Raw Milk and Lactose Intolerance Don't Mix

Milk contains lactose. People with lactose intolerance have insufficient amounts of the enzyme lactase. Therefore, they can't digest all the lactose that's present in milk. The lactose that remains in their intestines creates the problems of diarrhea, gas, bloating, and flatulence.

This is absolutely straightforward, simple, basic digestion 101. But what if your agenda is to push the miracle of raw milk? Raw milk is milk. People with lactose intolerance can't drink it, right? Wrong. If you make up your own science, you can prove anything.

You can find this nonsense all over the Internet. Here's one example: from something called The Douglass Report, which is - get this - "Medicine's Most Notorious Myth-Buster." I can't make this stuff up.

But the natural form of lactose that’s found in real milk (i.e. raw milk) isn’t the problem. Raw milk contains an enzyme called lactase that helps your body break down and absorb the lactose. When milk is pasteurized and homogenized, though, lactase is just one of many enzymes that is killed off in the process.

That’s why most people who are lactose intolerant find that they can drink raw milk without any of the uncomfortable side effects that they typically experience when they eat or drink dairy. Raw milk still contains the lactase that helps your body properly process lactose.

Is that true? Of course not. But it sounds science-y. And hey, there's a study:

The best one I’ve found is a survey conducted by researchers in Michigan. It’s not ideal, but it’s still pretty eye opening. The Michigan researchers surveyed 155 people who had been diagnosed with lactose intolerance, 82 percent of them said didn’t experience any symptoms when they drank raw milk.

Studies are serious science, right? I mean, it would be nice to have a reference to the peer-reviewed medical journal that the study was published in, but you can't expect every little blog post to do footnotes. It's perhaps more of a problem when there was no peer-reviewed study to begin with. The Michigan researchers are the raw milk advocacy organization called the Weston A. Price Foundation. Although advocacy groups can do real research, this one doesn't. The FDA dismissed the study as being methodologically flawed.

If you've been reading this blog since the dawn of time you already know all this. I talked about that study in 2008, when I looked at a raw milk advocacy article by David H. Gumpert in a posting called Raw Milk Article Long But Flawed. I followed up in a 2010 post called Study Confirms That Raw Milk Doesn't Work for Lactose Intolerance:

The folks at the Weston A. Price Foundation, apparently having found out that no one who is not already a True Believer will swallow a fake "study" having as much scientific validity as one of those online "test your own IQ" sites. They hired Christopher Gardner, an associate professor of medicine at Stanford Medical School to do a real, controlled study.

Here's the result you get when you conduct a real study.

"The data fail to support our hypothesis that Raw Milk confers some benefit over Pasteurized Milk in the form of an improvement in the experience of symptoms of lactose intolerant adults."

Man, I would have loved, loved, loved to have seen their faces as Weston A. Price when they got that piece of news.

The study findings came out exactly the way any sensible person would have expected, given the known science:

[P]articipants went through three eight-day phases during which they consumed pasteurized milk, raw milk, and soy milk. Gardner notes that "the severity of the symptoms was virtually identical for the raw vs. pasteurized milk, while the symptoms of the soy milk were quite a bit, and statistically significantly, lower."

Why am I bringing this all up again? Nothing's changed, has it? Nope, nothing's changed. But the on-the-ball folks at Time magazine, the ones with the huge salaries and the unlimited research budgets, have just now noticed this study! Seriously. On Time.com on March 10, 2014, I saw this headline, Study Shows Once and for All That Raw Milk Doesn’t Help Lactose Intolerance. I thought this was so important that I needed to share the news with you. Until I read the article and discovered that it referred to the Gardner study that I reported on four years ago. And Time, Inc., doesn't do any better than the brilliant minds at the Douglass Report in giving sources, cites, times, or context.

I am not inherently against raw milk. If you can drink milk without symptoms and have a good local farm available that works tirelessly to ensure that their cattle are clean, then raw milk should be just fine for you. The battle to keep cows clean is a difficult one, which is why outbreaks of disease occur and why raw milk cannot be more than a tiny niche in the milk market. My point is smaller and simpler: there is no difference between raw milk and pasteurized milk for people who get symptoms of lactose intolerance. There is no extra lactase; there are no magic probiotics; there is nothing that will counteract the lactose that is 5% of the milk. This is not an anti-raw milk message: it is a pro-good-science message. It was true in 2010, it's true today, it will be true in 2018.

