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Coming up on this episode of The Doctor's Pharmacy. There is no evidence basis for all adults eating three servings of dairy a day, milk or milk equivalents.
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Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to The Doctor's Pharmacy. Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in.
Today, David, we're going to talk about milk. And you always have been an iconoclast, breaking apart notions, for example, that calories are all equal, which is pretty much still in play.
play right now that everybody thinks calories are equal except a few rogue scientists like you, although it's becoming more accepted. But milk, God, milk is nature's perfect food. It's what we should all be drinking three glasses a day of according to our government policy and kids at least two glasses a day if they're under nine. And it's supposed to be great for your bones. It's supposed to help you grow big and strong. It's supposed to help prevent disease. And
Somehow, it doesn't seem like that's actually what the science shows. When we take a good look at it, it's a different story. You and your colleague, Walter Willett at Harvard, one of the most renowned nutrition scientists along with you, recently published a paper in the New England Journal of Medicine called Milk and Health, which I encourage everybody to read if they're a nerd like me, or if you want the easy version, go to Medium. There's a fabulous article there in Medium about the
the question about milk. Is milk truly healthy? Time to question everything you know about milk. So I encourage you to check that out. Now, David, what inspired you to write this article? Well, people drink a lot of milk. And even though we're consuming a great deal of it, if we were to comply with USDA recommendations, three servings a day for virtually everybody,
we would have to double our consumption, which we're talking about billions of gallons of milk produced more every year, which would have a massive impact on the food supply. And the question is, what impact would that have on health? And remarkably, there are astoundingly few clinical trials that have examined the impact of milk
those recommendations on diseases today, obesity, type 2 diabetes, cardiovascular disease. So maybe a place to start is like, where did we get these recommendations? Yeah, I mean, you reviewed over 100 papers. So you got these recommendations that our government gives us. But yeah, how do we get them?
Some of these recommendations to consume a minimum amount of things date back to a different era, like 100 years ago. At least the philosophy did. When the big concern for much of the American public was not too much, like we have today, obesity, but too little. Diseases of deficiency, vitamin C deficiency, vitamin A, vitamin D deficiency,
protein deficiency, and in some cases, calorie deficiency. People weren't getting enough food. So the questions became, what was the minimum amount that we needed to assure the health of the population?
Now we're in a very different era and that mindset of minimum recommended amount hasn't necessarily caught up because so many diseases today, it's not that we're completely free of deficiency syndromes and things like rickets, vitamin D deficiency is beginning to come back, especially in children amidst the obesity epidemic. But so we still of course need to pay attention to what the minimum amount of
vitamins, minerals, other nutrients might be. But when we start thinking about foods like dairy, the question is, shouldn't be, what is the minimum amount based on these old notions of nutrients, but what amounts are optimal for the population today, given the prevalence of high prevalence of obesity, diabetes, and heart disease?
Yeah. So back then, you know, I remember reading about the development of the four food groups, right? Milk was one of them. Dairy is one of the four food groups. But
That was a construct of industry, not science, where big industrial producers of these products, meat, milk, produce, and grains, basically got together and said, well, how do we sell more of our stuff? Let's make the four food groups. And it really had nothing to do with science. And at the same time, we also have to understand that milk is something that most of the world's population doesn't tolerate. 75% or 70% are lactose intolerant. Most populations around the world don't consume milk on a regular basis, like most
China and Asia and most Asian countries, Africa. There are some exceptions, obviously the Maasai, but I think that for the most part, it's not a staple food after weaning. And yet somehow in the West, we've come to think about it as, you know, just American as apple pie and, you know, and the American flag. And so, and in fact, you can't even get a school lunch
authorized unless milk is included in the school lunch. But you really question that. I think, you know, you wrote an article a number of years ago, which was sort of a prelude to this one that was in, I think, JAMA, also with Walter Willett, where you sort of questioned the guidelines and brought up some of this data. And I wrote an article that sort of kind of derived from that called Got Proof, which essentially was a spoof on the whole Got Milk campaign, which, by the way, people don't understand that the Got Milk campaign wasn't
an industry effort solely, that it was part of a government program called the Chekhov Program, which is where the United States Department of Agriculture supports industry to sell more of its products. It's supposed to help with research, right? The money is tied to the government by the industry, apparently to support research, but it actually went to marketing of
these ads called Got Proof, and they were literally taken down by the Federal Trade Commission because there was no evidence for the claims we're making. Can you talk about that? And then how did we get to these three glasses? Right. Well, so we began by looking at the mindset, the philosophy that gave rise to these minimum recommendations. And you point out that it's not just science, but it's also food politics, that the USDA, which has...
