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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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May 25, 2015

Dear Mark: Your Milk Questions Answered

By Mark Sisson
36 Comments

For today’s Dear Mark, I’m responding to as many of the questions and concerns relayed in the comment section of last week’s raw milk post. You guys had a lot of them, ranging from whether raw milk can help with eczema and adult asthma, if homogenization is dangerous, why raw milk might taste and smell fishy, to how many people get sick from pasteurized milk. I also respond to reports of raw milk not being a panacea for immune health, and even an active impediment to it.

Lots of ground is covered today, so let’s get right to it.

Here we go:

Is homogenization dangerous?

The initial hypothesis posited by Dr. Kurt Oster was that homogenization unleashes for full absorption an atherosclerotic enzyme called xanthine oxidase. In the larger non-homogenized milk fat globules, the story went, xanthine oxidase is readily exposed to digestive enzymes and fully broken down into harmless metabolites. Oster said that homogenization places the xanthine oxidase in smaller, more novel milk fat globules called liposomes that protect it from digestion, allowing it to be absorbed intact and get into the blood where it increases oxidative stress and triggers atherosclerosis.

This hypothesis fell apart in 1983 when a researcher showed (among other things) that milk homogenization had never been shown to create liposomes, nor had homogenized milk consumption been shown to increase blood levels of xanthine oxidase.

Furthermore, intake of full fat dairy — the vast majority of which is homogenized — shows consistently negative associations with heart disease. The more full fat dairy people eat, the less heart disease they have. It doesn’t establish causation, of course, but it does make the homogenization-heart disease hypothesis unlikely.

While I prefer non-homogenized dairy, I’m not convinced homogenized milk is dangerous.

I”m curious…..I had some really good raw milk about a year ago, but then stopped getting it because it had turned “fishy.” Is that because of the cows being grassfed or having grains in their diet?

Probably not. A mutation in the FMO3 gene can cause cows to produce excessive amounts of trimethylamine, or TMA, in their milk. TMA is the compound that got a huge amount of press a couple years back for supposedly causing heart disease in people who eat meat. Gut bacteria can metabolize carnitine from meat into TMA, and this seemed to be elevated in people with heart disease. Fish is probably the richest source of TMA around, and TMA causes the “fishiness” commonly ascribed to fish (and, it seems, your milk).

So that’s probably the cause. I’m not sure there’s anything to worry about it, but it’s not a pleasant sensation and I’d probably stop drinking it, too.

As an adult, I’m struggling with asthma. Does anyone know if there is a supposed beneficial effect (anecdotal or otherwise) for an adult already with asthma drinking raw milk?

There are of course anecdotes from adults with asthma, but the strongest scientific evidence appears to be for early life exposure. The “farm effect,” which has been recreated in animal models, is strongest in utero and early infancy.

For what it’s worth, taking NAC (which increases glutathione synthesis, similar to raw milk) has no effect on adults with asthma, positive or negative. And aerosolized glutathione seems to worsen symptoms and bronchoconstriction in adults with mild asthma.

Maybe try it if you can get a good, clean (tested), trustworthy source of raw milk for a reasonable (one you’re willing to pay) price.

What about eczema?

There’s no solid evidence of an association between raw milk consumption and eczema risk in the literature. However, people with skin diseases like eczema tend to have depressed levels of glutathione. If raw milk is increasing glutathione, and low levels of glutathione are causally-related to eczema risk, consuming raw milk during childhood might very well boost a person’s resistance to eczema. But those are a lot of “if”s and there’s no way to say anything definitively.

I wouldn’t be surprised if it conferred resistance when consumed early in life, though.

My sister and I grew up drinking raw milk, probably because it was cheaper, having gone through less processing. My sister was diagnosed with asthma in her teens, and I was always allergic to some grasses and trees. The raw milk didn’t hurt us, but it also wasn’t a magical cure-all for allergies and asthma; it didn’t give us superhuman immune systems and make us impervious to disease.

