By Natalie Miller
It’s a slogan synonymous with a time when healthy bones and the milk mustache were the nation’s trends. In fact, the phrase represents one of the most influential campaigns in the history of advertising. It was first introduced in 1993 and is today fondly remembered as the campaign that brought us the milk-adorned faces of countless celebrities from sports and TV stars to news anchors, musicians, and even presidents.
Milk was the shining star of our childhood—and our children’s. It’s a cold, refreshing beverage that pairs perfectly with cookies and can also be mixed with chocolate syrup. It’s also packed with calcium and other vitamins and was once hailed as the best food for strong, healthy bones and teeth and to prevent osteoporosis.
Recently, with the much-talked-about Netflix documentary What the Health, milk has come under fire with reports that claim milk is not only less nutritious than we once thought, but that it is poison.
What the Health filmmaker Kip Anderson calls upon many experts in his documentary that support these claims and point out that the hormones and antibiotics fed to cows are not tested on humans and can have catastrophic results on dairy consumers. Citing studies from Harvard and the Journal of the National Cancer Institute, Anderson shows that milk not only doesn’t protect against weak bones but can also increase the risk
of cancers linked to hormones, such as breast, ovarian, and prostate cancers.
“Milk does not build strong bones,” declares Neal Barnard, MD, Physicians Committee for Responsible Medicine, in the documentary.
Sounds pretty bad, but Alicia Romano, MS, RD, LDN, Clinical Registered Dietician at the Frances Stern Nutrition Center at Tufts Medical Center, warns consumers against eliminating milk.
“I would not go as far as to demonize milk and say it weakens bones,” she says. “I have not seen any evidence to suggest this. In regards to cancer, there remains unclear and inconsistent data on the relationship between dairy products and cancer.”
Milk and dairy research show varying results. Another study by the Journal of the National Cancer Institute, conducted several years after the one cited by What the Health, does show higher risk of mortality after breast cancer diagnosis. However, the study also notes that the results were only for those drinking high-fat dairy. Low-fat dairy did not produce the same results.
Romano explains that studies she has reviewed do show a link between a high calcium diet and increased risk of prostate cancer. However, she says there is no-cause- and-effect relationship. The same can be said about the evidence relating the intake of milk to increased risk of ovarian and breast cancer, she says.
“The research remains limited; the data is lacking and inconsistent,” she says.
This ambiguity also exists in studies that show milk contributes to, rather than prevents, weakened bones. One case-control study conducted by the American Journal of Epidemiology found the consumption of dairy was associated with an increased risk of hip fracture in old age. The BMJ, formerly the British Medical Journal, also published results of a study that claims high milk intake is associated with higher fracture incidence in women.
However, the study also recommends a cautious interpretation of the results in light of the “inherent possibility of residual confounding.” The results should be taken with skepticism because there are many factors that could affect the results.
The baseline issue, says Romano, is the inability to isolate each nutritional component during a study. So what’s really to blame? Is it the milk itself or the hormones? Is it the calcium or the fortified Vitamin D?
“On the flip side,” she says, “there are benefits beyond the bone-building capacity of milk, including the possible decreased risk of high blood pressure as well as the possible decreased risk of colon cancer.”
Heart-healthy, low-fat milk should still be considered an excellent source of nutrients that may aid in bone health, particularly in children—unless they have a dairy allergy or intolerance, she says.
While the American Academy of Pediatrics doesn’t recommend cow’s milk for infants, it does say that “fortified cow’s milk is an important dietary component of a toddler’s diet because of its high-quality protein, calcium, and vitamins A and D.”
The recommended serving for children is two to three milk or dairy servings a day, she says, adding that adults should consume less.
“Overall, any possible risks [to adults drinking milk] are defined over two servings of dairy per day,” she explains. “Consuming one to two glasses of milk or dairy products per day as a convenient source of dairy and protein…is perfectly fine.”
But for half the population, dairy is not an option. Lactose intolerance is a global phenomenon affecting millions of people. It’s estimated that about 2.5 percent of children under 3 are allergic to milk. And according to estimates from the US National Library of Medicine, approximately 65 percent of the world population has a reduced ability to digest lactose after infancy, meaning they are lactose intolerant.
The cause of this could be linked to how dairy products are produced, according to many reports. Industrial farms feed cattle food that is full of pesticides, growth hormones, and antibiotics. Moreover, cattle carry many strains of bacteria due to the lack of sanitary conditions in overcrowded facilities.
While pasteurization is an essential component of dairy production—this is the process of using heat to kill pathogenic microorganisms—it also destroys the lactose-digesting enzyme called lactase. Dairy consumption, particularly in children, is also linked to many issues such as eczema, acne, constipation, acid reflex, iron deficiency, and anemia.
For non-dairy consumers, there are other ways to get the proper amount of calcium and to even enjoy milk. Lactose-free milk works for some people who are lactose intolerant. This formula is treated with the lactase enzyme to ease digestion.
There are also many non-dairy options. Romano recommends unsweetened soy milk due to the presence of protein. Soy milk has often been associated with a thick, chalky taste, but this alternative drink contains almost as much protein as dairy milk.
Other popular non-dairy alternatives like almond, rice, coconut, and hemp drinks are safe, but they lack protein and are often sweetened. However, as long as these substitutes are unsweetened and fortified with calcium and vitamins like D and E, they can be a healthy substitute for dairy, especially in cereals, oatmeal, and smoothies. One variable faced by those jumping from cow to nut is the creamier, sweeter, and nutty (or coconut-y) flavor found in these products.
Milk is also not the only source of calcium, Romano explains. There are many foods that have naturally occurring calcium. She recommends dark leafy greens—which are also rich in vitamin K for bone health—like kale, collard greens, and bok choy, as well as soybeans and chickpeas, as important sources of calcium.
“The more important piece is adequate lifelong dietary calcium intake needed to reduce the risk of osteoporosis,” she says. “This should be done in the presence of adequate vitamin D intake, adequate vitamin K intake as well as regular weight-bearing exercise to build optimal bone density and strength.”
Overall, the adage “everything in moderation” applies here as well. A moderate one to two glass per day consumption of milk in addition to a varied diet with non-dairy sources of calcium should be just fine for the general public, says Romano. However, the nutrients in milk only offer a small piece of the picture when optimizing bone health.
(Raising a glass), here’s to you!