Whole and reduced fat milk and whole and reduced fat milk products (yogurt, kefir, koumiss, buttermilk, cheese), provide excellent nutrition for gaining strength, muscle and health.
In addition to high quality protein, whole milk provides carbohydrate to support energy levels and a healthy gut microbiome, fats with health benefits, and vitamins and minerals you need for gaining and maintaining strength, muscle and health.
Contrary to common belief and advice of “experts” for decades, there is a lack of evidence that consuming full-fat milk products promotes cardiovascular disease. In fact recent systematic reviews of both observational studies and randomized trials have concluded the opposite, that consumption of dairy products, including full fat milk products, improves diet quality and may reduce the risk of cardiovascular disease and type 2 diabetes.1, 2, 3, 4, 5, 6
Proponents of plant-based diets have claimed that use of milk products or calcium promotes prostate cancer, perhaps by increasing insulin-like growth factors (IGFs). Like other hysterical claims these people make against traditional animal products, this claim is based on epidemiological evidence which is confounded by many factors. As I have noted elsewhere, epidemiological evidence is based on dietary recall questionnaires, which are inadmissable as scientific evidence because they do not actually measure dietary intake, but merely tabulate memories of perceptions, which are not objective data.7, 8
A 2017 review of evidence for the IGF hypothesis found no strong evidence for it (risk ratios were in the range of 1.09 to 1.51, substantially less than the 2.0+ required for substantial, actionable link).9 A 2019 epidemiological study reported a 3-fold increased risk of prostate cancer recurrence among men who were overweight or obese (BMI≥27kg/m2) but no association in men with BMI<27kg/m2, indicating that obesity is the driver of recurrence, not the consumption of milk products.10 A 2019 epidemiological study found no evidence for harmful effect of dairy consumption on overall prostate cancer risk among men in the United States.11
Some people claim that milk promotes acne and various other disorders. In my book The Hypercarnivore Diet I devoted several pages to evaluating these claims, and found they are all based on weak epidemiological evidence in populations that have many highly problematic dietary components other than milk, such as polyunsaturated plant oils. The analysis is too extensive to put in this article.
An assessment of the totality of evidence regarding health effects of dairy product consumption concluded that consumption of dairy products improves body composition, and reduces the risk of overweight and obesity, type 2 diabetes, cardiovascular disease (especially stroke), osteoporosis, colorectal cancer, bladder cancer, gastric cancer, and breast cancer, with no effect on pancreatic cancer, ovarian cancer, or lung cancer.35
Allergies to milk are more rare than commonly believed. The estimated prevalence of milk allergy in children has been confirmed to be only about 2% in the U.S., Denmark, Sweden and Australia.12 In Asia the prevalence of milk allergy is similar to Western populations.13 Milk allergies were found more common in European than Hispanic, African-American, or Asian children in the U.S..14 Children usually grow out of milk allergy by age of 4 years.15 Therefore, 98% of children are not allergic to milk, and few if any adults are genuinely allergic to milk.
Whole milk has the second highest quality of protein of all whole foods (Table 1). Reduced fat milks (2%, 1% or non-fat) contain the same protein (whey + casein) as whole milk.
Milk protein is composed of whey protein and casein. Cheese is made by removing the whey from the milk, which reduces the lactose content protein quality. Cheese only contains the casein portion of milk protein. The protein quality of casein is inferior to that of whole milk protein (Table 1). This implies that the protein quality of cheese (casein alone) is inferior to that of milk or fermented milk products made from whole, 2%, 1% and non-fat milk.
Whole milk supports superior muscle protein synthesis when consumed after resistance training.16 Milk is equal or superior to synthetic commercial recovery drinks in function and costs less.17 Milk is superior to commercial electrolyte for restoration of fluid and electrolyte balance after heavy exercise.18 Milk may produce a greater postexercise muscle protein synthesis response than beef.19 Whole milk supports a greater postexercise utilization of available amino acids than the same size serving of fat-free milk.20 In healthy elders, consuming whole milk protein after resistance training produces the same muscle mass and strength gains as whey protein isolate.21
Whole milk protein has been shown to reduce energy intake at subsequent meals to a greater extent than either casein or whey,22 so if you want to control your appetite, choose whole milk protein over isolated milk protein powders.
Lactose is a disaccharide composed of glucose and galactose. Both glucose and galactose play critical roles in human physiology. Several macromolecules (cerebrosides, gangliosides, and mucoproteins) found in nerve cell membranes have galactose as a component. Molecules on blood cells that determine ABO blood types also contain galactose.
Many people avoid milk because it contains lactose. However, research has shown that most people who believe they are lactose intolerant can digest more lactose than they believe.23
Further, almost no lactose intolerant person has difficulty digesting fermented milk products, because the bacteria recruited to produce yogurt, kefir, buttermilk and other fermented milk products predigest the lactose.24, 25, 26, ,
Lactose improves calcium absorption27 (unless you are lactase deficient28) and supports healthy gut flora.29
Whole milk contains 3.5% fat; reduced-fat milk, 2%; low-fat milk, 1%; and skim or non-fat, no more than 0.2%.
