Friday, May 15, 2015

Got Milk? Part 5: Conclusions?

Where do we go from here?  We hope that a brilliant researcher reads this and looks into lactose as a cause of modern diseases and writes about it. The purpose of this series was not to scare you away from ever touching dairy again, but to show some correlations and possible causation. Obviously since not every single person that drinks milk also has an AI disease, there is more to the story. Could it also be the fact that we wean babies onto a low-fiber diet and at the same time give them immune stimulating lactose? All of the 'baby antibiotics' surely don't help, either. We singled out MS in this series, but we've also seen a nearly identical correlation to Type 1 Diabetes, and possibly with many other auto-immune diseases that are thought to be gut-related.


In the digging through research for this series, one of us found this undated post written by Barry Groves, PhD, at his blog "Second Opinions."

Diet and Multiple Sclerosis (MS) Information

Part 2: Foods and Multiple Sclerosis
Is it milk? . . .
The dairy connection, however, is not so clear-cut: Malosse and colleagues found a highly significant correlation between liquid cow's milk and MS prevalence, and a low, but still significant, correlation with cream or butter consumption. But they found no correlation for cheese. They say 'These results suggest that liquid cow milk could contain factor(s) – no longer present in the processed milk – influencing the clinical appearance of MS.'

Although allergic reactions are triggered by proteins, from the Malosse group's data, it's likely that the milk sugar, lactose, could be a culprit: lactose is at its highest level in liquid milk, there is a much smaller amount in cream and there is none in cheese as it has been converted to lactic acid by the fermentation process. Thus lactose fits the findings perfectly – except for one small anomaly: there is practically no lactose in butter.

Groves also goes on to speculate that the problem could be with the treatment, ie. pasteurization, of milk, but doesn't quite dig deep enough to make any conclusions. But as far as we can see, this is the only reference to a lactose connection with MS.

Past observations on MS and milk

Over the years, much scientific speculation to "milk" as a factor in MS has been given, with no real winners...
A random sampling through the years:

1967:  "On this basis the following theory for development of multiple sclerosis may be proposed:  In industrialized countries as those in North America and North Western Europe cow-milk feeding of new-borns is common. Cow-milk contains a five times lower amount of PUFA than mother’s milk (Albritton  1954)."

1975: "The prevalence of multiple sclerosis varies widely throughout the world, with a very definite preference for the white race. This difference seems to be caused, at least in part, by dietary habits. Lack of breastfeeding and excessive consumption of cow's milk during infancy is postulated as an important factor in the appearance of multiple sclerosis later in life."

1976: "This report emphasises the striking correlation between the world distribution of dairy production and consumption and the incidence of multiple sclerosis. The irregular distribution of multiple sclerosis has been extensively investigated and many comparative studies of specific variables undertaken. It seems likely that there could be a combination of predisposing or precipitating factors involved in its aetiology, and that some environmental phenomenon plays a part. This report suggests that milk consumption may be a common aetiological factor."

1986: "As a result of variations in related United States and New Zealand data and other pertinent observations the possibility of a link between high childhood milk intake followed by a large or sudden reduction during the adolescent growth spurt, and the subsequent incidence of MS in young adults is proposed. The possible involvement of calcium and lead metabolism is also discussed. It may be that the elusive environmental variable associated with the incidence of MS is partly a behavioural one related to western social attitudes."

1992: "We have studied the relationship between MS prevalence and dairy product consumption in 27 countries and 29 populations all over the world, with Spearman's correlation test. A good correlation between liquid cow milk and MS prevalence (rho = 0.836) was found; this correlation was highly significant (p < 0.001). A low but still significant correlation was obtained with cream or butter consumption (rho = 0.619 and rho = 0.504, respectively). No correlation was found for cheese. These results suggest that liquid cow milk could contain factor(s) - no longer present in the processed milk - influencing the clinical appearance of MS. The possible role of some dairy by-products is discussed in the light of a multifactorial etiology of MS."

2000: "Experimental autoimmune encephalomyelitis (EAE) induced by sensitization with myelin oligodendrocyte glycoprotein (MOG) is a T cell-dependent autoimmune disease that reproduces the inflammatory demyelinating pathology of multiple sclerosis. We report that an encephalitogenic T cell response to MOG can be either induced or alternatively suppressed as a consequence of immunological cross-reactivity, or "molecular mimicry" with the extracellular IgV-like domain of the milk protein butyrophilin (BTN)."

2007: "Altogether, our data suggest that increased production of milk-related transcripts in the lymph nodes and blood succeeds an inflammatory event in experimental autoimmune encephalomyelitis and MS."

2014: "Exposure to some environmental agent such as different nutrition and contact with allergens may have a role in developing multiple sclerosis (MS). The present study was aimed to evaluate the cow's milk allergy (CMA) in MS patients compared to healthy controls...There were no detection of cow's milk specific IgE in serum of MS patients and healthy subjects."

Is it lactose alone?

This issue of MS seems to revolve around the drinking of fluid milk in modern forms. Most other forms of dairy are lower in lactose, or the lactose is completely gone.  Butter, cheeses, yogurt, kefir, and sour cream all may be perfectly fine dairy sources for everyone. Certainly when our herding ancestors were learning to handle dairy, they did not have much access to fresh milk as there was no way to keep it "fresh" for longer than a few minutes after milking...and certainly not pasteurized, fortified milk. They possibly drank some fresh milk, but in order to make it a moveable commodity it had to be fermented, separated, or hardened.  On-demand, fluid milk in every household has only been widely available since after 1863 when pasteurization was invented.  Prior to then, all milk consumed was 'fresh.' Even refrigeration would have been a limited option using ice-houses and naturally cold temperatures. Modern refrigeration also changed our milk habits in the mid-1800's and now milk is quickly chilled and never rises above a certain temperature as it is transported around the world. Now, milk is available to every man, woman, and child on the planet, if they so desire.

In a couple of emails, "mentor to the Vegetable Pharm Staff," Dr. Art Ayers of Cooling Inflammation blog, told us he thinks that lactose is mainly a problem when gut bacteria have lost the ability to degrade the lactose no matter what your genetic ability (LP/LNP) might be.

Exceptional commenter "Span_Carvan" noted in a related conversation a couple weeks ago:

Gab, you didn't read that McGill article cover to cover, did you? It's all in there. That is an A+ first-rate paper. An A+ paper covers all grounds, including all previously-mentioned contradictions, yet still forges ahead with the main thrust of the research, reconciles all prior counter-evidence while remaining skeptical about the conclusion to be drawn. The inference drawn is restricted but reasonable, only limited by the strengths of the correlations and supporting evidence. The paper said,

"Countries with higher LNP frequency populations tend to be economically disadvantaged. This is true largely in South America, Africa, and south Asia. Countries like the People’s Republic of China, South Korea, and Japan have already or are adopting more western lifestyles. Most of these countries had lower rates of IBD until towards the end of the last century. It is therefore possible that reporting of IBD rates is influenced by lack of experience with IBD or in economically less favored countries by lack of doctors and inexperience with the disease."

So East Asia isn't necessarily impoverished and those countries have very high rates of colorectal cancer. Korea has the highest rate worldwide. And their rates of IBD are rising quickly and are not reflected by the study data, which goes back to 2000 or prior years since you also need accompanying LP/NLP data. There is no question that IBD is increasing rapidly in non-European OECD countries like Korea, Japan, Chile, Mexico, etc.

From Crohn's disease in Korea: past, present, and future:  "In an interesting study of the incidence of inflammatory bowel disease (IBD) among young males due for conscription in 2003 to 2008, the mean annual incidence of CD increased from 1.8 per 100,000 persons in 2003 to 2004, to 2.7 per 100,000 persons in 2005 to 2006, and to 5.1 per 100,000 persons in 2007 to 2008. This indicates that the incidence of CD is increasing rapidly in young Korean males."

