Few of us were born when the forces for milk pasteurization launched the first major attack on Nature’s perfect food.  In 1945, a magazine called Coronet published an article, “Raw Milk Can Kill You,” blaming raw milk for an outbreak of brucellosis in a town called Crossroads, U.S.A., killing one-third of the inhabitants.  The Reader’s Digest picked up the story and ran it a year later.

Just one problem with this piece of “reporting.”  There was no town called Crossroads and no outbreak of brucellosis.  The whole story was a fabrication—otherwise known as a lie.  And lies about raw milk have continued ever since. Unfortunately, the fictitious Crossroads story paved the way for laws against selling raw milk, starting with Michigan in 1948.

Here’s another example of lies against raw milk (which I referenced in an earlier post, but it is worth repeating). In 2007, John F. Sheehan, BSc (Dy), JD, US Food & Drug Administration, Center for Food Safety & Applied Nutrition (USFDA/CFSAN), Division of Dairy and Egg Safety, prepared a PowerPoint maligning raw milk; it was presented to the 2005 National Conference on Interstate Milk Shipments (NCIMS) by Cindy Leonard, MS.

As shown in the table below, all of the fifteen reports associating outbreaks of foodborne illness with raw milk that Sheehan cites are seriously flawed. For example, in two of the fifteen, the study authors presented no evidence that anyone consumed raw milk products and in one of them, the outbreak did not even exist. Not one of the studies showed that pasteurization would have prevented the outbreak.

Fast forward to the present and the ruckus about bird flu in dairy cows—more lies, very clever lies, but lies nevertheless.

In a press release dated March 25, 2024 , the U.S. Department of Agriculture (USDA), Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), as well as state veterinary and public health officials, announced investigation of “an illness among primarily older dairy cows in Texas, Kansas, and New Mexico that is causing decreased lactation, low appetite, and other symptoms.”

The agencies claim that samples of unpasteurized milk from sick cattle in Kansas and Texas have tested positive for “highly pathogenic avian influenza (HPAI).” Officials blame the outbreak on contact with “wild migratory birds” and possibly from transmission between cattle. The press release specifically warns against consumption of raw milk, a warning repeated in numerous publications and Internet postings.

According to the press release, national laboratories have confirmed the presence of HPAI (Highly Pathogenic Avian Influenza) through testing, but it does not reveal the type of test used to detect this so-called viral illness.

The first lie:   Researchers have found HPAI virus in the milk of sick cows.

Officials have NOT found any viruses in the milk or any other secretions of the sick cows. The CDC has yet to reply to repeated requests for proof of finding the isolated HPAI virus in any fluid of any sick chicken or other animal. Nor have health and agriculture agencies in Canada, Japan, the UK and Europe provided any proof of an isolated avian influenza virus.

As for all the studies you can find in a PubMed search claiming “isolation” of a virus, not one of them shows the true isolation of a virus, any virus, from the fluids (phlegm, blood, urine, lung fluids, etc.) of any animal, bird or human.

The truth is that “viruses” serve as the whipping boy for environmental toxins, and in the confinement animal system, there are lots of them–hydrogen sulfide, carbon dioxide, methane and ammonia from excrement, for example. Then there are toxins in the feed, such as arsenic added to chicken feed, and mycotoxins, tropane and β-carboline alkaloids in soybean meal. By blaming nonexistent viruses, agriculture officials can avoid stepping on any big industry toes nor add to the increasing public disgust with the confinement animal system. Way back in 2006, researchers Crowe and Englebrecht published an article entitled, “Avian flu virus H5N1: No proof for existence, pathogenicity, or pandemic potential; non-‘H5N1’z causation omitted.” Nothing has changed since then.

Here’s your homework assignment:  Contact USDA at Aphispress@usda.gov and ask them to provide proof of the isolation of the HPAI virus or any virus in the milk of the sick cattle.

SECOND LIE: National laboratories have confirmed the presence of HPAI (Highly Pathogenic Avian Influenza) through testing.

They don’t say anything about the kind of test they used, but it almost certainly was the PCR (polymerase chain reaction) test. The PCR test detects genetic material from a pathogen or abnormal cell sample and allows researchers to make many copies of a small section of DNA or RNA. The test was not designed to determine or diagnose disease, it was designed to amplify or increase a certain piece of genetic material.

Each “amplification” is a doubling of the material.  If you amplify thirty times you will get a negative; amplify 36 times or more, and you will get a positive.  At 60 amplifications, everyone will “test positive” for whatever bit of genetic material you believe can cause disease. If you want to show that you have a pandemic brewing, just amplify, amplify, amplify. Folks, this is not a valid test, not good science by any stretch of the imagination—especially as there is no virus to begin with. How many times did our health officials amplify the samples they obtained from the milk of the sick cows?  Be sure to ask them when you email Aphispress@usda.gov for proof of the virus.

THIRD lie: The “virus” is highly pathogenic.

According to the Wall Street Journal, one—just one–person working in the dairies got sick and tested positive for avian influenza after exposure to dairy cattle presumed to be infected with the H5N1 bird flu.  The person reported eye redness, or conjunctivitis, as his only symptom—a symptom that can be explained by exposure to any of the many airborne toxins in confinement dairies, or even to toxic EMF such as 5G.  (How are they treating the illness? With vitamin A and herbal eyedrops?  No, the poor sod is getting treatment with a toxic antiviral drug.)

According to the CDC, the disease in humans ranges from mild infections, which include upper-respiratory and eye-related symptoms, to severe pneumonia.  If the “virus” is so highly pathogenic, we’d expect a lot of workers working around these sick cows to end up in the hospital. . . but we’ve heard of none so far.

FOURTH LIE: You can get avian flu from drinking raw milk, but pasteurized milk is safe

According to medical biologist Peg Coleman, “Recent risk communications from CDC, FDA, and USDA regarding transmission of highly pathogenic avian influenza virus or HPAI (subtype H5N1) to humans via raw milk include no supporting evidence of viral transmission from raw milk to humans in the peer-reviewed literature. . . An extensive body of scientific evidence from the peer-reviewed literature . . . does not support the assumption by these US government agencies that [non-existent] HPAI transmits to humans via milkborne or foodborne routes and causes disease. Nor does the scientific evidence support the recommendation that consumers should avoid raw milk and raw milk products [emphasis in the original].”

Coleman notes the suite of bioactive components in raw milk, including bovine milk, that destroy pathogens and strengthen the gut wall. “Many of these bioactive components of raw milk are . . . sensitive to heat and may be absent, inactive, or present in lower concentrations in pasteurized milks. . . Cross-disciplinary evidence demonstrates that raw milk from healthy cows is not inherently dangerous, consistent with the CDC evidence of trends for 2005-2020 and evidence of benefits and risks. There is no scientific evidence that HPAI in raw milk causes human disease.”

And while USDA, FDA and CDC assure the public that pasteurization will make milk safe, they note that “Milk from infected animals is being diverted or destroyed,” implying that pasteurization alone does not guarantee safety. In any event, sales of industrial pasteurized milk continue their relentless decline.

Fortunately, raw milk drinkers are already skeptical of government pronouncements and are skilled at seeing through lies.  Both large and small raw milk dairy farms report that sales are booming. The current bird flu fracas is just another Crossroads, U.S.A., a bunch of lies fostered by a dishonest dairy industry taking aim at the competition.

The post Raw Milk at the Crossroads…Again appeared first on Real Milk.

During the last few years, bureaucrats and public health officials have been quiet about raw milk, but then Iowa legalized its sale in May. The accompanying publicity—in The New York Times and USA Today,^1,2 plus many other publications—has resulted in a flurry of pro-pasteurization, anti-raw milk Internet posts. One of these appeared on December 8, 2023,³ written by Claire Panosian Dunavan, professor emeritus of medicine and infectious diseases at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and past president of the American Society of Tropical Medicine and Hygiene.

Dunavan can’t understand the “risky allure” of raw milk. “Is it buyers’ faith in ‘nature’s perfect food’ or sellers’ pure, naked greed?” she asks.

The main claims in her article:

• In the 1890s, Nathan Straus (co-owner of Macy’s) started a private foundation to dispense pasteurized milk after his son died of typhus during a vacation in Italy—the death blamed on raw milk. (Dunavan then credits Straus with a drop in U.S. infant mortality from 125 per 1,000 to fewer than 16 per 1,000 between 1891 and 1925.)
• Raw milk consumers are 840 times more likely to suffer illness than those who drink pasteurized dairy.
• Recent outbreaks of illness blamed on raw milk have occurred in California, Utah and Idaho.
• Raw milk contains dangerous pathogens like campylobacter and salmonella.
• Raw milk may cause Guillain-Barré syndrome.
• People are avoiding pasteurized milk because of milk allergy “as opposed to a serious, even life-threatening infection.”
• The real villains are the people who sell raw milk “because they believe there’s an audience out there that will buy it,” even though they “know” that raw milk will harm some people.

PURE, NAKED GREED?

Let’s look at these points one by one, starting with the accusation that raw milk farmers are motivated by pure, naked greed. (In the spirit of full disclosure, I am a dairy farmer who sells raw milk.)

Conventional dairy farmers today receive about the same price as they did during World War II, even while their costs have skyrocketed. Typically, they get $1.45 per gallon, which costs them $2.00 to produce.⁴ This explains why the number of licensed dairy operations in the U.S. has steadily declined by more than 55 percent,⁵ from 70,375 in 2003 to 31,657 in 2020. More than three thousand dairy farms stopped production during 2020 alone—that’s eight per day.

Some of these farmers have avoided going bankrupt by switching to raw milk sales. Typically, consumers are happy to pay from five to ten dollars per half gallon—enough to save the family farm, especially if the farmer reduces his costs by nourishing his cows on grass (the natural food for cows) rather than feeding grain.

Dunavan refers to farmers’ desire to make a decent living as “pure, naked greed,” but let me give you an example of real greed. Dairy company CEOs typically make salaries upwards of three million dollars per year. They do this by keeping milk prices as low as possible—hence the heartbreak of losing the farm inflicted on thousands of dairy farmers. That is what most of us would call pure, naked greed.

TRUE CAUSES OF INFANT MORTALITY

About Nathan Straus losing his son to typhus and blaming it on raw milk, according to that font of conventional knowledge, Wikipedia, typhus is caused by bacteria spread by lice, chiggers or fleas.⁶ Since Dunavan is a public health expert, she should know this. (I have not been able to find any reference to raw milk causing typhus, except for the case of Straus’ son.) Typhus reigns in filthy conditions and it was a real problem, especially in cities, before the advent of modern housing, sewage systems and washing machines. Even today we see outbreaks of typhus, but public health experts typically blame them on rats, never on raw milk!⁷

As for the decline in infant mortality in the U.S. at the turn of the twentieth century, it was during this period that public officials worked to clean up our cities with the installation of sewage systems, rubbish collection and clean water. This was also the period when the car gradually replaced the horse and mule—before the car, our cities were stinking cesspools of manure and grime. Immigrants huddled in crowded housing without running water and refrigeration, and with only rudimentary sanitation (Figure 1). The death rate by the age of five was 50 percent—and this was blamed on raw milk rather than unsanitary conditions—officials called it the “milk problem” (Figure 2).

FIGURE 1. Slum life in New York City’s Golden Age.

FIGURE 2. Manure piled up on a New York City street creating deadly unsanitary conditions—health officials called this the “milk problem.”

Raw milk may indeed have contributed to the high death rate because it came from distillery dairies—inner city confinement dairies of unimaginable filth where cows were fed distillery waste. The milk was so deficient and watery that chalk was often added to make it look white–this was the milk that Straus wanted to pasteurize. However, pasteurization cannot take the credit for the decline in infant mortality as it was around this time that distillery dairies were banned. The real hero was not Nathan Straus, who did nothing for public clean-up efforts, but Dr. Henry Coit, who worked to bring clean raw milk from the countryside to the cities. Public health officials at the time lauded Coit’s certified raw milk with saving children’s lives and noted that children in orphanages brought up on raw milk were healthier than those given pasteurized milk.

QUESTIONING THE REPORTS

About raw milk safety, Dunavan repeats the recent claim that people who drink raw milk are eight hundred forty times more likely to contract food-borne illness than those who don’t.8 But an analysis by epidemiologist Peg Coleman, based on data considered by the Food and Drug Administration (FDA) and the Food Safety and Inspection Service (FSIS), found that on a per annum basis, out of twenty-three foods considered, pasteurized milk ranked second highest and raw milk ranked seventh highest in causing severe illness.9 The real question that one must ask, however, is how accurate are reports of illness and death from raw milk?

