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Raw deal: Got diarrhea?

I recently saw a 14 year old girl in my office with a 2 day history of severe abdominal cramps, bloody diarrhea, and fever. Her mother had similar symptoms as did several other members of her household and some family friends. After considerable discomfort, everyone recovered within a few days. The child’s stool culture grew a bacterium called Campylobacter.

Campylobacter is a nasty little pathogen which causes illness like that seen in my patient, but can also cause more severe disease. It is found commonly in both wild and domestic animals. But where did all these friends and family members get their campylobacter infections? Why, from their friendly farmer, of course!

My patient’s family and friends had taken a weekend pilgrimage to a family-run farm in Buck’s County, Pennsylvania. They saw farm animals and a working farm. And they all drank raw milk. Why raw milk? Because, as they were told and led to believe, raw milk is better. Better tasting and better for you.

In 1862, the french chemist Louis Pasteur discovered that heating wine to just below its boiling point could prevent spoilage. Now this process (known as pasteurization) is used to reduce the number of dangerous infectious organisms in many products, prolonging shelf life and preventing serious illness and death. But a growing trend toward more natural foods and eating habits has led to an interest in unpasteurized foods such as milk and cheese. In addition to superior taste, many claim that raw milk products provide health benefits not found in the adulterated versions. Claims made about the “good bacteria” (like Lactobacillus) conquering the “bad” bacteria (like Campylobacter, Salmonella, and E. coli) in raw milk are pure fantasy. Some even claim that the drinking of mass-produced, pasteurized milk has resulted in an increase in allergies, heart disease, cancer, and a variety of other diseases. Again, this lacks any scientific crediblity.

With this growing interest in unpasteurized dairy products has come an increase in the rate of food-born infections. The federal government developed the Grade ‘A’ Pasteurized Milk Ordinance in 1924, providing a set of guidelines for the safe processing and handling of milk products. Although all 50 states have voluntarily adopted these guidelines, the FDA has no oversight jurisdiction. It is up to individual states to determine their own safety protocols and enforcement strategies. While selling raw milk is currently illegal in 26 states, those with a will have found a way to skirt the law to get their fix of the real deal.

My patient was a victim of a recent outbreak in Pennsylvania, but similar outbreaks of infectious disease due to unpasteurized milk products are a recurring headache for public health officials. Between 1973 and 1993 there was an average of 2.3 milk born disease outbreaks per year. That number increased to 5.2 per year between 1993 and 2006. Whatever the numbers are, there is no question that the increasing consumption of raw milk is a genuine threat to public health.

The health claims made for raw milk, and against its pasteurized cousin, are being heavily pushed by a small but passionate contingent one might refer to as “food guardians.” These are people who espouse a return to the good old agrarian days of wholesome, farm-raised foods, free from man-made chemicals and mass-market processing. Some of these ideals are highly respectable and healthful responses to the ways in which society has dealt with the need to push products to a mass market at profit. For example, the use of pesticides, animal hormones and antibiotics, and farm run-off can have deleterious environmental and human health consequences. However, many of the health claims that are made about products like raw milk are not supported by scientific evidence, and lack scientific plausibility. Despite this lack of evidence, however, the allure of raw milk products is clearly on the rise.

Beyond the obvious public health consequences of this trend lies the problem of an increasing public credulousness when it comes to pseudoscientific claims. This is similar to the trend we are seeing regarding concerns about the dangers of vaccines and excessive fears concerning certain potential environmental hazards.

Unscientific and outright fraudulent claims about the health benefits (as well as the hidden dangers) of a variety of foods is on the rise. And bogus or unsupported nutrition claims are big business. From the immune boosting and weight loss powers of the acai berry, to the cancer protective effects of vitamins, nutrition pseudoscience is all the rage. While raw milk will never have quite the celebrity cache of these “super foods”, it is promoted with the same lofty yet empty claims, and provides the added bonus of infectious diarrhea.

On a recent visit to a local high-end wine shop, I came face-to-face with the ease with which people fall prey to the marketing of food pseudoscience. A woman was examining a bottle of wine when the store keeper approached to offer help. She told her a little about the wine and then said, “And all of their wines are biodynamic.” To this, the shopper exclaimed “Oh wow, that’s great.” She bought the wine, likely without having a clue what the term “biodynamic” even means. Biodynamic farming is a mixture of Gaia-like principles (the earth is a living organism) and organic practices, with a smattering of mysticism, alchemy, and astrology. In essence, a smorgasbord of pseudoscientific farming practices perfect for the current culture of armchair environmentalism and the new found heal-thy-self mantra of the well-to-do. While the motivating factors and socioeconomic status may differ between those drinking biodynamic wine and those drinking raw milk, both are relying on false beliefs and unsupported claims in making their choices to consume these products.

As a lover of cheese, I appreciate that there are those whose refined palates favor the delicacy of unpasteurized, aged cheeses so prevalent in other countries. But to stretch this taste preference to include health benefits unsupported by science and even common sense is not just misguided, it can be dangerous. Dangerous because it increases the risk of infectious disease, but also because it perpetuates a credulous perspective that adds to the ongoing erosion of our appreciation and acceptance of science.

Posted in: Health Fraud, Nutrition, Public Health, Science and Medicine

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46 thoughts on “Raw deal: Got diarrhea?

  1. Diane says:

    I didn’t see brucellosis mentioned. I think the romance of raw milk would quickly fade if this particular infectious disease were to make a comeback.