"5" is going up there with Western European countries like France. In the 1980-1990s, the rate was miniscule at 0.5 per 100,000. Why? Pushing milk to unsuspecting NLP populations. Milk made such people taller but they're falling prey to autoimmune issues like IBD.

The "A+ Paper" Span_Carvan referred to was: Latitude, sunshine, and human lactase phenotype distributions may contribute to geographic patterns of modern disease: the inflammatory bowel disease model.

This paper, from May 2014, also tells us:

IBD [irritable bowel disease] offers a model for evaluation of the hypothesis that LP/LNP serves an evolutionary background for a number of modern day diseases.


A conclusion...of sorts

To wrap-up the first 5 parts...There is still much to be learned about what exactly is happening at the genetic level and whether or not milk drinking by those genetically gifted with the ability to drink milk is harmful or not. We must admit we have stumbled into a conundrum. Gabriella Kadar made some interesting observations about the drinking of milk, a genetic factor, and MS. But what is worse...drinking milk in the modern way (cooled,  pasteurized, homogenized) or having messed up guts from being formula fed, antibiotics as baby, or weaned onto a low fiber diet?

We will be watching closely to see if a connection to lactose and gut flora is ever made with MS (or other AI conditions).

Thanks for reading!



  1. Very interesting and well done. Thanks for all of your efforts. I have become a big fan of home made kefir and will continue on. A little honey, cinnamon, and vanilla- it's all good.

  2. Absolutely excellent series you guys. I've been reading and expressing my ensuing grim conclusions by finally eliminating all dairy. I'm pretty much right in the bullseye zone, and MS is my nightmare outcome. Thank you for your intensive research and clarity of explanation - it's extremely appreciated. :)

  3. Thanks for not making this the same old raw versus pasteurized milk arguments I've bee reading for the last 10 years. This is truly the first good article I've read that shows milk is not all it's cracked up to be. Usually they want you to think raw is the only way to go. I always thought it strange that adults drink so much milk which is meant for babies. When I see pictures of Mongolians they aren't drinking little cartons of chocolate milk they are eating nasty looking curdled stuff and have bags of weird milk stuff hanging around their tents.

    The government and milk lobby should be all over this. It takes more milk to make a piece of cheese than a glass of milk, right? They could sell more milk if we started eating more cheese and kefir.

    Thanks again for looking at things from a different angle than everyone else.

  4. Can we please stop using the unqualified term "dairy" in this discussion? How about using terms like FD and UFD (un-fermented dairy) and UPD (un-pasteurized dairy).... might help reduce possibly inaccurate blanket perceptions and conclusions. It should be clear from the evidence presented in this series that all sources, and processing/handling, of dairy are not created equal and not all correlated with MS. Most people in India and Pakistan consume FD on a daily basis and have the lowest MS rates according to the colored map presented earlier in this series. But their "dairy" is by way of daily delivered un-refrigerated milk, which comes mostly from small local dairies and is likely UPD as well. It is also mostly consumed in a soured/fermented state. I'm guessing this is probably the way that our herding ancestors consumed it given lack of refrigeration and the extra time/effort/resources required to make cheese. Butter was probably also not a common item for the same reason.

    @Terra provides a good example with their conclusion ... "I've been reading and expressing my ensuing grim conclusions by finally eliminating all dairy."... which from my read seems like an over-reaction given the evidence presented - so far.

    It sure would be nice if someone would study isolated lactose, and pasteurized milk versus raw milk wrt MS to test that lactose hypothesis. Isolated lactose would prob be the best place to start.

    1. I have no access to UPD, only what they sell at Kroger's. AFAIK, raw milk is completely illegal where I live. I think there are many people in Terra's shoes who would be wise to give up all dairy and see if it shifts things, then to add back, start with FD and UPD. But if Terra lives somewhere like me, that means NO DAIRY. Because I have no idea where to even go for blackmarket FD/UPD. So, possibly we can give Terra a break until she buys a cow or moves to India where milk is healthy and people have no MS.

    2. Brad, the country stats for India are misleading. The incidence of MS in northwestern India (the Punjab) is about 55/100,000. Usually it is the men who are treated. Women are mostly just diagnosed and then they are basically hidden away.

      Usiing India as an example of a country where milk is consumed and MS rates are low is not valid. Their healthcare system is not up to diagnosis of neurodegenerative diseases. They are just barely coping with the basics such as infections and immunizations.

    3. @Gabriella, How about Sudan, Portugal, and Argentina then? Their MS rates don't seem to correlate with their higher milk consumption. They are consuming mostly non-pasteurized perhaps?

    4. Costa Rica also seems to not correlate well. More reporting issues? or, could it be that other diet or lifestyle factors are at play other than Milk/lactose? ... or is it the people in these countries process/handle their milk differently?

    5. @Gab et al, I just did a little digging into this "milk" per capita consumption data on the FAO site and found it a little odd and hard to interpret. They have two categories of milk data - 1) Milk excluding butter, and 2) Whole Milk. It appears the published data is using #1. If you use #2 data then it changes quite a bit the correlation, or lack of, with MS incidents. So what can we make of this? The "dairy" being consumed in large amounts in countries like USA, Australia, Norway, UK, etc. is non-milk?.. So it's cheese and yogurt mostly eaten in these wealthier countries?... and no doubt poor quality especially the sugar laden industrial yogurts. More things to ponder.



    6. Brad, I don't understand. Argentinians are not milk drinkers. Neither are Costa Ricans. Most of the milk in Argentina is made into cheese or other fermented product, or made into powdered milk and exported. It is also a low MS country despite it's 'latitude'. New Zealand is 42 south, Argentina ranges from 34.6 to 58.4. So New Zealand is well within the latitude range of Argentina, yet has a huge MS problem.

    7. What's the point about Sudan?

      Although East African countries have populations that are LP, the dairy industry is not developed. It costs a LOT of money to set up a dairy farm and obtaining fodder or feed for cattle is prohibitively expensive. Kenya is wanting to encourage the fluid 'sweet' milk farming sector but there is no uptake.

      Perhaps referring to milk as fluid soured milk and fluid sweet milk would make more sense? Just that except maybe for buttermilk and kefir, most of the fermented milk products are no longer fluid. If you want to be picky then fermented drinkable milk or not fermented drinkable milk?

      If you've ever lived in the UK or in Scandinavia, you would know that fluid 'sweet, not-fermented' cow milk is on the menu. In Germany as well.

      Except for you, there doesn't seem to be a difficulty in understanding what is meant by fluid milk. That is how it is defined in all of the country reports and studies I've read.

    8. @Gab, I was going purely on the data from FAO. Did you look at it or that Wiki link? That was kinda my point that I did not understand. If you look at the FAO data for "Whole milk" which is excluding cheese, butter, cream, yogurt etc., their data shows that Argentina and Brazil has similar consumption to that of the UK. If you their data (1) as I said in the previous post which includes all forms of dairy except butter, then Argentina and Brazil is far below that of the UK.
      I'm not trying to make any point, just trying to understand the data.

    9. So in other words, the FAO data does not agree with your opinion that Argentinians are not milk drinkers.

    10. Here is that link again to the world map showing "milk" consumption.

      Note how Sudan is dark blue.
      And this map is showing dairy of all kinds excluding butter.
      As I posted before, if you look up the FAO data for "whole milk" instead of "milk excluding butter" you will see that the data for Argentina and Brazil is identical to the UK. Meaning, they should not be much lighter blue than the UK if we are talking about only MILK and not other forms of dairy. Let me look up the data again and I'll post it here below...

    11. Here it is:

      Year 2007. "Milk, Whole" kg/capita/yr:
      Argentina 111.60
      Australia 117.20
      Brazil 115.20
      UK 119
      USA 130.00
      Costa Rica 145.90
      Sudan (former) 151.40
      India 45.10

      Are these numbers completely nuts? I don't know.
      But look at how they change when you choose "Milk - Excluding Butter" instead of "Milk, Whole"....