conventionally overseeing these recommendations has a dual message, dual mission. One is promotion of public health, but the other is to advance the financial interests of the big food commodity producers. And dairy is absolutely a very, very powerful. So, um,
You made another very important point that really cuts to the chase, that much, that at least half of the world's population doesn't consume milk.
or milk products on a regular basis. And yet the children seem to be able to grow up without suffering continuous bone fractures or have short stature or other problems. So we know that milk is not required to be a healthy child or a healthy adult. And of course, before 10,000 years ago, when perhaps the first dairy animals were domesticated,
No humans would have ever consumed any dairy products. And you wouldn't be milking a saber-toothed tiger? You know, good luck. So we know that milk isn't necessary to survive, to keep our bones from crumbling.
But that doesn't mean that milk is inherently harmful or that we shouldn't be drinking it. And a point that I'd like to continue to return to during our talk today is an interaction with diet quality. To understand the impact of a food like milk or really many other foods, because there's essentially no...
there's no one food that you have to eat in order to live. So the question is, how do these foods support health for a specific population? And to understand that, we need to think about what foods are being traded off. So for a child that's consuming junk foods all day long, sugary beverages and packaged savory snacks, cheeseburgers and like,
Dairy products might be among the healthiest things that they eat. These are whole foods for the most part, as long as they're not loaded up with sugar, as actually does still happen in schools. So dairy products would tend to increase diet quality, displace some of these highly processed junk foods, and would be good for health. Yeah.
Yeah, compared to what is really the question. What are you eating instead of it? Yeah, for somebody who's got a really healthful diet based on whole foods, who's avoiding a lot of processed carbohydrates and others,
Just dumping in more dairy products to reach some kind of theoretical nutrient balance may miss the mark. And with regard to calcium, which is the most commonly cited— So, what you're saying is basically saying dairy is better than Coke is not saying much, right? Right.
Well, no, I mean, there's a lot of, you know, two thirds of what's consumed in the U.S. is highly processed poor quality. And so I think what we want to do is ask, what is the background diet we're talking about? To simply say, don't drink milk.
would, I think, produce a lot of harm because there are children in the United States and even more so in countries with borderline nutritional status where milk provides one of the best sources of protein, of fats, of slow-digesting carbohydrates, potassium, calcium, and other nutrients.
So to remove milk from the diet of people either in the United States, kids with borderline nutrition quality, or overseas, Africa or South America, where nutrient deficiency is a real problem, I think could cause great harm. But let's drill down on calcium because that's the one that – that's the nutrient that is driving –
fear of low milk intake. It's driving milk intake. Yeah. Because, you know, especially women, you know, they want to get enough calcium to avoid milk fractures. And if you go by the calcium balance studies that were used to come up with this recommendation, you know, you need a gram, a thousand milligrams or more calcium a day to meet new comments. It's almost certainly flat out wrong.
These balance studies were based on very short-term studies, 21 days, where, yes, if you dump in a lot more calcium, the body will absorb some of that calcium and put it into bones. But what it's basically doing is filling up
temporary spaces in bones. They don't stay there. And so if you did longer term studies, you would see that adding more and more calcium doesn't keep building a bone. You have this short term boost in bone calcium, but then you fill up all these little temporary niches and nothing, there's no more benefits. The thing is those transient spaces don't stay there. You don't have a calcium bank for life,
by consuming a lot of milk as a kid. And we can talk more about that. So, I mean, I was, I have to confess here. I mean, I hope it doesn't want to bias my opinion about milk is more hopefully medical and scientific. But when I was a kid, I hated milk.
And I just didn't like the taste of it. My mother's like, how are you going to grow up to be big and strong if you don't drink milk? Well, I never drank milk and I'm six foot three. And maybe I want to be an NBA player instead of a doctor. If I did drink milk, who knows? I really never did. And my bone density is great. And I think that it is a bit of a mythology about that.
So we do need calcium. There's no question. The bones are made primarily of calcium and phosphate, but how much calcium? And the minimum requirement to have perfectly healthy bones, probably at most a half of what has been
traditionally viewed as necessary in the United States. In the UK, their minimum calcium requirements are about a half of what they are here. And in some populations, like in South America, the adults do perfectly well getting even a third or a quarter of the amount of calcium, like 300 milligrams a day.
