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  • Writer's pictureDerrick W. Spell, MD FACP

Not Milk?

I grew up on a small, rural farm in the 1970’s and 80’s. My family raised cattle along with other traditional farm animals. Meat, especially beef, was the centerpiece of most meals. (My mom would often disclose which dearly departed cow we were appreciating that night!) Milk and milk products were consumed on a regular basis. Cheese was added as a topping to hamburgers, sandwiches and other various entrées. We enjoyed pizza several times a month. Milk was gulped down routinely with breakfast, desserts and late evening snacks. Milk was also the drink of choice with lunches at school. (And if you were really fortunate, chocolate milk was available!)

My family’s consumption of milk and dairy products was standard for the times. We were told that milk “does a body good” and that dairy was important “for strong bodies and for strong minds.” As I advanced my education during the 1990’s, it was hard to open up a magazine or watch TV without seeing a superstar donning a milk moustache. I didn’t realize it at the time, but these trendy “Got Milk?” ads helped promote demand at a pivotal time when milk consumption was steadily dropping. Yet even with all of the clever advertising, dairy farmers weren’t the only ones actively promoting milk!

The federal government has supported the dairy industry for decades by convincing Americans to drink more milk. Milk has been recommended in every government dietary guideline since first published in 1917. In fact, the new 2020 USDA Guidelines still recommend at least three servings of dairy products each day! Why does the USDA want us to consume so much dairy? Because the federal government wants to justify their continued support of the American dairy industry! (Spoiler alert, Uncle Sam is not concerned about your well-being. The primary medical justification for the USDA dairy product recommendation was the reduction of bone fractures. We’ll return to that later.) Our government has been actively involved in supporting dairy businesses since the 1930’s. The official USDA website confirms that the government takes part in “regulating and assisting the dairy industry.” This support means that the government continues to subsidize the excess production of cow’s milk even as Americans drink less of it. Official USDA data confirms that our country’s milk consumption has dropped by 40% since 1975. These measures have led to a surplus of more than 1.4 billion pounds of government cheese! (Ironically, that amount of cheese stacked together is almost the size of the U.S. Capitol Building.)

One problem I have with recommending milk to the masses is that most adults can’t digest milk properly! According to our government’s National Institute of Health, approximately 65% of adults have a reduced ability to digest lactose. Lactose, a type of sugar found in milk, must be broken down by a digestive enzyme called lactase. As we progress from childhood to adulthood, we all produce less of the lactase enzyme. This leads to a condition called lactose intolerance, which is characterized by symptoms including abdominal pain, bloating, gas and diarrhea. Lactose intolerance is most prevalent in Asian Americans (up to 95%) and African Americans (up to 80%).

There are additional health concerns about milk that warrant further discussion. Milk and dairy products are the leading sources of saturated fat in the American diet. Dairy products like cheese and butter also contain a lot of cholesterol. We know that diets high in saturated fat and cholesterol increase the risks of heart disease and stroke. Cheese is particularly loaded with fat, usually accounting for about ¾ of the total calories. For example, one slice of cheddar cheese (110 calories) has nine grams of fat (81 fat calories) and 29 milligrams of cholesterol. Even the “low-fat” dairy products contain significant fat calories and saturated fat. The regular intake of dairy products also increases the risk of certain cancers, especially cancers of the reproductive system. In addition, frequent consumption of dairy products high in fat and calories makes successful weight management more difficult. (And we already know about all of the harmful consequences associated with being obese!)

Truthfully, the health benefit of a diet with high consumption of milk products has never been established. Dairy products contain a lot of vitamins and minerals that are important in a balanced diet. However, all of these nutrients can be obtained from other non-dairy sources that are more beneficial. Excellent dietary sources of calcium include greens (kale, broccoli, turnip greens, and mustard greens), tofu, colorful vegetables (like sweet potatoes), nuts and beans. Vitamin D can be obtained from mushrooms and the cold-water fish, especially salmon and rainbow trout. Supplements can also provide adequate intake for these micronutrients, especially if extra amounts are needed for medical conditions or deficiencies. (Once weekly Vitamin D supplements are particularly useful in this regard.)

The main reason that the USDA continues to recommend daily milk and dairy products is to meet calcium requirements for bone health. (Bear in mind that the dairy industry gives millions of dollars to members of Congress each year for influence over our national nutritional policy. Besides, something must be done with the milk and dairy products that are “subsidized” with your tax dollars!) However, experts in nutrition have started to question our true calcium needs as of late. One large analysis including more than 70,000 women followed for two decades found no evidence that milk drinking can prevent bone fractures or osteoporosis. Researchers have also discovered that countries with the highest consumption of milk paradoxically have the highest rates of hip fractures! These concerns (and more) were recently summarized in a review article entitled “Milk and Health” published in the New England Journal of Medicine. The authors of this paper, two prominent physicians from the Harvard Medical School, conclude that “the current recommendation to greatly increase consumption of dairy foods to three or more servings per day does not appear to be justified.” They explain that for individuals eating a high-quality diet, increased dairy consumption “is unlikely to provide substantial benefits, and harms are possible.” These doctors concur that calcium and vitamin D “can be obtained from other foods or supplements without the potential negative consequences of dairy foods.”

As we discuss in The Bite-Sized Guide to Getting Right-Sided, I believe we should all dial back our consumption of dairy products. I recommend avoiding milk and cheese as much as possible. Cheese has no nutritional benefit and is an unnecessary source of calories. (If you delight in eating pizza, ask for light or easy cheese!) If you enjoy drinking milk from time to time, I recommend switching to almond milk or soy milk. I changed from cow’s milk to almond milk at the beginning of my weight loss journey. I find almond milk is much easier to digest than cow’s milk. It also has much less calories and an improved nutritional profile including less saturated fat and cholesterol. Many brands of almond milk contain more of vitamins A, D, E and calcium than cow’s milk.

Despite what we’ve been led to believe, milk is not a nutritional requirement. You do not need milk to have strong bones. There are numerous sources of calcium that are much more wholesome than milk. Cow’s milk is meant for baby cows, not adult humans! If you want to learn more about beneficial food choices, please check out my book The Bite-Sized Guide to Getting Right-Sized!

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