Raw milk. Raw deal?

This is the sixth of 16 student posts, guest-authored by Anna Lyons-Nace. 

Natural…unprocessed…raw.  These terms are often used by consumers, nutritionists and health experts to denote the most healthful, high-quality food options available for consumption. However, when pertaining to the recent increasing trend in raw milk consumption, can consumers be confident that they are choosing the safest and most healthful option?  Statistical data and health studies would suggest otherwise.

Before we delve into the discussion any further, we should first establish what is considered raw milk and what is not raw.  Raw milk is considered any animal milk, most often from cows, sheep and goats, which is not pasteurized, but still utilized for human consumption. Keep in mind that raw milk can also be used for producing other dairy products such as cheese and yogurt. Raw milk may also undergo a straining process, but it is otherwise unprocessed.  Sources of raw milk are typically local farming operations.  In fact, the interstate sale of raw milk for direct consumption has been prohibited in the U.S. by federal law since 1987, due to safety concerns regarding shelf life and disease risks.  However, there are many states that allow the intrastate sale of raw milk, while a few states prohibit it completely.  This means that the vast majority of what we see in our local grocery stores will have undergone the process of pasteurization, which will be clearly stated on the label.  Pasteurization involves heating the milk to very specific temperatures for short time frames in order to kill potentially harmful germs. Pasteurization was introduced in the U.S. during the first part of the 20^th century, at a time when millions of people were contracting life-threatening illnesses such as typhoid, diphtheria and tuberculosis, often through milk consumption. Applying the simple process of pasteurization, along with other health advances, led to a dramatic decline in such diseases, and is considered a major public health triumph.  Decreasing or eliminating potentially harmful microbes through pasteurization, not only makes the product safer for consumers, it also increases shelf life.

So why is raw milk becoming a sought after commodity for many consumers?  This can probably be attributed to such things as a general increase in societal demand for whole, natural and sustainable food products; as well as the perceived benefits of the milk itself. Raw milk drinkers claim that the unpasteurized product is higher in nutrients, protective enzymes and immune boosting probiotics, and can help treat a variety of ailments from asthma to gastrointestinal disorders. Supporters also claim that pasteurization is the cause of milk allergies and lactose intolerance.  It is important to note that these claims remain largely unsubstantiated by published scientific studies.  In many cases these claims have been categorically refuted by direct scientific evidence.  The Food and Drug Administration (FDA) frankly states that “research shows no meaningful difference between the nutrient content of pasteurized and unpasteurized milk”.  Science has also shown that most enzymes of concern by advocates are not altered by pasteurization. For those with allergy concerns, medical experts and research agrees that it is the proteins naturally present in milk (both raw and pasteurized) that are the cause of allergic reactions to milk and have no relationship to the pasteurization process.  In regards to lactose intolerance, it needs to be understood that lactose intolerance is a genetic error of metabolism that some people are born with, and there is lactose present in both raw and pasteurized milk.  So unfortunately for the lactose intolerant, raw milk is not the solution. As for probiotics, milk does not naturally contain probiotics; so if they are detected in the raw milk they are likely from another source such as air exposure or fecal contamination.  But the good news is that we as consumers have many, safer options for experiencing the benefits of probiotics, including yogurt with active cultures and over the counter supplements.

Now that we have explored some of the common myths surrounding raw and pasteurized milk, it is most important to discuss the reality of the risks involved with raw milk consumption. Real world case studies, as well as research by such reputable organizations as the Centers for Disease Control and Prevention (CDC) and the FDA, consistently show that the risks of raw milk consumption far outweigh any real or perceived benefit. A 13 year study by the CDC showed raw milk and raw milk products are 150 times more likely to cause a disease outbreak than are pasteurized dairy products. These risks come in the form of a long list of disease causing germs that can contaminate dairy products, and are the reason that pasteurization was instituted in the first place. Some of the more significant contaminants that can be present in raw milk include such pathogens as Salmonella, E. coli, Listeria, and Campylobacter.  These pathogens can cause a variety of symptoms, but most commonly produce gastrointestinal illness such as vomiting and diarrhea that can range from mild forms to fatal illnesses. The most vulnerable to becoming sick from drinking raw milk include babies, young children, those with weakened immune systems and pregnant women. But “healthy” people can become ill as well, and there are many documented cases. Data collected by the CDC from 1998-2009 documented 93 disease outbreaks due to raw milk and raw milk product consumption.  These outbreaks caused 1,837 illnesses, 195 hospitalizations, and 2 deaths.  It is important to note that for every case that is reported and diagnosed, there are many illnesses that go unreported, which means these case numbers in reality are certain to be much higher.  The most recently reported outbreak occurred in Oregon this past April.  The outbreak involved 19 people, 15 of which were children, with 4 of the children ending up in the hospital undergoing treatment for kidney failure.  Eleven of the cases were confirmed to have been caused by a very dangerous strain of E. coli that was traced back to a dairy farm that supplied the families with raw milk. In reflecting on outbreaks such as these, it is important to remember that these illnesses are preventable.   But hopefully, these sad cases will also serve to educate us as consumers, so that we can make informed and healthy choices for ourselves and our families.

References

1. Langer AJ, Ayers T, Grass J, Lynch M, Angulo FJ, Mahon BE. Nonpasteurized dairy products, disease outbreaks, and state laws-United States, 1993-2006. Emerg Infect Dis. 2012 Mar;18(3):385-91.
2. Oliver SP, Boor KJ, Murphy SC, Murinda SE. Food safety hazards associated with consumption of raw milk. Foodborne Pathog Dis. 2009 Sep;6(7):793-806. Review.
3. Centers for Disease Control and Prevention, Trying to Decide about Raw Milk? Last Updated March 7, 2011, http://www.cdc.gov/foodsafety/rawmilk/decide-raw-milk.html (Accessed June 5, 2012)
4. Centers for Disease Control and Prevention, Raw Milk Questions and Answers, Last Updated March 22, 2012, http://www.cdc.gov/foodsafety/rawmilk/raw-milk-questions-and-answers.html (Accessed June 5, 2012)
5. Milk Facts, Heat Treatment and Pasteurization, http://milkfacts.info/Milk%20Processing/Heat%20Treatments%20and%20Paste… (Accessed June 8, 2012)
6. Food and Drug Administration, Raw Milk Misconceptions and the Danger of Raw Milk Consumption, Last Updated November 1, 2011, http://www.fda.gov/Food/FoodSafety/Product- SpecificInformation/MilkSafety/ConsumerInformationAboutMilkSafety/ucm247991.htm (Accessed June 5, 2012)
7. Food and Drug Administration, Questions & Answers: Raw Milk, Last Updated November 1, 2011 http://www.fda.gov/food/foodsafety/product-specificinformation/milksafe… (Accessed June 5, 2012)
8. Food Safety News, 19 Ill with E. Coli in Oregon Raw Milk Outbreak, Last Updated April 21, 2012, http://www.foodsafetynews.com/2012/04/post-5/ (Accessed June 5, 2012)
9. International Association for Food Protection, Raw Milk Consumption: An Emerging Public Health Threat? Last updated 2012 http://www.foodprotection.org/events/other-meetings/3/iafp-timely-topic… (Accessed June 6, 2012)
10. International Association for Food Protection, Nutritional Straight Talk on Raw and Pasteurized Milk, last updated 2012 http://www.foodprotection.org/files/timely-topics/TT_02.pdf (Accessed June 6, 2012)