So that level of calcium can be obtained from, so if you're going to get a gram or more a day of calcium, milk is sort of the obvious source. But if you accept that we don't need that much, 500, 600 milligrams a day are probably more than sufficient. Well, that's easily obtained from just a basic diet. A serving of kale is going to get you a third to a halfway there.
- Chia seeds. - A serving of sardines, nuts, seeds. - Yeah, chia seeds, tahini, those are my favorite. I mean, one of the things you said that I just want to come back to, which is really important, is this whole idea of calcium balance.
And when you look at countries like Sweden that you wrote about in your paper, they have the highest intakes of calcium and the highest risk of fractures. And countries like Indonesia and China have the lowest intakes of calcium and the lowest risk of fractures. So one of the things I remember when I was a medical director at Canyon Ranch, I often talked about was osteoporosis. And it was really clear that there are a lot of things in our culture that drove calcium loss. So it's not just about how much you take in, it's how much you pee out.
So caffeine, alcohol, sugar, phosphoric acid from sodas, too much meat perhaps, I don't know if that's true, but that's what it seemed to be, the high protein acid load. All these things, stress, all these things cause bone loss. And if you mitigate those, in other words, you cut those out of your diet or you reduce them and you deal with stress and you deal with the fact of how you're losing calcium, that your net may be better than if you're taking super high levels of calcium.
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The other thing that's interesting to note is that cows get their calcium and have great bones. Where do they get it from? Grass, right? They're drinking milk. They're drinking three servings a day. For a little bit, and then they don't. And they're getting it from grass. So why get secondhand calcium? Green leafy vegetables are actually a very good source of calcium. A serving of kale has almost as much calcium
as a serving of milk and you get many fewer total calories that way. But let's go back to these ecological comparisons. Those are the comparisons where you look at different countries and see different risks. It's important to understand that those are, there are limitations to those kinds of analyses. What they do convincingly tell us is that you can, it's possible to be a human being, consume no milk,
relatively low levels of calcium and have low fracture risk. The problem with these studies is that they're very confounded. So when you look compared to the Swede to the Filipino, there's a big difference in height and height is a major risk factor for bony fracture. So ironically, it may be that milk consumption in adolescence, in childhood and adolescence,
actually increases risk for fracture in adulthood. So how could that be? We talked about that you don't really put away a calcium bank in childhood. You don't get that benefit. But the one thing that is pretty clear that milk does in childhood is accelerate growth. Hugely, it's not going to turn a...
horse racing jockey into a baseball player. But you get about an extra centimeter for every additional serving glass of milk a day. So maybe, and this is a population average, but so maybe for comparing low and high consumers, you grow an extra inch. But on a population basis, that increased height
is one of the major risk factors of having a fracture. You know, simply put, the bigger they come, the harder they fall. So I'm just kind of screwed. I'm like six foot three. I would just advise you don't fall. Well, I'm going to, I'm working on my core strength and muscle mass, and that also helps mitigate it.
Yeah. But this is a big, you know, this is one of the first myths to go. That drinking a lot of milk as a kid is going to reduce your risk of getting a fracture in his adulthood. And if anything, it's the opposite. So this is the basis for our recommendations, which is you need calcium-preventing osteoporosis, and that's why our...
guidelines tell us to have three glasses of milk a day. Yeah, well, you do need calcium. You just don't need that much. And the amount that you need can be obtained from other sources. And so what about the idea of weight? Which again, is not to say that milk is inherently bad or toxic. We talked about one situation where it could be helpful. People with borderline nutritional status, when they drink milk, they're drinking, you know,
you know, drinking like a glass of milk and maybe you just have two cookies after school as a kid instead of having the whole package without milk or with fat-free milk, which doesn't taste very good and isn't very satiating. Yeah, I want to get into the fat-free thing in a minute because I know that's your favorite topic. But I just want to sort of summarize here about the calcium story because what you're saying essentially is that all the data, and there were over 100 papers you reviewed, all the data really didn't point to a benefit of
of increased calcium intake through supplements or through dairy and that there was...
potential risks as well. And then it wasn't just a benign intervention that there may be increased risks with increased calcium intake in different situations, whether it's cancer or whether it's from perhaps the high levels of calcium causing greater growth and fracture risk. We don't know, but it's not a slam dunk. So you think based on the current data that you reviewed in the New England Journal of Medicine study, you think that the government should change its dietary guidelines?
