Mornin’!  I’ve been sussing out the answers to some of your important health questions, so let’s get right to it:

In response to my post about milk, Melanie asks whether I know of any cases of illnesses or deaths related to raw milk.

Yes, Melanie, I do: the Centers for Disease Control says that between 1988 and 2008, two people died after consuming raw milk. The CDC cites 1,614 reported illnesses, 187 hospitalizations and 85 reported outbreaks of human infections during that same time frame — all connected to raw milk.  Campylobacter outbreaks — associated virtually exclusively with raw milk and meat — have been scourges in parts of Africa.  Historically, “milk sickness” has injured or killed people.  So, yes, raw milk can most certainly can contain pathogens. I would not personally give it to a young child, my grandmother or anyone with a compromised immune system.

Still, pasteurized dairy has also killed people– albeit to a much smaller extent.  Pasteurized milk, powdered milk and cheese all have been implicated in salmonella outbreaks.

Sushi can contain pathogens.  So can vegetables: remember the salmonella tomato outbreak a few summers ago.  And so can deli meats; that’s one reason pregnant women are advised not to consume cold cuts, as the fetus is especially vulnerable to listeria.  Much of the meat sold in this country is produced in a way — via CAFO/factory farming — that makes it more hospitable to E. coli and/or salmonella.  The CDC estimates 1 in 50 average consumers is exposed to a salmonella-tainted egg each year: that’s, what?  Six million people?  Not small numbers.

From a political standpoint, the following might thus strike you as odd.  We do not ban sushi, or raw vegetables, or sliced turkey, or eggs, or medium-rare steaks.  But we do ban raw milk: it’s illegal in more than half the states in the union.

Part of this is because milk is big, big, big-with-a-Big-B Business.  The milk lobby is highly influential.  Pasteurization (especially high-temperature pasteurization, which extends shelf life), along with truck refrigeration and highways, is what allows for the large-scale farming, the milk tank mingling (wherein the milk from dozens, hundreds or even thousands of cows is mixed together and sold) and the trucking practices that, taken together, overhauled the industry decades ago and made it into a giant agribusiness.

If we were all to be allowed to buy clean raw milk from local farmers, the status quo would suffer.

But that’s not the question. The question is — is raw milk safe?

The answer : often yes.  And sometimes no.  And that no can be deadly. Still, in many states where the sale of raw milk is allowed, the farmers producing that milk  must regularly submit their product to a cascade of tests, sometimes to the point of what they deem harassment.  Raw milk advocates encourage potential customers to meet those farmers, to observe whether their children drink the milk, and to make sure that the operation is pristine and that the milk is regularly tested.   (The CDC counters that even “clean” raw milk could later display pathogens.  This is true.)

In the end, whether you drink raw milk will depend on your risk threshold.  Are you guaranteed never to become sick from raw milk?  NO.

So why do some people drink it?

Quality of milk is a big issue here.  It’s not so much a raw vs. pasteurized issue as it is a question of how the animals are raised.

When you buy milk from the store, even if it’s organic milk, it has usually been mixed with the milk of dozens or hundreds of other cows.  It has been homogenized, which is not great for our digestion.  It has been pasteurized at such a high temperature (Ultra High Temperature, or UHT) that virtually all the beneficial bacteria are dead.  That milk will last on the shelf until your grandkids have dentures.  The cows have almost certainly been raised on grain instead of grass, and they’ve likely been raised in conditions that are far removed from the tranquil, pastured life they might experience at a small local farm.  (Not that all small local farms are ethical.  Let’s not romanticize here.)

When you purchase raw milk from a local farm, you’re often getting 100% grass-fed milk from cows grazing on pristine pastures.  The cows are not pumped full of hormones to increase milk production or to keep them lactating year-round.  They’re allowed to rest and follow more natural rhythms.  And studies show that grass-fed milk is nutritionally superior to grain-fed milk.

The issue that concerns me most here is that if raw milk is universally banned, there will be fewer and fewer farmers out there who produce truly high-quality, single-herd, fresh and seasonal milk. I can always pasteurize it myself. In fact, when I lived in Miami and bought through my milk pimp, I often pasteurized it by making yogurt or cheese out of it.  Those yogurts were the best I’ve ever had, and it would be a shame to see conscientious farms go out of business due to fearmongering.

That makes sense, but why do some people insist on drinking raw grass-fed milk?

The same reason people consume sushi or raw vegetables or salads: they like it.