  2. Noadi says:

    Okay, now growing up in a family where there’s a lot of farming I’ve had unpasturized milk and cheese numerous times. My grandparents never even thought of the risks in giving it to all the grandchildren. None of us ever got sick, either from sheer luck or the fact it’s easier to keep 2-3 dairy cows healthy and clean than on a larger farm.

    Even with my experience I’d never give any young child raw milk. The risks are just too high and they’re more likely to get seriously ill than an adult. To ascribe some sort of health benefits to something with the risks raw milk has is so beyond stupid and dangerous I don’t know how to respond to that.

    By the way it does taste better not because it’s raw but because it generally has more cream than standard whole milk and homogenization changes the texture of milk. You don’t need homogenization for pasteurization so if you can find it try pasteurized un-homogenized milk, it’s wonderful once you get over the initial weirdness factor of milk that separated into layers that have to be shaken together.

  3. madder says:

    Wasn’t tuberculosis (whether due to M. bovis or M. tuberculosis) also one of Pasteur’s targets? I hope these people don’t become the source of a sufficiently large outbreak of tuberculosis that they affect the rest of us.

  4. Geek Goddess says:

    Good article – I have a number of friends who can’t separate ‘natural’ from ‘benign’.

    BTW – you use “it’s” only when you mean “it is”
    For possessive case, use “its” with no apostrophe, so for example you would write

    ‘ just below its boiling point’

  5. arclight says:

    From 1976-79 we occasionally bought raw milk in Bucks County and never had any trouble with it. While that’s no criticism of pasteurization, I have to wonder how the ‘cleanliness’ of milk has trended over the past 75 years or so and to what extent the common dairy farming practices of the day have had an influence. I don’t want to play that “food was so much better and safer when I was a youngin’” card but the worst food poisoning incidents I remember from that era were botulism outbreaks from canned mushrooms. Nothing as bad as today’s frequent salmonella outbreaks in nuts and vegetables.

    I don’t know if outbreaks just get more press today (like school shootings) or the likelihood of an outbreak hasn’t decreased to compensate for the growth in producers or if overall, food is simply more dangerous now. Paranoia sells papers though my impression is that over the past eight years the agencies charged with ensuring food safety were either being gutted, shuttered, or were simply asleep at the wheel.

    And while I don’t buy into the BS that pasteurization is a bad thing (at least compared with bloody diarrhea), I do take issue with UHT (ultra high temperature) pasteurization. UHT pasteurization is a major cost saver for dairies but wrecks the milk for making your own mozzarella; UHT milk won’t curdle properly and results in ricotta instead. This won’t matter to most people but it does call into question whether that watery whitish substance in the bottle can legitimately be called milk if one cannot make cheese from it.

    For taste, variety, and appearance, I’ll take “slow” food over ultra-processed least-cost crap food any day but I don’t think I should have to take on a substantial health risk to do so.

    I can understand why some people would take the risk on raw milk given the poor quality of most commercial milk and a poor understanding of the consequences of drinking unpasteurized tainted milk. This is yet another instance of market failure, educational failure and regulatory failure that has typified American life since at least 2000.

    Oh, fwiw, Bucks County is just northeast of Philadelphia; the other Campylobacter outbreaks occurred in Lawrence Country on the other end of the state. Are you sure this is part of the same outbreak?

  6. SD says:

    arclight:

    “From 1976-79 we occasionally bought raw milk in Bucks County and never had any trouble with it. While that’s no criticism of pasteurization, I have to wonder how the ‘cleanliness’ of milk has trended over the past 75 years or so and to what extent the common dairy farming practices of the day have had an influence.”

    The explanation I seem to recall hearing: changes in diet (sp. large amounts of cereal grains instead of grass) lead to changes in the cow’s intestinal flora, favoring the growth of some bacteria over others. Some of these bacteria are the “harmful” sort. Since a cow is topologically a torus without a convenient dividing line between “butthole” and “milkhole”, some of these bacteria wind up in the milk, from which they wreak mischief if not exterminated by pasteurization. Factory farming exacerbates this problem, partly by mass production, and partly by the standard practice of pasteurization itself; if you expect that the nasties are going to be taken care of by flash-heating the milk, you don’t have to worry quite so much about keeping your milking operation as clean as you would otherwise.

    Never having had my hand up a cow anus or on a cow udder, and therefore having no information with which to judge the truth of this statement, I cannot say for certain that this is the case But it does pass the basic smell test; different stuff encourages the growth of different bacteria, and cows didn’t evolve next to corn fields, so the practice of feeding cows large amounts of cereal grains instead of the usual grasses may well participate in this problem. (I defer to any ag-science types.)

    Pasteurization could also plausibly be expected to Do Stuff to the various proteins and fats in the milk, thereby explaining the different health effects allegedly reported from drinking “processed” milk vs. raw milk. (Again, take this with a large grain of “Hell, I dunno”.)

    “moo”
    -SD

  7. wertys says:

    Drinking raw milk is dumb. Might as well eat potatoes with dirt all over them or drink beer that’s been brewed in a bathtub. the barnyard aromas are supposed to be a warning of faecal or other contamination.

    WRT how things were in the ‘old days’ may I submit that is a good example of survivorship bias ? Arclight never saw anyone get sick because people who got sick didn’t do it in public. Because you never saw it doesn’t mean it didn’t happen. Better evidence could come from public health data about rates of proven infection, then vs now.

