White Coat Underground

Joe Mercola’s website has always been a “target-rich environment” for quack hunters. His rants against vaccines, his incorrect flu information, his support of homeopathy, and just about everything else at his website comes free of evidence and full of unfounded assertions (as well as some seriously side-splitting giggles).

But his latest post up at—where else?—the Huffington Post is patently dangerous. It is entitled, “Why You Shouldn’t Drink Pasteurized Milk”. If he had gone into the high caloric content of milk, the possible uses of alternative sources of calcium and other nutrients derived from milk, etc., it might have been an interesting piece. But instead it is a plea to drink “raw” (unpasteurized) milk. To those of you who already do this, I apologize for my next statement; it’s aimed not at you but at professionals who should know better:

WHAT A FEROCIOUSLY STUPID IDEA!

Pasteurization is the process of heating milk to a temperature that kills most of the pathogenic (disease-causing) bacteria. And milk, no matter where it comes from, is a great medium for growing pathogenic bacteria. Since pasteurization became common in the U.S., milk-related illnesses have dropped from about 25% of food-borne illnesses to almost none. That’s a good thing. And that was back in the day when the milk came from small family farms, the very places that raw milk enthusiasts say we should get our milk from to avoid illness.

The toll from raw milk

According to the CDC:

During 1998–2005, a total of 45 outbreaks of foodborne illness were reported to CDC in which unpasteurized milk (or cheese suspected to have been made from unpasteurized milk) was implicated. These outbreaks accounted for 1,007 illnesses, 104 hospitalizations, and two deaths (CDC, unpublished data, 2007). Because not all cases of foodborne illness are recognized and reported, the actual number of illnesses associated with unpasteurized milk likely is greater.

Here is a brief rundown of what raw milk has done for us in the last few years:

Pennsylvania, 1994, 29 people sickened by Salmonella, more than half children under 7.
Pennsylvania, 1983, 57 people sickened by Campylobacter.
Washington State, 1999, 54 sickened by multi-drug resistant Salmonella from raw milk cheese

And that’s just a sample. We also have E. coli, Listeria, Brucella—raw milk makes people sick. Very few outbreaks have been conclusively linked to pasteurized milk (I found one report, but it lacked the rigor available with current genetic testing.)

The benefits of raw milk

From a rhetorical standpoint, it’s not possible to prove a negative. It may be that somewhere, somehow, some day, a preponderance of the evidence will show dirty milk to possess significant benefits unavailable from pasteurized milk. If that does happen, there will presumably be a push to make raw milk safer via some technology, such as irradiation. But current evidence shows no benefits from raw milk, and plenty of risk. There are no benefits to weigh against these substantial risks. Additionally, there are no recorded risks introduced by pasteurization. So why not do it?

There is no rational, evidence-based response. Consumers who choose to consume raw milk are taking big risks, but these risks are usually taken out of ignorance. But when a doctor such as Mercola recommends it, it is a dangerous abuse of his power as a professional. It is reckless. It is stupid. It endangers public health. He should be ashamed.

But of course, he has no shame.

Comments

#1 locutus13
June 3, 2010

The stupid it burns!
From the post where Mercola was voted #10 game changer; if quacks could fly HuffPo would be an airport. Like I said the inmates are in charge of the asylum.
#2 RJ
June 3, 2010

“But of course, he has no shame.”

Ne he doesn’t. But he does have a very lucrative business and an effective marketing system (HuffPo).

This guy advocates a religion, based on a faith they want to believe as true. Not on evidence, not on fact. I can only hope he is held accountable for his poor advice as he represents himself as a physician.
#3 Rogue Epidemiologist
June 3, 2010

While pasteurized milk has been the culprit in a non-neglible number outbreaks, the attack rate for pasteurized milk is much lower than that of unpasteurized milk. The number of people who consume unpasteurized dairy is a fraction of a percent of those who consume pasteurized dairy.

Still, raw dairy people are dogmatic adherents with a fervor that rivals the Morgellon’s crowd. And the crux of their argument rests on research done by Weston Price in the early 20th Century. No modern studies have ever agreed with Price’s findings.

If you want a thick, creamy dollop of woo, check out their website, especially their criticisms of current research papers that conclude that unpasteurized milk is hazardous to people’s health.

That reminds me, I have a cup of Yoplait in the office fridge.
#4 Adam_Y
June 3, 2010

But when a doctor such as Mercola recommends it, it is a dangerous abuse of his power as a professional. It is reckless. It is stupid. It endangers public health. He should be ashamed.

