Raw Milk Not for Lactose Intolerants

Raw milk is all over the news again, the latest round in this culture war, pardon the pun. Time to sort out fact from fiction.

Raw milk is just milk straight from the cow, with no processing. No homogenizing, no pasteurization, no added vitamins. These days it's also touted by the organic crowd if the cows have not been given the usual antibiotics to protect them from the plague of illnesses that farm cows are susceptible to.

For most of humanity's history, pretty much up until the 20th century, raw milk was the only kind of milk anybody knew. You lived with your animals or very close to them. You or your family or the nearby farmer milked the animal – cow, goat, sheep, camel, yak, whatever – and brought the bucket home. The cream rose to the top and was skimmed off to make butter or mixed in for a richer and fattier milk.

Even when cities developed, the animals were kept close by. In New England villages, for example, the commons – the grassy open area in the center of town – had cows grazing on them. Giant London was full of cows after it had grown to the largest city in the world.

This couldn't last. Cities eventually grew too big for everyone to get their milk from small herds. City dwellers objected to the smell and waste from cows in their midst. Farms moved outside cities and newfangled ways of transportation, like the milk train and later the refrigerated train car, allowed milk to be delivered fresh from the farm to an urban audience. Well, fairly fresh. The well-off got the best milk and the poor got milk from open containers that arrived looking like "dirty cheese."

After Louis Pasteur put forth his germ theory, doctors and scientists started realizing that warm raw milk was an excellent breeding ground for bacteria. Pasteurization – the heating of milk for a period long enough to kill the bacteria – became recommended for all milk.

The one problem with pasteurization is that heating milk changes its taste. The longer milk is cooked and the higher the temperature, the more the taste changes. Over a long period an optimal combination of the two was standardized. (Today, there is also ultra-high-temperature (UHT) pasteurization, which cooks the milk for a very high temperature but for a very short time. This allows milk to be shelf-stable, either giving it a much longer shelf life in the refrigerator case or go without refrigeration in the store entirely. Almost all lactase-reduced milk is UHT treated because its smaller volume of sales doesn't allow for the quick in-store turnover of regular milk. Some small regional firms may make "fresh pasteurized" lactase-reduced milk, but you would have to check locally for it.)

The raw milk forces did not go quietly. They advocated the creation of "model farms," in which careful and continual care of the cows and quick delivery to stores would eliminate the need for pasteurization and any changes in taste or any of the reduction of nutrient content that they claimed pasteurization imparted.

The model farms worked as models. They all failed in production for several reasons. First, the extra expense required for continual care drove up the costs of the milk so that the target audience – the poor who required milk for nutrition – couldn't afford it. Second, the larger the herd the more difficult and expensive continual care became. And third, no matter how careful they seemed to be, problems always crept in somewhere, either from diseases to the cows themselves or inadequately perfect handling before the milk got to the final drinker.

The mass market demanded mass milk. Controlled, cheap, standardized, guaranteed healthy milk in mass quantities. Pasteurization laws were passed in every state. Milk was homogenized so that the cream was evenly distributed throughout. Vitamins A and D, lacking or inadequate in cow's milk, were made mandatory as add-ons. Milk, "nature's perfect food," needed some tweaking to arrive that way at the kitchen table.

Cut to the present. Milk's reputation has taken numerous hits over the last few decades. Hormones and antibiotics given to cows to boost production and protect them against the diseases inherent in mass factory farms have been decried as tainting the milk itself. Whole milk's fat is accused for the obesity crisis in the nation's youth. Anti-meat forces want all milk taken off the menu.

Some of the milk forces have battled back by eliminating the changes that mass milk demanded. Some don't want homogenization. Some don't want pasteurization. Some don't add the hormones and antibiotics to the cow's feed. Some don't do any of these things.