Well, let me just say, so, you know, we talked about the trade-offs and milk. So one downside of extra growth we talked about was fracture risk.
But another downside of being tall is cancer risk. Being the taller you are, the higher your risk of cancer. Partly it's more so you're okay, you're taking good care of yourself. But first of all, you've got a bigger body. But the other thing about milk is to consider how milk has evolved. The purpose of milk is to help grazing animals on the plains of Africa
You know, the infants that are at high risk of being eaten by the local carnivores grow rapidly so they can be strong enough and fast enough to be free of predation. So that's a very strong selective, you know, fitness factor, evolutionary drive to get these baby babies.
ruminants, the gazelles and the other grazing animals to grow very quickly. So that's a good thing. Except if you're consuming these foods that stimulate growth in children, but in adults, these growth factors that may be stimulating biological systems that relate to
cancer. And while the data are definitely not clear yet, there seems to be evidence of cancer, of high levels of dairy consumption causing prostate cancer in men, especially aggressive forms of prostate cancer and endometrial cancer. Although, interestingly,
milk intake may protect against colorectal cancer, and that may be an effect of the calcium. You know, on the issue around
around growth. It's very interesting because there are 60 different naturally occurring hormones in milk, not including the ones that they pump into the cows or that they milk them all pregnant or that they give them for growth factors. So these are just naturally occurring. And the purpose of these is to grow a little baby calf into a big cow very rapidly, like you said. So I think, you know, that might be good for infants, but it's probably not good
for long-term, long-term health. And it's worse now because of modern industrial farming, because in the, you know, a hundred years ago, you'd, you know, it's send the cows out, they'd get pregnant. And, and,
You wouldn't be breast, you wouldn't be milking them during pregnancy. The baby cow would be born, would feed a little bit, and then you'd milk for a while until the next cycle. But now in hyper-efficient industrial agriculture, cows are being milked
throughout their pregnancy. And so those hormones that would be normally present in pregnancy, estrogens and progesterones and other hormones, get dumped into milk. So the milk supply is, even though milk normally has many growth-promoting factors, it has even more so today. So that's something to bear in mind. And even if you're having organic milk, it could still be
This case where you're milking organic milk, unless you're getting it from like a local farm that's using more traditional low intensity dairy agricultural practices, organic milk is not going to be any different in that regard. So, David, in terms of the recommendations, I want to sort of pressure a little bit on that because I think, you know, we have a government that's telling us we should be having three glasses of milk a day and we can't have school lunches without milk. Do you think that's the right policy? Do you think it needs to be modified? What should we do?
It's wrong. We came forth in our paper, at least in our opinion, quite clearly that there is no evidence basis for all adults eating three servings of
dairy a day, milk or milk equivalents. And we recommend zero to two, you know, which takes into account that milk and dairy products have been traditionally part of many cultures. They can be delicious, you know, cheese, a
yogurt and fermented dairy products actually look very good. They tend to be in the best epidemiologic studies consistently popping up as among the most protective foods we eat. Now, that might not have to do with the inherent dairy per se, but the
But the fact that yogurt is one of the few naturally fermented foods that remain in our diet. A hundred years ago, most cultures, Germany or France, a lot of what we would have eaten would have been fermented at least through the winter. Even the foods that people think are like pickles aren't naturally fermented. They might be chemically treated to pickle them.
Whereas yogurt, especially if it's not sugar sweetened, is one of those traditional sweeteners.
fermented products that may be beneficial to the gut microbiome and have other, you know, help. Yeah, I mean, that's important. We just said the sweetened ones. I mean, there's more sugar per ounce in sugar sweetened yogurt, like fruit sweetened yogurt than a per ounce of soda. So it's definitely not a health food when you add the sugar in. And I think that the question then... So we're not arguing to get rid of dairy products, but we just don't think that this
intense consumption. I mean, three servings a day, which would make dairy products among the most
the dominant source of calories for any single food in many people's diets. We think there's no evidence basis for that. And for people who, we don't think that there's going to be much harm from consuming one or two servings a day. But for people who are not consuming any dairy products and eating a high quality diet, they shouldn't feel badly about that choice. There's no reason to suddenly dump in a lot of dairy.
Historically, humans just never drank milk. I mean, were you going to milk a saber-toothed tiger or a buffalo? Probably not, right? So we just never consumed it until the advent of modern agriculture. And we're the only species, period, that consume milk after weaning.
