November 17, 2014
Aaron E. Carroll
full story, comments:
Almost no one will dispute that when a baby is born, breast milk is the best
nutrition a mother can provide. All mammals nurse their young, and breast milk
benefits a newborn infant in ways
above and beyond nutrition. In fact, until 1 to 2 years of age, the
American Academy of Pediatrics, the
Health Organization, the
Institute of Medicine and more promote breast-feeding as optimal.
Unfortunately, breast-feeding until that age is often difficult, if not
impossible, because mothers have to return to work, and children go off to
preschool or day care. So we often replace human milk with the milk of cows or
other animals. But at a certain point, we have to acknowledge that we are the
only mammals on the planet that continue to consume milk after childhood, often
in great amounts.
More and more evidence is surfacing, however, that milk consumption may not only
be unhelpful, it might also be detrimental. This is in spite of the fact that
the United States Department of Agriculture and other organizations advocate
that even adults should drink at least
10,000 years ago, when human beings began to domesticate animals, no adults
or older children consumed milk. Many people don't drink it today because they
are lactose intolerant. They do just fine.
But if you believe the advertising of the dairy industry, and the
recommendations of many scientific bodies, they are missing out on some
fantastic benefits to milk consumption: that milk is good for bones, contains
calcium and vitamin D, and "does a body good."
There's not a lot of evidence for these types of claims. In 2011, The Journal of
Bone and Mineral Research
published a meta-analysis examining whether milk consumption might protect
against hip fracture in middle-aged and older adults. Six studies containing
almost 200,000 women could find no association between drinking milk and lower
rates of fractures.
More recent research confirms these findings. A study
published in JAMA Pediatrics this year followed almost 100,000 men and women
for more than two decades. Subjects were asked to report on how much milk they
had consumed as teenagers, and then they were followed to see if that was
associated with a reduced chance of hip fractures later in life. It wasn't.
A just-released study
in The BMJ that followed more than 45,000 men and 61,000 women in Sweden age
39 and older had similar results. Milk consumption as adults was associated with
no protection for men, and an increased risk of fractures in women. It was also
associated with an increased risk of death in both sexes.
This wasn't a randomized controlled trial, and no one should assume causality
here. But there's no association with benefits, and a significant association
Even studies that examine the nutrients in milk, trying to look for protective
effects, often come up short. A
2007 meta-analysis in
the American Journal of Clinical Nutrition examined high-quality studies of how
calcium intake was related to fractures. The many studies of more than 200,000
people age 34 to 79 could find no link between total calcium intake and the risk
of bone fractures.
This meta-analysis also reviewed randomized controlled trials that examined
if calcium supplements could lower the risk of fracture. More than 6,000
middle-aged and older adults participated in these studies, where subjects were
randomly assigned to get extra calcium or a placebo. Not only did the extra
calcium not reduce the rate of fractures, the researchers were concerned that it
may have increased
the risk of hip fractures.
In the United States, milk is often fortified with vitamin D, which many believe
also lends the drink bone-friendly properties. But the evidence behind this
assumption is sketchy as well. It is true that vitamin D is necessary for
calcium absorption, and for bone health, but that doesn't mean that most people
need to consume more. A meta-analysis
published this year in The Lancet examined the effect of vitamin D
supplementation on bone mineral density in middle-aged and older adults. It
found that, for the most part, consuming extra vitamin D did not improve the
bones of the spine, hip or forearm. It did result in a statistically
significant, but less clinically meaningful, increase in bone density at the top
of the thighbone. Taken as a whole, however, vitamin D had no effect on overall
total body bone mineral density.
None of this should be taken to mean that people with actual vitamin D or
calcium deficiencies shouldn't be treated by supplementation. They absolutely
should. But the majority of people in the United States are not clinically
deficient in these nutrients, and that's whom milk is pitched to.
In addition, milk is not a low-calorie beverage. Even if people drink nonfat
milk, three cups a day can mean an additional 250 calories consumed. Low-fat or
whole milk has even more calories. In an era when every other caloric beverage
is being marginalized because of obesity concerns, it's odd that milk continues
to get a pass.
Yes, it's full of protein. Most Americans aren't protein deficient, though. Even
people who avoid animal milk are worried they're missing something. Rather than
acknowledge that they get along just fine without it, many seek out "milk"
substitutes, like soy milk, around which whole industries have been built.
Politics are certainly at play here. Organizations like
Dairy Management Inc., a nonprofit
created by the United States government in 1994, exist to "increase dairy
consumption." Dairy Management created the popular "Got Milk?" campaign. Today,
the vast majority of Dairy Management's funding for its marketing strategies
comes from the producers
themselves. The U.S.D.A.'s role in promoting dairy was firmly established in
1983 Dairy Production and Stabilization Act, which made it the business of
the government to carry out a "coordinated program of promotion designed to
strengthen the dairy industry's position in the marketplace and to maintain and
expand domestic and foreign markets and uses for fluid milk and dairy products."