Despite raw milk's checkered history, small farms have popped up all over the country to provide milk straight from the cow to the few who are willing to go out of their way to seek it out. Most states either prohibit the sale of raw milk or impose strict regulations on its sale, but it is generally available on farms or in natural foods stores in a multitude of places.

But there continue to be sporadic problems. In fact, the FDA just put out a warning after an E. coli outbreak in Washington:

Following an outbreak in the state of Washington, the Food and Drug Administration (FDA) is warning the public against drinking raw milk because it may contain harmful bacteria that can cause life-threatening illnesses. Raw milk is not treated or pasteurized to remove disease-causing bacteria.

The risk of drinking raw milk was most recently demonstrated in Washington State by an outbreak associated with raw milk containing the bacteria called Escherichia coli O157:H7 (E. coli). To date, eight illness have been reported in Washington state, several of which were in children. Two of the children remain hospitalized. Health authorities have identified locally sold raw milk as a source of the outbreak, and have ordered the unlicensed dairy to shut down.

According to the Centers for Disease Control and Prevention, more than 300 people in the United States became ill by drinking raw milk or eating cheese made from raw milk in 2001, and nearly 200 became ill from these products in 2002.

The Associated Press later ran a follow-up story in which the dairy denied that it's milk was the source of the contamination. However, that the dairy was unlicensed and illegal, and that three of its own employees got sick lessens any defense that they make. Salmonella bacteria were also recently found in raw milk from a dairy in Arizona. Other illnesses have been reported in Oregon and Pennsylvania.

To quote Ruth Kava, Director of Nutrition for the American Council on Science and Health (ACSH):

As part of the misguided alternative health movement, some have bought into the myth that raw milk is nutritionally and otherwise superior to milk that has been processed in any way.

Some parents also have "unwarranted fears," of genetically-engineered hormones given to cows to prolong lactation. Neither of these myths is true; but that hasn't stopped the proliferation of farms that will provide the unwary with supposedly beneficial raw milk.

The FDA says flatly that:

There is no meaningful difference in the nutritional value of pasteurized and unpasteurized milk.

The unfortunate truth is that raw milk may be a wonderful, better-tasting product if everything associated with it is done perfectly, but the risks associated with it are high. Why? Here's a quote from Dr. Bill Keene, who was a senior epidemiologist for the Oregon State Department of Health:

The risks involved with drinking raw milk are clear-cut for Keene: “When you milk a cow, fecal organisms always end up in the milk, along with skin tissue from the cow’s teat. If you test milk, it has bacteria in it. Even if you do a good job milking a cow there’s still bacteria present. This may be harmless bacteria for the most part, but from time to time it can make you really sick.”

The public debate regarding the health benefits and risks of drinking raw milk appears to come down to what a consumer decides to believe, Paulson said. “It’s a lot like a religion for some. They decide drinking raw milk is what’s best, and there’s not much the law can do to protect people from themselves.”

“Our job is to try to present the information,” Keene said. “And then we say, ‘Good luck, hope you get away with it.'"

My sentiments exactly.

So what does this have to do with lactose intolerance? After all, nobody would make the claim that raw milk should or could be for those with LI.

Unbelievably, this isn't the case. The Organic Pastures Dairy Company has the following sentence on its website as one of its "health boosting rewards" for raw milk:

Lactose intolerant consumers can eat raw milk because lactase producing bacteria are present.

Really? Then how do you explain the ten thousand years of symptoms from those non-mutants who drank raw milk in the past? Are there are chemical tests or double-blind medical studies on the site to back this up? Of course not. On the contrary, they tout tests showing their low bacteria count and give a lactose percentage of 4.23%, about normal. How they reconcile the two claims is beyond me. Yet, these claims are being repeated verbatim in articles by raw milk supporters.

Unless and until the notion that those of us with lactose intolerance can drink raw milk is proven scientifically, treat raw milk exactly as you would regular milk. You can have it in the same amounts, drink it with lactase pills, or leave it alone. Just don't trust in any magic claims.