      Argentina 197.80 <----
      Australia 222.70 <----
      Brazil 120.00
      UK 240.00 <----
      USA 257.00 <----
      Costa Rica 171.10
      Sudan (former) 179.60
      India 73.20

      Do these numbers make sense???
      I read that India is a huge milk consumer - though perhaps from buffalo.

    12. One of the things I find interesting here is that from that data it shows that Brazil consumes a fair amount of milk but not much other dairy in comparison... which makes sense and is what I observe. This is likely due to the high cost of cheese, butter, and cream versus the UHT milk they sell exclusively. And soured milk or home made yogurt is not part of the culture in general.
      Maybe this has no bearing on this MS topic. I don't know.

  5. @anonymous, U.S. milk consumption *is* falling and cheese increasing. Just a side not. Also...

    "milk is not all it's cracked up to be."

    this is what I was talking about. Is it just semantics? Sour milk is still "milk" and I think it is very a crackin' food nutrient-wise. In India a not uncommon diet consists largely of ... milk, fruits and vegetables, rice, lentils and fish.

    1. Also... "milk which is meant for babies"...

      Why do you think that it is not (meant) for adults as well? Are chicken embryos meant for humans? Grains and seeds are meant for birds, right? I hope you can see what I mean. Something as nourishing as milk and easily acquired certainly seems like normal adult human food to me.
      I don't think it's a given that milk was not (meant) for adults merely because of LNP. It could be that the lactase gene tuned off with age as a means to speed up the human reproduction cycle - ie, get Junior off the tit so mommy can move on to making Junior # 2, 3, and 4. There are prob various viable hypothesis on the reason for this. Maybe it's already known why?

    2. This is quite eerie. Dr. Ayers sent me this study, published today in the Cell Host and Microbe Journal: Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life, and he highlighted this line in the text:

      "Nutrition had a major impact on early microbiota composition and function, with cessation of breast-feeding, rather than introduction of solid food, being required for maturation into an adult-like microbiota."

      So, yes, I do think that milk is "baby food." But I also think our ancestors devised ways to capitalize on an abundant animal-based food source that did not require killing the animal to get to.

      There may be some confusion in this series with my over-use of the term "fresh" and "fluid" milk. What I am getting at is that if you own a cow (or goat, camel, sheep), and you have absolutely no access to electricity or ice, the milk you get is totally different from milk that goes straight into a refrigerated tank, refrigerated truck, and to your refrigerator at home. Whether pasteurized or not.

      And also, let's say you own a couple cows, have no way to store it in the cold, but want to take a trip to visit your friends a long ways away. You need to convert that milk to a form that is transportable. Cheese would be the best. I'm sure the first cheese was made entirely by accident.

    3. I don't know what "adult-like microbiota" means but that there is a difference with a major diet change is not surprising. While milk certainly is "baby food", designed specifically for young mammals does not also mean that it is cannot also be "human food". That was the point I was making. That it is just FOOD, which it is, and very nutrient dense food at that.

      Yes, un-refrigerated milk is totally different, no doubt. But obviously not pasteurizing (raw) takes that difference to yet another level.

      Yeah, I can see how cheese was/is similar to dried meat and fish (jerky), a method of preservation.

    4. Brad, did you read the article? There is information about 'adult-like microbiota'.

    5. Skimmed through it just now. So mainly it's the ability to handle carbs among other differences. Interesting.

      My comments were more questioning @anonymous' inference that milk is not *also* adult food - in addition to it's obvious special role as food for infants.

  6. I consider production of butter and cheese similar to threshing and winnowing to remove chaff from grain. It is pretty obvious that the low nutritional/digestible quality and toxicity of chaff/bran is a good reason to remove chaff. Buttermilk and whey contain the lactose and many of the antimicrobial proteins, e.g. lactoferrin, lysozyme, of milk. The high lactose whey or buttermilk are improved by fermentation that feeds on the lactose to produce lactic acid bacteria/dairy probiotics. My point is that cultural practices for grain or milk remove the less nutritive parts that might also damage gut flora.

    It would be interesting to follow the whey and see if it is associated with autoimmune disease. Whey is used to destabilize gut flora to make weight change easier, e.g. bariatric surgery or body builders.

    1. These antimicrobial proteins only hurt gut bacteria but not the lactic acid bacteria that ferment the lactose - so they are microbe specific? Or these bacteria also remove or transform these harmful proteins during fermentation reducing harm to the gut? Kinda confusing to me. Also how does whey destabalize gut flora?

  7. This series should not sound as antimilk. 10000+ years of using milk of other species as food source, cow milk included, and with success, and even resulting into human genome change, is a significant sign that dairy and milk cannot be bad per se.

    So what went wrong in our modern times (supposing that autoimmune diseases are modern?

    Regarding MS and milk link we tried to research, here a paper that should have been discussed (some quotes, with the focus on our point of interest):

    Rising incidence of multiple sclerosis in females associated with urbanization. (2012)

    MS incidence rose markedly on Crete over the past 3 decades.
    Of the major changes that accompanied urbanization, smoking among women with MS increased dramatically, while imported pasteurized cow milk virtually replaced fresh goat milk produced locally.

    And some more:

    Besides demographic data, information was collected on childhood diseases, comorbid medical conditions, smoking, milk consumption, alcohol and dietary habits, use of contraceptives, multivitamin supplements, age at menarche and first childbirth, traveling abroad, and sunbathing.

    Consumption of dairy product. In the parental generation, which lived mostly in the countryside, consumption of fresh goat milk during childhood was a rule; however, about half of these parents had switched to pasteurized cow milk during adulthood (table 3). Among patients with MS, 50% of rural and 17% of urban residents consumed fresh goat milk produced by domestic animals during childhood. By disease onset (mean age: 30 years), however, only 5% of the rural and 2% of the urban patients with MS continued to drink fresh goat milk. While controls also showed a similar switch from fresh goat to pasteurized cow milk, control subjects consumed a combination of fresh goat and cow milk more often than did patients with MS (table 2).

    Given the multitude of societal changes that accompanied urbanization on Crete, identification of the factors responsible for MS rise presents a major challenge.

    Comparison of patients with MS with their parents revealed some of the major changes that occurred over a single generation. As MS was rare among the parental generation, the living conditions of the parents (working and living in the countryside, consuming fresh goat milk, being raised in a relatively large family, and giving birth at a younger age) may have been protective.

    Some of these differences also emerged when our MS cohort was compared to a control group ascertained randomly from the same population. Thus, as compared to controls, patients with MS spend less time in villages prior to their relocation to the urban centers and were more likely to smoke, drink alcohol, or consume pasteurized cow milk.

    Regarding the source of milk consumed by the Cretan population, it is well known that, over the past 3 decades, imported pasteurized bovine milk became widely available, virtually replacing fresh goat milk produced by domestic animals.
    This change, which occurred initially in the urban centers and later on in the countryside, is reflected in the milk type consumed by our patients with MS and their parents during their transition from rural to urban living. It is known that consumption of bovine milk is relatively high in industrialized countries27,28 and that a significant correlation exists between cow milk consumption and MS.27 In contrast, MS remains low in many developing nations in which bovine milk consumption is not widespread. Previous studies showed that the protein composition of the goat and sheep milk is distinct from that of cow milk 29,30 and that pasteurization of the latter increases its immunogenic potential.31

    1. Walk into any US grocery story and in the dairy section you will find gallons and gallons of pasteurized, homogenized cow milk. This has only been an option in the last 80 years or so. I find it entirely plausible that widespread consumption of this ubiquitous product may be causing issues for susceptible individuals.