Raw milk is as far on the other side of the spectrum from industrialized feedlot milk as it gets: it’s usually hyper-local, grass-fed, from a single herd feeding on pesticide-free grass and super-fresh.  But you don’t have to drink raw milk to get those things.

Nutritionally, pristine, clean milk does contain more friendly bacteria than processed milk.  Other reasons cited: flavor, rejection of “dead” milk that’s been nuked beyond recognition, political support of small farmers doing it right and against Big Brother, plus a panoply of personally held convictions.  Do searches on raw milk and you’ll find a lot of highly anecdotal “evidence” of its benefits: they tend to cite each other and the Weston Price Foundation (a pro-raw group whose founders’ books sell like hotcakes among the true believers) as evidence. People claim the stuff cures everything from eczema to infertility to cancer.  These are convictions, not science.

Me, I just think raw milk tastes good and makes a kick-ass ice cream.  (I should add, though, that the Weston Price folks are a good resource for finding conscientious dairy farmers.)

You do reduce — and even outright lose — some B vitamins when you pasteurize milk, but you can make up for that with other animal foods. You also lose great flavor when you pasteurize: there’s a reason why parmigiano reggiano is made exclusively with raw milk, and why so many French cheeses taste so damned good.

Ah, the Europeans.

Yes.  Although they’re not big milk drinkers, at least not in the South: most of the milk I find in Italy is aseptically packaged Parmalat that can be bought off the shelf, not in the refrigerated section.  Except for cappuccini, the Italians and French prefer cheese and other fermented milk byproducts to milk itself. The fermentation process tends to make milk more digestible, or, in the case of crème fraîche, raw cream more digestible.

Milk was traditionally a seasonal food. Cheese and yogurt were born as a way to preserve it down the line.  Although you can make yogurt from raw milk, history suggests that the fermentation process traditionally was kickstarted by heat.  In this way, potential pathogens died out.  It’s the same with aged raw-milk cheese: a good parmiggiano reggiano is aged for two years, and when it comes to killing off bacteria, that’s as good as pasteurization.  (Six months of aging is the current requirement in the U.S., although the FDA is currently reviewing whether six months is long enough to kill pathogens.)

Any good cheesemaker will tell you that raw milk makes the best cheese.  Age it enough, and you’ve got a pretty ideal combo.  Whether raw milk makes the best milk is still up for debate.

(As you can likely tell, I am not a raw milk activist.  I do indeed drink raw milk occasionally, but only when I know and have vetted the farmer.  Even then, there’s a small risk, so I doubt I’d give it to my future children or my grandmother.  I usually buy pasteurized, grass-fed milk.)

Dr. Oz

This raw milk question is gaining a lot of traction right now due to recent statements by Drs. Mehmet Oz (anointed as “America’s Doctor” by Team Oprah) and Michael Roizen.  They call drinking unpasteurized milk “playing Russian roulette.  Somewhere down the line, you’re going to get a bellyful of bacteria, like salmonella, listeria and e.coli, which will put you in a world of hurt. And the elderly, small children and people with impaired immune systems could face life-threatening complications.” Read the whole piece here.

That’s some scary language, but they are right.  They’re also not telling the whole story.  What they do not mention is that, again, people have experienced the same devastating effects after consuming pasteurized dairy, ground beef and even, lest we forget, tomatoes.

That said, it is not necessary to drink raw milk in order to reap the nutritional benefits of a 100% grass-fed product from pesticide/herbicide-free farms. (Heck, it’s not even necessary to drink milk, period.  In fact, the more research I do, the less dairy, in general, I consume, as the jury’s still out on whether it’s a health promoter or inhibitor.  But the dairy I do ingest is as high-quality as I can afford.)

So what the heck should I drink?

As I noted in the milk post (which I humbly recommend you read if you haven’t), the main things you want to look for in milk is that:

1) it has been grass-fed on quality grass, not grain, (something even Roizen and Oz agree with); and that

2) it has not been homogenized, a process which changes its stucture for the worse.

So fear not the pasteurized stuff, although, as I said in the original piece, try to go for low-temp pasteurized products from smaller farms. You can replace the friendly bacteria you lose via pasteurization, as Dr. Oz suggests, with “spore form” probiotic capsules, or with simple yogurt.  Just make sure the yogurt container says “live active cultures,” and try to steer clear of sugar or other additives that might inhibit the nutritional benefits.

Phew!  Hope that answers your question, Melanie dear.

Happy weekend!

Next week: answering your questions about the safety of scanpans, chewing gum and ziploc omelets.  (No, not a MacGyver recipe.)

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