    I do definitely agree that food seems better when it has not been subjected to interventions which change the taste or other qualities of it (drink a cask-strength unfiltered single-malt scotch and you’ll notice it straight away) but this is largely a matter of taste, and all food needs to be rendered safe for consumption. As well, any meal you lavish attention upon will taste better, and even though I’m well aware of my cognitive bias in doing so, it doesn’t mean I can’t enjoy it ! Slow-cooked morrocan lamb shanks….*drools*.

  8. Prometheus says:

    It’s been a very long time since I was involved in agricultural microbiology (not since I was on staff at Moo-U), but there were (maybe still are) states that allowed “certified dairies” to produce and sell raw (or at least unpasteurized) milk and milk products.

    The idea behind “certified dairies” is similar to “state inspected” brothels – inspection and quarantine. The “certified dairies” were inspected periodically (much more frequently than dairies that pasteurized their milk) and the milk and milk products would be frequently checked for pathogenic bacteria. If a “red flag” came up, the dairy would pull all the product since the last “clean” inspection and could not ship anything until the tests came back OK again.

    Of course, the “certified dairies” were fanatic about cleanliness because they knew that one slip-up would not only cost them a couple days worth of production but could also scare people away from their product.

    Regular dairies were slightly less obsessive because they knew that their cleanliness procedures (washing the udders prior to and after milking, inspections of the herd, sterilizing all milk-handling equipment, etc.) were “backed up” by pasteurization.

    I imagine that SD hasn’t been in a diary, because even the “non-certified” dairies know that their milk is being checked for bacterial contamination. All it takes is one culture to come back “positive” and they can’t sell their milk to anyone until they can show that they’re “clean”. As a result, every dairy I’ve been to is exceedingly clean, especially for someone who grew up on a cattle ranch (for meat, not milk).

    As for the cereal diet changing the intestinal flora of dairy cattle, I’d be interested in seeing the data on that. Microbial ecology is an interest of mine and I don’t recall anyone showing that the gut flora of cattle – with respect to potential pathogens – changes with a transition from grazing to cereal feeding. It would be easy enough to test, since cattle generally graze until they are sent to the stockyards, where they are switched to a grain diet to fatten them up.

    Tuberculosis, brucella, listeria, campylobacter, and E. coli O157:H7 can all be found in raw milk.

    I’ll have mine pasteurized, thank you.

    Prometheus

  9. Interesting.

    A random USMLE step 2 factoid, for everyone’s benefit: in addition to infectious diarrhea, Campylobacter infections are associated with Guillain-Barre Syndrome.

    Per NEJM, 26% of patients w/Guillain-Barre or Miller Fisher (n= 96, n=7 respectively) vs 2% or 1% in control groups had evidence of recent Campylobacter infection.

    Guillain-Barre associated with Campylobacter infection was also associated with worse disability at 1 year, and poorer prognosis overall.

    Reference:
    http://content.nejm.org/cgi/content/abstract/333/21/1374

  10. SD says:

    Prometheus:

    “I imagine that SD hasn’t been in a diary, because even the “non-certified” dairies know that their milk is being checked for bacterial contamination. All it takes is one culture to come back “positive” and they can’t sell their milk to anyone until they can show that they’re “clean”. As a result, every dairy I’ve been to is exceedingly clean, especially for someone who grew up on a cattle ranch (for meat, not milk).”

    Nope, never been in a dairy. Thanks for the clarification.

    I report only what I seem to recall hearing as an explanation for the raw milk vs. processed difference, and make no statement about its accuracy or lack thereof. Take it out on them, not me. >;->

    “make mine processed, please”
    -SD

  11. gkoenig says:

    Sadly, I think the raw milk and other fads are a reaction to the misuse of scientific information by large agribusiness companies, drug companies, and others. By massive publicity campaigns to promote their products, laden with half truths, misrepresentations, etc., (all in the interest of maximizing profits without regard to the good of the public), they have acted to destroy the public’s faith in science.
    I heard a representative of a large agribusiness concern on the radio say something to the effect that “there is no scientific evidence that organic produce is any better for you.” Well, perhaps that is a true statement, but the way it is worded, the campaign it is part of (to destroy faith in organic farming), acts to confuse and demoralize the public rather to inform it. Real science is the process of asking questions, not trying to insinuate that the case is closed! How good is our science today compared with 40 years ago? Better? OK, how much better will it be 40 years from now? Too often I hear science used as an excuse to say that “we now know everything there is to know” Nonsense! Organic produce may be fabulously better for you than conventionally grown stuff. The answer is, we don’t know yet. It may be years before we know. The answer is, let’s keep an open mind! Let’s keep asking the questions! Scientific method is about putting your biases to one side and moving forward with an open mind.
    Of course, meanwhile, whether or not organic produce is better for me to eat, there is little question that it is better for the soil, other life on the planet, etc. So the words of that agribusiness representative are even more reprehensible because they are human centric. We are intimately connected to the biosphere. Our health is directly connected to the health of the soil. Anything we can do to bring this point home to the public is worth it, even if “there is no scientific evidence that …” at the moment.
    So, I blame industry for this. For cheapening our food by over-processing, adding toxic or untested ingredients, etc. and then claiming that ‘science proves this is all safe.” Of course people are running in the other direction in the face of this distortion, … right into the arms of the raw milk farmer. They are running to escape the lies and distortions of big business that has claimed that ‘science is on their side’ for years by now. For example, watch what happens with sucralose (Splenda) in a few years with its hydrocarbon with covalently bonded chlorine. People are eating this stuff? I promise you it will be a disaster. OK, by strict scientific method, “there is no scientific evidence that …” but clearly that’s because there has been insufficient investigation! That’s because big money pushed the approvals through. But even without direct evidence, the carcinogenic properties of other covalently bonded chlorinated hydrocarbons should give us pause, right? I’m disgusted that we allow this to continue.