    2. @Kate, the thing is, in the US liquid milk consumption has been falling in recent decades, while overall dairy consumption has been increasing. Not only cheese, which is probably less harmful by comparison, but many other forms of industrial/processed dairy products, excluding butter and dairy. What are these products? Some are obvious others are not, to me, at this time. Sugar laden yogurt is an obvious one, but there is another class of products called "flavored milk products" which I assume is something like chocolate milk?.. no doubt also pumped full of sugars and man made preservatives and chemicals (and minus any good probiotics). What are the other products? Puddings? Protein supplements (bodybuilder shakes)? Coffee drinks like these calorie laden Starbucks Frappachinos? If you are an ingredients reading geek like myself you quickly learn that dry milk powder is used in all sorts of products similar to sugar. It's is used to thicken and sweeten some products and increase the protein content. For example margarine has dry milk as an ingredient.

    3. ^^^ I meant to say "excluding butter and cream"

    4. Oh duh!.... ice cream and other frozen deserts is no doubt a big part of "flavored milk products".

    5. US Milk consumption graph. While this is a pronounced drop in "Whole Milk" the TOTAL milk graph, of all types of milk, including skim/fat-free and reduced (2%) fat milk, is still downward/decreasing slope though not as pronounced.

    6. Yogurt graph...

    7. The information I'd like to see, though, is how much milk is being consumed by kids. Do school lunches still provide that nifty little 1/2pint box of milk? How nasty must the milk be that we provide to the kids to meet a government mandate?

      One of the points made in this series was that more than likely this is all an "immune system in training" problem that triggers events in the early years of development.

    8. My guess is, at least in the US, milk consumption by children peaked in the 60s and 70s. I know I was given a glass at most meals! Other than that there was the occasional kool aid, and the very rare soda pop. My own kids, growing up in the 90s, had more choices at school (mostly bad natch). And we all know how sugary drink alternatives have mushroomed. Still, given all those gallons of milk in the stores, someone is still drinking a lot of milk, probably kids mostly. I've got a very young niece who goes through a gallon in a few days. I think of my own parents, growing up on a farm with a milk cow or two. This was not a steady supply. Refrigeration was limited or was an ice house. And butter and simple cheese products were the most prized. A very different pattern than modern milk consumption.

  8. Any thoughts on Half & Half, which at this point is the "worst" item in my diet? I consume it in my coffee about four times/day. Love it. It's my only treat. Experience bloating immediately on consumption, and have grown used to that.

  9. If it causes you bloating then I'd stay away from it. Half-n-half does not do that to me, nor any types of dairy food.

  10. paranoid orthorexics..drink milk for christ's sakes

  11. Very interesting. Thank you. TF

  12. I grew up on KLIM, powdered milk in Venezuela. Only until I got to boarding school (high school) did I know what fresh milk was.

  13. @Anonymous - the term "orthorexia" is defined badly enough to reject it completly. With hopeless definition you end with something like:

    "The answers of the participants to these questions revealed a tendency to orthorexic behavior, mainly regarding aspects such as: making food choices conditioned by worry about health status, evaluating food rather from nutritional quality than from its taste, believing that consuming healthy food may improve appearance, discrediting the influence of mood on eating behavior and banning food choices considered by them as eating transgressions. [...] it was possible to observe a high frequency of orthorexic behavior among the studied Brazilian dietitians."

  14. Tim, I enjoyed the series, thanks. I agree that fermented dairy is generally better than unfermented. I just happen to disagree to some degree on some points. No offense intended.

    Gemma wrote May 15, 2015 at 10:00 PM
    "This series should not sound as antimilk. 10000+ years of using milk of other species as food source, cow milk included, and with success, and even resulting into human genome change, is a significant sign that dairy and milk cannot be bad per se.

    So what went wrong in our modern times (supposing that autoimmune diseases are modern?"

    Bingo Gemma! Nice summary and excellent question (I don't think we can assume that milk consumption began immediately with domestication of animals, but we do know that milk consumption has been going on for some thousands of years). There's obviously something more to MS than milk consumption or lactose content. Consumption of lactose-containing fluid milk in the form of raw milk, boiled milk (such as in the form of traditional "milk tea"/Suutei Tsai consumed by Mongols, Asiatic Turks and others), buttermilk (milk minus butter), and whey water (milk minus cheese curds) long predate the high rates of MS of 20th century modern societies. Traditional Mongols didn't just throw out the fluid portion left over after making butter or cheese--they consumed all fractions of the milk for centuries at least. Much of it was fermented, but plenty of unfermented and slightly fermented liquid milk was also consumed, yet their rates of MS are still very low.

    1. ...and that's despite most Mongols not having the European phenotype for lactase persistence.

    2. Phil, the diagnosis of MS relies on the McDonald criteria. MRI examination is also involved. In Mongolia the use of MRI is very recent and yes, they have diagnosed MS. These people get the Asiatic form of MS which is slightly different than classic MS seen in nothern Europeans. Lesions are optic nerve and spinal cord. As the country becomes better 'developed' from a diagnostic perspective, the rate of MS will be better determined.

    3. Autoimmune diseases are not recent. The ability to organize medical education is recent.

      Absence of evidence is not evidence of absence.

      Neonatal and early childhood mortality rates were high. This was not the sentimentalized 'garden of Eden' that so many people believe it to have been. What percent of the population made it to past 65 years of age? My readings indicate it was approximately 2%.

      MS was lumped with other neurological diseases as hysterical paralysis and was known to exist for at least 2,000 years. Charcot noticed that not only women developed 'hysterical paralysis'.

    4. Yes, Mongolia does have reported MS cases. I said the reported rate is very low there, not zero. Sure, the data is far from perfect and we need more and better data.

      I agree that there was never any 'Garden of Eden' and that absence of evidence is not evidence of absence (that's actually one of my favorite quotes, along with correlation is not causation and others). I'm just not itching to jump ahead of the data, nor dismiss everything that doesn't fit the hypothesis without first investigating. The absence of evidence of high rates of MS in Mongolia and among all traditional pastoral societies isn't evidence of absence, and it also doesn't mean that they nonetheless must have high rates of MS or other autoimmune disorders and that all the observers have been wrong. It's possible, but I have yet to see strong evidence of this.

      Here is some other research to consider:

      [quote]Diseases and conditions of the modern era, including multiple sclerosis, type 1 diabetes, and allergies, involve disrupted immunoregulatory circuits, likely reflecting reduced exposures to "old friend" organisms with which humans coevolved.[/quote]
      (Graham A. W. Rook, When urban living reduced contacts of humans with microbes and worms, it increased our risk for chronic inflammatory disorders)

      [quote]when patients suffering from early relapsing multiple sclerosis (MS) become infected with helminths the disease stops progressing, and circulating myelin-recognizing Treg appear in the peripheral blood [32,33], an exciting observation that has led to formal clinical trials [34].[/quote]
      (G. A.W. Rook,* C. L. Raison† and C. A. Lowry, Microbial ‘old friends’, immunoregulation and socioeconomic status, 2013)

      [quote]the many examples in the book are based on correlation, not causality. The correlations are indeed compelling, however. One, for instance, is that mothers who live on farms with animals have children with less asthma and fewer allergies. Another correlation links the end of malaria in Sardinia to a rapid rise in two autoimmune diseases, multiple sclerosis and type-1 diabetes. This book is dense with such examples.[/quote]
      Rosalind Michahelles, Review of AN EPIDEMIC OF ABSENCE by Moises Velasquez-Manoff

      Since correlation is indeed not causation, we don't yet know for certain whether lactose content or fluid milk or "old friends" or something else is the primary cause or trigger of MS.

    5. Here's another example of milk-drinking people without observable high rates of autoimmune disease that was just coincidentally written about in RN's blog (Ugandans):

      "It's my belief that the most important factor to consider in a meal are the FODMAPs contained within. Before proceeding, I should define what I mean: Fermentable: Oligosaccharides, Disaccharides, Monosaccharides and Polyols.

      Generally speaking, this correlates to Indigestible: Carbohydrates, Dimer Sugars (e.g., lactose), Monomer Sugars (e.g., glucose) and Sugar Alcohols (e.g., sorbitol, xylitol, etc.). ...