Oooo bloody dam hell a man who actually wrote that he believes its possible to live by staring at the sun is a freaking doctor!!!! I thought he was a guru scam artist along the lines of Treudeau.
#5 Pascale
June 3, 2010

My nephrology fellowship at Minnesota featured a summer season of e. coli induced hemolytic uremic syndrome every year, often in children of dairy farmers who drank raw milk. Why go to the store and buy pasteurized milk when you can get it straight from the cow? Because your kid might get aggressive bloody colitis followed by systemic bleeding and kidney failure requiring dialysis. And then, even if they are in the 90% who recover completely, up to 40% have sustained enough damage to have hypertension and progressive kidney disease 10-20 years down the road.
Yes, “raw” milk is natural. So is e. coli. So is HUS.
Sometimes nature is a bitch.
#6 Lora
June 3, 2010

This may be a dumb question. However, a few of my colleagues did their dissertations and postdocs on Listeria spp. biofilms in dairies, and my understanding is that said biofilms are notorious for forming on the pasteurization coils in dairy processing plants. They are extremely difficult to remove because cannot be scrubbed manually. The biofilm goop protects the bacteria from complete high level disinfection as well. These pasteurization coils are not evenly heated and merely produce an *average* temperature as opposed to a constant, even temp that would guarantee knocking down bacteria throughout the coil–instead, you’ve got hot spots and cold spots, and the hot spots do the actual pasteurizing while the cold spots can harbor cooties.

Would it not be better to cold-filter the milk with sterilizing-grade filters which could be disposable and regularly changed? When the bacterial buildup on the filters gets too high, the filters will simply clog and not flow, so the operator is forced to change to clean filters every so often. Less mistake-y. Said filters come in not-terribly-expensive cellulose and diatomaceous earth types.

Just wondering. Seems like it would solve a lot of the complaints about pasteurized milk (funny taste, doesn’t make good fermented/cultured dairy, etc.). And pretty much every batch would be equivalent to shelf-stable, as it would be sterile, therefore could be shipped all over the place and kept at room temp for months on end.
#7 Adam_Y
June 3, 2010

This may be a dumb question. However, a few of my colleagues did their dissertations and postdocs on Listeria spp. biofilms in dairies, and my understanding is that said biofilms are notorious for forming on the pasteurization coils in dairy processing plants. They are extremely difficult to remove because cannot be scrubbed manually. The biofilm goop protects the bacteria from complete high level disinfection as well. These pasteurization coils are not evenly heated and merely produce an *average* temperature as opposed to a constant, even temp that would guarantee knocking down bacteria throughout the coil–instead, you’ve got hot spots and cold spots, and the hot spots do the actual pasteurizing while the cold spots can harbor cooties.

Considering how many applications require evenly heating of huge vats of liquids I really am skeptical of what you say is relevant. And if it is its not the world’s hardest problem to fix. Its basic engineering 101.
#8 Adam_Y
June 3, 2010

By relevant I mean I could see it being a problem in the past.
#9 aed939
June 3, 2010

Pasteurization of milk makes no sense. The industrial processed milk produces heat milk to destroy the natural antimicrobials lactoferrin and lactoperoxidase. These are so effective, they are actually sprayed on deli meats and deli meat plastic wrappings. Also pasteurization kills the bacteria that naturally sours the milk, converting lactose to lactic acid, which preserves the proteins and extends the shelf life, whereas pasteurized milk rots in 3 weeks.
#10 mxh
June 3, 2010

What’s with these woo-types recommending against things have dramatically improved human health and added something like 40 years to human life expectancy (vaccines, pasteurization…). What’s next? Argue against water sanitation?
#11 kb
June 3, 2010

Filters might not work because of the fat in the milk being too big. I know some of the processing involves the fat being removed and then put back, but even if you filtered it when it’s 100% fat free, the fat would be unsterilized when you added it back. There’s also something about breaking up the fat into itty bitty pieces so it doesn’t separate out, but it may not be smaller than bacteria. I’ve also heard that the lack of the homogenization process is part of what makes raw milk taste good, that having the bigger fat globules taste better than the broken up ones, so filtering would take away that part of it. I’m making all of this up without asking Google anything, so I could be wrong.
#12 Cath the Canberra Cook
June 3, 2010

I find that a lot of people confuse pasteurising and homogenising. I’ve had people wax lyrical about the old days when your bottle of milk had that rich cream at the top, and that was the best bit to put on your porridge etc etc. Which is true but irrelevant. These are totally different things – that old-style gold-top milk was definitely pasteurised!