So what we eat now as milk is quite different. And what we drink is quite different than the dairy even 100 years ago or 500 years ago, because that was all from weird heirloom looking cows, which had a very different form of casein, which wasn't inflammatory, called A2 casein.
It wasn't fed antibiotics, it wasn't grown in CAFOs or confined animal feeding operations under horrible conditions and fed all kinds of horrible things including ground up animal parts, skittles and corn and all things that are not its natural diet.
And they give them antibiotics, which gets in the milk, and they give them growth factors, literally growth hormones, to stimulate the production of milk, estrogens and so forth. Like DES, which was actually banned in humans because it caused all kinds of cervical cancer and fetal abnormalities in women who took it. It was supposed to be sort of helping prevent miscarriages, but it didn't do that.
They still give that to cows. So when you're also having conventional milk, even organic milk, they're often milking them when they're pregnant. So you get all this flood of hormones. You get inflammatory casein. You get animals that are living in horrible conditions, fed all kinds of weird stuff, and
So basically, it's not the dairy it used to be. So while maybe you could tolerate dairy if you're having it from some heirloom cow raised on grass and not fed all this weird stuff and antibiotics and hormones might be okay. And I think we kind of have to take a big, broad look at the whole history of dairy production and see how much has changed in the last 50 years and how dangerous that is for us, for the animals on the planet.
So you've talked about how our dairy has changed, but how does the dairy that is not grown in these great conditions and not produced in these great conditions, what impact and what mechanisms does it hijack in our body to create the whole list of things that you mentioned in the opening?
So first I want to say, look, this is not my opinion. There's a recent paper that was published in the New England Journal of Medicine, the most prestigious medical journal in the world, by Drs. David Ludwig and Walter Willett, two of the most renowned nutrition scientists at Harvard, and it was called Milk and Health. And in that, they looked at over 100 studies on dairy, and they basically blew apart all the myths that we've held so dearly to, all the myths that have been actually
Promulgated by the dairy council on the dairy industry and our own government Remember those got milk ads right got milk. It's gonna build strong bones gonna do all these wonderful things your body and it was propaganda in fact the Federal Trade Commission or the FCC I think the Federal Communications Commission outlawed those ads because
They were like, "Got proof?" And they were like, "No, there's no proof. In fact, the opposite is true." And so all the things we believe that it's important for building strong bones and growing tall and strong may help you grow tall and strong, but that's not necessarily a good thing. That it helps you with your nutrition in so many different ways is just a fallacy.
It's not good for weight loss, it's not good for your bones, it's not bad for your heart, it may cause cancer, it causes allergies, autoimmunity, a whole host of problems that come from consuming conventional dairy.
we really have to come to grips with the fact that the science just is not there for humans consuming dairy. I mean, zero is fine. If you want to consume dairy, then we'll talk about what kinds to consume, because there are ways to consume dairy that are probably okay. But for most of it, it should not be a staple food. It's not nature's perfect food. It's not something that actually helps prevent fractures. In fact, in the review paper that they did, basically, they found that for looking at 100,000 people,
and particularly adults, that they followed them. And the more milk they drank, the more fractures they had. So for every glass of milk they drank, they had a 9% increase in fracture rate. So not only did it not prevent fractures, but it increased fracture. And it also has adverse consequences around cancer. It may increase prostate cancer. It may increase endometrial cancer, uterine cancer. It affects people's digestion.
widely because it actually increases lactose intake and probably 75% of the world is lactose intolerant. What about heart disease and the saturated fat in milk? Well, it turns out that there's no correlation. And there was a paper review over 6 million person years of data by Dr. Darius Mazzafarian from Tufts was published a few years ago called his butter back. I think it was called his butter back. And it looked at all the data on heart disease and both
um, butter and heart disease and diabetes. And what they found was fascinating. There was actually an inverse correlation
Correlation is not causation, so we have to understand that. But it was an inverse correlation, meaning the more dairy you drank, the less diabetes you had in terms of fat, in looking at saturated fat. So it may actually not be causing any diabetes. It may protect against diabetes, and it also can cause no change in the risk of heart disease. So there was zero effect on heart disease. So we think butter is bad for your heart. Turns out it may not be. And of course, it's very individual.