Fat provides 47% of the energy (calories) in whole milk; 30% of calories in 2% milk; 15% of calories in low-fat milk; and virtually none of the calories in skim milk.
Since fat improves the assimilation of fat soluble vitamins and may improve protein utilization (see protein section above), I recommend using whole, reduced-fat or low-fat milk for the bulk of your milk or milk products.
Milk fat (aka cream, butterfat) is about 63% saturated fat, 29% monounsaturated fat, and only 3% polyunsaturated fat. Some of the saturated milk fats may have specific health benefits. About 11% of the fats are short-chain fatty acids (SCFA) including butyric acid and caproic acid. About 10-20% of the fats are medium chain triglycerides (MCFA). Milk fat also provides conjugated linoleic acid (CLA).
Both in vitro and in vivo experiments suggest that several milk fatty acids (SCFA, MCFA, odd branch chain fats, CLA), phospholipids and sphingolipids have anti-cancer properties.30
Some evidence indicates CLA might have anti-cancer, anti-obesity and anti-atherosclerosis effects.31
However, like all other fats, milk fat has a high energy density. If you need to reduce your energy intake, first limit your use of separated milk fats – i.e. cream, cream cheese, butter, ghee. Then, if to further reduce your energy (calorie) intake, use either 2% or 1% fresh or fermented milk products.
Milk is naturally nutrient-dense. It contains some of every essential micronutrient. It is especially rich in or valuable for the following nutrients required to maintain health:
Milk also provides significant amounts of choline, selenium, iodine, and boron.
A review of established knowledge and specific research found preliminary evidence that deficiencies of phosphorus, potassium, zinc, iron and especially calcium, magnesium, and selenium – all three well supplied by milk – may contribute to loss of muscle tissue and strength.32
Bioactive components of milk have been shown to have beneficial immune-modulating, anti-microbial, anti-tumor, pro- and pre- biotic, anti-inflammatory, and even anti-epileptic properties.33, 34
I personally use conventionally produced milk, because it has a similar nutritional density to organically produced milk, with a lower cost per unit.
There is no evidence for hysterical claims that conventional milk is full of hormones or toxic contaminants including antibiotics. I review this extensively in The Hypercarnivore Diet; space does not permit adequate address of this topic here. Antibiotic residues are not allowed in milk and a farmer can be fined and prevented from selling milk ever again if antibiotic residues are found above tolerance levels in his milk.
Conventional milk is very nutrient dense. The nutrient content of milk is primarily regulated by the mammary glands, which will take whatever nutrients the offspring needs from the mother's body. There may be marginally greater levels of nutrients in animals fed differently, but there is no evidence that anyone will suffer nutrient deficiencies by using conventional milk rather than organic. I regularly monitor the nutrient density of my diet, and I easily meet all required nutrient needs despite rarely using organic milk products.
I do not use nor do I generally recommend raw milk. Unless you raise the animals yourself, the risk of serious bacterial infection from raw milk is too high, while there is a lack of evidence that raw milk has any nutritional benefits outweighing the risk.
Moreover, contrary to claims made by proponents of raw milk, several traditional pastoral tribes heat-process their milk. For example, the Mongols process much of their milk with high heat (boiling!), as shown in this video:
African pastoralists also use heat to process milk for storage.36
Raw milk (“farm milk”) has been reported to have higher levels of endotoxin than pasteurized milk in one study37 but not another.38 There is some evidence that using some raw milk may protect against allergies and asthma in children, but not adults.39 Although children who grow up on farms drinking raw milk have a reduced risk of allergy and asthma, many environmental factors differ between farm life and urban life and evidence that raw milk is the critical or only factor is lacking. In fact, farm children often consume boiled milk, which is subjected to more intense heating than pasteurized milk.40
Claims that raw milk is more nutritious, more digestible or a better source of beneficial bacteria lack evidence.40 Meanwhile up to a third of all raw milk samples contain pathogens, even when the milk has low total bacterial counts or is sourced from healthy animals.40
These bacteria can cause gut distress which may be interpreted as milk intolerance. Pasteurization or boiling of milk can destroy the bacteria, so if you have difficulty digesting milk, use heat processed milk. Some people may find boiled or ultra pasteurized milk more digestible than pasteurized milk. Different brands of milk may process their milk differently, so sometimes its just a matter of trying a different brand.