The Weston A. Price Foundation analyzed a 2007 PowerPoint presentation by John F. Sheehan, then director of FDA’s Division of Dairy and Egg Safety, who contended that pasteurization is the only way to ensure the safety of milk.¹⁰ Table 1 shows that the fifteen studies Sheehan referenced (through 2005) either were methodologically flawed or that bias or outright fabrication guided the conclusions that he drew; not one of the studies cited by the FDA actually proved that raw milk caused the illness. We need to do the same analysis for reports of raw milk illness from 2005 to the present—one that includes the claims of illness from raw milk in California, Idaho and Utah. It’s safe to assume that many of them are bogus, given the alacrity of public health officials to blame raw milk for any illness without a thorough examination of all the data.

TABLE 1. Unfounded conclusions from raw milk studies

According the late Dr. Ted Beals, who analyzed reports of foodborne illness from 1999 to 2011,11 government data report an average of forty-two illnesses from raw milk per year out of nearly ninety-one thousand (90,771) illnesses from all sources. Using these figures, Dr. Beals concluded that one is thirty-five thousand times more likely to become ill from other foods than from raw milk. Beals also noted that there is no way to quantify whether any one food is safer than another from the data we have, but at the same time, it is clear that there is no basis for singling out raw milk as “inherently dangerous.”

Recently, melons have ranked high in causing illness—including an outbreak from cantaloupe that resulted in over three hundred illnesses, over one hundred hospitalizations and four deaths. Where is Dunavan’s outcry against greedy melon growers? And what about raw oysters, which kill fifteen people per year?¹² Where are the warnings to oyster lovers not to eat these terrible things?

PATHOGEN FACTS

Dunavan implies that raw milk can cause Guillain-Barré syndrome (GBS)—a degeneration of the nerve cells that causes muscle weakness and paralysis—because raw milk can carry campylobacter, and campylobacter often gets the blame for GBS. Of course, many, many foods harbor campylobacter. In 2019, there were over 150,000 reported cases of GBS worldwide;¹³ a quick Internet search does not find any of these cases associated with the consumption of raw milk.

By the way, campylobacter and salmonella, the two pathogens most commonly associated with raw milk, do not grow in refrigerated raw milk. In a pilot study sponsored by the Raw Milk Institute, refrigerated raw milk inoculated with high and moderate counts of these pathogens suppressed their growth.¹⁴ Inoculated listeria did grow in raw milk, but an association of this pathogen with raw milk is extremely rare. Moreover, a recent systematic review found that the risks of severe listeriosis infection were greater for pasteurized milk products than for raw milk products.¹⁵

CONSUMERS SHUNNING PASTEURIZED MILK

Dunavan wonders why people would indulge in the risky behavior of drinking raw milk. There are very good reasons for drinking raw milk, but first, let’s consider why fewer and fewer people are drinking pasteurized milk. In both the UK and the U.S., consumption of pasteurized milk has declined by 50 percent since 1974 (Figure 3). (I would love to know whether Dunavan herself drinks pasteurized milk!)

FIGURE 3. UK per capita liquid milk consumption, 1974–2018

To find out why consumption of pasteurized milk is declining, let’s consider a 2019 study out of China, entitled “Processing milk causes the formation of protein oxidation products which impair spatial learning and memory in rats.”¹⁶ The researchers subjected milk to four processing techniques: boiling, microwave heating, spray-drying and freeze-drying. (Boiling takes milk to 212 degrees F; ultra-pasteurization takes milk to 280 degrees F. Most milk sold today is ultra-pasteurized.) All four techniques (even freeze-drying) caused oxidative damage to the milk proteins and resulted in “various degrees of redox state imbalance and oxidative damage in plasma, liver, and brain tissues.” Feeding damaged milk proteins to rats resulted in learning and memory impairment—no wonder IQ levels are falling!

The researchers concluded, “humans should control milk protein oxidation and improve the processing methods applied to food.” But how to improve those processing methods? What types of processing methods would they suggest? How about no processing at all? Why not just treat milk carefully and cleanly and let the many natural antimicrobial compounds in raw milk do their work?¹⁷

Milk proteins are not tough like muscle or collagen proteins; they are extremely fragile and easily damaged by heat and pressure (as in heated drying). No wonder the consumption of industrial pasteurized milk is declining—the body sees processed and damaged milk proteins as foreign proteins and mounts an immune response. This explains why milk protein is the number-one allergy and why studies link consumption of pasteurized milk with digestive disorders, rashes, asthma, diabetes . . . and even sudden death.

Based on statistics provided by the Allergy & Asthma Network,18 one can deduce that pasteurized milk causes approximately twenty deaths from anaphylactic shock per year! The type of milk that is truly dangerous is pasteurized milk. Yes, indeed, a good “reason not to” drink pasteurized milk is allergy—life-threatening allergy. Parents are figuring out that they shouldn’t give this junk to their children. . . or drink it themselves.

Pasteurized milk is the milk that causes health problems, while raw milk is indeed Nature’s Perfect Food—after all, it is the food in Nature that nourishes all mammals, loaded with vitamins and minerals, each one of which has a special enzyme that ensures 100 percent assimilation. When milk is pasteurized, these nutrients are largely destroyed, or rendered very difficult to absorb (Table 2).

TABLE 2. Destruction of nutrients by pasteurization

REASONS TO GO RAW

More reasons to drink raw milk: less asthma and respiratory infections, fewer allergies and rashes. These are the conclusions of a number of European studies, which pasteurization proponents in the U.S. dismiss, but which public health officials in Europe have taken seriously. These include:

• A 2001 study published in The Lancet: Less asthma, fewer allergies;²⁷
• The 2006 PARSIFAL study (Clinical & Experimental Allergy): Less asthma, fewer allergies;²⁸
• The 2011 GABRIELA study (Journal of Allergy and Clinical Immunology): Less asthma, fewer allergies;²⁹
• A 2012 study (Current Opinion in Allergy and Clinical Immunology): Less asthma, fewer allergies;³⁰
• The 2014 PASTURE study (Journal of Allergy and Clinical Immunology): Less respiratory infection.^31,32

In the U.S., asthma kills nine people per day, many of them children. When parents see that raw milk relieves asthma in their child, they go out of their way to obtain this magical product from greedy farmers.

There’s more: early studies indicate that raw milk given to growing animals confers longer and denser bones compared to pasteurized milk.³³ I’ve heard from several gals diagnosed with osteoporosis who started drinking raw milk daily and passed their bone density test two years later. Raw milk also contributes to strong, healthy teeth.³⁴ And many people who can’t tolerate pasteurized milk can enjoy raw milk without problems.³⁵ I’ve even had parents tell me that their children’s behavior improved after they made just one change in their diet—switching from pasteurized to raw milk.

LOOKING TO THE FUTURE

For these and other reasons—such as the fact that raw milk tastes so good—raw milk sales are booming. Our website realmilk.com gets over 400,000 visits per month, most of them to the Raw Milk Finder page. When we set up realmilk.com in 1999, we had only a handful of listings; today, the website lists over 3,000 places to get raw milk in the U.S., and there are many more not listed. Raw milk farmers tell me that they can’t produce enough raw milk to meet the demand—which means that these greedy farmers aren’t charging enough for it.

The truth is, pasteurization is a Rust Belt technology—a bit like hitting a pile of manure with a sledgehammer. It lets the industry get away with raising cows in filthy, crowded conditions, but it doesn’t make milk any safer and it ruins Nature’s perfect food. We have come a long way since the days of Nathan Straus. We have the technology to produce clean raw milk—stainless steel, rapid cooling, on-farm testing, an efficient nationwide cold chain—and get it to every growing child in the country.

Raw milk is the future. I predict that within twenty years, pasteurized milk will be a thing of the past. Small, grass-based dairy farms will proliferate to meet the demand, and no couple will start a family without making sure there is a supply of raw milk nearby. Health officials like Professor Dunavan can protest all they want, but fewer and fewer people are listening.

This article was first published in the Winter 2023 issue of Wise Traditions in Food, Farming, and the Healing Arts, the quarterly journal of the Weston A. Price Foundation.

ABOUT THE AUTHOR

Sally Fallon Morell is founder of A Campaign for Real Milk and president of the Weston A. Price Foundation.

REFERENCES

1. Blum D. Raw milk is being legalized in more states. Is it safe? The New York Times, Jul. 11, 2023. https://www.nytimes.com/2023/07/11/well/eat/raw-milk-risks.html
2. Leys T. “Public health has lost the war”: States legalize raw milk, despite public health warnings. USA Today, Jul. 3, 2023. https://www.usatoday.com/story/news/nation/2023/07/03/raw-milk-legalized-states-unpasteruized-disease-risks-public-health/70369454007/
3. Dunavan CP. Got raw milk? Medpage Today, Dec. 8, 2023. https://www.medpagetoday.com/opinion/parasites-and-plagues/107766
4. “How much money does a farmer make per gallon of milk? Wise-Answer, Feb. 7, 2020. https://wise-answer.com/how-many-gallons-are-in-a-hundredweight-milk/
5. Nepveux M. USDA report: U.S. dairy farm numbers continue to decline. American Farm Bureau Federation, Feb. 26, 2021. https://www.fb.org/market-intel/usda-report-u-s-dairyfarm-numbers-continue-to-decline
6. https://en.wikipedia.org/wiki/Typhus
7. Rettner R. California woman got typhus from a neighborhood rat. Live Science, Aug. 6, 2021. https://www.livescience.com/woman-gets-typhus-california-rat.html
8. Beach C. What are the odds? 840 times more likely for raw milk drinkers. Food Safety News, May 2, 2017. https://www.foodsafetynews.com/2017/05/what-are-the-odds-840-times-more-likely-for-raw-milk-drinkers/
9. Coleman P. Perspectives on foodborne risks. A Campaign for Real Milk, 2023. https://www.realmilk.com/health/perspectives-on-foodborne-risks/
10. Response to the FDA: A point-by-point rebuttal to the anti-raw milk PowerPoint presentation by John F. Sheehan, BSc (Dy), JD, Division of Dairy and Egg Safety. Prepared by the Weston A. Price Foundation, November 2007. https://www.realmilk.com/wp-content/uploads/2012/11/SheehanPowerPointResponse-UpdatedAug2010.pdf
11. Beals T. Those pathogens, what you should know. A Campaign for Real Milk, Jul. 31, 2011. https://www.realmilk.com/those-pathogens-what-you-should-know/
12. Morell SF. Death by oysters. A Campaign for Real Milk, Feb. 11, 2012. https://www.realmilk.com/death-by-oysters/
13. Bragazzi NL, Kolahi A-A, Nejadghaderi SA, et al. Global, regional, and national burden of Guillain-Barré syndrome and its underlying causes from 1990 to 2019. J Neuroinflammation. 2021;18(1):264.
14. Coleman ME, Oscar TP, Negley TL, et al. Suppression of pathogens in properly refrigerated raw milk. PLoS One. 2023;18(12):e0289249.
15. Sebastianski M, Bridger NA, Featherstone RM, et al. Disease outbreaks linked to pasteurized and unpasteurized dairy products in Canada and the United States: a systematic review. Can J Public Health. 2022;113(4):569-578.
16. Li B, Mo L, Yang Y, et al. Processing milk causes the formation of protein oxidation products which impair spatial learning and memory in rats. RSC Adv. 2019;9(39):22161-22175.
17. Weston A. Price Foundation. A Campaign for Real Milk PowerPoint presentation. A Campaign for Real Milk, Nov. 19, 2012. https://www.realmilk.com/real-milkpowerpoint/
18. Anaphylaxis statistics. Allergy & Asthma Network. https://allergyasthmanetwork.org/anaphylaxis/anaphylaxis-statistics/
19. Rajakumar K. Infantile scurvy: A historical perspective. Pediatrics. 2001;108(4):E76.
20. Gregory 3rd JF. Denaturation of the folacin-binding protein in pasteurized milk products. J Nutr. 1982;112(7):1329-1338.
21. Macdonald LE, Brett J, Kelton D, et al. A systematic review and meta-analysis of the effects of pasteurization on milk vitamins, and evidence for raw milk consumption and other health-related outcomes. J Food Prot. 2011;74(11):1814-1832.
22. Said HM, Ong DE, Shingleton JL. Intestinal uptake of retinol: enhancement by bovine milk beta-lactoglobulin. Am J Clin Nutr. 1989;49(4):690-694.
23. Runge FE, Heger R. Use of microcalorimetry in monitoring stability studies. Example: vitamin A esters. J Agric Food Chem. 2000;48(1):47-55.
24. Hollis BW, Roos BA, Draper HH, et al. Vitamin D and its metabolites in human and bovine milk. J Nutr. 1981;111(7):1240-1248.
25. Vegarud GE, Langsrud T, Svenning C. Mineral-binding milk proteins and peptides; occurrence, biochemical and technological characteristics. Br J Nutr. 2000;84(Suppl 1):S91-S98.
26. D W Fleming et al. Pasteurized milk as a vehicle of infection in an outbreak of listeriosis. N Engl J Med, 1985 Feb 14;312(7):404-7.
27. Riedler J, Braun-Fahrländer C, Eder W, et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet. 2001;358(9288):1129-1133.
28. Waser M, Michels KB, Bieli C, et al. Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clin Exp Allergy. 2007;37(5):661-670.
29. Loss G, Apprich S, Waser M, et al. The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study. J Allergy Clin Immunol. 2011;128(4):766-773.e4.
30. Wlasiuk G, Vercelli D. The farm effect, or: when, what and how a farming environment protects from asthma and allergic disease. Curr Opin Allergy Clin Immunol. 2012;12(5):461-466.
31. Turchiano R. LMU researchers shows [sic] that infants fed on raw milk rather than UHT cow’s milk are less prone to infection. ClinicalNews.org, Oct. 23, 2014. https://clinicalnews.org/2014/10/23/lmu-researchers-shows-that-infants-fed-on-raw-milk-rather-than-uhtcows-milk-are-less-prone-to-infection/
32. Loss G, Depner M, Ulfman LH, et al. Consumption of unprocessed cow’s milk protects infants from common respiratory infections. J Allergy Clin Immunol. 2015;135(1):56-62.
33. Weston A. Price Foundation. Experiments in nutritional value of milk from history of Randleigh Farm. A Campaign for Real Milk, Jan. 1, 2000. https://www.realmilk.com/randleigh-farm/
34. Silverman MM. Teeth and bone hardness in diagnosis and prevention of premature aging. Weston A. Price Foundation, Feb. 7, 2009. https://www.westonaprice.org/health-topics/dentistry/teeth-and-bone-hardness-in-diagnosis-and-prevention-of-premature-aging/
35. Beals T. Pilot survey of cow share consumer/owners: lactose intolerance section. A Campaign for Real Milk, Mar. 29, 2008. https://www.realmilk.com/lactose-intolerance-survey/

