{"id":2802,"date":"2022-07-29T07:35:15","date_gmt":"2022-07-29T12:35:15","guid":{"rendered":"https:\/\/suigenerisbrewing.com\/?p=2802"},"modified":"2024-05-24T11:33:47","modified_gmt":"2024-05-24T16:33:47","slug":"a-realistic-look-at-the-safety-of-raw-milk","status":"publish","type":"post","link":"https:\/\/suigenerisbrewing.com\/index.php\/2022\/07\/29\/a-realistic-look-at-the-safety-of-raw-milk\/","title":{"rendered":"Fact or Fiction – Safety and Health of Raw Milk"},"content":{"rendered":"\n

I apologize to my regular readers for this unusual post. This is a planned post, as part of my fermented food series<\/a>. It was supposed to follow another of my hard-core microbiology experiments, but I’ve needed this resource elsewhere so I’m writing it about a dozen articles early.<\/p>\n\n\n\n

This article is going to take a historical and scientific look at the use and safety of raw (unpasturized) milk – something worth thinking about when considering making fermented milk products such as yoghurt<\/a> or cheese<\/a>. I’ve included extensive links to my sources throughout this article, so please check those out before accusing me of being a shill for the pasteurization industry.<\/p>\n\n\n\n

This post going to be a long one, so here’s an index for those who want to jump around:<\/p>\n\n\n\n

    \n
  1. What is Raw Milk<\/a><\/li>\n\n\n\n
  2. Myths and Claims About Raw Milk<\/a><\/li>\n\n\n\n
  3. A (Brief) History of Milk Consumption & Fermented Milk Foods<\/a><\/li>\n\n\n\n
  4. A Microbiological & Epidemiological Look at Raw Milk<\/a><\/li>\n\n\n\n
  5. Being as Safe as You Can<\/a><\/li>\n\n\n\n
  6. Conclusions<\/a><\/li>\n<\/ol>\n\n\n\n
    \n\n\n\n

    What is Raw Milk<\/h2>\n\n\n\n

    Raw milk is simply milk that has not been pasteurized – e.g. has been taken directly from an animal, and then sold (or used) without any treatment to reduce bacterial or fungal contamination. Because of this, raw milk contains more microbes than pasteurized milk.<\/p>\n\n\n\n

    I’ve written about pasteurization before<\/a>. In short, pasteurization relies on heating a food item to a temperature, for long enough a time, to reduce the bacterial counts to below 100 colony forming units per mL (CFU\/mL). Note: 1 CFU = 1 viable bacterial cell. Most pasteurization processes reduce bacterial counts well below this point, typically to 30 CFU\/mL or lower<\/a>. In comparison, high-quality raw milk is defined as raw milk containing under 10,000 CFU\/mL<\/a>. It’s not uncommon in unregulated markets (e.g. USA and Canada) for raw milk to start with over 10,000,000 CFU\/ml<\/a>!<\/p>\n\n\n\n

    That may sound scary, but is it really? The answer is…complicated. I’ll address this in detail more below, but the short version is that the risk of milk containing a pathogen scales with CFU’s. So as pasteurized milk contains very few bacteria it is therefore unlikely to have pathogens, while both the number of bacteria and risk of pathogens increases in high-quality raw milk, and increases even further in lower-quality raw milk. In other words, it’s a sliding scale of risk, rather than an absolute safe versus not-safe situation.<\/p>\n\n\n\n

    The difference between low- and high-quality raw milk is largely driven by how milk is collected and monitored. In countries with a regulated raw milk industry (e.g. France) there are strict rules on animal health (e.g. monitoring for mastitis and gastroenteritis prior to milking), milking procedures (e.g. milking machine and udder sanitation, milk room cleanliness standards, etc), milk storage (e.g. how quickly milk must be cooled, and to what temperatures), and active monitoring of the milk supply for pathogens. This allows much of the risk of raw milk to be mitigated. They also have a traceable milk system, allowing infections to be traced back to the farm, and actions taken to identify and correct the cause of the contamination.<\/p>\n\n\n

    \n
    \"A
    A methylene blue test used to test the safety of milk. A blue dye is added to the milk. Bacteria will reduce the dye to a colourless state. The time it takes for the milk to go from blue to white is used to determine its safety. In this example, I’ve compared commercial pasteurized cows milk (left) to home-pasteurized and raw goats milk (middle and right). The colour change in the raw milk took 8 hours, indicating that the milk is of high quality.<\/figcaption><\/figure>\n<\/div>\n\n\n

    Lower-quality milk is common in unregulated\/illegal raw milk markets (e.g. the USA and Canada). Because there are minimal or no regulations, there are few or no standards protecting the raw milk supply. In many cases even the tools needed to ensure a safe supply are hard or impossible to come by. In the case of Canada where the sale of raw milk is outright illegal, there are often active attempts by raw milk producers to evade detection and monitoring. As you can imagine, in these markets the quality of milk can vary hugely. Some producers will take the same care and diligence in ensuring a quality supply as farmers in regulated systems. Other will not, with a corresponding increase in the risk of contamination.<\/p>\n\n\n\n

    But even those taking the utmost care in unregulated systems simply cannot achieve the same quality as those in regulated systems. This is largely due to “invisible” contamination, such as that coming from a low-grade mastitis. While the animal is not obviously ill, the milk will be contaminated with the bacteria causing the mastitis. In regulated markets, these low-grade infections are detected in milk plants using specialized assays for detecting bacteria. Few*, if any milk producers in unregulated markets will have access to the tools to do this themselves.<\/p>\n\n\n\n