      [Ugandans are] not all obese, diabetic, and suffering from heart failure. In fact, they're quite the opposite. I won't spin you the fairytale that they're all 6'6''& 250lbs of lean muscle with glowing skin and flowing hair. But healthy they certainly do appear. ...

      We utilise 9 strains within the blend. The choice of the specific species and strains is based upon, in part, research performed in Uganda on raw-milk drinking Rwandans and several other population-sets in rural Africa. ..."

    6. Phil, there's data someplace where analysis of microbiome in European Type 2 diabetics indicates that in these people there are some bacteria missing compared to the healthy people. In India, the type 2 diabetics are also missing some species of bacteria but it's different than in Europeans.

      When it comes to auto-immune diseases and the susceptibility of the individual, there may be something like this going on as well. And it is also possible that rates of MS and type 1 diabetes may be lower or non-existent in populations with a different allele for lactase persistence.

      Same thing goes on with people who have the 'genes' for coeliac. They don't all get it. Fasano's clinic cohort of first degree relatives who have been diagnosed with coeliac indicates that. But it also indicates that as people with these genes get older, the likelihood of developing Coeliac increases. He doesn't know why. Infection? Antibiotics? Changes in gut microbiome?

    7. Yes, I suspect that the microbiome is the single most important common factor.

  15. This was a very interesting, thought-provoking series. They clearly took a lot of work to put together. Thank you for that.

    I too hope someone in the research field takes them as a challenge for further investigation. Something certainly seems suspicious with milk. I would love to know if it's the lactose or the protein, and whether it's a bad set of genes or a maladaptive microbiome as the trigger. The good news is that I feel like in 5 or 10 years we have a reasonable shot at being able to answer those questions with more certainty than a coin toss.

    1. Allan, what do you mean by the term 'coin toss'?

    2. Coin toss is 50-50. Right now, I feel like it's 50-50 on lactose vs. protein and genetic predisposition vs. microbiome-induced. Or rather, the intellectual arguments for each side are compelling on their own, so lacking data to put one over the top, I consider them all about equally valid, hence a coin-toss.

      Saying that now, I hope it doesn't come across as dismissive of your case against lactose. I certainly don't mean it that way, but (and this may well be my error) I felt like there were only a few times in the 5 parts where as I was reading I thought OK, this point cannot be used against protein as easily as it can against lactose.

    3. Allan, without making this 13 parts, as Tim sarcastically suggested, it is really impossible to provide all of the information for why it is that protein is not the problem. We could easily continue and include type 1 diabetes in the hypothesis. In fact, Type 1 diabetes is even easier. But there's only so much attention we can get from people who read a blog. So there you have it. We put in as much information as succintly as possible, but the rest of it? Who would read it all? We don't want to melt down Tim's blog. He's a generous guy and all, but there's limits. We may choose to continue at some point though.

      And since most people are looking for a 'now' improvement to their health, there isn't as much uptake on preventive measures. Most people who read the blog do it for their own benefit and not necessarily consider the potential preventive benefits to children they may or may not have. It is always a 'hard sell' when it's down the line preventive for diseases that most people don't every think their children could develop.

    4. Best think for one's kids is prob to move to a state, or country, where they still have small/local farms and quality food where Monsanto and Cargill and CAFO's do not yet exist. Preferably with a tradition of home cooked meals and lower in fast food joints.

    5. ...or am I dreaming that such places still exist today?



  16. @Allan

    The question is not: lactose or protein.

    Of course it is not lactose dissolving the myelin sheats. It is the immune system cells, primed by a certain protein structure, in some unlucky individuals. Such cells, directed against own tissues, should be normally "deleted". In some cases it does not happen (=autoimmunity weapon is not destroyed).
    And it seems lactose just potentiates the autoimmunity landscape.

    1. "I feel like it's 50-50 on lactose vs. protein and genetic predisposition vs. microbiome-induced."

      Over the years, researchers seem to have looked at every variable from birth month to latitude, dietary factors to genetics. There is no research to speak of that has even looked at lactose or raw vs pasteurized milk. But the proteins don't seem to have a correlation as MS rates change around milk consumption and much less with butter or cheese, telling me maybe proteins are not a player. I think Gab is spot-on that lactose plays an overlooked role.

      "And it seems lactose just potentiates the autoimmunity landscape."

      That's my takeaway from all of this, too.

    2. Some smart scientist should get on this. It should be pretty straight forward to test lactose in isolated form.

    3. Thanks Gemma, for whatever reason that reply caused it all to crystalize for me, and even why pasteurization and ultra-pasteurization can be a problem -- it's not what they do to milk, it's that the remove an otherwise beneficial source of microbe inoculation.

      Sorry to be this slow on the uptake.

    4. @Allan

      Thanks, very occasionally I have such effect on people. And in other cases, I am simply absolutely, horribly wrong. Why, oh why didn't I wait just one single day with my "deep thoughts" on the normal mechanism of autoimmunity control and deletion of the immune cells primed to react to our own tissues?

      This study published yesterday shows that these "autoimmune" cells are not deleted, only partially pruned, and stay present in the body. They are in the normal state of affairs kept in check by restriction mechanism, "some kind of internal emergency brake".

      "Decades’ worth of textbook precepts about how our immune systems manage to avoid attacking our own tissues may be wrong.

      Contradicting a long-held belief that self-reactive immune cells are weeded out early in life in an organ called the thymus, a new study by Stanford University School of Medicine scientists has revealed that vast numbers of these cells remain in circulation well into adulthood."

      Adults harbor lots of risky autoreactive immune cells, study finds

      The authors logically argue that deleting such cells would expose our bodies to smart pathogens that would readily exploit such a "hole" in the immune defence by mimicking our own tissues. So, these cells do stay ready, in every individual, just in case such a pathogen appears. And then, only then, when the inflammation is too strong and the restriction is released, these cells start an attack.

      And I think that by doing so, they cause the collateral damage to ourselves (and start a vicious cycle).

  17. A timely article by Sisson - Is Raw MIlk Really Better?

    1. Thanks, and that article has still more info about how the problems with milk are not all about lactose:

      "Even though they may not necessarily have clinical lactose intolerance, many people still can’t tolerate milk. Sure enough, studies show that self-reported milk intolerance doesn’t help identify lactose malabsorption. One isn’t necessarily the other. They still have gastrointestinal issues with milk, even if it’s not the lactose. Millions of raw milk consumers, some of whom flout the law and pay exorbitant prices to obtain the stuff simple because they can’t tolerate pasteurized milk, report complete cessation of symptoms when drinking raw milk."
      Read more:

      My sister's biggest problem with milk in their youth was pasteurized milk fat. They actually fared better with high-lactose nonfat milk.

    2. I suspect that the biggest single factor that makes milk either good or bad for most people is bacteria, though it's just a hunch. It could explain why a goat kefir with added probiotics is my best dairy product, even though it contains lactose and is pasteurized.

    3. Doesn't kefir have enough probio's on it's own? Why would you add it?

    4. I don't know why they added it, but I find it to be the most beneficial dairy product I've tried yet, and probiotics never worked for me before trying it, so I'm not complaining. :)

  18. so -----a nice article for those interested MS ( Athlete's foot, eczema drugs could reverse MS, study finds ) call me crazy , as I talk my pipe dream Researchers found an antifungal and a steroid reversed MS in mouse models of the condition by stimulating stem cells to boost myelin production. Think---- steroids naturally as vit D3 --- d3 lanolin -- lanolin used to make steroids. There using steriods and antifungals... D2 lowers D3 in studies --( d2 from the pharmacy is made from MOLD...aspergillus )

    1. d2 is making more people ---->sick when there already sick --they dont get better with osteoporosis and auto immune disease gets worse over time.....

      just an interesting little note

  19. Gemma wrote: Sisson article says: "even if it is not lactose." Well, read this. it will surprise you (full access)

    Lactose malabsorption among Masai children of East Africa (1979)

    I'm actually familiar with that study. Note that it says that "milk is an important constituent of the Masai diet" and that some suggest that milk can be "nutritionally useful" even for people with lactose intolerance, like the Masai were thought to have (though a more recent suggested that they may have a different LP gene than Europeans). I suspect that those who benefit most have bacteria either in the milk or in their GI tract or both to help derive nutrition from the milk.