  12. vargkill says:

    Im by no means an SBM nutt hugger, but even i can admit
    that drinking raw milk is a bad idea!

  13. HCN says:

    By the noodles of the FSM, was that vargkill? He seems to be climbing out from under the bridge!

  14. Every time I read an article like this one, I want to pull the hair out of my head, strip off my clothes, and run down Santa Monica Blvd. naked. Save for the fact that probably no one would notice, I calm down, down a glass of wine (pasteurized, I presume), and think how crazy is the world.

    People reject the vast science of vaccines and listen to Jenny McCarthy. Then they go drink raw milk, despite the vast science supporting pasteurization.

    Not being an expert on modern evolutionary synthesis, but are they reducing their fitness, so that smarter and more logical individuals will pass their genes onto the next generation?

    Please please please tell me natural selection works at this level.

  15. gimpyblog says:

    Hmmm, I won’t eat pasteurised cheese on the grounds that it is a vile affront to my palate.

    I think you go too far in your arguments, while obviously there is more health risk associated with unpasteurised products you can’t use that as justification to deprive people of the choice to eat them, regardless of their motivations for doing so. Just acknowledge the risk and let them think for themselves.

    PS The French, those lovers of unpasteurised cheese and wine, have better health outcomes than the USA per capita.

  16. gimpyblog says:

    I’ll just add that cheese is made with bacteria and fungus so worrying about the pasteurisation or not seems a little odd. Would you ban Camembert or Roquefort because of the risks of Listeria?

  17. durvit says:

    I have no time for the alleged health benefits and believe that they do not have any evidence to support them and accept that there are strong reasons to deprecate the safety of raw milk.

    With cognitive dissonance to the fore, I could give up chocolate more readily than I could unpasteurised cheese. And if you knew how much I look forward to my 2-3 squares of chocolate several days a week you would realise that I don’t say that lightly.

    I don’t smoke or drink alcohol. I wear a seat-belt. I cycle with a helmet. I adopt all manner of sensible, evidence-based approaches to many aspects of my work and lifestyle.

    I choose to eat unpasteurised cheese. I wouldn’t give it to a child, elderly person, pregnant woman or anyone with a compromised immune system. I even store it separately so that there is a minimised risk of cross-contamination. But, I will continue to eat unpasteurised cheese because otherwise you may as well be eating plastic.

    It is surprisingly easy to find salmonella in nuts, vegetables and various cereal flours. I skirt round social niceties to avoid accepting food and drink from some people because I have profound mis-givings about their food storage and preparation practices or I spot rodent droppings in their kitchen and they offer me something that has neither been securely stored nor washed.

    I don’t eat that much processed food (except for tinned tomatoes) so I’m not exposed to the contamination issues related to those products: Food Companies Are Placing the Onus for Safety on Consumers .

    “You don’t assume these dangers to be right in your freezer,” said Mr. Warren, who settled with ConAgra [about a claim involving food poisoning from a pot-pie]. He does not own a food thermometer and was not certain his microwave oven met the minimum 1,100-wattage requirement in the new pot pie instructions. “I do think that consumers bear responsibility to reasonably look out for their well-being, but the entire reason for this product to exist is for its convenience.”

    It’s a personal risk assessment.

  18. John Snyder says:

    Geek Goddess: Thanks. You are correct!

    arclight: I linked to the wrong page. My patient was a part of the Buck’s county outbreak in September, 2008. I’ll make sure to correct this in the post. Thanks.

    gimpyblog: I never said or implied even that raw milk should be illegal. I simply pointed out the unscientific claims being made for it and against the pasteurization process. As I said, I myself am a lover of all cheeses…Also, the organisms responsible for the fermentation of milk products like cheeses are generally not pathogenic when ingested. Salmonella, campylobacter, E.coli, mycobacteria are not among them.

  19. Jojo says:

    @gkoenig. You stated that there is no question that organic produce is better for the soil. This is not true. Organic farming produces lower yielding crops and therefore requires more land to produce the same amount of food. This requires the use of more land for farming and puts more of our limited top soil resources at risk and will accelerate desertification across the global. I agree that there are benefits to organic farming, but preservation of soil is not one of them.

  20. desiree says:

    this is the third time i’ve tried this comment! is SBM always this weird about posting comments?

    anyway:

    For example, the use of pesticides, animal hormones and antibiotics, and farm run-off can have deleterious environmental and human health consequences.

    i’ve been trying to ask the author whether they believe organic produce and foods and hormone-free meats and milk are actually healthier. i didn’t think the evidence supported a difference between treated and untreated milk, and i thought that health benefits for organics were similarly unproven.

  21. Jules says:

    Heh, if you only knew the conditions most dairy cows live in, you wouldn’t drink milk at all. One must wonder why pasteurization is necessary at all to begin with–surely the cows’ living conditions must have something to do with it.

    I make my own yogurt from normal whole milk, but I must confess that, risk of bacterial infection be damned, I’d happily pay an arm and a leg to make it out of raw milk. Yogurt is delicious as I make it–with raw milk it must taste like nothing short of heaven. My understanding of the safety question is that the risks are minimalized the sooner you drink it out of the cow, so if I were to try this crazy route I’ll find a friendly farmer first.