The post Got Raw Milk? UCLA Professor of Medicine Says “No, Thanks!” appeared first on Real Milk.

In my recent Wise Traditions article (Spring 2023),¹ I wrote about Microbial Risk Assessment (MRA), a qualitative or quantitative structured approach developed by international consensus.² Overall, the approach would begin with the best available data at the time, consider alternative assumptions where uncertainty existed about model parameters, and conclude with reporting risk estimates with uncertainty, data gaps and limitations.

Uncertainty and data gaps are crucial to address because data are rarely sufficient to estimate risk without invoking assumptions where data are sparse, inconsistent, of a poor quality, ambiguous or conflicting. An MRA can be considered a snapshot in time for a given set of data and assumptions. Targeted research may be conducted to fill significant data gaps. As scientific knowledge advances, earlier data and assumptions may prove invalid, and the MRA would require updating, consistent with international principles and guidelines.²

One common and crucial misunderstanding that I address in this article the fact that epidemiology is not risk assessment as defined by international consensus.² Epidemiologic data are generally used for two major purposes in MRA, starting with the first MRA element: identifying which pathogens present in foods have the potential to cause adverse human health effects (hazard identification). Consistent with the work of Abe and colleagues,³ I report numbers of illnesses rather than numbers of outbreaks due to higher relevance for representing the burden of illness for risk management decisions.

CURRENT DATA ON HAZARD IDENTIFICATION

For the purposes of this article, I use a Centers for Disease Control and Prevention (CDC) data set for 2005 through 2020,⁴ comparing the CDC data with global data considered by the European Food Safety Authority (EFSA) and European Union (EU) opinions about hazards associated with raw milk.⁵ According to the CDC data (Figure 1), the major pathogen causing illness associated with raw milk for the sixteen-year period was Campylobacter (1,570 illnesses, including one death in a case with chronic underlying disease). In addition, Campylobacter was associated with 1,647 pasteurized milk illnesses, for a total of 3,217 illnesses. Note that although parasites caused some milk-borne illnesses in the U.S. in this time period (sixty-two cases of cryptosporidiosis; thirty-eight cases of giardiasis), this article emphasizes bacterial illnesses.

FIGURE 1. Pathogens associated with raw milk (CDC, 2005-2020).

As a microbiologist, it is puzzling to me that the major milk-borne hazard, campylobacteriosis, was associated with 3,217 illnesses, yet the pathogen cannot actually grow at refrigeration temperatures in raw or pasteurized milk. Neither can Campylobacter grow under normal aerobic conditions for culturing. Recent studies document promising results for chemical, phytochemical and microbial interventions that can disrupt persistent Campylobacter biofilms that might be the root cause for milk-borne illnesses.^6-9 Other major foods that also contributed to the burden of campylobacteriosis in this time period included:

• Poultry (603 illnesses)
• Mollusks (408 illnesses)

Moderate numbers of illnesses associated with raw milk outbreaks were reported for pathogenic E. coli (267 illnesses, zero deaths) over the sixteen-year period. Other foods contributed to the majority of the burden of pathogenic E. coli cases, including:

• Leafy-vine-stalk vegetables (2,221 illnesses)
• Beef (1,485 illnesses)

Moderate numbers of illnesses associated with raw milk outbreaks were reported for salmonellosis (162 illnesses, zero deaths) over the sixteen-year period. Other foods contributed to the majority of the burden of salmonellosis cases, including:

• Poultry (6,244 illnesses)
• Leafy-vine-stalk vegetables (6,000 illnesses)
• Pork (2,759 illnesses)
• Beef (1,715 illnesses)
• Melons (1,544 illnesses)
• Root/underground vegetables (1,540 illnesses)
• Processed nuts (1,490 illnesses)
• Sprouts (983 illnesses)

The smallest hazard associated with raw milk in this period was two Listeria monocytogenes illnesses; one of the two individuals was immunocompromised and died¹⁰. Multiple lines of evidence support the success of existing risk management controls (such as proper refrigeration,⁵ hazard analysis and critical control points or risk analysis and management plans11 and proper hygiene in milk parlors) in limiting listeriosis cases associated with raw milk.

These recent CDC data for raw milk hazards are consistent with the 2015 findings of the EFSA,⁵ which reported that major bacterial hazards included Campylobacter, pathogenic E. coli and Salmonella, but not listeriosis.

Hazard identification for pasteurized milk differs in that a recent systematic review for North America documented four deaths and a higher risk of hospitalization and death from listeriosis associated with pasteurized, not raw, milk.¹²

Other foods that contributed to the majority of the burden of listeriosis cases in the U.S. were:

• Melons (153 illnesses)
• Pasteurized solid/semi-solid dairy (73 illnesses)
• Pome, stone, and sub-tropical fruits (54 illnesses)
• Deli meats (49 illnesses)
• Leafy-vine-stalk vegetables (48 illnesses)
• Fungi (41 illnesses)
• Raw solid/semi-solid dairy (37 illnesses)

Considering foodborne deaths, we have just seen that one death each from campylobacteriosis and listeriosis over the sixteen-year period were attributed to raw milk. Note that in this period, 141 other deaths were attributed to Listeria monocytogenes. Foods other than raw milk were associated with 75 deaths from salmonellosis and 40 deaths from pathogenic E. coli.

Overall, considering the CDC data for 2005-2020 in the Hazard Identification phase of MRA, neither raw nor pasteurized milks are risk-free, and both are associated with bacterial hazards that, under certain conditions, may contribute to risk of foodborne illness. Both raw and pasteurized milk were rarely associated with fatalities, though five were reported in the sixteen-year period, two associated with raw milk and three with pasteurized milk. Note that some illnesses and deaths were also associated with other raw and pasteurized dairy products in this period as documented in the previous bullets, though I do not report on these data further in this article.

DATA FOR EXPOSURE ASSESSMENT

Microbiology, not epidemiology, provides the major source of evidence for the MRA element exposure assessment, notably data on the presence or absence of pathogens in raw milk and pathogen growth or decline during storage. Another common and crucial misunderstanding addressed herein is the fact that data on the presence or absence of pathogens, or levels of indicator microbes (such as total plate counts, coliforms and generic E. coli), are insufficient evidence to estimate microbial risk. The more important determining factors in predicting both the chance or likelihood of illness and the severity of illness are the levels or densities of pathogens and natural microbiota, and whether or not pathogen growth occurs under typical storage conditions of the food.

Some significant shortfalls in MRA quality were identified in the exposure assessment of the MRA on severe listeriosis associated with twenty-three ready-to-eat foods including raw and pasteurized milks.13 Colleagues in the Society for Risk Analysis (SRA), Applied Risk Management specialty group developed the Risk Analysis Quality Test (RAQT)14 that I applied to both MRAs considering milk prepared by FDA/FSIS (2003)13 and FSANZ.¹⁵

The exposure assessment for milk-borne listeriosis by the two U.S. agencies—the Food and Drug Administration (FDA) and the Food Safety and Inspection Service (FSIS)—was based on sparse data and invalid assumptions. The Agencies assumed that quality and safety of pre-pasteurized milk (that is, milk from multiple farms in bulk tanks and regional silos stored for unspecified periods prior to pasteurization) was equivalent to that of fresh raw milk from farms producing raw milk for direct human consumption.

FDA presented results of their recent systematic review on prevalence of pathogens in raw milks at the International Association for Food Protection conference in Toronto this year.16 Not surprisingly, the prevalences of pathogens in pre-pasteurized milk greatly exceeded prevalences from government monitoring programs for dairies producing raw milk for direct human consumption.¹⁷

The agencies also assumed that pathogen growth was equivalent in raw and pasteurized milk, though a cited study reported contrary results¹⁸ (no growth or lower growth in raw milk). Further, a manuscript on analysis of results from a 2022 pilot study on growth of the four major pathogens in raw milk produced for direct human consumption was accepted by PLOS ONE in July of 2023.¹⁹ This study documents suppression of pathogen growth at 4.4 °C over the fourteen-day storage period for all three major pathogens identified as hazards raw milk in the U.S. in the previous hazard analysis section.

RISK ANALYSIS QUALITY TEST OF SRA

A half-day workshop and a round table panel symposium were conducted at the SRA conference in Tampa on beta testing of the Risk Analysis Quality Test (RAQT) for milks. WAPF leader Pete Kennedy participated in the 2022 SRA workshop in Tampa where the beta testing results for the MRAs were discussed.

Prior to the round table, a panelist, former FDA economist Richard Williams recalled a closed-door internal FDA meeting where the draft MRA results were shared with management. Even though pasteurized milk was classified as a high-risk food, as noted in the Summary Table below, a decision was made that consumers were not going to be warned about risks of consuming pasteurized milk. The language of the final 2003 MRA document reflected this pro-pasteurization bias clearly, describing the decision that set separate courses for risk management of raw milk (“priority candidate for continued avoidance”) and pasteurized milk (“priority candidate for more study to confirm model predictions or identify factors not captured by current models that would reduce risk”).

The basis for assigning “avoidance” and “more study” to two foods both ranked as high risk was not specified in the assessment. In my view, both commodities merit more study and updating of the risk assessment based on data and assumptions more than twenty years old. Re-evaluation in light of more than a decade of scientific advances characterizing the microbiota of milks would be in keeping with the general principles for MRA.²

Based on the set of data and assumptions considered by FDA and FSIS at the time, the agencies reported risk as both per serving estimates and annual estimates of severe illness. Both are estimates that together characterize risk that may inform decision-making. In the Summary Table’s left column on a per-serving basis, the agencies ranked raw milk fourth highest of the twenty-three food groups considered, and pasteurized milk ninth highest. In the right column on a per annum basis, the agencies ranked pasteurized milk second highest and raw milk ranked seventh highest.

It is notable that FDA manager John Sheehan excluded citation of the 2003 FDA/FSIS ranking of both raw and pasteurized milk as high risk for severe listeriosis from his affidavits for the Toronto case in 2018 and 2019. Nor did he acknowledge FDA/FSIS assignments of different risk management actions for raw and pasteurized milks that strongly suggest a pro-pasteurization bias. The discussions about RAQT results at the SRA meeting considered the CDC dataset for 2005-2020 and data from the recent decade of advances in knowledge of the microbiota of milks.²⁰

Summary Table 1. Relative Risk Ranking and Predicted Median Cases of Listeriosis for the Total United States Population on a per Serving and per Annum Basis

REASSESSING RISK WITH INDEPENDENT EPIDEMIOLOGIC DATA AND SCIENTIFIC ADVANCES

The final two general principles of MRA2 are of great relevance to global societies: risk estimates should be reassessed over time by comparison with independent epidemiologic data on human illness; and MRAs may need reevaluation as new relevant scientific data become available.