When you look at the data, you go, "Wait a minute, all the things we believed are just not true." We eat dairy now in a homogenized, pasteurized form, which is unlike we ever did before historically. And pasteurization is good because it reduces the risk of infection and terrible things you can get from raw milk. But the homogenization process actually changes the informational quality of the food. So if you look at consuming the identical amount of dairy from raw milk versus homogenized milk or unhomogenized milk, let's say, or some homogenized milk,
There are profoundly different effects on your cholesterol. The homogenized milk is terrible, whereas the unhomogenized milk is actually good for your lipids. So it's very subtle, but there are a lot of nuances around how to think about when you're choosing dairy or if you want to eat dairy, which dairy to eat so you're not actually causing harm to your body. We know from the literature that dairy can cause eczema and allergies and asthma and irritable bowel and all kinds of problems, sinus infections.
We know that increases menstrual difficulties and hormonal dysregulation. It's got over 60 different hormones in milk It may increase insulin it could cause all kinds of issues when I see patients we do food sensitivity testing we do allergy testing and I've also seen what happens when you take these foods away like dairy from the diet We see profound changes in people's health. So acne goes away, which is a hugely caused by dairy and
people's digestive problems go away their eczema goes away their asthma goes away their sinus problems goes away their congestion goes away a lot of clinical benefit you get from removing dairy it's other than gluten the most common food sensitivity and it may not be a true allergy but it just may be a sensitivity that is triggering immune response that creates all these side effects so if you're trying to sort of see how your body is
without all the inflammatory triggers getting it rid of dairy is key and getting rid of gluten is key and then there's sort of a secondary list you know eggs or grains or beans or corn or soy or nuts or seeds or nightshades those are sort of down the list of the elimination diet but dairy and gluten are you know king and queen on the elimination diet historically humans just never drank milk i mean were you going to milk a saber-toothed tiger a buffalo probably not right so we just never consumed it until that event of modern agriculture
and we're the only species period that consume milk after weaning so what we eat now is milk is quite different and what we drink is quite different than the dairy even 100 years ago or 500 years ago because that was all from weird heirloom looking cows which had a very different form of casein which wasn't inflammatory called a2 casein
It wasn't fed antibiotics, it wasn't grown in CAFOs or confined animal feeding operations under horrible conditions and fed all kinds of horrible things including ground up animal parts, skittles and corn and all things that are not its natural diet.
And they give them antibiotics, which gets in the milk, and they give them growth factors, literally growth hormones, to stimulate the production of milk, estrogens and so forth. Like DES, which was actually banned in humans because it caused all kinds of cervical cancer and fetal abnormalities in women who took it. It was supposed to be sort of helping prevent miscarriages, but it didn't do that.
They still give that to cows. So when you're also having conventional milk, even organic milk, they're often milking them when they're pregnant. So you get all this flood of hormones. You get inflammatory casein. You get animals that are living in horrible conditions, fed all kinds of weird stuff, and
So basically, it's not the dairy it used to be. So while maybe you could tolerate dairy if you're having it from some heirloom cow raised on grass and not fed all this weird stuff and antibiotics and hormones might be okay. And I think we kind of have to take a big, broad look at the whole history of dairy production and see how much has changed in the last 50 years and how dangerous that is for us, for the animals on the planet.
So you've talked about how our dairy has changed, but how does the dairy that is not grown in these great conditions and not produced in these great conditions, what impact and what mechanisms does it hijack in our body to create the whole list of things that you mentioned in the opening?
So first I want to say, look, this is not my opinion. There's a recent paper that was published in the New England Journal of Medicine, the most prestigious medical journal in the world, by Drs. David Ludwig and Walter Willett, two of the most renowned nutrition scientists at Harvard, and it was called Milk and Health. And in that, they looked at over 100 studies on dairy, and they basically blew apart all the myths that we've held so dearly to, all the myths that have been actually
promulgated by the dairy council and the dairy industry and our own government. Remember those Got Milk ads? Right? Got Milk. It's going to build strong bones. It's going to do all these wonderful things to your body. And it was propaganda. In fact, the Federal Trade Commission or the FCC, I think the Federal Communications Commission, outlawed those ads because
They were like, "Got proof?" And they were like, "No, there's no proof. In fact, the opposite is true." And so all the things we believe that it's important for building strong bones and growing tall and strong may help you grow tall and strong, but that's not necessarily a good thing. That it helps you with your nutrition in so many different ways is just a fallacy.