This is an important point: drinking the purest most grass-feddiest raw milk as a child doesn’t guarantee perfect immune health. Epidemiology suggests that doing so improves a kid’s chances of avoiding asthma and allergies — and there’s a potential mechanism, too — but it’s not reducing it to zero. The studies never say that drinking raw milk eliminates the risk of immune-mediated disease.

A good article – I would be interested in knowing how many people have gotten sick from pasteurized milk.

According to Chris Kresser (and CDC data), from 2000-2007 the United States had “8 outbreaks with 2,214 illnesses, with an average of 277 illnesses per year” associated with pasteurized milk. Based on a 2007 CDC survey which found that 78.5% of the US population drinks pasteurized milk, that’s a 1 in 888,000 chance of getting sick from pasteurized milk.

In the same time period, there were 37 outbreaks and 800 illnesses from raw milk. Since just 3% of the population drinks raw milk (according to the same 2007 survey), that’s a 1 in 94,000 chance of getting sick from raw milk.

An interesting study would be to feed half the calves with pasteurised the other with raw and see if there is a noticeable difference over their lifetime.

It’s actually been done.

For four months, two dairy calves of the same breed were brought up either on pasteurized or raw milk. At the end of the trial, the raw milk-fed calf weighed 200 kilograms and the pasteurized milk-fed calf weighed 115 kilograms. Raw-fed manure was normal and smelled decently, like manure should. When the pasteurized-fed calf pooped, it was runny and grey-white and just all around disgusting. After slaughter, the raw-fed calf’s liver and kidneys were a deep red-purple, the color you want when shopping for quality organs; the pasteurized-fed calf’s organs were pale and sickly-looking. When the stomachs were cut open, the raw-fed calf’s contained mostly solid, relatively cohesive waste. The pasteurized-fed calf’s stomach contained extremely fluid waste that spilled out across the floor.  And the nail in the coffin was probably the state of the testes, which were vibrant and full and powerful on the raw-fed calf.

Words don’t do the differences justice, though. Check out the blog post for pictures of the two calves’ livers, kidneys, stomachs, testicles, and overall appearances to truly see the difference.

Now, we’re not cows. And those calves were relying entirely on the milk, whereas adult humans drinking raw or pasteurized milk generally aren’t using it as a primary source of calories and nutrients. Humans are drinking a cup here, a cup there, on top of our normal diet. Even if pasteurized milk isn’t a suitable base for a monofood diet, we can get away with using it as a source of additional nutrients because we eat so many other foods.

If we’re talking human children, especially infants for whom milk is the primary source of nutrition, raw human milk is a much better option than pasteurized human milk. I even mentioned a bunch of studies in the last milk post showing how infants given pasteurized human milk fail to thrive.

I bought into the raw dairy hype a few years back and managed to make myself sick as hell with tonsillitis. I should have known better because consuming dairy throughout my youth caused me chronic sinus infections.

Yeah, raw milk is still milk. If you have intrinsic issues with milk, if you’ve developed sinus infections in the past from drinking milk, don’t count on raw milk being different. It may very well help, and you might react better to raw dairy than you do to pasteurized dairy, but don’t “push through” pain, inflammation, and full-on illness just because raw milk is supposed to be good for everyone. It’s not.

I’d like to know more about pasteurized vs. ultrapasteurized milk. Most of the organic milks available locally are ultrapasteurized.

Let’s just go through the different types of pasteurization.

Regular pasteurization involves heating milk to 161°F for 15 seconds.

Ultra pasteurization involves exposing milk to 280 ºF temperatures for two seconds. This kills all microbes and makes the milk so shelf-stable that it can sit out, unrefrigerated, for months.

Vat pasteurization involves heating milk to 145° for 30 minutes.

You’ll often hear that ultra pasteurizing milk “flattens” the proteins, makes them unavailable to our digestive enzymes, and allows them unfettered access in their intact state to our blood stream via our permeable intestinal lining, thereby increasing allergic reactions and dairy intolerances. This is in contrast to vat pasteurization, which is supposed to be “gentler” on the milk, allowing more beneficial bacteria and helpful enzymes to survive and reach your cup.