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2. Astrup A. Yogurt and dairy product consumption to prevent cardiometabolic diseases: epidemiologic and experimental studies. Am J Clin Nutr 2014 May;99(5):1235S-1242S. <https://academic.oup.com/ajcn/article/99/5/1235S/4577498>
3. Drouin-Chartier JP, Brassard D, Tessier-Grenier M, et al. Systematic Review of the Association between Dairy Product Consumption and Risk of Cardiovascular-Related Clinical Outcomes. Adv Nutr. 2016;7(6):1026–1040. Published 2016 Nov 15. doi:10.3945/an.115.011403 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105032/>
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8. Archer E, Lavie CJ, Hill JO. The Failure to Measure Dietary Intake Engendered a Fictional Discourse on Diet-Disease Relations. Front Nutr. 2018;5:105. Published 2018 Nov 13. doi:10.3389/fnut.2018.0010 < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243202/>
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10. Tat D, Kenfield SA, Cowan JE, et al. Milk and other dairy foods in relation to prostate cancer recurrence: Data from the cancer of the prostate strategic urologic research endeavor (CaPSURE™). Prostate. 2018;78(1):32–39. doi:10.1002/pros.23441 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716878/>
11. Preble I, Zhang Z, Kopp R, et al. Dairy Product Consumption and Prostate Cancer Risk in the United States. Nutrients. 2019;11(7):1615. Published 2019 Jul 16. doi:10.3390/nu11071615 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683061/>
12. Food Allergy Research and Resource Program, Institute of Agriculture and Natural Resources, University of Nebraska-Lincoln. Prevalence of food allergies. <https://farrp.unl.edu/resources/gi-fas/prevalence-of-food-allergies>
13. Lee AJ, Thalayasingam M, Lee BW. Food allergy in Asia: how does it compare?. Asia Pac Allergy. 2013;3(1):3–14. doi:10.5415/apallergy.2013.3.1.3 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563019/>
14. Williams PV. The Epidemiology of Milk Allergy in US Children. Pediatrics 2013 Oct.132(S1):S17-S18. <https://pediatrics.aappublications.org/content/132/Supplement_1/S17.2>
16. Roy BD. Milk: the new sports drink? A Review. J Int Soc Sports Nutr. 2008;5:15. Published 2008 Oct 2. doi:10.1186/1550-2783-5-15 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569005/>
17. James LJ, Stevenson EJ, Rumbold PLS, Hulston CJ. Cow's milk as a post-exercise recovery drink: implications for performance and health. Eur J Sport Sci. 2019 Feb;19(1):40-48. doi:10.1080/17461391.2018.1534989. Epub 2018 Oct 31. Review. PubMed PMID: 30379113.
18. James L. Milk protein and the restoration of fluid balance after exercise. Med Sport Sci. 2012;59:120-126. doi: 10.1159/000341958. Epub 2012 Oct 15. Review. PubMed PMID: 23075562.
19. Burd NA, Gorissen SH, van Vliet S, et al. Differences in postprandial protein handling after beef compared with milk ingestion during postexercise recovery: a randomized controlled trial. Am J Clin Nutr 2015;102:828-36.
20. Eliot TA, Cree MG, Sanford AP, et al. Milk ingestion stimulates net muscle protein synthesis following resistance exercise. Med Sci Sports Exerc 2006 Apr;38(4):667-74.
21. Hamarsland H, Johansen MK, Seeberg F, et al. Native Whey Induces Similar Adaptation to Strength Training as Milk, despite Higher Levels of Leucine, in Elderly Individuals. Nutrients. 2019;11(9):2094. Published 2019 Sep 4. doi:10.3390/nu11092094 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770720/>
22. Lorenzen J, Frederiksen R, Hoppe C, Hvid R, Astrup A. The effect of milk proteins on appetite regulation and diet-induced thermogenesis. Eur J Clin Nutr. 2012 May;66(5):622-7. doi: 10.1038/ejcn.2011.221. Epub 2012 Jan 25. PubMed PMID: 22274550. <https://www.ncbi.nlm.nih.gov/pubmed/22274550>
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24. Brown-Riggs C. Nutrition and Health Disparities: The Role of Dairy in Improving Minority Health Outcomes. Edberg M, Hayes BE, Rice VM, Tchounwou PB, eds. International Journal of Environmental Research and Public Health. 2016;13(1):28. doi:10.3390/ijerph13010028. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730419/>
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29. Szilagyi A. Adaptation to Lactose in Lactase Non Persistent People: Effects on Intolerance and the Relationship between Dairy Food Consumption and Evalution of Diseases. Nutrients. 2015;7(8):6751–6779. Published 2015 Aug 13. doi:10.3390/nu7085309 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555148/>
30. Rodríguez-Alcalá LM, Castro-Gómez MP, Pimentel LL, Fontecha J. Milk fat components with potential anticancer activity-a review. Biosci Rep. 2017;37(6):BSR20170705. Published 2017 Nov 15. doi:10.1042/BSR20170705 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372256/>
31. den Hartigh LJ. Conjugated Linoleic Acid Effects on Cancer, Obesity, and Atherosclerosis: A Review of Pre-Clinical and Human Trials with Current Perspectives. Nutrients. 2019;11(2):370. Published 2019 Feb 11. doi:10.3390/nu11020370 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413010/>
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