BTW, I was under the impression that a big reason for pasteurising was to fight TB. But you didn’t mention that in the article. Am I wrong about that?
#13 DVMKurmes
June 3, 2010

Bovine tuberculosis (which also infects humans) was one of the bacteria people used to get from raw milk, but infected cattle have been eliminated through testing and culling of infected animals. (James Herriot spent his honeymoon TB testing cattle in the 1930′s). In the US, cattle and other ruminants still have to be tested when transported across state lines or sold, so it has basically been eliminated as a disease in dairy cattle. Still plenty or other bacterial reasons for pasteurization though.
#14 deinan
June 4, 2010

“Amasi (so called in Zulu and Xhosa, and “maas” in Afrikaans) is the common word for fermented milk that tastes like cottage cheese or plain yogurt. It is very popular in South Africa. Amasi is traditionally prepared by storing unpasteurised cow’s milk in a calabash container (igula in isiZulu) or hide sack[1] to allow it to ferment. The fermenting milk develops a watery substance called umlaza; the remainder is amasi. This thick liquid is mostly poured over the mealie meal (maize flour) porridge called pap, or drunk straight. It is traditionally served in a clay pot (ukhamba in isiZulu) and eaten with wooden spoons.[1]”
http://en.wikipedia.org/wiki/Amasi

Note this raw milk was not even refrigerated, as also not done by the Maasai.

“Traditionally, the Maasai diet consisted of meat, milk, and blood from cattle. An ILCA study (Nestel 1989) states: “Today, the staple diet of the Maasai consists of cow’s milk and maize-meal. The former is largely drunk fresh or in sweet tea and the latter is used to make a liquid or solid porridge.”
http://en.wikipedia.org/wiki/Maasai
#15 Lora
June 4, 2010

AdamY: Pasteurization is done through coils, not vats. No mixing, only laminar flow. Most of the equipment in established farms is on its last legs and ready to be replaced, but the cost of running a stirred tank + glycol jacket + heat exchanger is prohibitive (try, $0.5mil/10000 gallons–$50/gallon milk?). Plus the cost of installing a stirred tank is pretty high; there’s a reason they are mostly used for things that retail at $1000/ml. The cost of a simple liquid pump, OTOH, is $1000 for the pump, about $10k for the filter housings, a few hundred bucks for filters that will last a while. Electricity to run it is no more than would be required for pasteurization, if not less.

See, I took ChemEng 101 too.

DOI cites for your perusal:
10.1111/j.1472-765X.2001.01004.x
10.1089/fpd.2005.2.115.
#16 OleanderTea
June 4, 2010

We now know that Pal is in the pocket of teh eebil BIG INDUSTRIAL PASTURIZATION COMPLEX!

(Someone will make that charge in all seriousness very soon.)
#17 Vicki
June 4, 2010

I can buy pasteurized, non-homogenized milk. I don’t bother, because I want the cream mixed through the milk, not a dollop of cream for my porridge and then low-fat milk from the rest of the bottle. But there is a market for it, and that’s fine.

The stuff about South African milk products is interesting anthropologically, but without data on various aspects of public health, not all that relevant. I expect we could find an article or 17 describing the various fermented milk products traditionally used in Northern Europe, too.
#18 madder
June 4, 2010

@aed939:
If those antimicrobials are so powerful, how could the outbreaks mentioned by Pal have come to happen? How could TB have ever infected milk consumers? How does the concentration of those compounds in deli spray compare to their concentration in milk?
#19 katydid13
June 4, 2010

I actually know people who have raw milk imported to DC from an Amish farm in PA for their toddlers. They are argue that the farmer “knows his cows” so there is no danger.

It makes me crazy because they are good friends of mine, generally intelligent people, and generally seem to get science. The kid has all his shots, always wears a sun hat, get slathered in non-toxic sun screen and bug repellant, and has BPA free sippy cups. But drinks raw milk.

At what point do you say to your friends, I think you are putting your child at risk and I love him so I wish you would stop?
#20 PalMD
June 4, 2010

It doesn’t matter how well they know their cows. Small farms have problems as well.
#21 JustaTech
June 4, 2010

What I see here is the opportunity for a dairy farmer to make serious money with a great, rich niche market: low-temperature pasteurized milk. Most milk in the US is heated very high very fast (under pressure?), but it is also possible to pasteurize at lower temperatures; it just takes longer. The lower temperatures change the flavor less (or so I’ve been told) and I know that you can heat milk hot enough to kill viruses (HIV) without seriously compromising the enzymatic functions. (Great paper about having HIV+ mothers in South Africa hand-express breast milk and heat it in peanut butter jars to kill the HIV without damaging the nutritional content.)

“All the safety of pasteurized, all the benefits of raw!”
#22 katydid13
June 4, 2010

Pal, I didn’t mean to imply knowing the cows was a GOOD arguement, just that’s what they say.
#23 Bill in NC
June 4, 2010

For dairies, there is a huge financial incentive to sell raw milk.

Raw milk sells (usually direct to consumers) for several times what a dairyman could get from pasteurizing the same and selling it through normal channels.

Even if a consumer purchases a ‘milk share’, all the raw milk still gets dumped into a bulk tank.

So, although Bessie’s milk might be OK, Elsie or Clarabelle could be contaminating the entire bulk tank.

One story I read about sickness from raw milk pointed out that the dairy in question was so filthy no distributor would buy their pasteurized milk.