    I do, however, feel like we scare ourselves helpless when it comes to bacteria–only to be astonishingly cavalier about the REAL germs. People who studiously disinfect the restaurant’s tableware, for instance–and then order a rare burger.

  22. Dacks says:

    Where I live, a lot of the push for raw milk comes from proselytizers of Weston Price’s “findings.” He was a dentist who traveled during the mid 1900′s and decided that the health of the native people was determined by their diet, which did not include access to processed sugar and other processed carbohydrates (not a wholly unreasonable conclusion.) However, he extrapolated from that to an entire philosophy of diet which includes ideas such as pasteurization killing “good” enzymes, and soy consumption being the source of disease, etc.

    At any rate, this group is gaining in popularity, particularly among naturopaths.
    http://www.westonaprice.org/

  23. James Fox says:

    Naturalism has clearly become some kind of religion that requires its followers to hold onto ignorance and shun modern scientific ideas that could stain their pure and natural selves. Almost every religion, cult and sect has had this notion as a founding premise in some manner. Historically facts and reliable evidence have only been minimally effective in combating this type of belief system. The world view and nature of beliefs that lead to dangerous thinking need to be addressed as well as the specific faulty ideas or practices.

  24. Karl Withakay says:

    gimpyblog: “PS The French, those lovers of unpasteurised cheese and wine, have better health outcomes than the USA per capita.”

    Those two facts may or may not be related in any way. It is possible that the French health care system is better able to deal with their possibly greater number of food borne diseases.

    It’s a logical fallacy to assume that just because a given nation has better health care outcomes than the US, that all aspects of that nation’s health care practices are therefore superior to those of the US.

    Correlation neither equals causation nor does it prove an actual relationship.

  25. mdiehl says:

    Several posters have alluded to unpasteurized cheeses. Can anyone direct us to studies about the incidence of illness in France related to this?

  26. gimpyblog says:

    Karl Withakay

    Those two facts may or may not be related in any way. It is possible that the French health care system is better able to deal with their possibly greater number of food borne diseases.

    It’s a logical fallacy to assume that just because a given nation has better health care outcomes than the US, that all aspects of that nation’s health care practices are therefore superior to those of the US.

    Correlation neither equals causation nor does it prove an actual relationship.

    Of course. But I did not claim that France was superior in all ways, my point, which I did not make, was that worrying about raw milk should really be so far down the list of valid concerns of the US healthcare system as not to warrant much debate. Yes the raw milk people are wrong about the health benefits, yes the foodies are right about the taste. Just because some people want to justify their right to drink raw milk with nonsense does not mean people should be critcised for drinking raw milk.

  27. LovleAnjel says:

    With unpasterized cheese, I am under the understanding that over the years it takes for the cheese to develop (I’m talking proper cheese here), the ‘good bugs’ do indeed push out the ‘bad bugs’ (my expertise? I watch the food channel). But, of course, raw milk doesn’t have all that time to develop a ‘balanced ecosystem’, so it can be chock-a-block with your friend and mine, dysentary.

    How many of these ‘raw milk’ people refuse to give their babies natural honey?

  28. weing says:

    I thought the milk was pasteurized and the cheese cloth has the good bacteria/fungi that give the desired flavor or the micro-organisms are added to vats.

  29. John Snyder says:

    desiree:

    You are correct that there is little good data regarding health differences between organic and non-organic foods. However, there is some evidence (and biological plausibility) for adverse effects of prenatal exposure to pesticides, and we have validated markers of maternal pesticide exposure in newborn meconium and cord blood. Although most data relate to occupational exposures during pregnancy, there is some evidence to support the precautionary principle. That said, this often leads to more public fear and concern than is warranted.

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1241770

    http://pediatrics.aappublications.org/cgi/content/abstract/117/3/e546

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1867968

    http://www.ncbi.nlm.nih.gov/pubmed/11527224

    http://www.ncbi.nlm.nih.gov/pubmed/16451864

    http://www.ncbi.nlm.nih.gov/pubmed/18414640

    http://www.ncbi.nlm.nih.gov/pubmed/18332717

    gimpyblog:

    I absolutely told the family who contracted Campylobacter from their raw milk consumption that I recommend they NOT to do it again. Any other recommendation would have been irresponsible. They had no problem with this advice.

  30. Karl Withakay says:

    gimpyblog,
    I see your point, but it’s not like a disproportional amount of effort and attention is being focused on the raw milk issue.

    It’s important that people understand the real risks and lack of proven benefits of consuming raw milk so they at least can make a truly informed decision.

    It may be relatively far down on the list of health priorities to address, but it’s also relatively low hanging fruit. To ignore the low hanging fruit is to risk letting them all accumulate and risk death by a thousand paper cuts. I know that’s essentially a slippery slope argument, but they’re not always fallacious.

    Homeopathy, acupuncture, chiropractic for anything but lower back pain, questionable dietary supplements, various unsupported recommendations about diet (such as raw milk), fad exercise machines that promise a full workout in 5 minutes, reiki, craneosacral, therapeutic touch: any of these things or anything that falls under these categories, by itself individually may not seem worth much attention, but together they constitute gestalt of unscientific health practices that is stronger than the sum of its parts.

    Sometimes it is easier to whittle away at the monster than it is to attack it head on; sometimes you need to focus your effort on the monster directly, and sometimes you need a combined approach.