Is it true?

The “protein flattening, digestion inhibiting” argument seems to always be attributed to Lee Dexter, a goat farmer and microbiologist. I couldn’t actually find any references in the literature supporting this specific claim, however. And according to some research, the heating of milk can actually reduce allergenicity of milk proteins in people with milk protein allergy. There’s even research suggesting that kids with milk allergy can use baked milk (which they tolerate) to develop widespread tolerance of unheated milk, which is pretty cool. Another study found that ultra high heat treatment of milk made the proteins more digestible, but only immediately after treatment. Storage of ultra pasteurized milk reduces digestibility.

That said, a lot of people report having issues with ultra pasteurized milk. When a friend of mine had to give his two year old daughter ultra pasteurized cow milk because it was the only thing available one night while traveling abroad, she woke up later that night with intense stomach pains lasting several hours. The next day, they found a source of organic, vat-pasteurized cow milk and everything went back to normal. Ironclad peer reviewed science this is not. But it’s hard for a parent to ignore something like that when it happens to their kid. If it works, it works.

I’ve also had vat pasteurized milk from grass-fed, Jersey cows that, to be quite honest, I wasn’t crazy about. It tasted “cooked,” for lack of a better word. The temperature is lower than the other methods, yes, but 30 minutes is a long time to heat milk.

Hi Mark, I’m wondering if making the raw milk into yogurt decreases the risk of pathogens at all? Maybe the good probiotic bugs would kill any bad bugs? Thanks!

To make yogurt, milk must first be heated. That goes for raw milk too. Since raw milk contains live bacteria that already enjoy a strong foothold, it’s difficult for the yogurt bacteria to establish themselves and turn the milk into yogurt. Thus, not just even but especially raw milk is heated to kill any resident bacteria and open up the floor for the inoculation to take place.

If you want to make kefir from raw milk, you don’t need to heat it.

I think that about does it for questions, folks. If you’ve got any further comments or responses to today’s questions, go ahead and leave them down below.

Thanks for reading!

TAGS:  big moo, dear mark

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36 Comments on "Dear Mark: Your Milk Questions Answered"

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Coco
Coco
2 years 29 days ago

The part about the calves being fed pasteurized milk is really scary and depressing because it’s what I was fed as a baby. If you add the fact that I was born by c-section and got a gazillion of antibiotics, it’s hard not to think all that is still affecting me. Sigh.

Shary
Shary
2 years 29 days ago
Take heart, Coco, the numbers are in your favor. Millions of children have survived and thrived following a C-section birth and being fed baby formula instead of breast milk. I doubt that it’s still “affecting” you as an adult. We humans just aren’t that fragile. That said, I can’t imagine why anyone would think feeding calves pasteurized milk–and how they react to it–could have any possible bearing on how pasteurized milk affects humans. The only common denominator in such a ridiculous experiment would be that pasteurized cow’s milk isn’t any more a natural food for calves than pasteurized breast milk… Read more »
Sofie
Sofie
2 years 29 days ago

Damage done to you when you were a baby can still affect you as adult. Many things can’t be healed. If mom is deficient in vitamin A and the baby is born blind, the baby will stay blind as an adult, regardless of how much vitamin A they eat.

Of course, this also means there’s not much point worrying about it. You’ve got to live with what you got 🙂

Coco
Coco
2 years 29 days ago

It’s not because others thrived with it that it’s harmless. Maybe I’ve been brainwashed by what I read on the internet but I believe it when I read that breastfeeding helps shape the jaws and the teeth. I believe it when I read that anything that compromise the gut flora can compromise health. Anyway, I’m just a little bit discouraged because I lost all my health gains and I don’t know why. Please don’t mind me.

Daniel
Daniel
2 years 28 days ago

I made a passing comment last week and was thrilled to see Mark had dug up an article about the cows fed pasteurised milk. I was of course aware and Mark made mention of it in his comment that a cow is not a human and they rely solely on milk unlike most readers here.

