The Raw Milk Conundrum

I’ve been watching the raw milk debates heat up in recent years and finally decided to dive into the topic for this blog. I spent several hours poring over articles, research abstracts and reviews of research, government statistics for food borne illness, and more, in an effort to give a balanced perspective on the subject. The fact that there are so many issues involved with raw milk including public health/safety, consumer freedom, current food production and distribution systems, and nutritional quality, makes this a very messy issue to tackle in a diplomatic way. People who have opinions on the topic are passionate. After all of my research I remain somewhere in the middle of the debate, so in theory anyway, I hope to present my thoughts based on my research and observations as objectively as possible.

First, as a health care provider in an often EXTEMELY litigious culture, when asked about raw milk by clients I need to think about liability. It may be true that a small number of deaths each year from food borne illnesses are attributed to raw milk but statistics represent real people. I don’t want my clients (or anyone else’s for that matter) to get sick or die because I told them to drink raw milk. Now a farmer who has fed her family raw milk for years with no ill effects may not give this a second thought, but then her kids aren’t likely to sue her if things go badly.

As a dietitian passionate about the benefits of a diet based on whole foods, raw milk poses more of a challenge. In concept I like the idea of drinking milk straight from the cow in its natural, unadulterated state and have enjoyed raw milk, yogurt and cheese at different times from local sources. But the pasteurization of milk is an example of processing that can benefit both consumers and manufacturers in our industrialized food system. Pasteurization does kill some (though not all) of the potentially dangerous microorganisms in milk (benefits to milk drinker) and it extends the shelf life of the milk (benefit to milk manufacturer and all involved in the supply chain). Realistically, these benefits go both ways in that “safer” milk may mean fewer law suits and longer shelf life helps keep cost of milk down.

Nutritionally speaking, it is true that some naturally occurring nutrients in raw milk are destroyed by pasteurization, though the degree to which this happens varies with the process used (simple pasteurization, ultra heat methods, etc.). There may be more beneficial fatty acids, special proteins that help us absorb or use folic acid (folate binding proteins), and beneficial bacteria (probiotics) in raw vs. pasteurized milk, however extensive research in this area is lacking.

Also, raw milk is not the only source of these nutrients and probiotics. So, from a nutritional perspective, at this point there just is not enough objective evidence to convince me that the benefits of drinking raw milk outweigh the risks, at least for the general population. I’m thinking in particular about high risk groups like kids, elderly, and people with compromised immune systems who are most likely to get really sick or die from the pathogens that may be found in raw milk.

Of course there are many other foods we eat knowing there are risks involved but we either really like the way these foods taste, don’t realize there are risks, or believe the health benefits outweigh the risk of illness. I’m thinking raw sushi, sprouts, lettuce, and let’s not forget the food that probably sickens (and kills) the most people every year, ground beef. In fact this is where the consumer freedom arguments kick in and cries of nanny-ism abound. We live in a dangerous world and take risks all the time. At what point must the government step in and protect us from ourselves? (No answers for this one, just laying it out there.)

In fact it is this aspect of the debate that probably gets me fired up the most. I can’t help thinking that while government agencies fret about raw milk, the largest outbreaks of food borne illness in recent years are linked to hamburgers, eggs, chicken, peanut butter, and various vegetable crops tainted by pathogens spread by animal matter. I think about the fact that contaminated ground beef cannot be tracked to its source due to current laws and food industry practices, yet thousands are sickened by this food every year. Just over a month ago (June 2010) there was a recall affecting nearly 40,000 pounds of ground beef from manufacturing plants in New York and California.

Meanwhile, according to the CDC “from 1998 to May 2005, raw milk or raw milk products have been implicated in 45 food borne illness outbreaks in the United States, accounting for more than 1,000 cases of illness (CDC, unpublished data, 2007).” To further put this into perspective, according to data supporting a recent bill proposed by Senator Jon Tester (D-Mont) to improve the meat inspection and tracking process:

Roughly 73,000 Americans are sickened annually by E. coli, 2,000 are hospitalized and 60 are killed, according to the Centers for Disease Control and Prevention. Medical costs associated with E. coli exceed $405 million a year.

So, on one hand people are clamoring for a better system to make our food supply safer on the heels of numerous outbreaks of food borne illnesses (most would admit this is a good thing – unless you own a meat packing plant), while other people want the government to stay out of their business and let them drink raw milk (knowing there are higher risks of contamination by food borne pathogens). What’s the government to do?

Finally, while I agree that changing our food system to foster more localized food production and distribution, including better care for its animals, could be safer in terms of sanitation and ultimately decrease contamination risks. At the very least this type of system would make it easier to track problems and affect fewer people when pathogens do contaminate a food. But here’s the reality: our entire food system isn’t going to change overnight. In the meantime, allowing the sale and distribution of raw milk is tricky. Currently 25 or so states have some kind of legal raw milk sales, though some are just for animal feed and not human consumption. However, I worry that if we encourage raw milk consumption on a larger scale, big agribusiness will be lured into the fray to cash in on this current food trend, just as it has with organic and “natural” foods. I suspect such a transition would not help small farmers.

To wrap this up, professionally I don’t recommend raw milk. There may be nutritional benefits to raw vs. pasteurized milk (in fact I suspect there are and we will learn more with further research on the topic) but right now the evidence of nutritional superiority isn’t compelling enough to balance the risk of contamination, especially for vulnerable people (kids, elderly, sick, etc.). As for the consumer freedom part of the issue I think if raw milk is legal then people can weigh their own risks just as they do with other adventurous eating habits like raw sprouts, sushi, and of course, burgers.