    Another recent study suggests that Northern Europeans did NOT develop LP by drinking lots of milk in the past in Europe! I meant to save it but forgot to. So many assumptions have been turning out to be wrong.

    Here's an interesting bit that may help explain why the Maasai can tolerate milk so well despite possibly not having full-fledged LP:
    "Most of the milk was consumed [by the Maasai] as fermented milk or buttermilk - a by-product of butter making [milk minus the butterfat after it has been churned out].
    ("The technology of traditional milk products in developing countries". Retrieved October 15, 2012.

  20. "I’ve had raw milk easily last up to about 2 weeks in the fridge, no problem. It’s pasteurized that spoils rather quickly."

  21. My great aunt in Ireland did not have a fridge until the 1970's (she resisted installation of electricity when she saw people burned out of their homes when electricity was first installed decades earlier), yet she drank plenty of milk without it.

    1. And the milk was either raw or boiled, not pasteurized. When my Irish grandfather came to the USA and heard the gov't say that pasteurization was essential, he called it "A bunch of nonsense," for he had grown up on raw and boiled milk/dairy.

    2. So far my grandfather is "batting 1000" for things he called nonsense that moderners claimed was essential.

    3. It's so odd and sad that important things that people alive during my lifetime knew have been so forgotten within such a short time.

      On the bright side, raw milk may soon become available at farmer's markets in my state. Looking forward to trying it.

    4. When it comes to food - a HUGE market - there is a never ending spew of lies and nonsense, trumpted up "studies", etc. Do you think it will change?
      The big Agro biz are always fighting, they might lose a battle here and there and win others. Eg. While American's fight to get mandatory GMO labeling just last week in Brazil, where they have had it for many years, got rid of the law nation wide.

      Then you have local "authorities" in the USA that do shit like this..

    5. When my father lived in Switzerland, he remembers when the cows would come home from the pasture to be milked and his aunt would boiled the milk. He said there was nothing like drinking freshly boiled milk.



    6. Same deal with my Irish grandparents. The Swiss are a good example to examine when testing the hypothesis that lactose or milk is the primary or necessary cause of MS, as Switzerland consumes more milk per capita than the USA yet has a lower overall rate of MS. It's more difficult to blame the Swiss numbers on poor testing than with Mongolia or the Maasai.

      And if the argument is switching to longevity instead of MS as the key determinant of the verdict on milk, then Switzerland also surpasses the US in life expectancy Other nations that exceed the USA in both life expectancy and per capita milk consumption include Finland, Sweden, the Netherlands, Greece, Denmark, Luxembourg, Norway, France, and Italy.

      "If it doesn't fit, you must acquit." ;) As with any scientific hypothesis, the burden of proof lies not with skeptics, but rather with the proponents of the hypothesis. Many examples that fit a hypothesis don't prove it, while a single black swan example that doesn't fit the model can undermine a hypothesis.

    7. This comment has been removed by the author.

    8. Phil, not that it matters but keep in mind that the data used in that Wiki link for milk consumption, if you go look at the FAO data, is using all dairy excluding butter. So it's not just fluid milk. It's a shame that they lump everything together as I'm sure more info could be teased out if they broke out fermented milk and yogurt from the cheese, butter, and liquid milk.

    9. Then of course there is the animal source of the milk, which could also play a part - goats, sheep, buffalo, cow, camel, horse, etc.

    10. @Paleo Phil

      Country statistics are not helpful here. Only when you start breaking the country data, you find MS hotspots. Even in Switzerland.
      The same is true for LP genotype. As stated previously (in Part 4), LCT allele is a big confounder in GWAS studies (MS included).

      I don't understand the point about longevity.

    11. I think the point about longevity is that it might not be advisable to avoid a food that may be seen to have an association with one particular disease when that same food is associated with decreased overall mortality. While it may be true that this series does not have the goal of condemning the consumption of dairy, in general, readers (could) lose sight of that given the series does not cover much about the health benefits of some kinds/types/amounts of dairy.

    12. " the series does not cover much about the health benefits of some kinds/types/amounts of dairy. "

      The aim of this series was to investigate a certain hypothesis, and not to present evidence on health benefits of dairy, which is plentiful elsewhere.

    13. @Gemma, There are MS hotspots and farm vs. urban population data that don't fit well with a lactose, milk, or dairy hypothesis (or any single food), as I noted before. This is one of the reasons that the various dairy hypotheses for MS haven't gained greater importance in the scientific community and why the search for causes and mechanisms continues.

      The point on longevity was a response to Gabriella's point that "the Maasai are not poster children for longevity." That excuse does not explain away all the many populations that do not fit the lactose hypothesis and it's also a tangent from the hypothesis, as it's not the same thing and it does not follow that a population with low longevity must necessarily have a high level of MS or tendency toward MS that would show up if more of the people lived longer.

      MS doesn't only develop in the elderly: "MS symptoms can start anywhere between 10 and 80 years of age, but onset is usually between 20 and 40 years, with a mean of 32 years."

      Short lifespan has also been used to explain away the low rates of autoimmunity and modern disease in general among traditional societies and the argument has been responded to in detail already by Cordain, Sisson and many others. While lifespans have been increasing among all age groups, so too has autoimmunity. To summarize, lifespan doesn't explain away everything.

      If lactose were the primary and necessary cause of MS, then surely by now we should have some hint of MS as a problem among pastoral and rural milk-drinking populations. The experience and knowledge of my rural Irish relatives' and their physicians fits with the overall MS and autoimmune disease data, in which MS and its cluster of symptoms were relatively unknown and then the incidence and prevalence rose dramatically during the 20th century and continues to rise.

      Re: the LCT allele. Please don't get me wrong, I'm not trying to imply no role for LP phenotypes. Doesn't the following study that was mentioned in Part 4 suggest not that lactose consumption is a factor in autoimmunity, but actually that the LP phenotype is connected irrespective of adult lactose consumption? Where does it show in the study or elsewhere that the LP phenotype only becomes a factor if lactose consumption persists into adulthood, especially given the recent evidence that dairy consumption in Europe did not even drive the development of the LP phenotype there, which I discussed earlier?

      "Latitude, sunshine, and human lactase phenotype distributions may contribute to geographic patterns of modern disease: the inflammatory bowel disease model"

      I suspect that lactose consumption and the LP phenotype may play some role in MS. I would just word the hypothesis much less strongly and overall the guess would be more toward "multifactorial etiology," as suggested in at least one of the studies that Tim referenced, with microbes potentially playing a key role. The biggest factors would need to account for whatever changes occurred during the last 50-100 years to explain the dramatic rise in incidence and explain all the hotspots and the non-MS milk-drinking populations.

    14. @Paleo Phil

      "There are MS hotspots.. that don't fit well with a lactose.. hypothesis"

      No, there are and it fits. Have you missed the map? It shows LP and MS overlapping.

      How LP genotype and phenotype, and lactose digestipon status play a role, needs to be researched.

      So yes, I hope the search continues.

      Feel free to discuss longevity and lifespan with Gabriela, not me. It has nothing to do with MS. Sardinia is a known Blue Zone (longevity) and yet, it has one of the highest MS prevalence in the world!

      "If lactose were the primary and necessary cause of MS"

      Again, lactose per se seems not to be the (only) problem, if properly metabolized.

      "Doesn't the following study that was mentioned in Part 4 suggest not that lactose consumption is a factor in autoimmunity, but actually that the LP phenotype is connected irrespective of adult lactose consumption?"

