Milk: To Raw or Not to Raw?

 

There seems to be a lot of debate about whether raw, or unpasteurized, milk is better for your health than the pasteurized version. Those in the raw milk camp claim that unpasteurized milk is more nutritious, has immune modulating qualities and is overall better for our health than pasteurized milk. Those opposing raw milk, including government health organizations, cite potential for foodborne illness as their main reason for not supporting the product. So, what is the truth? Is raw milk better for us or do the risks of illness outweigh their supposed benefits?

Before we get into the claims regarding raw milk, let’s take a quick look at the process of pasteurization. Invented by Louis Pasteur, pasteurization aims to decrease the amount of microorganisms in food that may cause spoilage or illness. The method of pasteurization used for the majority of milk is called High Temperature Short Time, or HTST. As the name implies, this method applies a high temperature for a short period of time to the food product. In the case of dairy, fluid milk is heated at 72 C (161 F) for 15 seconds which significantly reduces the microorganism content of milk. 

Why is pasteurization of milk important, you ask? Milk provides a very hospitable environment for bacterial growth, and although some of the bacteria can be harmless or even beneficial, some are potentially harmful. Organisms such as listeria, salmonella, E. coli, and campylobacter have all been found in milk. 

Before milk was routinely pasteurized, there were a number of milk-related outbreaks causing illness and death. In the early 1900’s in the United Kingdom, about 65,000 people died from raw-milk related tuberculosisIn 1927, some 5000 Canadians fell ill and over 500 people died due to typhoid from unpasteurized milk

More recently, one review found that between 1993-2006 in the United States there were over 1500 reported cases of illness from unpasteurized dairy products, with 202 hospitalizations and 2 deaths. Another review found that between the years 2000-2012, raw milk has contributed to 50 outbreaks, causing 826 illnesses (including 4 infants), 48 hospitalizations, 7 deaths (including miscarriages and stillbirths), 19 cases of hemolytic uremic syndrome (kidney failure) and 2 cases of Guillian-Barre Syndrome

By one estimate, those drinking unpasteurized milk are at 150 times greater risk per serving consumed, of contracting foodborne illness. Those most at risk are the elderly, pregnant women, children and immunocompromised individuals. Healthy adults, on the other hand, are likely to experience gastrointestinal or flu-like symptoms but probably nothing fatal.

It should be stated that milk from a healthy cow udder is sterile and that proper sanitation practices can greatly reduce the number of detrimental microorganisms present. Raw milk advocates state purchasing milk from smaller scale farms is a must, as they can better ensure the cleanliness of their environment. While this may be true, it is hard to really ensure cleanliness on a microscopic scale, especially when animals are involved. Even though some farmers test for bacterial contamination of their unpasteurized milk, it does not mean it’s safe. According to the Center for Disease Control, there have been illness outbreaks attributed to raw milk in facilities that routinely test for contamination.


Raw Milk: the Claims

If documented risks exist from drinking unpasteurized milk, then why are people consuming it? And why do people support it with such a passion? 

If you search online for “benefits of raw milk” you are likely to find a myriad of health claims. Now, we all know the internet world. Sometimes the things get embellished. Sometimes (ok...oftentimes) there is little evidence to back up these claims. So, let’s check out the claims and the available evidence.


Nutrition

Raw milk is more nutritious than pasteurized milk. That is certainly what you are led to believe by certain  internet "health gurus". But is it true?

While it is correct that the pasteurization process does lower the nutrient value of milk, is it enough to make a significant difference? Remember, all food processing (including cooking) will lower the nutrient content of foods. The nutritional value of fruits and vegetables declines from the moment they are harvested. So, a decrease in nutritional value isn’t necessarily a bad thing. It’s a normal process. However, to be fair to this argument, let’s see how raw, unpasteurized milk compares to pasteurized milk.