Many microbial risk assessment teams use epidemiologic evidence as a reality check at the end of the MRA process to compare the numbers of annual illnesses estimated from their risk models with the numbers actually observed over time from human disease surveillance programs. If inconsistencies are significant, the MRA data and models might be reexamined, the MRA results may be flagged as uncertain (low confidence), or additional data might be collected to replace assumptions for future reevaluation of the MRA.

The FDA/FSIS MRA Summary Table 1, opposite, lists estimates of high risk for per serving associated with raw milk (seven serious listeriosis cases per one hundred million servings) and moderate risks (three serious listeriosis cases per year). Now, compare the FDA/FSIS MRA annual estimate with subsequent epidemiologic data on listeriosis from the CDC dataset for 2005-2020:

• MRA estimate: three serious listeriosis illnesses per year (2003)
• CDC reported cases: two listeriosis illnesses over sixteen years (2021)

If the MRA estimate represented current data, one might expect approximately forty-eight cases in the subsequent sixteen-year period, not two. Also, in fifteen of sixteen years, no listeriosis cases were observed associated with raw milk. Clearly, subsequent CDC data are inconsistent with the FDA/FSIS ranking of moderate risk per annum for raw milk or of the FDA position that raw milk is inherently dangerous.

The high risk ranking for listeriosis in raw milk per serving from the 2003 FDA/FSIS assessment is also inconsistent with subsequent reassessments of independent academic teams that estimated lower risk for raw milk²¹ and higher risks associated with increasing temperatures for pasteurizing milk.²²

Granted, uncertainty may be high in both MRA simulations and epidemiologic data.

Based on international consensus on general principles,² the epidemiologic evidence and the protective effects against infectious pathogens¹⁸ and non-communicable disease¹⁷ support the need for updating the milk FDA/FSIS MRA (2003),¹⁰ as well as the MRA subsequently prepared by FSANZ (2009).¹⁵

Moreover, trends since 2005 in raw milk outbreaks and illnesses across all bacterial pathogens are flat or declining, not increasing, for both the U.S. overall and for each U.S. state (manuscript under review). In fact, Figures 2 and 3 (below) document the fact that retail raw milk production in California and numbers of raw milk licenses approved by New York state are increasing in this time period, while raw milk outbreak numbers and rates are flat or declining. This is exactly contrary to what would be expected if access to raw milk was linked to increasing numbers of outbreaks and illnesses.

FIGURE 2: California retail raw milk production from one licensed dairy and state outbreaks by year.

FIGURE 3: New York state licenses for raw milk dairies and outbreaks by year.

Milks, both raw and pasteurized, are not risk-free. For the most recent eighteen years of data from the U.S. CDC (2005–2020, NORS Access dataset; 2021-2022, NORS online Dashboard), the state of California reported a total of six outbreaks, eighty-three illnesses, eleven hospitalizations, and no deaths associated with raw milk. Of those eighty-three illnesses, sixty-eight were campylobacteriosis and fifteen were due to pathogenic E. coli O157:H7. One California producer (Raw Farm, formerly Organic Pastures) sold nearly nine million gallons of retail raw milk from 2017 to 2022, without a single outbreak reported in the state linked to raw milk consumption. This volume of raw milk in the California retail market represents a risk of infectious illness of less than one in twenty million 250-mL servings.

For New York, the most recent eighteen years of data (2005–2022), a total of eight outbreaks, fifty-eight illnesses, four hospitalizations, and no deaths were reported. All those fifty-eight illnesses were campylobacteriosis. No raw milk consumers became ill from other pathogens—which caused more hospitalizations (and deaths) from consuming leafy greens!

The available evidence is consistent with adequacy of current hygienic procedures and cold-chain for raw milk producers, which minimizes risk of illness and enhances safety for listeriosis, perhaps illnesses from pathogenic E. coli and Salmonella, but not for Campylobacter. The burden of campylobacteriosis for both raw and pasteurized milks warrants further study and evaluation, particularly regarding technologies to disrupt biofilm formation.^6-9 We note the societal need for cultivating a culture of quality analysis in governmental MRA projects and support updating the 2003 and 2009 MRAs for raw milk.

This article was first published in the Fall 2023 issue of Wise Traditions in Food, Farming, and the Healing Arts, the quarterly journal of the Weston A. Price Foundation.

ABOUT THE AUTHOR

Margaret E. (Peg) Coleman, MS, MS, is a medical microbiologist, a microbial risk analyst, and a fellow of the Society for Risk Analysis (SRA). Her long career in microbial risk analysis began with the U.S. federal government (USDA/FSIS and ARS) and continues as a consultant. Her primary interests are benefit-risk analysis, resilience of human superorganisms and humans’ microbial partners in health.

ACKNOWLEDGEMENTS

WAPF provided support for preparation of this article, structuring of the CDC Access database and travel to the International Food Protection (IAFP) conference in Toronto. Also appreciated is ongoing support from: Michele Stephenson for querying the CDC Access database and generating figures; and Sally Fallon Morell of WAPF, Mark McAfee of RAWMI, and Abby Rockefeller of Churchtown Dairy. Mark and Abby recently supported a contract with an independent laboratory for conducting the pilot study on pathogen growth and decline, as well as provided support for further analysis of the pilot study data and preparation of the manuscript on that analysis.

REFERENCES

1. Coleman P. Raw milk risks from a microbiologist’s perspective. Wise Traditions. Spring 2022;23(1):101-105. https://www.realmilk.com/raw-milk-risks-from-a-microbiologists-perspective/
2. Codex Alimentarius Commission (CAC). Principles and guidelines for the conduct of microbiological risk assessment. CAC/GL-30 (1999). https://www.fao.org/3/y1579e/y1579e05.htm
3. Abe H, Garre A, Koseki S, et al. Analysis of a quantitative risk assessment of listeriosis from pasteurized milk: the combinations of which factors cause listeriosis in this low-risk food? Food Control. 2023;152:109831.
4. Centers for Disease Control and Prevention. Access® database for outbreaks reported from 2005 to 2020 from all transmission sources (food, water, animal contact, environmental and person-toperson) provided by Hannah Lawinger, CDC NORS Data Request Manager to author on May 26, 2021. Note that data on numbers of illnesses for food groups reflected records from the Access® database with both IFSAC-3 and IFSAC-4 data.
5. EFSA Panel on Biological Hazards. Scientific Opinion on the public health risks related to the consumption of raw drinking milk. EFSA Journal. 2015;13(1):3940.
6. Wagle BR, Upadhyay A, Upadhyaya I, et al. Trans-cinnamaldehyde, eugenol and carvacrol reduce Campylobacter jejuni biofilms and modulate expression of select genes and proteins. Front Microbiol. 2019;10:1837.
7. Elgamoudi BA, Korolik V. Campylobacter biofilms: potential of natural compounds to disrupt Campylobacter jejuni transmission. Int J Mol Sci. 2021;22(22):12159.
8. Mgomi FC, Yuan L, Chen CW, et al. Bacteriophages: a weapon against mixed‐species biofilms in the food processing environment. J Appl Microbiol. 2022;133(4):2107-2121.
9. Lavilla M, Domingo-Calap P, Sevilla-Navarro S, et al. Natural killers: opportunities and challenges for the use of bacteriophages in microbial food safety from the One Health perspective. Foods. 2023;12(3):552.
10. Nichols M, Conrad A, Whitlock L, et al. Short communication: Multistate outbreak of Listeria monocytogenes infections retrospectively linked to unpasteurized milk using whole-genome sequencing. J Dairy Sci. 2020;103(1):176-178.
11. Raw Milk Institute. Risk Analysis and Management Plan. https://www.rawmilkinstitute.org/common-standards.
12. Sebastianski M, Bridger NA, Featherstone RM, et al. Disease outbreaks linked to pasteurized and unpasteurized dairy products in Canada and the United States: a systematic review. Can J Public Health. 2022;113(4):569-578.
13. Center for Food Safety and Applied Nutrition, Food Safety and Inspection Service. Interpretive Summary: Quantitative Assessment of the Relative Risk to Public Health from Foodborne Listeria monocytogenes Among Selected Categories of Ready-to-Eat Foods. U.S. Food and Drug Administration and U.S. Department of Agriculture, September 2003. https://www.fda.gov/food/cfsan-risk-safety-assessments/quantitative-assessment-relative-risk-public-health-foodbornelisteria-monocytogenes-among-selected
14. https://www.sra.org/risk-analysis-specialty-groups/applied-risk-management/scientific-literature/
15. Food Standards Australia New Zealand. Microbiological Risk Assessment of Raw Cow Milk. Risk Assessment Microbiology Section, December 2009. https://www.foodstandards.gov.au/code/proposals/documents/p1007%20ppps%20for%20raw%20milk%201ar%20sd1%20cow%20milk%20risk%20assessment.pdf
16. Williams EN, Van Doren JM, Leonard CL, et al. Prevalence of Listeria monocytogenes, Salmonella spp., Shiga toxin-producing Escherichia coli, and Campylobacter spp. in raw milk in the United States between 2000 and 2019: a systematic review and meta-analysis. J Food Prot. 2023;86(2):100014.
17. Dietert RR, Coleman ME, North DW, et al. Nourishing the human holobiont to reduce the risk of non-communicable diseases: a cow’s milk evidence map example. Appl Microbiol. 2022;2(1):25-52.
18. Northolt MD, Beckers HJ, Vecht U, et al. Listeria monocytogenes: heat resistance and behaviour during storage of milk and whey and making of Dutch types of cheese. Neth Milk Dairy J. 1988;42:207-219.
19. Coleman ME, Oscar PT, Negley TL, et al. Suppression of pathogens in properly refrigerated raw milk. PLoS One. Forthcoming (accepted July 2023).
20. Oikonomou G, Addis MF, Chassard C, et al. Milk microbiota: what are we exactly talking about? Front Microbiol. 2020;11:60.
21. Latorre AA, Pradhan AK, Van Kessel JAS, et al. Quantitative risk assessment of listeriosis due to consumption of raw milk. J Food Prot. 2011;74(8):1268-1281.
22. Stasiewicz MJ, Martin N, Laue S, et al. Responding to bioterror concerns by increasing milk pasteurization temperature would increase estimated annual deaths from listeriosis. J Food Prot. 2014;77(5):696-712.

The post Perspectives on Foodborne Risks appeared first on Real Milk.

The late Dr. Theodore (Ted) Fairbank Beals, MD, made significant contributions to bringing more science into dialogues about raw milk benefits and risks.

Dr. Beals was instrumental in obtaining data through the Freedom of Information Act (FOIA) from U.S. states that monitor microbes in raw milk from farms licensed at the state level. Dr. Beals introduced these FOIA data to readers of this journal before his death last year in 2021.¹

My collaborators and I share the belief articulated by Dr. Beals that policies without a sound basis in scientific evidence cannot promote health and well-being in the populations subject to those policies. Yet, policies around pasteurizing raw milk, both human donor breastmilk and milk from ruminants, are not based on 21st-century scientific evidence. This article will introduce readers to highlights from the FOIA data project report and provide information about its application in Microbial Risk Assessment (MRA) (See below).

HIGHLIGHTS OF THE FOIA DATA AND EXPOSURE ASSESSMENT

The objective of our project was to summarize the data from routine testing for microbial pathogens in fresh unprocessed milk from licensed farms obtained by FOIA through Dr. Beals as mentioned above. Results from the Microsoft Access database project are summarized in Table 1 below.²

A more extensive table on pathogen testing results for raw milk was developed from multiple documents, which summarized the data from FOIA as well as data from multiple countries (Canada, Finland, Germany, Poland, U.S., and U.K.). The overall results are shown in Table 2 below.³ Note that pathogens were detected in 0.01 percent or fewer of all samples.

Although just knowing data on the occurrence (frequency or rates of pathogen positives) in foods is insufficient to estimate risk, it is reasonable to ask how a food with such extensive recent data from around the world documenting that more than 99 percent of routine samples were undetectable for major foodborne pathogens is an “inherently dangerous food.” From my experience, experts with pro-pasteurization biases provide no recent evidence or analysis that supports this opinion.

TABLE 1. Results Reported under FOIA on Detection of the Presence of Major Microbial Pathogens in Raw Milk from Licensed Dairy Farms in Four State Sampling Plans.²

TABLE 2. Recent Results on Pathogen-Positive Rates in Raw Milk Reported in Peer-Reviewed Studies and Recent FOIA Data.³

MICROBIAL RISK ASSESSMENT

Microbial or Microbiological Risk Assessment (MRA) is a rigorous interdisciplinary process organized around a consensus framework ratified in 1999 by the one hundred sixty-three member countries of the Codex Alimentarius Commission.^11,20 MRAs may apply qualitative methods and report categories of risk levels (such as negligible, low, moderate, high risk) or quantitative methods (QMRAs) and report risk estimates per year or per serving.

