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Tuesday, March 11, 2014

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 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 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.

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