There has been an ongoing back-and-forth response from the Weston A. Price Foundation (WAPF) to my literature review of the pros and cons of drinking raw (unpasteurized) milk and a more recent series comparing the food safety track record of pasteurized and raw milk products.
The WAPF had their annual meeting last weekend in the Chicago area, and hopefully they are considering some of the points raised in these discussions.
Like any other food product, there are two primary approaches to solving food safety problems: regulation and education.
These two approaches are most effective when applied together, in an atmosphere of cooperation between the food industry, government, universities, and consumers.
Here are some of my recommendations for regulating raw milk and educating consumers about the risks associated with drinking it. I would very much welcome comments from readers with thoughts related to this ongoing debate and how to move it forward.
Regulation
Grade A pasteurized milk regulation has mostly followed Federal Pasteurized Milk Ordinance standards. However, states may require stricter standards for milk.
Raw milk is primarily regulated at the state and local level; interstate shipment is banned. The question state and local jurisdictions face is:
To Ban or Not to Ban Raw Milk Sales?
The Centers for Disease Control and Prevention (CDC) has reported that the number of foodborne illness outbreaks in states where raw milk is banned is lower compared with the number that occurs in states that allow the sale of raw milk. However, raw milk proponents argue that raw milk bans infringe on the right of consumers to make their own choice. WAPF has stated, “Unless raw milk is unique among all foods in the supposed danger it presents, it should not be singled out.”
All sources of literature and data show that raw milk does fall into a “riskier” category of foods. Raw milk is not alone: raw oysters, raw sprouts, soft cheeses (raw or pasteurized), unpasteurized juices, raw or undercooked beef or poultry, and ready-to-eat foods such as deli meats are examples of other risky foods.
In lieu of banning raw milk products, some states have adopted regulations that attempt to protect public health and allow for consumer choice. This is an approach I would suggest the following:
- Raw milk should be sold only on farms that are certified by the state and inspected and tested regularly. Make ambiguous black market milk/cheese sales and “pet food sales” meant for human consumption clearly illegal
- Raw milk should not be sold in grocery stores or across state lines–the risks of mass production and transportation are too great; the risk of a casual purchase by someone misunderstanding the risks is too great, as well
- Farms should be required to have insurance coverage sufficient to cover reasonable damages to their customers
- Practices such as outsourcing (buying raw milk from farms not licensed for raw milk production) should be illegal
- Colostrum should be regulated as a dairy product, not a nutritional supplement
- Warning signs on the bottles and at point-of-purchase should be mandatory. An example: “WARNING: This product has not been pasteurized and may contain harmful bacteria (not limited to E. coli O157:H7, Campylobacter, Listeria and Salmonella). Pregnant women, infants, children, the elderly and persons with lowered resistance to disease (immune compromised) have the highest risk of harm, which includes Diarrhea, Vomiting, Fever, Dehydration, Hemolytic Uremic Syndrome, Guillain-Barre Syndrome, Reactive Arthritis, Irritable Bowel Syndrome, Miscarriage, or Death, from use of this product.” (emphasis added).
Education
Regulation alone will not solve any food safety problem–whether we’re talking about raw milk, spinach, or ground beef.
Educational materials (directed to both producers and consumers) for the safe production, handling and processing of both pasteurized and raw milk products should be developed and widely distributed.
The WAPF and the Farm to Consumer Legal Defense Fund published a “Raw Milk Production Handbook.” These materials should be updated and enhanced in cooperation with experts from universities, especially cooperative extension programs specializing in dairy food safety.
Raw milk advocacy groups should discontinue misleading advertisements directed at consumers that include unsubstantiated claims about “grass feed” animals being free of pathogens, or statements that raw milk always kills pathogens.
Similarly, raw milk advocates should not falsely advertise that their products are a “cure all,” or that pasteurized milk contains no nutrients. These false statements (presumably made for marketing purposes) combined with misinformation about the potential food safety risks, undermine the credibility of raw milk advocates, and serve only to mislead the consumer.
A Bit of Background
“Comparing the Food Safety Record of Pasteurized and Raw Milk Products” (now available in one file) highlights significant differences between the safety of raw and pasteurized milk products. Here you will find a brief synopsis of the four-part series.
Part 1 – History and definitions
One-hundred years ago, milk caused about one out of every four outbreaks traced back to food or water in the US. Today, dairy products cause the fewest outbreaks of all the major food categories (e.g, beef, eggs, poultry, produce, seafood). Most scientists agree that the high level of safety for milk today is because of pasteurization (heat treatment to kill pathogens), and improved sanitation and temperature control during the bottling, shipping, and storage of fresh milk.