 

Sources: USDA Nutrient Database and  University of guelph. (*when range of values appears, average taken, **vitamin D fortified/added to milk) 

Although pasteurized whole milk does lose some of its nutritional value in the HTST process, when you take into account the Dietary Reference Intake (DRI) of the vitamins and minerals present, the decreases aren’t really that significant.  What also needs to be acknowledged that the vitamins and minerals that decrease with pasteurization aren’t particularly scarce in our food supply. If you are consuming a balanced and varied diet, you’ll likely be obtaining what you need nutritionally, independent of whether you drink raw milk or not.

For example, vitamin B6 which drops from 125 to 88 micrograms (mcg). Seems like a big difference, doesn’t it? However, when you consider that the DRI of vitamin B6 is 1300 mcg, the change isn’t really that concerning. Pasteurization causes a decrease from 10% of your daily needs to 7%. That 3% is not that worrisome.

Vitamin C is often cited by raw milk advocates as being decreased by 100% by pasteurization. That sounds terrible...except raw milk only contains 5 mg of vitamin C. That’s right, only 5 mg (psst...the DRI is 75 mg for women and 90 mg for men).  It’s such an insignificant amount that no one with any degree of nutrition education would consider raw milk a “source of vitamin C”. Want to know what else has 5 mg of vitamin C? You could obtain the same amount of vitamin C that is lost from pasteurization in ½ a large apple, ½ tablespoon of chopped red pepper, or 0.33 ounces of fresh orange juice. Vitamin C isn’t hard to obtain and shouldn’t be a selling point for raw milk.

Don't waste your time trying to get vitamin C from raw milk. There are so many other places to get this vitamin. 

Don't waste your time trying to get vitamin C from raw milk. There are so many other places to get this vitamin. 

The difference in vitamin K does seem quite different between unpasteurized and pasteurized milk. Raw milk contains 12 mcg while pasteurized milk only has 0.7 mcg. This is a difference of 11.3 mcg, or 13% DRI for women and 9% for men. But...do you want to know how easy it is to get vitamin K? You can obtain 11 mcg of vitamin K from 1/10th of a cup of raw kale, 2 teaspoons of olive oil, or 1/16th of one Brussels Sprout. Again, yes, there is a difference in the two milks but it’s not something to worry about.

Another nutrition argument that often arises in the raw milk literature is that unpasteurized milk contains a higher amount of the health promoting conjugated linoleic acid (CLA) and omega-3 fats. However, what often is omitted is that the higher concentration of these fats in raw milk are due to the cattle’s diet and has nothing to do with lack of pasteurization. 

Grass fed cattle produce a healthier fat profile, more specifically one that is richer in omega-3 fats and CLA. What’s more is that pasteurized milk from grass fed cattle (most commonly, organic milk) also contains these healthy fats.  Studies show that the pasteurization process does not significantly affect the fats present in milk.  For arguments sake, though, if you are still distrustful of the effects of pasteurization on CLA, one study found that you can get much more of this potential “immune modulating” and anti-inflammatory fatty acid by grabbing a spoonful of Cheez Whiz, which contain about 64 times the amount of CLA than raw milk. (Hmmm, maybe Cheez Whiz should become the next big superfood????)


 

Contains probiotics

Just in case you aren’t in the know, probiotics are the ”good” bacteria that populate the lower part of our digestive tract. These friendly, little bacteria have been credited with keeping our gut and bowel movements healthy, fighting off infection, decreasing inflammation and reducing allergies. While we don’t exactly know everything that these little microorganisms do for us or which exact ones do what, there is a consensus that we do need a healthy array of these friendly bacteria in our gut.

Raw milk advocates are correct in stating unpasteurized milk does contain these health-promoting probiotics, and pasteurized that milk does not. However, and this is a big however, the “good” bacteria in raw milk coexist alongside the “bad” illness causing bacteria such as Salmonella spp., Listeria spp., E. coli, and Campylobacter spp. So, yes, pasteurization does kill off these good little gut helpers but it also gets rid of the ones that make us sick (...and sometimes very sick).

Now it does appear that some of the beneficial bacteria present in raw milk may defend against the harmful ones, but obviously if people are getting sick from consuming raw milk products, these defenses aren’t 100% reliable. If you are interested in adding probiotics into your diet, it can be done without consuming raw milk. Foods such as probiotic yogurt, sauerkraut, kombucha, kimchi and miso are all safer sources of these gut-friendly microorganisms.