That said it’s still interesting what physiological changes simply heating a food can do.

Star?evo Steve
Star?evo Steve
2 years 27 days ago

I’m with you, Shary! That’s why I disregard every experiment done on flies, rates, rabbits, dogs, and monkeys and any possible applicability to humans. I disregard evolution all together! It’s all ridiculous, from some creatures eating grass that was only meant to be grass for its own sake, right down to misguided butterflies consuming nectar that was never meant for them.

Please help me edit this article:

https://en.wikipedia.org/wiki/Human%E2%80%93animal_breastfeeding

Star?evo Steve
Star?evo Steve
2 years 27 days ago

BTW, I spelled rats the old-fashioned way, “rates”.

Boundless
Boundless
2 years 29 days ago

re: … born by c-section and got a gazillion of antibiotics, it’s hard not to think all that is still affecting me.

These are major topics in Perlmutter’s new book “Brain Maker”, supported by cites showing the impact of that type birth, and the consequences of the excessive childhood ABs.

He outlines several things to do to compensate, which unsurprisingly largely turn out to be things primal followers are probably doing already (other than FMT or the novel method of administering the probiotics, perhaps).

Shary
Shary
2 years 29 days ago

Sorry, but I don’t know what you mean by “childhood ABs” or “FMT.” (Spelling things out is always good if you want people to know what you’re talking about.)

Regardless, Perlmutter doesn’t have all the answers. Chances are quite good that he doesn’t even have very many of them. What he does have is a dedicated following and a lot of money in the bank as a result. Regarding the “impact of that type of birth”, common sense and the sheer numbers involved prove otherwise.

Boundless
Boundless
2 years 29 days ago
Re: … don’t know what you mean by “childhood ABs” … Childhood antibiotics. Re: … or “FMT.” Left as an exercise for the reader. Re: (Spelling things out is always good if you want people to know what you’re talking about.) Not if you’re trying to motivate people to undertake independent research. Re: Regardless, Perlmutter doesn’t have all the answers. What makes you assume that I think so? My impression, after reading his latest book, was that he was being quite restrained. Re: Chances are quite good that he doesn’t even have very many of them. When it comes to… Read more »
Shary
Shary
2 years 29 days ago
Boundless, are you actually blaming birth by C-section for chronic diseases in adults? The numbers I referred to are the millions upon millions of people all over the world who were delivered by C-section that were perfectly healthy as children and remain so as adults. Many of the causes of adult diseases ARE nailed down, and they have nothing to do with C-sections. Actually, your comment “talks” a lot but says very little. Many of those rogue doctors you admire, such as Perlmutter, are either extremists or interested only in making money, or both. Why would you trust or believe… Read more »
Boundless
Boundless
2 years 29 days ago
We’re getting a bit afield of milk here. Re: … are you actually blaming birth by C-section for chronic diseases in adults? See page 36 in Brain Maker (visible for free in the Amazon Look-Inside feature). Follow the cites. Cause? Perhaps not. Strong correlation? Doubtless. Correlation is not causation, of course, but when it’s all we’ve got, we ignore it at our peril. In this case, it’s not all we’ve got. Biome tests are available. Re: The numbers I referred to are the millions upon millions of people all over the world who were delivered by C-section that were perfectly… Read more »
Caroline
Caroline
2 years 28 days ago

There’s a fine line between making people feel anxious or guilty and flagging up potential dangers in some of our increasingly common practices. Diabetes UK reports on a study suggesting that c-section babies are at 20% higher risk of developing type 1 diabetes. I don’t think we should ignore this when c-section rates are so high today. Similarly, the effects on babies of such a high percentage of women receiving iv antibiotics in labour needs attention.

Who Dat
Who Dat
2 years 28 days ago

Add to that list that my 5 month old c-section nephew eats more sugar/rice/soy carbs in day than I have considered or dreamed about eating in quite some time. Can you say sumo wrestler? I knew you could.