The majority (approximately 99 percent) of people in the US drink pasteurized milk, but a small group of individuals prefer their milk unprocessed (no heat treatment to kill pathogens, or other processing such as homogenization).
Many states require that milk sold to the public be pasteurized, and federal law prohibits any interstate shipment of milk that has not been pasteurized. Raw milk proponents argue that these food safety regulations are in conflict with basic “food rights,” or the choice to buy the type of foods they want to consume, including raw milk.
Throughout decades of debate about how to regulate raw milk, the public health and medical communities have remained steadfast in their support of pasteurization as a key measure to protect public health.
Part 2: Bacteria and other microorganisms in milk
Sick animals may carry pathogens that can be transmitted to people through their milk and cause life-threatening illnesses such as bovine tuberculosis and brucellosis. In the US, almost all dairy and beef herds are free of these diseases, but travelers to developing areas like Mexico, Africa, and the Middle East are sometimes infected by drinking raw milk, eating raw milk cheeses, or being exposed to sick animals.
Healthy dairy animals such as cattle and goats may shed foodborne pathogens like Campylobacter, E. coli O157:H7, Listeria monocytogenes, and Salmonella in their feces. These foodborne pathogens can cause mild illness in some people, and life-threatening or long-term debilitating disease in others including paralysis, kidney failure, and arthritis. Children, the elderly, and people with weakened immune systems (chemotherapy, AIDS patients) are more likely to become severely ill from these pathogens.
Pasteurization involves heat treatment of milk to a temperature that destroys foodborne pathogens. The only way to keep these pathogens out of untreated raw milk is through very strict sanitation, which can be difficult because of the large volume of feces produced by dairy animals including during the time they are being milked.
Some raw milk advocates believe that only feeding a grass-based diet will prevent shedding of pathogens in the feces of food animals, and later contamination of raw milk or meat. Since grass-fed cows have been linked to outbreaks, and pathogens have been found in their feces and milk, it does not appear that “clean grass-fed” cows or goats are safer than conventionally raised food animals based on diet alone.
Pasteurized milk can become contaminated if the equipment fails (if the milk does not reach the right temperature for long enough), or if it is contaminated later through poor hygiene (unsanitary conditions) or cross-contamination.
Part 3. Foodborne illnesses and disease outbreaks from milk
Both pasteurized and raw milk products have caused foodborne illnesses and outbreaks.
A review of thirty years of data in the US showed that there are a disproportionate number of outbreaks due to raw milk. While only approximately 1 percent of the population consumes raw milk, raw dairy products caused over 50 percent of the outbreaks during that time period.
In the same analysis, most pasteurized and raw dairy-related outbreaks involved less than fifty illnesses per outbreak.
The conventional pasteurized milk supply is more vulnerable to massive (over 1,000 illnesses) food poisoning events because of its wider distribution and frequency of consumption.
Part 4. Weighing the risks and benefits
Consumers must weigh many different factors when choosing the most appropriate dairy product for themselves and their families.
A comparison of the nutrition labels on raw and pasteurized milk purchased at a retail store shows very little difference between commercial raw, organic milk and organic or conventional pasteurized milk products.
The medical benefits of dairy products (raw or pasteurized) beyond basic nutrition are unclear. Epidemiological studies in Europe suggest that consumption of raw milk products in childhood may help prevent some allergic conditions (e.g., asthma, hay fever, eczema).
Consumers should be wary of product claims that appear to be implausible, or “too good to be true.” For example, claims that raw milk cures everything from autism to allergies to tooth decay to lactose intolerance and heart disease. Often such broad claims are made simply to market the product, and are not based on sound medical research.
Recent data from 2000-2007 in the US on outbreaks and illnesses from milk products shows that there is currently more risk from Campylobacter and E. coli O157:H7 due to drinking raw milk compared with drinking pasteurized milk.
In the same analysis, pasteurized milk and Mexican-style soft cheeses (e.g., queso fresco) that were contaminated during or after processing were associated with illnesses, miscarriages, and deaths from listeriosis.
Multi-drug resistant salmonellosis continues to be a concern in the dairy environment, and has caused outbreaks linked to raw and pasteurized milk/cheeses, and queso fresco cheeses.
Both pasteurized and raw dairy products can be dangerous if produced under unsanitary conditions, which are more likely if the product is being sold illegally. Consumers should avoid any dairy products sold illegally, especially “black market” or “underground” raw milk/cheeses, and soft Mexican-style cheeses such as queso fresco sold by unlicensed vendors, or imported illegally into the US.