UPDATE: Time did have a reason to discuss the study now, as it turns out. It finally got published in a journal. Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study by Surah Mummah et al., Annals of Family Medicine, March/April 2014, doi: 10.1370/afm.1618 Ann Fam Med March/April 2014 vol. 12 no. 2 134-141. Gardner is one of the co-authors. 

CONCLUSIONS Raw milk failed to reduce lactose malabsorption or lactose intolerance symptoms compared with pasteurized milk among adults positive for lactose malabsorption. These results do not support widespread anecdotal claims that raw milk reduces the symptoms of lactose intolerance.

I've removed some of the snarky comments from the original post, although I still feel that Time has an obligation to make some mention of sources in reporting about medical studies. And they are still invited to come here and read.

Better Tasting Lactose-Free Milk Coming?

"The future's so bright, I gotta wear shades."*

More news about better products maybe possibly hopefully some day coming to a supermarket near you.

To talk about the future, you know I'm going to start with the past and work my way there slowly. Feel free to skip a few paragraphs.

Lactase supplements were invented in 1964 by a Dutch company then known as Gist-Brocades. Happy 50th lactase! I don't know what market they were aiming for, since hardly anybody outside of a tiny community of researchers knew about the existence of lactose intolerance, but with high hopes and no fanfare whatsoever the company put out a product called Maxilact. The first Maxilact was a powder that could be added to fresh milk to break down the lactose into glucose and galactose, both simple sugars that the body can easily digest. America got introduced to lactase in the 1970s, when Alan Kligerman bought the rights and started a company now known as Lactaid. Lactase pills are now so common in every supermarket, pharmacy, and discount store that they don't really need much in the way of advertising. Same with lactose-free milks, which use a liquid solution of lactase to break down the lactose before it reaches your body. They can be found everywhere, too, with most major supermarket chains having their own house brand alongside of regional and national lactose-free milk brands.

Today lactose-free worlds is super-shiny indeed compared to the world of 1978, when I learned I was lactose intolerant. I didn't even hear about Lactaid pills until 1984. Milks arrived later, and they started as 80% or 90% lactose-reduced. True 100% lactose-free milks are newer still.

So what can be greater than 100% lactose-free milk in a dozen different varieties? How does better-tasting 100% lactose-free milk sound?

Milk that's had lactase added to it apparently has a problem, a problem named arylsulfatase. Don't feel bad if you've never heard of it. I never heard of it either and I've been studying the field for 36 years. But there it is in Elsevier's Encyclopedia of Dairy Sciences (Second Edition) from 2011. I'm sure it's a steal at $1136 for the ebook edition but fortunately this particular page is available at Google Books. Here's the science:

[T]he development of off-flavor in lactase-treated UHT (Ultra High Temperature pasteurized) milk is related to the accumulation of ρ-cresol - which when present in minute quantities leads to a severe "medical" or "animal" off-flavor. It was discovered that ther accumulation of ρ-cresol in UHT milk was due to the hydrolysis of sulfanated cresol, which is naturally present in milk, by the enzyme arylsuflanase. Arylsulfanase was introduced in the milk as a side activity in the lactase enzyme preparation, and was found to be present in all commercial neutral lactases. DSM Food-Specialties has recently selected a K. lactis strain [of the yeast used to manufacture lactase] that is devoid of arylsulfanase activity.

Who is DSM Food-Specialties? None other than the current parent company of Maxilact. It's taken a while, but Maxilact just put out a press release announcing that a European patent for this new strain of lactase has been granted.

The patent relates to a lactase enzyme, which is free from arylsulfatase. Arylsulfatase is an impurity found in lactase that converts components naturally present in milk to cause off-flavor in lactose-free dairy products, resulting in a limited shelf life. Adding arylsulfatase-free Maxilact® to a dairy formulation ensures that off-flavor development is no longer an issue and the shelf life can be extended.

Only one tiny detail remains open: This new better-tasting milk doesn't appear to exist commercially right now. Certainly not in America. Maxilact is a major player in the small community of lactase so I'm confident that somebody will start using this. Maybe we'll even see a major ad campaign about lactose-free milk, something that hasn't happened in several years.

The future: you gotta love it.

*Yeah, that was supposed to be ironic but nobody had the patience for irony in the 1980s. Besides misreading Timbuk3's catchy ditty about nuclear destruction, we also managed to hear only the first line in REM's "The One I Love" (This one goes out to the one I love/This one goes out to the one I've left behind/A simple prop to occupy my time) and make a wedding song of Sting's ode to stalkers "Every Breath You Take" ("I'll be watching you"). Seriously, an entire decade in which nobody bothered to listen to all the lyrics in a rock song. What's really ironic is that the older I get the less nostalgia I have.