So they sold it raw, direct to end users instead.
#24 GotMilk?
June 5, 2010

“It’s not possible to prove a negative.”

Why do you keep repeating this? It just isn’t true, yet you seem to base a lot of your arguments on this false assertion putting them on a very shaky foundation. “It’s not possible to prove a negative” is itself a negative, so I guess it can’t be proven either :/
#25 PalMD
June 5, 2010

OK, it is nearly impossible from a rhetorical standpoint to prove a negative”

But you can say, “it is vanishingly unlikely that…”
#26 khan
June 5, 2010

My sister is into raw milk and all sorts of other woo. I’ve stopped communicating with her.
#27 Karen
June 6, 2010

My mother grew up on a dairy farm. Raw milk was for the barn cats, who gathered at each milking for their share. Pasteurized milk from the grocery store was for the household. The milk truck came twice a week (it was a small farm) and took the chilled raw milk off to be pasteurized, homogenized, and sold in bulk through the local co-op. My mom’s family wouldn’t have thought of drinking milk straight from the tank.
#28 Mu
June 7, 2010

Lora, if you truly did take ChemE classes you should know that the energy needed for bacteria removal through filters is huge, and that those filters are notoriously easy to foul and plug. You need .1 micron level filtration, and as pointed out above, a lot of the “good” components of the milk will not pass at that level either. As for the biofilms, while there are bacteria that survive the pasteurization process, those are usually not pathogenic (probably because stuff that thrives at 176 F usually doesn’t do well at 98 F).
As for the sour milk as preservation argument, no one is stopping you from adding the desired bacteria back in. But in that case you know what you threw back in, the same difference between drinking fine wine or drinking naturally fermented stuff where you have no idea what you’re growing, or taking penicillin instead of eating moldy bread.
#29 Dr.Jimena Arnold MD
June 8, 2010

Someone wrote above

“What’s with these woo-types recommending against things have dramatically improved human health and added something like 40 years to human life expectancy (vaccines, pasteurization…). What’s next? Argue against water sanitation?”

Actually I always encourage people to drink natural spring water or use well water in their home. Disinfection byproducts are seriously danger which is found in your “clean” tap water (not to mention fluoride, chlorine and other additives)

Just google the dangers of pasteurized milk and you’ll come up with many articles and studies done on the subject. I’m not advocating drinking raw milk or any dairy at all. But if you’re going to drink it I’d recommend in its natural state and not heated/cooked.

JA MD
#30 Shay
June 8, 2010

I’m not advocating drinking raw milk or any dairy at all. But if you’re going to drink it I’d recommend in its natural state and not heated/cooked.

So you’re not advocating drinking raw milk but you’re saying that if we do drink milk, it should be raw.

Read Orwell much?
#31 Chris
June 9, 2010

Jimena Arnold is a sock puppet troll and not a doctor.

He/she probably does not know that there large portions of the American West where fluoride must be removed from the well water, nor how the related term “Colorado Brown Stain” came to be.

Though, the stupidity of this person that claimed that there were ways other than birth control pills to solve certain complaints explained by the commentators and now that we should Google the dangers of pasteurized milk is pure sick comedy.

Dude or Dudette (because as far as I know, you may just be an actual wool sock)… show some backbone and actually post real evidence. Don’t try to pull the argument from authority by claiming to be an MD, and the write the most anti-science idiocy imaginable.
#32 Chris
June 9, 2010

On further thought, the Jimena Arnold character sounds like another variation of the “I.M. Smart”, “Dr. Smart”, “Medicine Man” and “Medicien Man” loony troll.
#33 Vicki
June 9, 2010

Does anyone expect me to take seriously a complaint about fluoride contaminating my (nonexistent) children’s precious bodily fluids and saving them from having their teeth drilled?
#34 Mu
June 9, 2010

The “Jimena Arnold” character somehow managed to become a professor (the only people who use normally use both Dr. and MD in the title) without leaving any trace on the internet other than the posts in WCU.
Ein Schelm, wer Böses dabei denkt.
#35 James Sweet
June 14, 2010

FWIW, I don’t have a problem with an adult with a healthy immune system occasionally drinking raw milk for the flavor, if they are aware of the risk. I tried it once. I didn’t notice as much of a difference as advocates claim, but if other people do, I’m fine with that.

Pretending that it’s healthier, though… it never ceases to amaze me the crazy shit people will believe in. It’s particularly glaring that they say it’s all kinds of benefits for children. :/
#36 joe
June 14, 2010

Mercola is no different than Gary Null, another quack!! If you go to Gary Null’s web site and click on “About Gary”, there is a photo of him. My God! Who would take advice from him?? He looks like a mental patient.
#37 Chris
June 14, 2010

roger/joe… you are a very boring troll. (saw your post at Orac’s blog)