It's not good for weight loss, it's not good for your bones, it's not bad for your heart, it may cause cancer, it causes allergies, autoimmunity, a whole host of problems that come from consuming conventional dairy.
we really have to come to grips with the fact that the science just is not there for humans consuming dairy. I mean, zero is fine. If you want to consume dairy, then we'll talk about what kinds to consume because there are ways to consume dairy that are probably okay. But for most of it, it should not be a staple food. It's not nature's perfect food. It's not something that actually helped prevent fractures. In fact, in the review paper that they did, basically, they found that for looking at 100,000 people,
and particularly adults, that they followed them. And the more milk they drank, the more fractures they had. So for every glass of milk they drank, they had a 9% increase in fracture rate. So not only did it not prevent fractures, but it increased fracture. And it also has adverse consequences around cancer. It may increase prostate cancer. It may increase endometrial cancer, uterine cancer. It affects people's digestion.
widely because it actually increases lactose intake and probably 75% of the world is lactose intolerant. What about heart disease and the saturated fat in milk? Well, it turns out that there's no correlation. And there was a paper review over 6 million person years of data by Dr. Darius Mazzafarian from Tufts was published a few years ago called his butter back. I think it was called his butter back. And it looked at all the data on heart disease and both
butter and heart disease and diabetes. And what they found was fascinating, there was actually an inverse correlation
Correlation is not causation, so we have to understand that. But it was an inverse correlation, meaning the more dairy you drank, the less diabetes you had in terms of fat, in looking at saturated fat. So it may actually not be causing any diabetes, may protect against diabetes, and it also can cause no change in the risk of heart disease. So there was zero effect on heart disease. So we think butter is bad for your heart. Turns out it may not be. And of course, it's very individual.
When you look at the data, you go, "Wait a minute, all the things we believed are just not true." We eat dairy now in a homogenized, pasteurized form, which is unlike we ever did before historically. And pasteurization is good because it reduces the risk of infection and terrible things you can get from raw milk. But the homogenization process actually changes the informational quality of the food. So if you look at consuming the identical amount of dairy from raw milk versus homogenized milk or unhomogenized milk, let's say, or some homogenized milk,
there are profoundly different effects on your cholesterol. The homogenized milk is terrible, whereas the unhomogenized milk is actually good for your lipids. So it's very subtle, but there are a lot of nuances around how to think about
When you're choosing dairy or if you want to eat dairy which dairy to eat so you're not actually causing harm to your body We know from the literature that you know dairy can cause eczema and allergies and asthma and irritable bowel and all kinds of problems sinus infections We know that increases menstrual difficulties and hormonal dysregulation. It's got over 60 different hormones in milk It may increase insulin and cause all kinds of issues when I see patients we do food sensitivity testing we do allergy testing and
I've also seen what happens when you take these foods away like dairy from the diet. We see profound changes in people's health. So acne goes away, which is a hugely caused by dairy.
People's digestive problems go away. Their eczema goes away. Their asthma goes away. Their sinus problems goes away. Their congestion goes away. A lot of clinical benefit you get from removing dairy. It's, other than gluten, the most common food sensitivity. And it may not be a true allergy, but it just may be a sensitivity that is triggering an immune response that creates all these side effects. So if you're trying to sort of see how your body is,
without all the inflammatory triggers, getting rid of dairy is key and getting rid of gluten is key. And then there's sort of a secondary list, you know, eggs or grains or beans or corn or soy or nuts or seeds or nightshades. Those are sort of down the list of the elimination diet. But dairy and gluten are, you know, king and queen on the elimination diet. About 75% of the world's population is lactose intolerant. And we actually can do genetic testing. We do that in our practice all the time and check through a cheek swab
whether or not someone has the gene for lactose intolerance. That doesn't mean they're going to have lactose intolerance. It means they're predisposed to lactose intolerance. And then often because of stress and life and antibiotics and leaky gut and all the things we've talked about on this podcast, you'll see patients who start to develop
a real lactose intolerance. And that means they can't digest the milk sugar, the enzymes aren't there, they get bloating, distension, gas. If people have any of those symptoms, dairy's the first thing to go. The populations that are more at risk are African Americans, Asians, pretty much indigenous people, anybody who's not Scandinavian. If you're gonna eat dairy, what should you eat? And let's talk about it. Grass-fed is really important. And the reason is because one, it doesn't have the antibiotics, the hormones.