As I tell patients, almost everything is perfectly good in moderation, milk
included. What else would you put on cereal? Cookies without milk would be
unthinkable. There's nothing wrong with a periodic glass because you like it.
But there's very little evidence that most adults need it. There's also very
little evidence that it's doing them much good.
Aaron E. Carroll is a professor of pediatrics at Indiana University School of
Medicine. He blogs on health research and policy at
The Incidental Economist, and
you can follow him on Twitter at @aaronecarroll.
"Arrogance combined with stubbornness is a ticking bomb."
- Unarine Ramaru
* * * *
The November 17, 2017 edition of the New
York Times featured this headline story:
"Got Milk? Might Not Be Doing You Much Good"
The NY Times article reported all the key
news that was appropriately fit to print:
"More and more evidence is surfacing,
however, that milk consumption may not
only be unhelpful, it might also be
The dairy industry, in its arrogance,
immediately began damage control after
the peer-reviewed scientific study of
over 100,000 female subjects was published
in the British Medical Journal.
The editor of "Dairy Today", Jim Dickrell,
arrogantly criticized the study calling it
flawed while withholding details as to what
part of the study was actually flawed.
"A flawed study threatens to undermine new
efforts to re-invigorate fluid milk sales.
A Swedish study that purports to show high
death rates and bone fractures in women who
drink three or more glasses of milk per day
is being termed 'ridiculous' and 'awful' by
nutritionists familiar with the full body of
research of milk's health benefits. Reading
these results without understanding the
methodology of the study would raise red flags
for anyone. But once you understand the study
methods, those red flags droop lifeless in a
Droop Lifeless? Windless sky? I bet this guy's
poetry idols include Bob Frost & May Angelou!
The only thing drooping lifeless in the windless
sky is Dickrell's shattered libido resulting
from irrefutable dairy-destructive news.
Three score years ago, I was just three years
old. I lived with a mother who was a cigarette
addict; a chain-smoking fiend who went through
her carton of Marlboro each day. Ten packs.
Twenty cigarettes per pack. I existed in a smog
fog in 1954 and remember my cough. That same
year, an arrogant surgeon, Max Cutler, defended
the smoking of cigarettes as being an exercise
in the pursuit of good health. On 4/14/54 ,
the New York Times quoted Dr. Cutler:
"I feel strongly that the blanket statements
which appeared in the press that there is a
direct and causative relation between the
smoking of cigarettes, and the number of
cigarettes smoked, to cancer of the lung
is an absolutely unwarranted conclusion."
Eight years later, I was eleven. That year
(1962), Frank Getman, the arrogant president
of Merrell Pharmaceutical Company defended
the use of Thalidomide (a drug taken by
pregnant women to prevent miscarriages and
would later cause genetic deformities) said:
"There is still no positive proof of a casual
relationship between the use of thalidomide
during pregnancy and malformations in the
As a typical 29-year-old newly-married Yuppie
with no children who abused his own body and
his environment by doing all the wrong things,
I lived in a world in which a much-respected
republican President Ronald Reagan, a right
wing environmental authority declared these
arrogant words of wisdom on 9/10/80:
"Approximately 80% of our air pollution stems
from hydrocarbons released by vegetation. So
let's not go overboard in setting and enforcing
tough emissions standards for man-made sources."
A few months later (3/4/81), New York's arrogant
Governor Hugh Carey said:
"I offer here and now...to swallow an entire
glass of PCBs and run a mile afterward...to be
in danger you have got to take PCBs in quantities
steadily over a long period of time, and probably
be pregnant, which I don't intend to be."
Even the best of men occasionally show flashes
of clueless arrogance. My second prize for naive
statements is awarded to Gandhi for politically
incorrect comments of May, 1940:
"I do not consider Hitler to be as bad as he
is depicted. He is showing an ability that
is amazing and he seems to be gaining his
victories without much bloodshed."
Real men laugh at danger, look death in the face,
and jump to less-than brilliant conclusions. The
all-time winner of Notmilk's arrogance award:
"I don't need bodyguards."
- Jimmy Hoffa, June, 1975
A few years ago, I had an arrogant next door
neighbor who did not like me. I never learned
why. The man would throw his cigarette butts
in my garden. He would toss shards of broken
glass into my yard on a daily basis.
On three occasions, he called the building
inspector to report bogus violations on my
part. Not one summons was ever issued, but he
was still an inconveniently arrogant neighbor.
One winter, I got my revenge. We had a record
snowfall in New Jersey exceeding 27 inches .
A few days earlier, I had purchased a very
powerful snow blower. After the snowfall ended,
I made certain to clear his front walk and
driveway before my own. He never thanked me.
The following spring, the for-sale sign went
up in front of his home and he was soon gone.
I shatter arrogance with a unique brand of
creative supertemporally, semipiternally,
* * * *
"I do not punish my enemies with arrogance;
I punish ,them, undoubtedly more subtle -
with devoted respect."
- Kristian Goldmund Aumann
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