      The study does not imply that. I doubt anyone has actually broken the data apart and sequenced (LCT) AND questioned (dairy type consumption) the people with MS. Though the paper on Crete is quite telling regarding milk type. I only hope someone does it now.

      "Where does it show in the study or elsewhere that the LP phenotype only becomes a factor if lactose consumption persists into adulthood,"

      I do not get this question.

      " especially given the recent evidence that dairy consumption in Europe did not even drive the development of the LP phenotype there, which I discussed earlier? "

      I do not see your problem. The appearance of LP genotype is clearly connected to cattle herding, though the dairy was consumed much earlier. I hope it was clear. LP genotype spread in Europe by breeding, by "strong selective sweep", simply because LP population had more viable offspring.

      "with microbes potentially playing a key role"

      At least that we agree on. And non metabolized lactose as a co-.factor, as the papers I presented imply.

      But here I stop!

      I have collected and presented the studies and evidence, and as I said, the rest are wild ideas only. I leave the pleasure of deciphering the MS riddle to someone else.

    15. @Gemma, Thanks for your interesting comments in the discussions of this series, and I agreed with many of them (though I also like disagreements, because I can learn from them). I think the disagreement is more of emphasis and focus than kind. Based on your responses, it looks like the meaning of my comments didn't get across, and my original longevity comment wasn't directed to you specifically, nor did I expect you to necessarily respond to it. I can see that blog comments aren't well suited to complex discussions.

      I'm concerned that if I respond to each misunderstanding it will reqire a lengthy reply to explain fully and would emphasize differences, which might only cause further confusion or aggravation. So let me summarize that where you agreed my message got across and where you disagreed it did not. So unless you want me to try to explain, I think I'll call it done for now too.

    16. "I also like disagreements, because I can learn from them" +1
      Shame most people on the Web don't feel this way and take disagreements and skepticism as personal attacks. We should always try to focus on finding (the truth) and so poking holes, questioning, debating, and disagreeing are all part of the process - if we are focusing on science. Keeping emotions out of it though, yeah it takes effort and discipline in communicating.

  22. I don't blame anyone here who doesn't know this stuff. I had the rare advantage of growing up among pastoralists.


  23. Fermented milks had been made since early times, when warm raw milk from cows, sheep, goats, camels, or horses was naturally preserved by common strains of Streptococcus and Lactobacillus bacteria. """"""""""killed out in pasteurized milk""""""""" (The “cultures” were obtained by including a small portion from the previous batch. harmless lactic acid producers were effective in suppressing spoilage and pathogenic organisms, making it possible to preserve fresh milk for several days or weeks without refrigeration. Cultured products eventually became ethnic favourites and were introduced around the world as people migrated.

    Central to the production of cultured milk is the initial fermentation process, which involves the partial conversion of lactose (milk sugar) to lactic acid. Lactose conversion is accomplished by lactic-acid–producing Streptococcus and Lactobacillus bacteria <-----------------------------------killed in pasteurized milk ---so your store MILK is all cassien and lactose ---with nothing to break it down
    Subsequent or secondary fermentations can result in the production of other compounds, such as diacetyl (a flavour compound found in buttermilk) and alcohol (from yeasts in kefir), as well as butyric acid (which causes bitter or rancid flavours).

  24. modern butter milk, is nothing of the past butter milk......

    Modern buttermilk is made from low-fat or skim milk and has less than 2 percent fat and sometimes none. Its correct name in many jurisdictions is “cultured low-fat milk” or “cultured nonfat milk.”

    The starting ingredient for buttermilk is skim or low-fat milk. The milk is pasteurized at 82 to 88 °C (180 to 190 °F) for 30 minutes, or at 90 °C (195 °F) for two to three minutes. This heating process is done to destroy all naturally occurring bacteria and to denature the protein in order to minimize wheying off (separation of liquid from solids).

    The milk is then cooled to 22 °C (72 °F), and starter cultures of desirable bacteria, such as Streptococcus lactis, S. cremoris, Leuconostoc citrovorum, and L. dextranicum, are added to develop buttermilk’s acidity and unique flavour. These organisms may be used singly or in combination to obtain the desired flavour.

    The ripening process takes about 12 to 14 hours (overnight). At the correct stage of acid and flavour, the product is gently stirred to break the curd, and it is cooled to 7.2 °C (45 °F) in order to halt fermentation. It is then packaged and refrigerated.

    1. I'm lucky in that I have access to buttermilk made by a local farm mostly the old-fashioned way. Their buttermilk is the watery milk left over after the butter is churned out of it (they also sell the butter). They start with whole milk and use jersey cows to boot! The only difference from trad. buttermilk is that they use the least pasteurization necessary to meet gov't regulations. So when I talk about drinking buttermilk, that's what I'm talking about, not the modern stuff with added thickeners. This buttermilk is the first dairy product I tried that I noticed benefits from, despite the lactose content.

  25. Its a no wonder the Masai have good health--- there gut is loaded in the top end with LACTO strains --where they should be...

    Consistency. Raw milk generally makes buttermilk that has a much thinner consistency than that made with pasteurized milk. To thicken raw milk buttermilk, drain whey from the buttermilk using butter muslin or a tight-weave cloth.

    Raw milk is not homogenized; therefore, as the milk cultures and the buttermilk sets, the cream will rise to the top. The top layer of the raw milk buttermilk will be more yellow and of a much thicker consistency. This layer can be scooped off and eaten alone or stirred back into the buttermilk. one should be-using only fresh milk to make buttermilk. Raw milk comes with its own set of beneficial bacteria. If your milk is a few days old or wasn't chilled quickly enough, the bacterial count can be high. This means that the culture you introduce could have some hefty competition, which can lead to buttermilk with an “off” flavor or buttermilk that does not culture properly.
    Perpetuation of the Culture. Our direct-set Sour Cream Starter includes optional buttermilk instructions and is meant to be used once, while our Heirloom Buttermilk Culture is meant to be perpetuated from batch-to-batch.

    If using a perpetuating culture, it is necessary to first make a pasteurized mother culture to inoculate each batch of raw milk buttermilk, to keep the starter healthy.

    Please note that buttermilk made from a direct-set starter and raw milk may not re-culture well.

    1. Edward, what gives you the idea that Maasai have good health? Have you ever checked into the age demographics of Maasai? And I'm not referring here to life expectancy because, after all, infant mortality is very high. But what percent of the population makes it past age 40 or 50? Or 60?

      For people who are constantly tweaking their diets because they think it'll give them perpetual youth to over age 100, the Maasai are not poster children for longevity.

    2. @Gab, you seem to be conflating (health) with (longevity). American's may or may not live longer on average than the Masai but that does not mean that those extended lives are as healthy with the same functional abilities, energy levels, comfort and lack of pain, etc. Just because modern medicine of a wealthier nation can extend life via treatments and medication does not mean those people are healthier. In fact I believe that usually they are not. It's pretty much a given that the wealthier a country the worse the diet via poor quality processed food and over-eating, in addition to a much more sedentary lifestyle.

    3. I was just thinking about this "health" subject...
      And while it's true that the closer one is to dying chronologically could be construed as a state of health, I think it's also a rating of how close or far one is from the abilities you had in your prime - say, around 20 years of age. How functional are you in running, walking, lifting, thinking, having sex, etc. compared to your prime? That is health.

    4. Brad, healthy people don't require meds. Sometime in their 70s the M.D.s put them on blood pressure meds of one kind or another. I don't think there's too many Maasai, if any, in that age range, medicated or unmedicated.

      Did you know that Maasai practice arranged marriage? Only those societies and cultures do this where early death is prevalent. There's a good reason for marrying off the women when they are in their teens. Otherwise you'd have no children being born at all. Or raised. You won't be seeing women in these sorts of cultures getting married in their late 20s or early 30s like in evil developed countries because by the time they get to age 40 they're in menopause.