And it has higher levels of phytochemicals in it, better fatty acid composition, more antioxidants. So it's not only what you eat that matters, it's what you're eating has eaten. So cows graze on the natural diet of grass. They produce milk and meat with better fat composition and nutrients than those fed corn and grain and soy. So if you're going to consume butter or dairy products, remember that grass-fed is important.
or regenerative even better. Organic dairy is somewhere in the middle, right? Because organic could be not grass-fed. They could just feed it organic corn or organic soy. And also they might have some pasture in their diet, but basically most of their diet comes from organic grains and feed that are better because they're free of pesticides or besides antibiotics and has more omega, better six to three ratio. But it's still not great because they can actually milk organic cows while they're
while they're pregnant, which adds way more hormones and all the natural hormones that are in milk. There's, you know, things you can actually use like probiotic rich dairy, kefir, yogurt. They're better. They're better actually, um,
in terms of tolerance and digestion. Also, you can use ghee or clarified butter, which basically takes all the milk solids, all the casein, all the whey, and it can be used by people who are even allergic to dairy. So organic grass-fed ghee is great. It's basically like the Indian form of butter, and it has lots of nutrients, higher smoke point, and it's great for high-heat cooking.
I don't really recommend eating that much cow dairy. Now, there's an important thing to recognize. There's different kinds of casein in dairy products. There's A1 casein, A2 casein. Now, A1 casein is what most modern cows have. This is an inflammatory form of casein. That's the protein in milk. And that tends to be linked to more of the issues around milk.
A2 casein is from more of the heirloom cows. I think Jersey cows, Guernsey cows have more A2 casein. And there are dairy products like ice creams and others you can get from A2 cows, but they're really hard to find. And that's better for you. But goat and sheep dairy products are far better tolerated, have less inflammatory potential, and have primarily A2 casein.
So I'd encourage people to switch over. And I, for example, I can't tolerate regular dairy because I get congested, stomach issues. If I have goat or sheep, I'm fine. Goat cheese, sheep cheese, goat yogurt, no problem. So cow's milk can be very inflammatory. It can cause eczema, allergies, gut issues, acne because of this A1 casein.
But if you switch to goat and dairy, it's better and it's better tolerated. Also, the goat's milk has high levels of medium chain triglycerides, which help metabolism. Brain function has higher levels of vitamin A, which is great for your skin. And people who have more A2 casein tend to not have as much of the GI symptoms, have less inflammatory bar markers. They have better cognitive function. So goat or sheep milk can be a great alternative.
So what should you look for when you're buying dairy? Well, make sure you look for certain certifications that make sure the animals are produced in an ethical manner, right? Animal welfare approved, certified humane, American humane certified, Food Alliance certified, global animal partnership. These are ways to sort of find sources of dairy that are better for you. So what is possible to eat for dairy? Well, I recommend that people avoid for the most part cow dairy unless it's A2 cows.
that are regeneratively raised. And even then, some people still have trouble with cow dairy. But a little bit here and there is fine. If you want to have grass-fed, full-fat, unsweetened yogurt, that's okay. Ideally, sheep or goat is better. Kefir is another way to have a dairy product. You can get goat or sheep kefir
Whole milk, grass-fed cheese, again, better go to sheep with no additives. Grass-fed ghee or butter is fine. And if you can get them, go to sheep, I would highly recommend that. What should you avoid?
Well, dairy from conventionally raised cows, skim milk, 2% milk, low-fat milk, low-fat yogurt, non-fat yogurt, yogurt that has fruit sweetener additives or anything extra. In fact, Yoplait, which is one of the sweetened yogurts, that has more sugar per ounce than a can of Coca-Cola. So it's really bad for you. Don't have that thing you think is healthy, which is your sweetened yogurt in the morning.
Avoid the cheeses and so forth made with skim or reduced fat milk. The fat is actually the good part. Also, no processed cheese. I mean, it's not even called cheese. I mean, there's something called Kraft American slices. They can't call it cheese because it's less than 50% cheese. It's a cheese-like substance. And obviously, don't eat cheese that comes in a spray can or a squeeze bottle or some weird industrial cheese product. So anyway, that's the Staran Dairy.
Definitely don't need it. If you want to consume it, try sheep or goat. Realize it's not nature's perfect food. It doesn't help your bones. It may cause cancer. And there's a lot of reasons to just avoid it. So again, sheep or goat is fine. Try it. See how you feel. Your body is the best indicator of what works and what doesn't. Your body is the smartest doctor in the room.
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This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests' opinions, and neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional.
This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Now, if you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com. If you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health.