    “Just because some people want to justify their right to drink raw milk with nonsense does not mean people should be critcised for drinking raw milk.”

    I disagree; we should feel free to criticize those people if we want to, both those who are (willfully or otherwise) ignorant of the science and are basing their decision on unscientific woo and those who make their decision in full understanding of the scientific facts.

    Public criticism is one of the great freedoms we enjoy in a society of bountiful liberties.

    We should even feel free to be insolent in our criticism, if still respectful.

  31. Jules says:

    @ karl:

    we should feel free to criticize those people if we want to, both those who are (willfully or otherwise) ignorant of the science and are basing their decision on unscientific woo and those who make their decision in full understanding of the scientific facts.

    Please. Drinking raw milk is a calculated risk, and for those of us who value experiences beyond normal, it’s one that’s worthwhile, like skydiving. The risk of illness is marginal, and probably lower than my risk of getting swine flu on public transit (going by one popular estimate that 500,000 people partake of raw milk). If you eat sushi, enjoy a rare steak, keep an indoor/outdoor cat (all pet cats should be indoors), eat fast food, shake someone’s hand, handle cash, use a gym, don’t wash your hands after using a public restroom (statistically, men are far worse than women, who are bad enough)–these are all perfect ways to get something nasty or end up dead or injured, so going by your logic everybody who does any of these things are idiots.

    I don’t doubt that drinking raw milk is more risky (I put it on par with eating at McDonald’s, for chances of getting a food-borne illness). And I think the woo surrounding it–it’s better for you! it’ll cure your cancer!–is ridiculous. But I think that, if you just like the way it tastes and can live with the consequences–well, why should you be subjected to any more ridicule than the idiot who lets his cats run outside? The levels of self-righteous indignation here are incredibly rampant, and appears to be inversely proportional to the ability to objectively assess risk.

  32. Jurjen S. says:

    Quoth gkoenig:

    Sadly, I think the raw milk and other fads are a reaction to the misuse of scientific information by large agribusiness companies, drug companies, and others.

    I’m more inclined to think it’s because those of us who don’t take an active interest in this sort of thing aren’t aware of the damage that used to occur before processes like pasteurization, and yes, vaccination, became widespread. We’ve never seen tuberculosis, transmitted through unpasteurized milk, tear through an inner-city population, like used to happen with appalling frequency in London only a hundred-odd years ago. A dwindling number of us have experienced measles or mumps or whooping cough, or had friends or co-workers disabled or killed by meningitis. And because we don’t fully understand the dangers things like vaccines and pasteurization protect us against, we question the need for them.

    Quoth Jules:

    Heh, if you only knew the conditions most dairy cows live in, you wouldn’t drink milk at all. One must wonder why pasteurization is necessary at all to begin with–surely the cows’ living conditions must have something to do with it.

    Not really. No amount of hygienic milking practices is going to stop pathogens like tuberculosis and brucellosis getting from inside the cow into the milk and thence into you.

    Quoth Prometheus:

    I imagine that SD hasn’t been in a diary, because even the “non-certified” dairies know that their milk is being checked for bacterial contamination. All it takes is one culture to come back “positive” and they can’t sell their milk to anyone until they can show that they’re “clean”. As a result, every dairy I’ve been to is exceedingly clean, especially for someone who grew up on a cattle ranch (for meat, not milk).

    And then there’s places like Dee Creek Farm in Woodland, WA:

    Lab testing confirmed that the E.coli O157:H7 that sickened people did originate from Dee Creek Farm, who illegally sold raw milk without required WSDA Milk Producer and Milk Processor licenses and sanitary public health inspections.

    Investigators found numerous sanitary violations as well as the presence of E.coli in the following areas:

    * A partially filled gallon container of milk provided to Clark County via a shareholder.
    * Individual cow milk samples that were provided to WSDA by Dee Creek Farm.
    * Environmental swab samples that were collected on the Farm, specifically:
    o Topside of rubber mat in milking area, beneath where cows are milked.
    o Holding pen mud-pack/pasture at entrance to milking area.
    o Mud on the ground just inside the door to the milking area.

    The operators of Dee Creek Farm tried to get around licensing requirements by selling “shares” in their cows, thus pretending that they weren’t selling the milk. Of the 18 people infected with E.coli, several lived in Oregon. Even though selling raw milk (with a license) is legal in Washington, selling across state lines is a no-no.

    I’m frankly amazed the place is still in business, though mind you, they don’t appear to have cows anymore.

  33. desiree says:

    thank you for those links!

  34. Karl Withakay says:

    Jules,
    It’s may be a calculated risk if you have all the necessary facts, or it may be an estimated risk for someone else who doesn’t. I believe the individuals in the story in this post didn’t have the facts when they made their choice.

    Please set aside the straw man, I never called anyone an idiot. I said I have to right to criticize someone. I’ll also say you have the right to criticize me for my criticism. I can criticize someone without out calling them an idiot, like I am doing now with you.

    Do you have any references or links to support your “popular estimate” or any clarification for what constitutes someone being counted as one who “partakes of raw milk” (that is, does someone who drinks 1 cup of raw milk once a year get included in that number along with someone who drinks 4 servings a day, every day?) The number that is really of interest anyway is the relative risk or rate of incidence, such as in the odds that one drink will result in illness.

    Do you have any data to support your assertion that drinking raw milk carries the same degree of risk for food borne illnesses (either in statistical risk or severity) as eating at McDonald’s?