Edmund Brown
Edmund Brown
2 years 29 days ago

Here’s an antidote to the depressingness of the calf study. I think the one Mark linked to was unblinded and too small to be much use.

http://wrongdirectionfarm.com/2015/02/11/aristotles-milk/
– this is unblinded and small sample size too, but I thikn one sick calf on a blog shouldn’t be cause for too much alarm…

FWIW I think raw milk is OK. I don’t drink it because any and all dairy doesn’t sit well with me… but it should be your choice if you want to take the risk.

Dave Perozzi
2 years 28 days ago
Edmund – Glad we could provide an “antidote to depressingness”… I went back to the sales slip for those calves. We sold them between 26 and 28 weeks and they averaged 501 pounds. From a 100 pound birthweight start, that means they were gaining right around 2 pounds a day right through a very cold winter. So milk pasteurization clearly doesn’t doom a calf to a miserable life. When I’m home I drink several gallons of certified organic raw milk each week. When I’m travelling I drink grocery store whole milk. While I can taste differences between various milks, I… Read more »
Carla ARNP
Carla ARNP
2 years 29 days ago

Great article answering many questions that I had, Mark.

Regarding the asthma question. Consider reading and listening to this information from The People’s Pharmacy. http://www.peoplespharmacy.com/2014/02/24/when-asthma-is-caused-by-a-chronic-lung-infection/

Boundless
Boundless
2 years 29 days ago

re: If you have intrinsic issues with milk …

Is there a significant difference in rates of bovine dairy sensitivity (and other ailments, like CVD) for beta casein A1 genetics and A2 genetics? If so, general milk advice probably needs to identify the audience.

My understanding is that North American herds are almost entirely A1/A1, whereas A2/A2 or A1/A2 are more common elsewhere.

Resurgent
Resurgent
2 years 29 days ago

So, If I make kefir with unheated raw milk – Will the kefir bugs kill any pathogens present in Milk..? This was not answered clearly.

Shary
Shary
2 years 29 days ago

Mark didn’t say, but the answer is probably not. Raw milk is still raw milk, whether it’s made into kefir or not, and it usually takes heat to kill pathogens. I don’t think there’s any War of the Bugs going on between the good guys and the bad ones in a glass of kefir, but I guess it would be necessary to observe this type of thing in a lab under a microscope to know for sure.

Shary
Shary
2 years 29 days ago

“If you have intrinsic issues with milk…”

Milk gives me GI problems. Therefore I don’t drink it at all. I do okay with most cheeses (on a limited basis), cream, and butter but not so much with yogurt or kefir. I don’t do raw dairy of any kind. I don’t miss it and neither does my body; I’m quite healthy without it. As indicated in the article, milk, whether raw or pasteurized, doesn’t work for everybody. It’s misguided to try to force it on yourself or anyone else just because it’s supposedly good for you.

Groktimus Primal
2 years 29 days ago

Wow, we “got milk” in that post. Never shall Mark have to beat that dead horse again!

Clay
Clay
2 years 29 days ago

I’m still surprised at how volatile this subject is. It’s up there with the vaccination stuff.

Isn’t all this back and forth really just a very complicated way to say
raw milk is obviously going to be more nutritious, but inherently it must carry a greater chance of being contaminated. You decide which is more important. But if milk makes you sick. Don’t drink it.

There, I just wrote Mark’s Part 3 installment of the great milk debate.

Boundless
Boundless
2 years 29 days ago
re: I’m still surprised at how volatile this subject is. And apt to remain so indefinitely. re: It’s up there with the vaccination stuff. Not quite. No is forced to drink milk (however sourced). In many places, however, vax is compulsory. If the combinations, additives, age of administration and/or side effects are a problem, then they are a serious and very political problem (and not one I’ve taken a position on yet). re: … raw milk is obviously going to be more nutritious, but inherently it must carry a greater chance of being contaminated. … But if milk makes you… Read more »
Starla
Starla
2 years 29 days ago

I have made raw yogurt from raw milk, and it works just fine.

Nocona
Nocona
2 years 28 days ago

Every month I make kefir and yogurt from raw milk, it is soooo very simple and delicious.