Foodborne risk is estimated by conducting a series of discrete and interconnected technical analyses illustrated in Figure 1.²¹ These involve:

• Hazard Identification
• Exposure Assessment
• Dose-Response Assessment
• Risk Characterization

This article emphasizes Exposure Assessment because the data received through the Freedom of Information Act (FOIA)1 and the growth study are useful for estimating and assessing the likelihood and magnitude of pathogen exposures to consumers in servings of contaminated foods.

It’s important to understand one basic principle of Dose-Response Assessment: as the number of pathogens ingested increases, the frequency (likelihood) and severity of illness increases. “Low levels equal low risk.”²²

Some key general principles of the eleven listed in the 1999 consensus document on principles and guidelines for Microbiological (Microbial) Risk Assessment11 are as follows:

1=Microbiological Risk Assessment should be soundly based upon science.
5=The conduct of a Microbiological Risk Assessment should be transparent.
11=A Microbiological Risk Assessment may need reevaluation, as new relevant information becomes available.

GROWTH AND SURVIVAL OF PATHOGENS

Regarding growth and survival of pathogens for exposure assessment, analysts may select growth models that intentionally over-estimate risk, such as using data for optimal growth of pathogens in pure culture broth.

However, a recent pilot study conducted by a certified laboratory4 and funded by the Raw Milk Institute (RAWMI) documented the inability of the major bacterial pathogens to grow in raw milk for a week of storage at the temperature that U.S. regulatory agencies recommend for refrigerated foods: 4.4 °C (40°F).⁵

20TH vs 21ST-CENTURY SCIENCE

Many 21st-century studies of the microbiota of milk^3,6 are inconsistent with beliefs based on 20th century science. Certainly, 20th-century science, opinions and beliefs selected by Food Standards Australia New Zealand (FSANZ)7 in 2009 swayed the Toronto judge in the recent decision maintaining Canada’s prohibition on access to raw milk.⁸ The judge apparently believed the pro-pasteurization argument that milk should be sterile and the microbes present are the result of fecal contamination.

Apparently, the Toronto judge relied on an outdated quantitative method whose models simulated not data from sound scientific studies, but a series of worst-case assumptions, extrapolations and opinions that intentionally overestimated risk and underestimated uncertainty. Further, the judge and others mistakenly assumed that evidence from outbreaks was sufficient to estimate risk, while evidence from predictive microbiology was excluded, dismissed or ignored.

Contrary to FSANZ’s view, pathogens in feces are not predictive of pathogen presence or levels in raw milk. My recommendations to FSANZ from a technical review⁹ included abandoning its outdated views on fecal contamination for raw milk and conducting a reassessment of their 2009 simulations using recent evidence for benefits and risks.

I am not the only scientist to question the assumptions and outputs of the 2009 FSANZ simulations. The European Food Safety Authority (EFSA)¹⁰ also considered the FSANZ 2009 report and peer-reviewed publications on more recent risk assessments for raw milk. EFSA concluded that risks for raw milk consumers can be mitigated and reduced significantly by controlling temperature, limiting shelf life and engaging consumer compliance with controls (that is, maintaining proper refrigeration temperatures for raw milk).

Further, EFSA concluded that many potential pathogens are not main hazards to consumers in the European Union including Listeria monocytogenes and Staphylococcus aureus.

Those familiar with New York state regulations for raw milk monitoring may be puzzled about the EFSA determination that these two pathogens are not considered main hazards to raw milk consumers. In fact, farmers who pay the licensing fee in New York state are paying for routine testing for two pathogens never linked to an outbreak associated with raw milk in the state, based on data obtained from the Centers for Disease Control (CDC).

The FSANZ modeled or simulated potential risk based on a series of intentionally conservative (biased) assumptions and indirect or extrapolated data that have not been validated then or since. FSANZ seems to have selected assumptions, opinions and extrapolations that exaggerated risks and underestimated uncertainties, consistent with their pre-conceived pro-pasteurization bias articulated throughout the report.

The FSANZ simulations were not soundly based on science, nor were alternative assumptions tested to increase transparency. In short, FSANZ did not comply with principles and guidelines stipulated from international consensus.¹¹ My peer review of the FSANZ report,⁹ undertaken twelve years after its release, identified many relevant studies available before release of the report that were intentionally or inadvertently excluded by FSANZ. I strongly recommended that FSANZ update the assessment and incorporate scientific data from technological advances of the last decade to improve the credibility of the assessment.⁹

Fear and dread of many (or all) microbes as “germs” that will kill us (germophobia) appear to factor strongly into policies requiring pasteurization and regulations on the presence of potential pathogens, not their levels or their risk for causing illness. The fear of microbes as “germs” appears to be entrenched even among well-meaning scientists and regulators in misconceptions of 20th-century science, and wall them off from any consideration of the tremendous advances in knowledge about the microbiota of milk, particularly the rich body of evidence for both benefits and risks of raw milk from both humans6 and cows.³ At present, the pasteurization and zero-tolerance policies for potential pathogens in raw milk appear inconsistent with the available evidence and the state of the science in the 21st century.

FUTURE FOR EVIDENCE-BASED POLICIES ON RAW AND PASTEURIZED MILK

Readers of Wise Traditions may be aware that many factors influence what is published and what is rejected about science and its applications in risk assessment. According to a recent report by the National Science and Technology Council,¹² novel scientific discoveries that challenge established dogmas may be suppressed, manipulated and inappropriately influenced by political pressures and interference to distort outcomes to maintain the status quo or meet preferred policy objectives or decisions. To quote from this report, scientific integrity can be impeded by “mischaracterizing, fabricating, removing, or disregarding relevant scientific information.” Undoubtedly, there is great need for developing or improving evidence-based decisions guided by the best available science and data, recognizing that scientific and technological information and data are central to the development and iterative improvement of sound policies. The report further describes political interference as “inappropriate, scientifically unjustified intervention in the conduct, management, communication, or use of science.”

Just as scientists are not unbiased or immune to economic, political and social pressures, neither are editors and reviewers for scientific journals. A recent New York Times article by Gina Kolata and Benjamin Mueller13 mentioned an innovative scientific paper “summarily rejected” by two prestigious journals (Nature and Science) before its eventual acceptance in a “niche publication called Immunity.” Similarly, our work on bovine milk was rejected by two scientific journals before acceptance by the Open Access journal Applied Microbiology. Certainly, my co-authors and I improved the publication and its communication of the evidence map work in responding to reviewers in three separate peer-review processes. However, I have no doubt that pro-pasteurization biases delayed publication of a comprehensive and simultaneous analysis of benefits and risks for raw milk for more than two years.

If you followed the Toronto case involving raw milk farmer Michael Schmidt, you may have realized that the U.S. government is on record for attempting to interfere with an independent scientific journal that published the 2018 Whitehead and Lake analysis of CDC data on raw and pasteurized milk outbreaks (see Table 3).¹⁴ The U.S. government expert (Mr. John Sheehan, FDA) testified that U.S. government analysts were working to repeat both the Whitehead and Lake analysis (2018) and a subsequent analysis of the same data by statistician Dr. Nick Azzolina¹⁵ who submitted an affidavit with his analysis of the same CDC dataset. The important point is that for the years 2005-2017, the CDC recorded more illnesses from campylobacter and listeria in pasteurized milk compared to raw. I am collaborating with Nick Azzolina, Joanne Whitehead, Bryony Lake and Michele Stephenson to extend the analysis for more recent outbreak data from the CDC for 2005 to 2019.

In cross-examination, Toronto attorney Ian Blue asked the government official whether the results of their reanalyses would be published if consistent with prior analyses. To date, I am aware of no subsequent publication that either refutes or confirms the findings of Whitehead and Lake or Azzolina. Yet the Toronto judge appears to have succumbed to blatant political intrusion and aligned her decision with the unsupported opinions of the government official over independent statistical analysis of U.S. outbreaks by an accomplished statistician.

Clearly, processes for scientific peer review are subject to political and other pressures. Yet, peer-reviewed studies are crucial to providing credible evidence about raw milk benefits and risks to courts, legislatures and regulatory agencies around the world. Even when some opinions and claims are made that pasteurization is a silver bullet that decreases risk and increases benefits to consumers, peer-reviewed studies with robust statistical analysis are crucial to helping judges, legislators and regulators to properly acknowledge and weigh the evidence.

TABLE 3. CDC Outbreak Data for Two Pathogens.¹⁴

RECOMMENDED DAILY ALLOWANCES FOR MICROBES?

A question that may be of interest to WAPF members concerns the concept of expanding Recommended Daily Allowances (RDAs) for vitamins to RDAs for microbes.^16,17 These studies were the subject of my Society for Risk Analysis webinar last year entitled “Resilience and the Human Superorganism: Give Us this Day Our Daily Microbes.”¹⁸ Foods naturally enriched in microbes, including raw milk¹⁹ and fermented foods (such as cheese, kefir, kimchi and kombucha), certainly could contribute to RDAs for microbes.

I strongly believe that questions from raw milk stakeholders are essential for consideration of the evidence (or lack thereof) behind pasteurization policies and monitoring requirements for farms licensed to sell raw milk. Consumers deserve to have a voice in decisions about pasteurizing donor breastmilk and cow milk, particularly to maintain and extend freedom of choice to consumers around the world.

In summary, recent research on the benefits and risks of raw milk³ does not support the outdated assumptions that raw milk is inherently dangerous, and that existing hygiene management programs, including Hazard Analysis and Critical Control Points, and Test-and-Hold Programs, cannot ensure a safe, low-risk product for raw milk consumers.

This article was first published in the Spring 2023 issue of Wise Traditions in Food, Farming, and the Healing Arts, the quarterly journal of the Weston A. Price Foundation.

ABOUT THE AUTHOR

Peg Coleman, MS, is a medical microbiologist, a microbial risk assessor and a fellow of the Society for Risk Analysis (SRA). Her long career as a microbial risk assessor began with the U.S. federal government (USDA/FSIS) and continues as a consultant. Her primary interests are benefit-risk analysis and resilience of human superorganisms, Homo sapiens complete with microbial partners in health.

ACKNOWLEDGMENTS

I am deeply grateful for contributions from WAPF, the Raw Milk Institute (RAWMI) and others through a 2018 crowdfunding campaign (Whole Truth, Whole Milk) through the Society for Risk Analysis (SRA) that provided partial support for preparing the two evidence map publications.^3,6 I appreciate ongoing support from Mark McAfee of RAWMI and Sally Fallon Morell of WAPF. I strongly value the opportunity to serve on the advisory board of RAWMI. I acknowledge support from Mark McAfee of RAWMI and Abby Rockefeller of Churchtown Dairy on the pathogen growth study project.

