and it is devine!!!!

    its also organic grass fed jersey a2..

    thankyou jesus!

    zephaniah wrote on March 4th, 2012
  5. I don’t see any information about lactose or casein on my dairy products. Should there be?

    joan wrote on March 5th, 2012
  6. Great article. Don’t know if anyone still looks at this, but I notice that when I drink heavy cream, I can feel my heart pounding very strongly in my chest, and I feel tired. And no, this is not a psychological issue. When I drink whole milk, this doesn’t happen. I always drink milk from grass fed cows. I agree that Jerseys probably have a better nutrient profile than Holsteins, and that raw beats pasteurized as long as it’s from a trusted source. When I eat fatty fish such as salmon, or pastured eggs, I do not get the same sensation. I think the extremely high fat content in cream taxes my digestive system unnecessarily. Also, cream is not technically a “whole food,” it’s just the fatty portion of the milk. I’ll drink probably 500-600 calories worth at one time. All that fat at once is probably not such a good thing. In small amounts, it’s probably a great source of energy, but as a staple…not so good.

    Greg wrote on March 11th, 2012
  7. I gave up dairy because of Sinusitus and Asthma problems except for occasionally using Bulgarian yogurt. I recently used double thick Greek yogurt and first of all got a headache (very rare for me) and secondly my one knee was aching so badly like arthritis that apart from an anti-inflammitory tablet I had to take pain tablets to relieve the pain. I also took Arthro Guard and MSM. Do you think it was from the Yogurt?

    Marge Ballin wrote on March 12th, 2012
  8. Hi Paleo and non paleo people. Can somebody please recommend a suggestion on where or how to purchase A2 dairy products in the USA? I’m in southern CA, but online would also be great

    Thank you!!

    Ryan Palmer wrote on March 28th, 2012
  9. We mostly use A2 milk, in coffee, on cereal etc. Whereupon, of course, the cat wheedles for some. Is A2 milk better for cats than A1, or is the specialised cats’ milk quite different?

    Judy wrote on April 11th, 2012
  10. How about cottage cheese?

    Marlon B wrote on April 14th, 2012
  11. I’m new to this. I’m just wondering if cottage cheese is ok

    Marlon wrote on April 14th, 2012
  12. I’m in the process of doing a minor self-study on the affects of bovine milk. My son is 12 months old and exclusively breast-feeding. When I drink milk, he gets minor diarrhoea for a short while. However, the same doesn’t seem to apply to when I eat cheeses. On a personal note, I do feel better with no milk in my diet, and it wasn’t particularly hard to get rid of either. I’m of the mind-set that milk is fine to drink under these circumstances : 1.) It is raw, and from grass-fed, hormone-free animals and 2.) If you have the “urge” to drink it, your body is trying to tell you you need it.

    Jen wrote on April 14th, 2012
  13. Everybody seems to be arguing about dairy – I think it is something that you have to figure out by trial and error. I went completely grain & dairy free a month ago when I started eating based off the primal blueprint. I’ve had problems with acne that I always assumed would clear up as I’ve gotten older, and it just hasn’t.

    Everything was going great until a few days ago. My skin cleared up really well, and I felt great. I figured the acne must have been from eating the grains, so I started eating sour cream and organic milk. Within 2 days my skin broke out horribly, and I felt like I was getting sick (sore throat & sinus pain).

    No dairy is worth that to me. I dumped that stuff down the drain.

    Also, mirroring what others have said about soy milk – it is horrible. I was a vegetarian for 2 years and ate a lot of soy, and as a male, it was a huge mistake. I’m lucky I didn’t sterilize myself. My testosterone levels bottomed out, and I was put on a testosterone topical ointment as well injections once or twice a month for about a year.

    Eggyhams wrote on April 22nd, 2012
  14. Anecdotal report: I had been drinking raw milk and cream from a local farmer on a daily basis for some time and I have noticed, on ocassion, digestion issues and excessive mucous. I had a recent bout of cold/hay fever and sinus problems, with severe congestion that I dealt with by taking Mucostop (natural enzymes that break down mucous). My sickness knocked me out for several days. It made me more perceptive about what affected my congestion, and I felt that milk made it worse.

    I have stopped drinking milk but continue to take whey protein for post-workout recovery as well as a meal substitute. I feel like it’s less mucous-forming than whole milk. My suspicion is that the fat and the casein are the sources of my issues with milk.

    Also, perhaps I over-consumed it, using it as a meal (breakfast) every day. Since milk is somewhat inflammatory, it needs to be balanced by other inflammation-reducing foods in the diet.

    I have not entirely eliminated dairy but I’ve stopped my daily milk consumption. Ocassionally, if I eat out I will have a dish that contains cheese. Eliminating dairy completely (including whey) is something I would like to try for a few weeks and see if I notice any difference.

    Nate wrote on April 29th, 2012
  15. Lactose intolerant here. I’m happy to see both sides of the issue discussed though! My husband lived in Kenya, and had some contact with the Maasai. Yes, all the hype is true! They consider plants to be “animal food” and subsist on lean, semi-nomadic beef (and blood), hunting, and milk. Unfortunately, we are taught that “milk does a body good” , and the majority of us(70-80% worldwide) can’t digest it. So even though I *look* like any other European,those hidden Cherokee genes ended my whipped cream eating!

    mntnmom wrote on April 30th, 2012
  16. After I got laid off after working away from home and was at home all the time, one of the first things we did was get a dairy goat (nubian, higher fat breed). I already had meat goats and chickens.

    I had been using organic cream only and some cheese as part of my diet, not paleo, mind you, but my living arrangements didn’t allow for it.

    Removing the cow’s dairy from my diet and drinking a lot of goat’s milk and eating a ton of chevre, I lost 25 lbs in less then 3 months, by eating mostly food from my home…chicken, grass fed water buffalo we get locally and vegetables from the garden.

    The milk was/absolutely raw, and I had none of the intestinal problems I would have with cow’s dairy…

    Not all dairy is created equal. I wouldn’t trade my dairy goats for anything in the world right now…they are without a doubt the key to our surviving a long period of unemployment while improving our health dramatically….They are on a diet of whole oats, flaked barley, peanut hsy and my yard. They produce milk at around $2.50/gallon

    Tom L wrote on May 4th, 2012

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