    You’ve essentially made the claim that all the risks you listed are equal, so if you expose yourself to one, you may as well expose yourself to all. Even if all risks were equal, some risks are more avoidable and less necessary than others.

    A well informed person might make their own personal judgments on which risks they choose to avoid and which they choose to embrace, as would usually be their right in the absence of an overriding public health interest (such as risks that could expose others to a contagious disease). I might then criticize their reasoning, as is my right, preferably using well reasoned, logical arguments.

    It doesn’t mean I expect everybody else to think I’m right and they’re wrong, just that I disagree with their choice and want others who may not have made up their minds to understand my reasoning.

  35. gkoenig says:

    Jojo said:

    Organic farming produces lower yielding crops and therefore requires more land to produce the same amount of food.

    I don’t doubt that this is true, on average. But your comment ignores the damage done to soil and organisms, indeed, the entire food chain, by toxic chemicals used to produce those higher yields. And let’s not forget the production of those chemicals in factories that often have large amounts of waste to dispose of. Although these waste products are not applied directly to soil used for farming, they end up in the biosphere somewhere else.

    Perhaps, by ‘soil’ I should have included ‘atmosphere’ and ‘water’ etc. I’m thinking large here. We use the term “throw [something] away” on a daily basis. But in fact, “away” doesn’t exist. Away from me is always thus closer to something else.

    To return to the main point, I do not agree that the mere presence of agriculture results eventually in deserts. Rather, it is exactly the quality of that agriculture, the whole of the practices used that make the difference. I contend that it’s possible for human beings to feed ourselves and at the same time maintain soil, water, and air in a healthy state for the entire ecosystem. No it’s not necessarily easy. It’s easier to spray some toxic chemical to kill the weeds and bugs and be done with it. I say that is just borrowing time before the damage that does comes back to haunt us. Perhaps after it’s too late to repair. The biggest threat, perhaps, given that, is overpopulation. And, alas, I have no easy answers for that, either.

    The best use of science, in my book, is to use it to discover how natural processes already work and to align our human designed agriculture with those natural processes as much as possible.

  36. BlueMonday says:

    I think that statements such as “drinking raw milk is dumb” are a bit unfair. I think a more appropriate statement would be “consuming food/drink of questionable safety is dumb.” Contaminated raw milk is dangerous–not raw milk. I understand, of course, that many people don’t have a way to test the cleanliness of their milk, so it may seem like a decent assessment, but it is inaccurate nonetheless.

    I am lucky to live in a place with a certified raw dairy, so I have assurance that when I chose to drink their raw milk, it’s clean. However, I still know people around here who pull up to a farmer’s house, get out their gallon-sized glass jar, and have him fill it up. That, I will not do. He may be a nice ol’ country boy, but that does not mean I can be sure his milk is safe.

    Sally Fallon, the founder of the Weston A. Price Foundation, is a real nut case, and she’s responsible for a lot of the bizarre extrapolations from his work. She calls raw milk “magic medicine.” I knew a woman who subscribes to their mantra, and she believed her son’s cleft palate was due to her lack of raw milk consumption during pregnancy. I mean, I drink it, but that’s because it tastes better and I can support a local farmer who is playing by the rules and keeping his nose clean. Hyperbolic claims like Fallon’s are frustrating and dangerous.

  37. Harriet Hall says:

    I think the correct statement is “drinking raw milk is risky.” If you understand the facts and choose to take the risk, that doesn’t make you dumb. It just means you are willing to accept a greater degree of risk than most of us. If you are told the facts and are unable to understand them, that might mean you are dumb – or uneducated.

  38. BlueMonday says:

    “Drinking raw milk is risky” does sound better. I’d avoid it if I were part of a higher-risk segment of society, even with the dairy’s certification. I probably wouldn’t stop eating raw cheese, though. The risk/benefit ratio falls strongly in its favor.

  39. dohashi says:

    I thought I’d point out that raw milk cheeses are just as able to harbour dangerous bacteria as raw milk itself. Although in theory cheeses are made with good bacteria that can out compete the bad ones, there can still be enough of the bad ones left to make people sick:

    http://barfblog.foodsafety.ksu.edu/tags/raw-milk-cheese/

  40. clgood says:

    I had raw milk once, at a dairy farm that I trusted.

    Man. That was the tastiest glass of milk in my entire life. By a large margin.

    (Yes, the extra cream no doubt gets much of the credit.)

    It was a calculated risk, not a “health benefit.” I would no more buy raw milk, especially from someone making health claims for it, than lick ashtrays.

  41. TsuDhoNimh says:

    I grew up drinking unpasteurized milk … until half the kids in town all came down with scarlet fever. They all drank milk from the same local farm and the bacteria contaminated the milk.

    We got our milk from a different farm, but the health department landed on all the milk producers like a ton of bricks and everyone switched to pasteurized milk.

    Yes pasteurized (even if unhomogenized) milk tastes different.

  42. jimibellson says:

    My family and I drink 5 gallons of raw milk a week. We’ve been doing so for about 10 years. Not only have we never been sick from the milk, we’ve never had diarrhea or vomiting from any flu or illness. I made sure that our farmers are testing their milk and I’ve seen them milk many times, they are meticulously clean. I have no fear about getting sick from their milk. As a matter of fact, I have seen health benefits. I used to get sick about 4-5 times a year (mostly colds) until I began drinking raw milk. I have not had a flu since and I probably have had 2 colds, in 10 years. And in case you’re wondering, I didn’t change anything else in my diet.
    I know this is anecdotal, but it works for me and my family. My kids never have to miss school. All the kids around them are catching all sorts of things and mine haven’t so far (3 and 7 yr olds).