REFERENCES

1. Beals T. Observations on the collection of fresh unprocessed milk samples from states regulating dairies: There are two kinds of milk. Wise Traditions. Summer 2021;22(2):97-100. https://www.westonaprice.org/wp-content/uploads/Summer2021.pdf
2. Stephenson M, Coleman ME. Final report: Database of primary microbial testing program data for raw milk stored in Microsoft Access®. Coleman Scientific Consulting, Aug. 27, 2021. Available at https://www.realmilk.com/database-of-primarymicrobial-testing-program-data-for-raw-milk-storedin-microsoft-access/.
3. Dietert RR, Coleman ME, North DW, Stephenson MM. Nourishing the human holobiont to reduce the risk of non-communicable diseases: A cow’s milk evidence map example. Appl Microbiol. 2022;2(1):25-52.
4. Brandt AL. Determination of Growth Rate of Salmonella enterica spp., E. coli O157:H7, Campylobacter spp., and Listeria monocytogenes in Raw Milk. Food Safety Net Services, Mar. 15, 2022. Available for download at https://www.rawmilkinstitute.org/updates/pathogen-growth-in-raw-milk?rq=determination%20of%20growth%20rate%20of%20salmonella.
5. Smith S. How well do pathogens grow in raw milk? Raw Milk Institute, Mar. 16, 2022.
6. Coleman ME, North DW, Dietert RR, Stephenson MM. (Examining evidence of benefits and risks for pasteurizing donor breastmilk. Appl Microbiol. 2021;1(3):408-425.
7. Food Standards Australia New Zealand. Microbiological Risk Assessment of Raw Cow Milk. Risk Assessment Microbiology Section, Dec. 2009. https://www.foodstandards.gov.au/code/proposals/documents/P1007%20PPPS%20for%20raw%20milk%201AR%20SD1%20Cow%20milk%20Risk%20Assessment.pdf
8. Affleck v. The Attorney General of Ontario, 2021 ONSC 1108 (CanLII). https://www.canlii.org/en/on/onsc/doc/2021/2021onsc1108/2021onsc1108.html
9. Coleman ME. Improving the Credibility of the Food Standards Australia New Zealand Report Entitled Microbiological Risk Assessment of Raw Cow Milk (2009) Considering New Evidence. Report submitted to Australian Raw Milk Movement, July 26, 2021. Available at https://www.ausrawmilk.org/.
10. European Food Safety Authority (EFSA) Panel on Biological Hazards. Scientific opinion on the public health risks related to the consumption of raw drinking milk. EFSA Journal. 2015;13(1):3940.
11. Codex Alimentarius Commission (CAC). Principles and Guidelines for the Conduct of Microbiological Risk Assessment. 1999. Accessed Mar. 8, 2021 at https://www.fao.org/3/y1579e/y1579e05.htm.
12. National Science and Technology Council. Protecting the Integrity of Government Science. Scientific Integrity Fast-Track Action Committee, Jan. 2022. https://www.whitehouse.gov/wp-content/uploads/2022/01/01-22-Protecting_the_Integrity_of_Government_Science.pdf
13. Kolata G, Mueller B. Halting progress and happy accidents: how mRNA vaccines were made. The New York Times, Jan. 15, 2022.
14. Whitehead J, Lake B. Recent trends in unpasteurized fluid milk outbreaks, legalization, and consumption in the United States. PLoS Curr. 2018;10:ecurrents.outbreaks.bae5a0fd685616839c9cf857792730d1.
15. Azzolina NA. Summary Report: Statistical Analysis of Raw Milk-Related Outbreaks, 2005-2016, 2019, as reported in Supplemental Table 1 from Whitehead and Lake, 2018. Analysis funded by RAWMI and submitted subsequently as an affidavit for the Toronto case.
16. Hill C. RDA for microbes—are you getting your daily dose? Biochem (Lond).2018;40(4):22-25.
17. Marco ML, Hill C, Hutkins R, et al. Should there be a recommended daily intake of microbes? J Nutr. 2020;150(12):3061-3067.
18. Society for Risk Analysis. Resilience and the human superorganism: Give us this day our daily microbes. June 2, 2021. https://www.sra.org/webinar/resilience-andthe-human-superorganism-give-us-this-day-our-daily-microbes/
19. Oikonomou G, Addis MF, Chassard C, et al. Milk microbiota: What are we exactly talking about? Front Microbiol. 2020;11:60.
20. LeJeune JT, Zhou K, Kopko C, Igarashi H. FAO/WHO joint expert meeting on microbiological risk assessment (JEMRA): Twenty years of international microbiological risk assessment. Foods. 2021;10(8):1873.
21. Coleman ME, Dietert RR, North DW, Stephenson MM. (2021). Enhancing human superorganism ecosystem resilience by holistically “managing our microbes.” Appl Microbiol. 2021;1(3)471-497.
22. Chen Y, Ross WH, Scott VN, Gombas DE. Listeria monocytogenes: low levels equal low risk. J Food Prot. 2003;66(4):570-577.

The post Raw Milk Risks from a Microbiologist’s Perspective appeared first on Real Milk.

Public health officials, the federal government and the dairy industry have long claimed that unless milk is pasteurized it should not be consumed or sold to the public. One of their arguments is that raw milk is “inherently dangerous.” They also claim that raw milk has been a significant source of consumers’ foodborne illness. Publications have stated that there have been incidents of outbreaks of foodborne illness in which raw milk was thought to be the source of the illness. These reports of outbreaks attributed to raw milk continue to be used as one of the strongest arguments for convincing legislatures to pass laws requiring milk pasteurization. The documented health benefits from raw milk do not overcome the perceived health risk in public health officials’ policies and communications, and they persist in insisting that milk must be pasteurized to be safe for human consumption. This article offers a counter-argument to the notion that unpasteurized milk is “inherently dangerous” by making a clear distinction between “pre-pasteurized milk” and milk that is intended to be consumed fresh and unprocessed. This distinction may be helpful to dairy farmers and consumers of fresh unprocessed whole milk as more states move toward allowing sales of this type of milk.

FOODBORNE ILLNESS

The harmful bacteria that are currently thought to cause outbreaks attributed to raw milk are Campylobacter jejuni, a small group of Escherichia coli that produce the shiga toxin, Listeria monocytogenes and salmonella. According to my data documentation, since 1999, the number of outbreaks associated with fresh unprocessed milk reported each year in the USA is, in fact, declining. This decline has occurred despite the well-recognized fact that the number of small dairies that are providing fresh unprocessed milk to families is rapidly increasing, and the number of people who are consuming fresh unprocessed milk has also been steadily increasing. Today, over 11 million people in the USA regularly drink this nutritious food. The argument that raw milk is “inherently dangerous” is based on the observation that manure, which contains many types of bacteria, is everywhere in the dairy environment, and that several well-documented studies have shown that the four bacteria of public health concern are frequently cultured in raw milk.

DATA COLLECTION FROM CONSUMERS AND FARMERS

In my personal contacts with dairy farmers and families consuming fresh unprocessed milk over more than 20 years, none had episodes of foodborne illnesses in those drinking the milk. Since some of the dairy farmers that were providing unpasteurized milk to their consumers were testing their milk for bacteria to show that their milk was safe, I asked them for copies of their lab reports on their milk, and none of the reports they sent me showed positive laboratory results for these four harmful bacteria. This was in complete disagreement with the published studies that report finding bacterial contamination in more than 25 percent of the milk they sampled.

I became convinced that this inconsistency in lab results was due to differences in how the milk was produced. The scientific studies that showed a high presence of the four bacteria in samples had tested milk only from dairies that produce milk to be shipped to dairy industry plants, where it was pasteurized and homogenized, before sale to the public. In contrast, the dairy farmers I was receiving lab reports from were producing milk that they knew was going directly to families that came to their farm to get fresh unpasteurized milk. These consumers and farmers knew each other personally and were consuming that farm’s milk because it was not pasteurized.

DIFFERENT MILKS

I concluded from this difference in lab results that the term “raw milk” is too general; in fact, we are talking about different milks: “fresh unprocessed milk” and “pre-pasteurized milk.” I stopped referring to all milk coming from dairy farms as raw milk, and instead, I indicated the difference by calling milk from dairies that specifically produce milk that is not to be pasteurized “fresh unprocessed milk” and calling milk that is being shipped to industrial pasteurization plants “pre-pasteurized milk.” The milk that researchers tested in their often-quoted studies was “raw milk” from dairy farms supplying the industry and intended to be pasteurized, that is, “pre-pasteurized milk.”

Over the years, I have been asked to testify in court cases related to milk and dairy farms. Whenever I testified in court or gave public presentations in support of our position that unpasteurized milk is safe for human consumption, I made the point that there are two types of raw milk, and I suggested that the distinction between milk intended for consumption without pasteurization and milk intended for pasteurization might explain why the four harmful bacteria have been found in the samples that they tested for the research studies-—that milk was being prepared for and shipped to their “consumers” (dairy processing plants) for pasteurization.

When I made this distinction, the supporters of pasteurization argued that my findings were worthless. They made four main scientific objections:

1. they criticized my findings as anecdotal;
2. they claimed that the samples from dairies whose milk was not intended for pasteurization were not collected properly;
3. they claimed that the lab reports I described had not been performed by reputable labs;
4. they suggested that the farmers who sent me their lab results were “cherry-picking” the reports that they sent to me, to assure me that their milk was free of harmful bacteria.

Countering these criticisms appeared to require collecting data that would satisfy all the critics’ criteria; however, such a study would be prohibitively expensive.

STATES ALREADY COLLECTING THE DATA NEEDED

As more states become convinced to allow people to obtain unpasteurized milk, their regulators have felt the need for specific legal requirements, to ensure that this milk was “safe.” Some of those requirements called for regular, periodic testing. In some of these states, regulators specifically wanted to test the milk for the four harmful types of bacteria that had been associated with milk-borne illnesses. This meant that these states were gathering and recording solid data about the occurrence of pathogens in samples of fresh unprocessed milk made available to the public. Based on this testing, the state could shut down any dairy whose milk might make consumers sick.

The individual states were not actually doing research; they wanted testing to help them determine whether the availability of the fresh unprocessed milk from a particular dairy should be halted until the milk was deemed safe. Nevertheless, these data would satisfy all of the criticisms that were repeatedly brought against the data I had collected from dairies that sent me their testing reports, and they were publicly available.

COLLECTING THE STATES’ LABORATORY TESTING

We made Freedom of Information Act (FOIA) requests to each of the 17 states that were doing milk microbiology testing. We specifically asked for all bacterial testing data that they were getting from laboratories as part of their regulatory control of unpasteurized milk in their state. We received more than 20,000 laboratory reporting sheets from the states and created a massive dataset. This included all testing by each state’s own periodic milk sampling, using their own labs for testing unpasteurized milk. The compiled dataset included 372 dairies from across the nation. The data represented the states’ documented collection and testing criteria. They also included results of a lot of laboratory testing, including some non-bacterial testing. The testing included milk from several types of milking herds, bulk tank samples and samples from other milk products produced by each specific dairy.

The purpose of this summary on this dataset is limited to comparing testing for the four harmful foodborne pathogens in fresh unprocessed whole cow’s milk, so as to accurately parallel the published research studies that showed that up to 25 percent of raw milk is contaminated with these harmful pathogens.

INCLUSION AND EXCLUSION OF SOME LAB TEST RESULTS

Of the 14 states returning FOIA responses, seven states required testing for the presence of the four bacteria (Campylobacter jejuni, E. coli O157:H7, Listeria monocytogenes and salmonella). In addition, one state tested for these pathogens in periodic samples, although such testing was not in their formal regulations; results from this state are included in this summary. Thus, our dataset includes routine, periodic laboratory results only, for the years 2010 to 2014, the years we asked for in our FOIA requests. It is important to note that these data included samples collected during all seasons and in various parts of the country.

In the following summary, we report on only fresh, whole cow’s milk, excluding data from goats and other animals and from other products made from milk. This subset includes milk from 187 dairies across all regions of the county. There were 4,692 samples of milk tested, including 3,506 individual tests for the four pathogens. As we entered lab information for these samples into the dataset, it became obvious that some of the samples were processed for reasons other than as part of the state periodic scheduled sampling. We included only those samples that were part of periodic testing because this paralleled the sampling performed in the research studies cited by those advocating pasteurizing of all milk. The samples excluded from the states’ results were:

• Duplicate: Samples retested to confirm initial lab results on the same sample.
• Follow-up: In those states requiring scheduled testing, there were procedures to resample a given dairy’s milk to verify that a previously detected contamination had been corrected before consumers were allowed to drink that dairy’s milk. These follow-up samples were excluded. If, however, the follow-up samples were taken on a regularly scheduled date, they were included.
• Investigation: Samples that were taken for testing performed as part of an investigation into an outbreak thought to have occurred at that dairy. These were excluded unless the sample was taken on the dairy’s regularly scheduled testing date.
• Other: Results from testing on samples that did not fall into the exclusions above but were not taken on that dairy’s regular, periodic testing schedule.

SUMMARY OF FINDINGS: THE PREVALENCE OF PATHOGENS IN THE TWO MILKS

Of the 187 cow dairies from eight states with regular, periodic testing of fresh, whole cow’s milk, 94 percent had no samples that contained confirmed evidence of any of the four pathogens during the period tested. And less than 1 percent (0.75 percent) of the fresh unprocessed whole cow’s milk samples contained one or more of these four pathogens. This compared to the 25 percent positive samples from the “raw milk” in the published results from milk going to the pasteurization plants, what I would call “pre-pasteurized milk.” It is clear that these two types of milk are significantly different: “pre-pasteurized milk,” destined for pasteurization in industrial milk plants, and fresh unprocessed milk, produced for families who want their milk unpasteurized. And thus, the claim that raw milk is inherently dangerous, based on testing only of milk that the dairy farmers knew will be pasteurized, is not borne out by the data on fresh unprocessed milk.

This review of the FOIA data from states that have enabled the provision of fresh unprocessed milk to families counters the argument that this type of milk is “inherently dangerous.” This information supplements the accumulating data showing that more dairies are providing their fresh milk to their neighbors and an increasing number of families are drinking their milk unprocessed. At the same time, however, the number of outbreaks of foodborne illness attributed to this milk is declining.