 

Allergy and Asthma Prevention

One of the benefits often cited by raw milk enthusiasts is that its consumption is linked with a decrease in eczema, asthma and hay fever. The claim is that milk in its natural form is packed with immune enhancing proteins and microbes that reduce incidence of allergies. And...they aren’t wrong.

A number of studies have been able to show a correlation between the consumption of raw milk and a decreased incidence in asthma, eczema and hay fever. These studies are all observational, meaning that they can’t prove a direct cause and effect relationship but the evidence is quite convincing that some sort of relationship exists. For now, though, we have yet to see a randomized controlled trial to show us a direct protective relationship.

And while researchers aren’t exactly sure what component (or components) in raw milk may be protective, it does make sense that milk intended to nourish a baby (cow, in this case) will have immune enhancing properties. Just think about it. We have known for quite a while that human breast milk contains immune enhancing properties and is protective against allergies, so why not cow’s milk?

It still does need to be stated that even though there appears to be a link between raw milk and decreased allergies, children are at an increased susceptibility to foodborne pathogens. Until we can ensure the safety of unpasteurized milk, it is still not recommended in the prevention of allergies, especially in children.


 

Improves lactose intolerance

Another common raw milk claim is that it is better tolerated by those with lactose malabsorption or lactose intolerance. Meaning that those with problems digesting lactose, or the sugar in milk, don’t suffer from the gas, bloating, diarrhea and discomfort associated with drinking regular pasteurized milk. The theory is that because there are more microorganisms (i.e. lactobacillus bacteria) breaking down the lactose in raw milk, it is better tolerated. While this seems like a logical hypothesis, most tolerance reports up until recently have only been anecdotal.

In 2014, a small pilot study tested the lactose tolerance levels between pasteurized and unpasteurized milk in those with confirmed lactose intolerance. This was a double-blind study (i.e. neither the researchers nor subjects were aware of the type of milk they were drinking) and it was found that consumption of raw milk did not reduce lactose malabsorption or related physical symptoms.

Similarly, another study found no differences in reported symptoms in lactose intolerant subjects consuming pasteurized or unpasteurized yogurts. Researchers did, however, find those consuming pasteurized yogurt expelled more hydrogen in their breath (a clinical sign of lactose malabsorption) than those consuming unpasteurized yogurts. Nonetheless, these subclinical differences did not induce any physical symptoms.

Since it seems that we don’t actually have a lot of evidence that raw milk is better tolerated by lactose intolerant individuals, it really shouldn’t be marketed as such. Lactose malabsorption is a normal body process (for most people our ability to digest lactose decreases with age) and is very common. It is by no means caused by drinking pasteurized milk, as is often alluded to in some pro-raw milk literature. (If you do suffer from lactose intolerance and want more information, check out these resources, here and here).  

 

Other Claims

There are numerous other health claims attributed to raw milk, as well. From healthier skin, increased bone density, increased lean muscle mass, weight loss (of course!), healing support to neurological benefits. However, there isn’t much science backing up these claims. Much of the benefits cited in pro-raw milk articles are simply anecdotal.  
 

Final Verdict?

Overall, it seems that the nutritional and health claims of raw milk are overrated. Although unpasteurized milk does seem to offer protection against the development of some allergies, there is still a big concern regarding the dangerous microorganisms that can live within it. We can never be sure that raw milk is free from these dangerous pathogens. 

For most health professionals and food safety organizations, the raw milk debate comes down to a public health issue. Position statements about raw milk (and discouraging consumption) are guidelines in the interest of the population as a whole. It seems as though many raw milk advocates fail to see the bigger picture, opting for personal benefit (despite lacking evidence) rather than seeing the risk that a wide scale increase in raw milk consumption could cause. 

Consumption of raw milk should really be a personal choice. If you are a healthy adult and fully understand the possible risks of consuming raw milk, you should be free to consume it. However, for those with weaker immune systems, pregnant women, children and the elderly, raw milk can pose more danger. For these more vulnerable individuals, the risks outweigh any of the possible benefits