Janknitz
Janknitz
2 years 29 days ago

In Europe (specifically Germany) shelf stable irradiated milk sold in plastic bags was common when I visited in the late 70’s and early 80’s. I wonder what effect that milk has had on the population there?

Kenn
Kenn
2 years 29 days ago

Regarding your last point — that making kefir doesn’t require the milk to be heated — the same is true of cultured buttermilk. Buttermilk ferments at room temperature and does not require the milk to be heated, and it’s easier to make than kefir, as it can be made with a bit of existing buttermilk as the starter and doesn’t require straining out the “grains” afterward.

Julie
Julie
2 years 28 days ago
As far as c-section goes, I think that it is not a huge risk factor in health. What I wonder is if people in the UK who just go along with c-section are more likely to listen to CW health advice, and just aren’t that aware period. I had an emergency c-section because my daughters HR dropped rapidly. The cord was between her legs, around her chest, and around he neck. There’s was no way she was coming out naturally. But my daughter is healthier than most kids, hardly ever gets sick, is not overweight (in Oklahoma no less) because… Read more »
MrsRathbone
MrsRathbone
2 years 28 days ago

Good point, there’s probably a strong correlation.

People today forget that the alternative to a c-section is often, OFTEN, loss of the baby and (if you shun all that modern medicine) the mum too – a totally unacceptable price to attain some kind of purism.

The alternative to a c-section isn’t a healthy natural birth – it’s often death, this is why “the evil stepmother” is such a feature of fairytales, because so many children lost their mothers, during their own or subsequent births.

In the UK, unsurprisingly, a lot of people who think c-sections are completely undesirable are male. 😉

Kathy
Kathy
2 years 28 days ago
TIn the US, there’s been a huge uptick in “convenience” C-sections over the past 20 years or so – when the baby is NOT in distress and the mother is NOT in danger. These C-sections carry a high mortality risk for the mother. They are often performed as a sort of lawsuit prevention in the ever-litigious OB field. Perhaps the critics of C-sections are confusing the needed procedures with these not-so-needed ones? (And fyi, prior to the 20th century, C-sections were performed on dead or dying mothers to attempt to save the child – whereas otherwise both would have perished.)
Marge
Marge
2 years 28 days ago

I know that it is said that you should heat milk to make yogurt. But I have been making my own yogurt from raw Jersey cow milk, and I have never heated the milk. I just warm it in a water bath up to about body temperature, and let it work with some yogurt as a starter. It is delicious.

Jim
Jim
2 years 28 days ago
Me too. I found some raw goat milk on my last trip to farmer’s market and wanted to use some of it to make yogurt. I looked it up in my fermenting book and it said, ‘if and only if you are you are starting with raw milk it is okay to skip the sterilization step.’ I mixed some cow’s milk yogurt into a quart of raw goat’s milk and stuck it into my dehydrator set to 112 degrees for 14 hours or so and it turned out very palatable. It goes on my grain free granola in the morning.
Mixie
Mixie
2 years 26 days ago

I’m sure this will be buried at this point, but I do have to throw out there that the CDC count is highly suspect. They include illnesses that were CORRELATED with raw milk consumption, without proof of causation. For example, I believe they are still including an outbreak in California that was later proven to be caused by contaminated spinach.

Kim
Kim
2 years 26 days ago
Yes, I believe you are correct. There seems to be a desire by the CDC to prove that raw milk is bad so they will blame raw milk whenever they can get away with it. Statistically speaking, a person is more likely to get sick from pasteurized milk than raw (albeit the risk is very low for both). The problem is, if you get sick from pasteurized milk, you are going to be MUCH sicker than if you get sick from raw milk. On the topic of heating milk to make yogurt – I make yogurt out of raw cream… Read more »
Koen Mulder
2 years 23 days ago

Hi Mark,

One small note: It actually is possible to make raw yoghurt. It’s exactly what we’re doing, along with raw kefir. (www.rauwpower.nl) It’s in the Netherlands however, so I guess that’s not really helping most of the commenters here.

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