In conclusion, this summary shows that as more people want to get their food from local farmers and want fresh, high-quality food, they are convincing elected officials that they should be allowed to determine if the food they eat is for their own health and taste, rather than for the business criteria dictated by the “food” industries. In subsequent summaries on these data, I will discuss the “value” of testing fresh unpasteurized milk for pathogens as well as additional information learned from the data on the correlation of different types of biological testing of fresh unprocessed milk.

About the Author

Ted Beals is a pathologist, health educator and administrator. He is the retired National Director of Pathology & Laboratory Services, Department of Veterans Affairs. Since retirement he continues his years of biomedical research, now focusing on dairy safety and foodborne illnesses. He is an international consultant and educator on the medical aspects of agricultural product safety. Ted is a lifelong advocate for organic principles, sustainable and local agriculture and the nutritional and medical values of nutrient-dense foods. Ted is active in promoting the rights of farmers to provide and consumers to obtain milk and other locally produced fresh unprocessed foods. Ted lives with his wife Peggy on forty acres in rural Michigan.

This article first appeared in the Summer 2021 issue of Wise Traditions in Food, Farming, and the Healing Arts, the quarterly journal of the Weston A. Price Foundation. 

OUTBREAKS

When two or more people become ill from the same food source, it is legally classified as an “outbreak” and must be investigated by the local public health authority. Based on the assumption that if people become ill from food it is due to pathogens or some other contamination, federal regulations require that any medical laboratory that detects evidence of pathogens believed to cause human illness must send that information to local public health officials and the CDC. Currently, the four bacteria considered of public health concern when found in milk—Campylobacter jejuni, a small group of Escherichia coli that produce the shiga toxin, Listeria monocytogenes and salmonella—are included in the pathogens that must be reported to health officials. If local investigation appears to show more than one person with the clinical finding of foodborne illness, health officials must then determine whether the illnesses are connected by type of food consumed and timing of exposure. It is important to point out that the milk is not the source of these illnesses. Rather, milk is the vehicle that transmitted pathogens from some other source into a person’s digestive system and thus spread the illness. It is also important to understand that the investigation of such incidents is not scientifically confirmed, only that the local health officials believe that the incidents might be connected. (See westonaprice.org/cdc-cherry-picksdata-to-make-case-against-raw-milk-2/.)

THE ORIGIN OF THE PHRASE “FRESH UNPROCESSED MILK”

In 2007, a workgroup was formed in the state of Michigan, to give a clear direction to the director of the Michigan Department of Agriculture and Rural Development on how to provide fresh milk to consumers. At its first meeting, the workgroup of 12 stakeholders realized that they needed to specifically distinguish the milk they were discussing. The Michigan Pasteurized Milk Ordinance had already defined “raw milk” as milk that would become pasteurized, so the workgroup went step by step and coined the phrase “fresh unprocessed whole milk” as the term to be used in their discussions. The term was used in the full consensus report from this workgroup (springhouse-press.com/books.html) and has since been used by many throughout the world.

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Summary: Comparative Safety of Raw Milk (744 KB)

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Ever since the proponents for pasteurization began their campaign against raw milk—and this dates back to the 1940s—their main argument has been the safety argument. Raw milk is “inherently dangerous,” they claim. Or as the early articles proclaimed: “Raw milk can kill.” The latest example of this rhetoric comes from a 2014 study out of Johns Hopkins, which concluded that “the relative risk of individual illness is almost 150 times greater per unit of nonpasteurized dairy product, compared to pasteurized.”

THE 2014 JOHNS HOPKINS STUDY

As reported in the Fall, 2016 issue of Wise Traditions, WAPF published a critique of this conclusion in 2015.¹ The claim is derived from an analysis published by Langer and colleagues in 2012, which actually found no statistical difference in the rate of illness (as opposed to the number of “outbreaks”) attributed to raw milk or products produced from raw milk compared to those produced from pasteurized milk. In addition, the Langer analysis limited its time frame to the years between 1993 and 2006. By selecting such a narrow time period, the data excluded the nation’s largest outbreak of salmonella: in 1985, a multi-state outbreak of salmonella that was traced to pasteurized milk from a Chicago milk plant. This resulted in over 16,000 confirmed cases, and the investigators estimated that between 150,000 and 200,000 people were sickened.

Our own analysis of illnesses attributable to raw and pasteurized milk over the years 1980 to 2005 indicates almost 11 times more illnesses attributed to pasteurized milk than to raw milk. Using the estimate that one percent of the milk is consumed raw, we can calculate that on a per-serving basis, raw milk is less than twice as dangerous as pasteurized milk. Recent data suggest that as many as three or four percent of Americans consume raw milk; using these data instead of the one percent figure would make pasteurized milk appear up to twice as dangerous as raw milk on a per-serving basis.

THE RECORD FOR PASTEURIZATION

Mark McAfee from Organic Pastures Dairy in California has compiled a list of all the outbreaks from pasteurized milk and pasteurized milk products since 1966. During this period there have been 153,657 illnesses, 188 hospitalizations, and 73 deaths from pasteurized milk and pasteurized milk products.² The average number of illnesses per year over the fifty-year period is 3,073.

Ted Beals, MD, has kept a list of reported illnesses from raw milk since 1999. This list indicates a maximum of 50 reported illnesses per year from raw milk. This is two percent of the rate of illnesses from pasteurized milk. If over this period two percent of the population has consumed raw milk, then the rate of illness from raw and pasteurized milk is about equal.

However, the vast majority of the illnesses claimed for raw milk are not proven, simply reported. For example, a report “Raw Milk Cons: A Review of the Peer-Reviewed Literature,” compiled by the personal injury attorney William Marler, cites 102 references for illness caused by raw milk. An analysis of these studies shows that 96 percent of these reports found no positive milk sample or no valid statistical association.³ That means that the number of illnesses caused by raw milk is probably far lower that the 50 per year claimed in the literature. And the key point remains: no published study records any deaths from raw milk.

DR. BEALS’ DATA

Here’s another way of looking at Dr. Beals’ data: during the eleven-year period of 1999 to 2010, illnesses attributed to raw milk averaged 42 per year.⁴ With at least 9.4 million people consuming raw milk, the rate of illness from raw milk is about .00044 percent. The CDC reports an estimated 48,000,000 cases of foodborne infections per year in the U.S. population of about 300,000,000. The rate of illness from all foods can then be calculated at 16 percent. Thus, one is at least 35,000 times more likely to contract illness from other foods than from raw milk.

Yet another way of looking at the data is as follows: between 1998 and 2005, there were over 10,000 documented outbreaks that contributed to 199,263 documented cases of foodborne illness. Raw milk was associated with 0.4 percent of these cases, a number that is probably exaggerated. There is no way to quantify whether any of these foods is safer than another from these data, but it is clear from these data that there is no basis for singling out raw milk as “inherently dangerous.”

VIRULENT E. COLI

The most serious illness ascribed to raw milk is infection by the virulent strain of E. coli O157:H7. The number of E. coli O157:H7 cases nationwide is difficult to determine, but in California, there are apparently about 75 “clusters” per year (personal communication of a California Health Department official to Mark McAfee of Organic Pastures Dairy). We can assume about 10 cases per cluster or 750 per year in California. Over a twelve-year period, that would be 9,000 cases. About three percent of the population of California consumes raw milk. If raw milk drinkers contracted the pathogen at the same rate as the general population, we would expect about 270 raw milk drinkers to be infected during the period. But in fact, there have been only seven raw milk drinkers who have contracted E. coli O157:H7 during the twelve-year period of 1999-2011. The low number of raw milk drinkers infected with E. coli O157:H7 suggests that raw milk is actually protective against this pathogen.

RAW MILK IS INHERENTLY SAFE

In the early days, we did not have much evidence to refute the headline-grabbing claims against raw milk, but today we have years of input and records. And these records show us that the claim of inherent danger in raw milk is false. While it might be difficult to come up with a precise comparison of illnesses per person for raw versus pasteurized milk, it is abundantly clear that raw milk is not more likely to cause illness than pasteurized. The key point is that there has never been a confirmed death from raw milk, but there have been more than 70 deaths from pasteurized milk and pasteurized milk products.

REFERENCES

1. www.realmilk.com/safety/the-johns-hopkins-raw-milk-study/
2. Spreadsheet of Outbreaks from Pasteurized Milk, www.realmilk.com/key-documents
3. www.realmilk.com/wp-content/uploads/2012/11/ResponsetoMarlerListofStudies.pdf
4. www.realmilk.com/real-milk-pathogens.html

This article appeared in the Winter 2016 issue of Wise Traditions, the quarterly journal of the Weston A. Price Foundation.

About the Author

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Two years ago, after testimony regarding a bill to legalize the sale of raw milk in Maryland, the House of Delegates’ Health and Government Operations Committee called for a study of raw milk from Johns Hopkins University.

The report was published in December 14, 2014, and it concluded that “the relative risk of individual illness is almost 150 times greater per unit of nonpasteurized dairy product, compared to pasteurized.”¹ Widely circulated in the media, this figure gave the Committee the rationale it needed to cease any further investigation of raw milk legislation.

Since the Johns Hopkins paper is a review of existing evidence rather than a presentation of any new evidence, it does not contain any important information that we have not already critiqued. Nevertheless, since it repeats past claims that raw milk is far more dangerous than pasteurized milk, we find it necessary to reiterate some of our previous criticisms and add several comments.

No Statistical Difference

The claim that “the relative risk of individual illness is almost one hundred fifty times greater per unit of non-pasteurized dairy product, compared to pasteurized” is the one we wish to address. It is derived from an analysis published by Langer and colleagues in 2012.² We previously have criticized this analysis,³ noting that the researchers found no statistical difference in the rate of illness (as opposed to the number of “outbreaks”) attributed to raw milk or products produced from raw milk compared to those produced from pasteurized milk. We would like to take this opportunity to make several additional points, emphasizing the way this analysis is used to support the conclusions of the more recent Johns Hopkins paper.

The Langer analysis found that raw dairy products accounted for 36 percent of individual illnesses attributed to milk, while the remainder could be attributed to pasteurized dairy products. Even though they found that almost twice as many illnesses were attributed to pasteurized dairy products as were attributed to raw dairy products, they argued that, since fewer than one percent of dairy products are sold as raw dairy products, then on a per serving basis, raw dairy products are almost 150 times more dangerous than pasteurized dairy products.

There are three principal flaws with this analysis: the first is in the time frame considered; the second is the question being asked; the third is in the unreasonable confidence given to the answer.

Limited Time Frame

The Langer analysis limited its time frame to the years between 1993 and 2006. By selecting such a narrow time period, the data become distorted. For example, these data do not include the nation’s largest outbreak of salmonella in its history: in 1985, a multi-state outbreak of salmonella was traced to pasteurized milk from a Chicago milk plant. This resulted in over 16,000 confirmed cases, and the investigators estimated that between 150,000 and 200,000 people were sickened.⁴

Because industrialized milk is produced on such a large scale, small improvements to the system can have large effects, while small things that go wrong can have horrifying consequences on a massive scale, as in the case of the 1985 outbreak. We would expect illnesses due to small-scale milk production to be more frequent yet far smaller in consequence. By contrast, we would expect illnesses due to large-scale milk production to be less frequent yet massive in consequence. To make a fair comparison, therefore, we must use as large a span of data as possible, so that we include the infrequent but large outbreaks due to pasteurized milk.

More Illnesses from Pasteurized Milk

We conducted our own analysis of illnesses attributable to raw and pasteurized milk over the years 1980 to 2005.⁵ These data indicated that there were almost 11 times more illnesses attributed to pasteurized milk than to raw milk. Using the estimate that one percent of milk is consumed raw, we calculated that, on a per serving basis, raw milk is less than twice as dangerous as pasteurized milk. Yet we can have little confidence in the claim that one percent of milk is consumed raw. Even the Langer and Johns Hopkins papers treat these figures as guesstimates. More recent data suggest that as many as three to four percent of Americans consume raw milk, and using these data instead of the one percent figure would make pasteurized milk appear up to twice as dangerous as raw milk on a per-serving basis.

It may be the case that only one percent of Americans drank raw milk in the 1990s and that consumption has risen dramatically since then. For example, in 1998, there were 40 sources of raw milk listed at realmilk.com, and today there are more than 2,000. Since we promote pasture feeding, clean milking, storage, and distribution practices, and careful attention to quality, we believe our campaign has made raw milk not only more available, but also safer and healthier than it would be without this attention to quality. Food frequency questionnaires are notoriously unreliable, so it is not at all clear that data on raw milk usage are accurate. When combined with clear reasons to believe that raw milk usage and raw milk quality have been changing over time, little confidence should be placed in these calculations of per-serving risk.