      Or are you only interested in men? Like how Maasai boys and Zulu and whatnot go through the circumcision ceremony? And how many of them die because of infection afterwards? Charming. Just bloody charming.

      I'd rather live where I do, thanks. If sexual activity means being married off to some dude at 13 years of age? Yeah, no thanks.

    5. @Gab. "healthy people don't require meds", yeah kinda obvious. My point is that there are huge numbers of unhealthy elderly Americans that take tons of meds, continuously, in order to sustain their health state or lives such as they are. Yes, the Maasai die early for a variety of reasons usually caused by things other than their diet or milk consumption, the subject were are focused on here.
      Now if you were claiming the Maasai's mortality rate was linked to their high milk consumption then that would be pertinent here.

    6. Though I do agree... "the Maasai are not poster children for longevity".
      Their activity level and diet makeup is mostly good, but they suffer greatly from a lack of cleanliness and access to modern medicine - when needed.

    7. Brad - Just imagine if we could give people like the Maasai access to timely, modern health care, but avoid the 'stupid' stuff like antibiotics for every little sniffle and drugs to treat every symptom.

      I think our health care system does good treating traumatic injuries, they just suck at keeping people healthy while eating shit for food.

      It would be interesting to see a longevity study.cause of death for the Maasai. I mean, they do look healthy when you see them. I'd rather live a happy, healthy life than be strung along to 90 as an HMO posterchild.

    8. The Maasai are tough to study accurately due to lack of recorded info and their culture of not talking about deaths. Their culture also creates lots of confounders regarding health and longevity. Eg., they often under-eat for various reasons. Women go on starvation diets for the last 3 months of pregnancy!

    9. HMO postechild. Haha. Exactly what I was trying to convey.

  26. Tim, I think you have the right idea. We can try to take the best we can from BOTH the traditional and modern worlds, rather than utterly dismiss either. I have never seen it as either/or.

  27. Gabriella Kadar,

    --->Edward, what gives you the idea that Maasai have good health? I dont promote the Maasai other do ...I dont look at them for health---never saw them as healthly others here do.... , I dont drink milk my health is fine

    1. I just pointed out the value of milk ---in a good way if its real....Sardinians use REAL milk as well.....but goat and sheep , theres a bonus as lactos are mainly in the stomach --- but you see high MS rates in sardinia as well which I say is from aspergillus

    2. I'll take real world anecdotal evidence over mountains of statistics and out of shape egg-heads any day. That, plus the opinion of professional fitness/physique trainers with decades of experience and success. Quality dairy is on of the most nutritious and healthy foods there is - especially if lean muscle mass is you goal - which is should be!

    3. Brad, the hypothesis has nothing to do with you on a personal level. Can't you understand this? We presented a hypothesis and you are going on about your own experience of life. Your experience of life has absolutely zero to do with the hypothesis. This is not about you.

    4. It's about food, and hence it is "about" everyone. Granted my general opinion on this food is a bit off the original topic (the hypothesis), but I feel the need to chime in particularly for that reason... the topic is very narrow in scope and I think you need to look at a food more broadly before condemning it. Not that you are specifically "condemning" it but the discussion does seem pretty skewed toward the negative, at least up to now in these parts - but maybe that is just my perception.

    5. Btw, the title "Got Milk?" should really be "Got MS?" if you are being so nitpicky on going off topic of the (hypothesis).

    6. Also, the opinion I expressed is not only my own experience (ie, I agree, not about me) but that of many experienced nutritionists. Don't even try to brow beat me into not posting my own comments. That just will not work with me. ;-)

    7. Brad, why would you even think I was browbeating you? Because I wasn't. If you think I was then maybe..... Seems in your opinion you can write anything you feel like writing. Whatever it is. But when I tell you 'it's not about you', you think I'm browbeating you?

    8. The "Got Milk?" title was my idea. It probably should have been called "Got MS?" and we should have stuck with that line of thought.

      We quickly realized that implicating "milk" was going to take us deep into a whole new line of research and I did not want to go there right now.

      I think on Part 3, Gemma asked "why are we calling this 'Got Milk?'" So we tried to quickly wrap it up and keep to the MS portion of the milk connection.

      But seriously, if you wanted to look at milk in general, pro's, con's, types, there is just no end. And when you throw genes and microbes into the churn it really gets thick.

    9. Look Gab, if I wanted to write about me or my experience I'd have said that I eat lots of diary and I'm in awesome shape for my age, but I didn't because that was not the point I was trying to convey. You made the comment "I don't drink milk my health is fine" which is a very (about you) statement and also has ZERO to do with the (hypothesis) and yet you felt the need to tell me "This is not about you"???
      let's move on...

    10. Brad, You'll need to double check this. Maybe Eddie wrote that.

  28. @Gabriella Kadar,

    Ive had the aspergillus theroy for a while and a recent study makes me laugh=== when I read it....antifungal drug and steriod ----helping MS.... wow

    Make sure you READ it this is from 2015 <------------------------

    aspergillus can utilize"""" lactose"""" amylase, starch ,pectin, , protease, pectinase, and others why they use it to make food additives (main thing they use) its also in soy sauce.... made made vit d2 is mold , citric acid in all your kids juices ( mold )

  29. Is it really Lactose? Is it milk?
    Mycobacterium paratuberculosis and milk.
    Mycobacterium avium subsp. paratuberculosis and multiple sclerosis in Sardinian patients: epidemiology and clinical features.
    Association of Mycobacterium avium subsp. paratuberculosis with Multiple Sclerosis in Sardinian Patients
    Mycobacterium avium subspecies paratuberculosis, Crohn's disease and the Doomsday scenario
    Anti-Mycobacterium Avium ParatuberculosisTherapy in Crohn’s Disease

    1. @Ashwin

      Thanks. We did look at MAP, given how animal model of MS is induced. It is tempting to point at it and it is easy to find such correlations.

      The problem is though, MAP is simply EVERYWHERE, not only in milk.

      And if I wanted to go on with this series, I would bring papers showing that there is more to human and Mycobacterium tuberculosis co-evolution than we may know, and that it may in fact protect us. (A hint: BCG vaccine)

      In MS, it all goes back to myelin, ceramides, sphingolipids... possibly as pain signals shared across kingdoms, not only building blocks of our tissues.

      But Tim would kill me if I suggested Part 6, I guess.

  30. I thought this might be of interest/relevance:

    1. @Diana

      Thank you. You were not the only one pointing to this new discovery. So it was addressed in Part 6.
      (My doom is probably sealed).

  31. What do you all think of lactose free milk?

    1. Years ago I figured that lactose-free milk would be the best. Some years later I tried a jersey-cow buttermilk and a particular goats milk kefir that I benefited more from and also enjoyed much more.

      I recently discovered that the source of the benefit from the kefir is not the added probiotics, as I guessed above that it might be. A cow dairy kefir with the same added probiotics did not give me the same benefit, nor do other goat kefirs, so it's apparently something else and is still a mystery at this time. Some things don't lend themselves well to simple answers.

  32. Same thing I think about yolk free eggs (egg white). Do you think Nature put lactose in the milk of all those different mammals for no good reason? Eat minimally processed whole foods. The less that man has mucked with a food, the better, generally speaking. If you cannot tolerate lactose well, then stick to fermented milk such as Kefir. That's what I think.

    1. Thanks Brad! Just saw some in the supermarket, that's all.
      I think it's time I finally got myself some kefir grains.

  33. Btw, off the MS specific topic but I saw a lot of dairy related articles on the Suppversity blog, which are always pretty data-heavy writeups. They point to lots of various studies showing both positives and negatives of dairy consumption (read; lots of questions, little conclusions). Worth a look if you're interested in digging into the dairy subject. In short what I gathered was that in general, and painting with the usual broad "dairy" brush (ie, nearly all the studies do not break down the different varieties especially *fermented*) , what I took away was that increased dairy consumption was *associated* with lower ALL CAUSE mortality.



    1. and/or google...


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