    The rate of food-borne illnesses is about 25% in the US and less than 1% of that from all dairy products. For raw milk about 60 cases of illnesses are reported a year (probably exaggerated) from an estimated 500,000 raw milk drinkers (probably underestimated). There were 21 beef product recalls in 2007 alone. In 2003 the FDA/USDA/CDC (Listeria Monocytogenes Risk Assessment) found there were 500 times more illnesses from L. Mono due to deli meats per year than raw milk and 29 times more L Mono illnesses from pasteurized milk than raw milk. As for TB, as long as the farmer doesn’t have it my milk won’t have it. TB cases in milk came from the handlers, not the cows. If you’re worried about getting sick from raw milk you better stop eating because you have a 1 in 4 chance of getting sick from mostly other foods.

    Who doubts the benefits of enzymes? And probiotics? And Vitamin C? Raw milk is packed with nutrients, most of which are destroyed with pasteurization. I don’t think there is any magic involved, just nutrients.

    I also would like to suggest that there are people out there who don’t rely completely on science to make their decisions for them. Yes, I suppose if you’re a scientist you may find this reprehensible but it takes all kinds in this world and it may enhance your work if you come to terms with that. Much of the research I’ve looked at for all sorts of issues leaves more questions than answers. Vaccinations, raw milk, chemotherapy, cholesterol and heart disease, vegetarian diet vs. meat-eaters, etc. I have yet to see any definitive answers on many burning questions, but I have seen lots of biased work done by those with an agenda or a paycheck at stake.

    So, what’s a modern day woman to do? I guess what humans have been doing since the beginning of time. Rely on our, oh my gosh, we do have them, instincts.

    If I were to have listened to the doctors when it came to giving birth I would have ended up with a C-section (like 30% of women in the US). Instead I relied on my instincts and had a perfectly healthy childbirth experience with a midwife.

    I see that many people here shun this sort of lifestyle but I don’t see any fabulous health benefits from following mainstream practices. I see mothers broken by their terrible childbirth experiences, babies who can’t breastfeed as a result, more families shattered from vaccinations (and we don’t really know why because no one will do the proper research in an objective manner), asthma, obesity, diabetes, autism, heart disease, cancer and many more on the rise, rise, rise. Excuse me if I question modern health science funded by big business. Yes, we’ve gotten good at developing medicine to supposedly fix things but how about taking a more holistic and preventive perspective on many of these problems?

    Until I see thousands of people dropping dead from drinking raw milk I’m going to keep on drinking it in large delicious satisfying quantities.

  43. jimibellson says:

    I can’t help it. This article really bugs me.

    I don’t see any cause for concern from what was written in this article. I don’t see any alarming statistics.

    “Between 1973 and 1993 there was an average of 2.3 milk born disease outbreaks per year. That number increased to 5.2 per year between 1993 and 2006. Whatever the numbers are, there is no question that the increasing consumption of raw milk is a genuine threat to public health.”

    First of all, these numbers are paltry compared to the numbers of other food-borne illnesses. Second, I see from your reference that there were 47 deaths, 17 deaths from PASTEURIZED milk! And 30 deaths from a specific Mexican-style raw milk cheese. This cheese came from a factory, not a farm meaning there could have been countless opportunities for contamination. A crucial point when considering that all of the 27 dairies supplying the raw milk for the cheese were tested and there was no listeriosis found in the herds or the milk. This is a prime example of how the news headlines don’t tell the whole story. Of those “outbreaks” from raw milk, if you look at each one there are multiple inconsistencies. Not to mention lies and inaccurate and inconclusive testing.

    Is this supposed to scare me? It has nothing to do with me, because I don’t consume pasteurized milk and I don’t eat cheese from a factory. If pasteurization is the answer to all of our milk nightmares, why doesn’t it prevent the deaths?

    And last but not least, what kind of a statement is, “Whatever the numbers are, there is no question that the increasing consumption of raw milk is a genuine threat to public health.” You are getting down on people for following so-called pseudo-science and you (who have a greater responsibility to write accurate unbiased information than the average consumer, I’m sorry to say) are doing exactly that. “Whatever the numbers are..”

    If you want to talk about “genuine threats to public health” don’t you suppose there should be a long, long list of things that go way before something that ALLEGEDLY occasionally causes diarrhea? Uh, let me see, obesity, diabetes, smoking, eating trans-fats, heart disease. 2/3 of adult Americans are on some form of medication. There is only state in this country that has an obesity rate lower than 20% (Colorado), if you take into account overweight people the national rate is about 65%! 8% of our population has diabetes and another 60 million people are either undiagnosed or have pre-diabetes!

    We are a nation of sick, fat people and you are scaring people about raw milk?

    Will you please add peanuts, tomatoes, spinach, factory-produced meat and chicken, and a whole slew of other foods to your list of foods that are a genuine threat to the public health? At least be fair about it.

    And, since you are so concerned about pseudo-science I do hope that you ruled out other possible causes of the campylobacter. Did you test the milk they drank? Did they touch other animals on the farm? I am sure you did or else you would not be making such claims. That wouldn’t be very scientific. Remember, you are the one with the responsibility to provide accurate and unbiased information.

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