Raw Milk Versus Other Foods

The second principal flaw is the question being asked. If the Johns Hopkins paper is meant to inform a decision of whether to liberalize raw milk laws, the appropriate question is not whether raw milk is more dangerous or safer than pasteurized milk. Rather, the question is how the safety of raw milk compares to other foods whose legality we take for granted and whether there is anything uniquely unsafe about it that should outweigh the right of the consumer to purchase and use it.

Compared to many foods whose legality goes unquestioned, even the FDA, USDA, and CDC estimate that raw milk is extremely safe. For example, a joint analysis produced by these agencies concluded that the risk of listeria, on a per-serving basis, is about 10 times higher in deli meats and hot dogs than in raw milk.⁶ It makes no sense for these agencies to single out raw milk when they themselves estimate it as so much safer than far more commonly consumed foods, and it is a distortion of perspective to support such an argument by comparing raw milk exclusively to pasteurized milk, regardless of the quality of data used to do so.

Bias in the Data

The third principal flaw is that far too much confidence is used in the attributions of illness to raw milk given the intrinsic difficulties of interpreting the data. The authors of the Johns Hopkins study do acknowledge these difficulties when they write, “nothing short of a clinical trial could remove all the potential confounding that underscores any outbreak review,” but this note of caution never tempers their final conclusions. As such, the media are likely to magnify the overconfident conclusions rather than the pitfalls of reading too much into such low-quality data. Outbreak reports are observational in nature. Observational studies are considered useful for examining whether things statistically correlate with one another, but not necessarily for examining whether one thing causes another. Clinical trials, by contrast, are designed to develop solid evidence of cause-and-effect relationships.

Among observational studies, outbreak reports are subject to a particularly high potential for bias. They do not examine whether a random sample of people who drink raw milk are more or less likely to get sick over time than a random sample of people who drink pasteurized milk. Instead, people who get sick report their sicknesses themselves and public health officials look for any link they can find. Raw milk has been heavily politicized and demonized for decades as a source of foodborne illness, so biases toward finding links with raw milk are strong.

We analyzed 70 studies⁷ that attributed outbreaks to raw milk and found that 96 percent of them lacked either a statistical correlation with raw milk consumption or evidence of contaminated milk, while 50 percent of them lacked both of these. We consider this strong evidence that raw milk is often blamed for outbreaks with inadequate evidence.

A Randomized Controlled Trial

Although the Johns Hopkins authors acknowledge that a clinical trial would provide needed clarity, they do not cite the only randomized, controlled trial we are aware of that examined the effect of milk pasteurization on infectious disease.⁸ This trial compared the rate of infections in infants fed raw human milk or a mixture of pasteurized human milk and formula. The infants suffered three times as many infections when fed pasteurized human milk and formula, even though 15 percent of the raw human milk samples contained pathogenic organisms, which were eliminated by pasteurization. While this study does not directly compare raw cow milk to pasteurized cow milk, it provides proof of principle that mammalian milk in its raw state strengthens immunity to such a strong degree that it results in a lower risk of infection in infants even if the milk itself is a source of infectious organisms.

We strongly support quality control that minimizes the risk of milk contamination, and we consider the demonstrated immune-boosting properties of raw milk, combined with clean and hygienic milking, storage, and distribution practices, to be most likely to protect people against infectious diseases.

References

1. jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-a-livable-future/_pdf/research/clf_reports/RawMilkMDJohnsHopkinsReport2014_1208_.pdf, page 9. Accessed May 17, 2015.
2. Langer and others. Nonpasteurized dairy products, disease outbreaks, and state laws-United States, 1993-2006. Emerg Infect Dis. 2012 Mar;18(3):385-91. doi: 10.3201/eid1803.111370.
3. realmilk.com/press/flawed-cdc-report-may-factor-state-raw-milk-defeats/
4. Ryan and others. Massive outbreak of antimicrobial-resistant salmonellosis traced to pasteurized milk. JAMA. 1987 Dec 11;258(22):3269-74.
5. realmilk.com/wp-content/uploads/2012/11/ResponsetoMarlerListofStudies.pdf
6. fda.gov/downloads/Food/FoodScienceResearch/UCM197330.pdf
7. realmilk.com/wp-content/uploads/2012/11/ResponsetoMarlerListofStudies.pdf.
8. Narayanan and others. Randomised controlled trial of effect of raw and holder pasteurized human milk and of formula supplements on incidence of neonatal infection. Lancet. 1984 Nov 17;2(8412):1111-3.

A Ray of Hope in the Johns Hopkins Report?

The Johns Hopkins report on raw milk contained predictable spurious data and warnings against raw milk. However, it was not entirely negative. In their report to the Maryland House of Delegates’ Health and Government Operations Committee, the authors, a group of prominent public health scientists from Johns Hopkins University, suggested for the first time, that both raw milk opponents and advocates, “would gain much by being willing to discuss and compromise on their positions.”

At the start of the report, the authors state: “Overall, our review identified no evidence that the potential benefits of consuming raw milk outweigh the known health risks. Based on our findings, we discourage the consumption of raw milk. The risks of consuming raw milk instead of pasteurized milk are well established in the scientific literature, and in some cases can have severe or even fatal consequences.” The authors do, however, note European studies showing that raw milk protects against asthma, allergies and eczema.

This article was first published in Wise Traditions, the quarterly journal of the Weston A. Price Foundation, Summer 2015

By the end of the report, the authors are much more sympathetic to raw milk, noting differences in how raw and pasteurized milk are produced: “It is important to reiterate the systematic differences between most raw and pasteurized milk production in the U.S. and how they complicate the public health argument for one or the other (Mendelson 2011). Today most pasteurized milk is produced at an industrial scale, with farms containing thousands of cows fed corn and soy products, and milk sent to dairy processing plants in bulk tanks. Dairy farmers at these industrial farms have the opportunity to be more lax about hygienic practices. Further, the potential for cross-contamination of milk before or after pasteurization is substantial due to these potential factors: a large number of workers, biofilms in distribution pipes, and unsterilized equipment” (Mendelson 2011; Oliver et al. 2005).

“On the other hand, milk that is intentionally sold unpasteurized is often produced on small farms with grass-fed cows and sold to local consumers (Baars 2013). While hygienic practices are not ensured in this setting, these farmers may be more concerned for each individual animal’s health and the health of their customers. They thus may strive to prevent microbial or other contamination. We believe in the benefit of consuming milk and other food products on a local scale, as it is both environmentally sustainable and can support the local economy.”

In their conclusion, the Johns Hopkins scientists seemed to be recommending a compromise approach in Maryland, based on strict labeling of raw milk. “In conclusion, given the scientific evidence, we do not recommend the consumption of raw milk. If raw milk sales became legal in Maryland, we would strongly recommend that a labeling system be implemented and that farm safety and hygienic practices be required. We would also recommend restricting pregnant women and children from drinking raw milk due to their increased susceptibility to microbial hazards.”

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This is the translation. The source page is located here: https://www.realmilk.com/health/chronic-disease-and-raw-milk/

Публикувано на 2 март 2003 г.

Последна промяна на 21 март 2020 г.

От Рон Шмид /Ron Schmid, ND/

Особено вирулентна форма на бактерията Салмонела е Салмонела дъблин (С. дъблин). Както при повечето инфекции със Салмонела, хората с потисната имунна система са най-застрашени (например пациенти със СПИН или хора, приемащи кортикостероиди или химиотерапия). Доклад в Western Journal of Medicine от май 1983 г. е озаглавен „Инвазивни инфекции със Салмонела дъблин, свързани с пиене на сурово мляко“.¹ Авторът провежда едногодишно проучване през 1980 и 1981 г. във Veterans Administration Medical Center (VAMC) в Сан Диего. През същата година във VAMC са диагностицирани 14 случая на инфекция със Салмонела; пет от тях са инфекции със C. дъблин. Възрастите на тези пет индивида варират от 56 до 97 и всички, освен един, имат сериозно предшестващо хронично заболяване или приемат имуносупресивни кортикостероидни или химиотерапевтични лекарства. Трима от тях са пили сурово мляко от ферма Алта Дена няколко пъти в рамките на предходните две седмици. Това не доказва, че суровото мляко е било източник на инфекцията, но е силна асоциация.

Единият случай е на 85-годишна жена с хронична левкемия, диагностицирана през 1979 г. Цитирано от статията: „През септември 1981 г. тя е лекувана за пръв път с циклофосфамид [силно токсичен химиотерапевтичен агент, който уврежда естествения имунитет към инфекция] и преднизон, три пъти на ден. Седмица по-късно развива диария, висока температура и втрисане и получава синкопален епизод [временна загуба на съзнание поради спад на кръвното налягане]. … кръвта, урината и изпражненията всички съдържат увеличаващо се количество С. дъблин … жената умира на 17-ия ден от постъпване в болницата. … Имунният статус на тази жена е компрометиран както от левкемията, така и от терапията. Тя изпада в шок с изключително силна салмонелна бактериемия [бактерии в кръвта].”

Трима от останалите четирима пациенти със C. дъблин инфекции са достатъчно болни, че да се наложи антибиотична терапия и прием в болницата; един е хоспитализиран в продължение на няколко седмици.

Тази кратка история представя един микрокосмос на разрива между практикуващите конвенционална съвременна медицина и тези, които се застъпват за холистичен подход, и пациентите, които толкова често са притиснати между тях. Тримата, които са пили суровото мляко, са се стремили да си помогнат за по-добро здраве. Лекарите, участващи в конвенционалното им лечение, и техните колеги, обвиняват млякото за последващите заболявания и за едната смърт. Но привържениците на суровото мляко, включително и аз, биха спорили, че ако не бяха имуносупресивните лекарства, никой от тези хора не би се заразил със Салмонела. Колко време 85-годишната жена безпроблемно е пиела сурово мляко преди първата си седмица на химиотерапия, в края на която се разболява смъртно? Статията не дава отговор на този въпрос. За многото ползи от суровото мляко авторът казва само: „Няма да коментирам валидността на хранителните твърдения, които се правят за суровото мляко.“

При оценката на относителните рискове трябва също да имаме предвид, че през 1985 г. инфекциите със Салмонела, проследени до пастьоризирано мляко, са засегнали приблизително 175 000 души, с над 16 000 случаи потвърдени от изследване на бактериалната култура в млякото, в епидемия засегнала няколко американски щата (както се съобщава в Journal of the American Medical Association, от 11 декември 1987 г., наред с други места).

Защитниците на суровото мляко трябва да признаят, че C. дъблин понякога се намира в сурово мляко, и че по всяка вероятност това понякога води до остри заболявания, особено за хора лекувани с имуносупресивни лекарства. Въпросното мляко в тези случаи е било от ферма в Южна Калифорния, която не храни кравите си с трева. Известно е, че количеството трева в диетата е критичен фактор за здравето на кравите и качеството на произведеното мляко. Вярвам, че когато кравите се хранят строго или предимно с трева, има малък риск от Салмонела или някакъв друг инфекциозен проблем произтичащ от млякото, дори за хора с имуносупресия. Знаем, че д-р Крю (Crewe) от Mayo Foundation е използвал сурово мляко при лечението на голямо разнообразие от сериозни хронични заболявания, и че той не съобщава за проблеми като описаните по-горе.² Медицинската професия по това време обаче не е била заета с лечението на милиони хора с имуносупресивни лекарства. Като предпазна мярка, считам, че хората с компрометиран имунитет трябва да търсят само най-доброто сурово мляко, а това означава сурово мляко от животни стриктно хранени само с трева.

1. Joshua Fierer, MD. Инвазивни инфекции със Салмонела дъблин, свързани с пиене на сурово мляко. Western Journal of Medicine, май 1983 г.

2. Статията на д-р Крю (Crewe) бе препечатана в Wise Traditions, лято 2002, 3(2):58-61.

Тази статия бе отпечатана в есенното издание на Wise Traditions, тримесечното списание на Фондация Уестън А. Прайс (Weston A. Price Foundation).

Ron Schmid, ND, лекар-натуропат, писател, учител и фермер, предписва сурово мляко за своите пациенти в продължение на почти 25 години. Д-р Шмид е възпитаник на Масачузетския технологичен институт (Massachusetts Institute of Technology) и Националния колеж по натуропатия (National College of Naturopathic Medicine) и е преподавал във всичките четири натуропатични медицинските училища в САЩ. Той е служил като бивш директор на клиника и главен лекар в University of Bridgeport College of Naturopathic Medicine. Автор е на „Традиционните храни са най-доброто лекарство“ (Traditional Foods Are Your Best Medicine) и „Неразказаната история на млякото“ (The Untold Story of Milk).

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