    *my usual readers will be unsurprised to learn that I do this testing on my farm’s milk (see image above).<\/p>\n\n\n\n

    As for pasteurization itself, the process is fairly simple, but can be conducted in a few ways. The information below is generally true for Canadian provinces (each regulates pasteurization individually, so there are some minor variances), and international standards are virtually identical. There are different approaches, but the generally accepted guidelines are:<\/p>\n\n\n\n

      \n
    1. Bulk pasteurization<\/strong>: Solely used by people at home. Heat a bulk supply of milk to a temperature of at least 63\u00b0C\/145F. This is maintained for a minimum of 30 minutes.<\/li>\n\n\n\n
    2. Flash Pasteurization: <\/strong>This is how most milk is pasteurized commercially. Milk is run through a narrow tube through a heat supply. This quickly heats the milk to a temperature of at least 72\u00b0C\/161F and this temperature is held for at least 25 seconds. The milk is then rapidly cooled.<\/li>\n\n\n\n
    3. Ultra High Temperature Pasteurization:<\/strong> Milk is passed through a tube at high pressure and rapidly heated to 135 C. This temperature is held for at least 2 seconds before the milk is rapidly cooled. This effectively sterilized the milk, allowing it to be stored at room temperature until opened.<\/li>\n\n\n\n
    4. Ultra Filtration: <\/strong>Rather than heating the milk, it is instead filtered through a 0.2 micron filter. This is used for some high-end milks, but is more expensive than pasteurization. It can also be difficult to perform with full-fat milk.<\/li>\n<\/ol>\n\n\n\n
      \n\n\n\n

      Raw Milk Myths<\/h2>\n\n\n\n

      There are a number of myths – both in favour and in opposition to – raw milk consumption. I can’t cover them all, but I will do my best to cover the major claims. As always, I will provide links to the studies I’ve based my “myth busting” on.<\/p>\n\n\n\n

      Myth 1: Raw milk tastes better.<\/strong> <\/em>It is often claimed that pasteurization changes milk’s flavour or texture. But is there a difference?<\/p>\n\n\n\n

      This is a difficult question to answer, as many things can contribute to our perception of flavour and texture. This includes factors such as personal biases, packaging, and even the location where the tests are run. These confounding factors can cause people to perceive differences where none exist…or can cause people to miss somewhat obvious differences. Luckily, a German research group did a well designed experiment comparing UHT, pasteurized, pasteurized organic, and raw milk. Importantly, they compared the same peoples’ perceptions of these different milks first blinded<\/em> (meaning the subjects did not know the source of the milk they were tasting), and then repeated the tests with the same people unblinded <\/em>(meaning the subjects knew what kind of milk they were drinking). What they found is quite interesting<\/a>:<\/p>\n\n\n\n

        \n
      1. Blinded participants (e.g. the participants didn’t know which milk they were tasting) rated all of the milks, except for UHT milk, equally. The UHT milk was rated slightly lower than the others. That’s right – if someone didn’t know the source of the milk, they rated pasteurized, pasteurized organic, and raw milk to be equally good. <\/li>\n\n\n\n
      2. But when the same participants weren’t blinded, and were fully knowledgeable of where the milk came from, everything changed. In this case organic pasteurized and raw milk were rated higher, while the UHT and pasteurized milk were rated lower. <\/li>\n<\/ol>\n\n\n\n

        In other words, the claimed differences in milk flavour (UHT aside) is entirely one of perception, and not an actual difference in taste.<\/p>\n\n\n\n

        Another claim is that raw milk cheese also tasted better (or, at least, different). That is a more complex topic, which I will cover in a later post.<\/p>\n\n\n\n

        Myth 2: <\/b><\/em>Pasteurized Milk Looses Nutrition.<\/em><\/strong> This is another of those pernicious myths. This is also an easy question to address, as modern technologies can detect literally one part per billion changes in these compounds. In simple terms, milk can be thought to have five major nutrient groups – proteins, lipids\/fats, vitamins, trace metals, and sugars.<\/p>\n\n\n\n

        The first, protein, is very minimally affected by pasteurization<\/em>. Proteins themselves are comprised of 20 different amino acids that are strung together in specific sequences to create functional proteins. Of these 20 amino acids, 19 are unaffected by pasteurization, while one – lysine – decreases by 1-4% in concentration<\/a> after pasteurization. Lysine itself makes up ~5.5% of the amino acids in animal proteins<\/a>, meaning that the total protein content of milk changes by 0.055% to 0.22%. This is roughly the amount<\/a> protein content varies with seasonal changes in milk. In the context of your nutritional needs, this change is meaningless<\/a> – its the equivalent to less than a teaspoon difference in your daily milk consumption.<\/p>\n\n\n\n

        The second, lipids and fats, are simply not affected by pasteurization<\/em> (see page 416<\/a>). In contrast, milk fat content varies greatly with seasonal and dietary changes. Commercial milk tends to be standardized to specific fat\/lipid contents, so this doesn’t affect consumers much. But if you are producing your own milk, or buying direct from a farm, you will encounter these seasonal changes in fat content.<\/p>\n\n\n\n

        The third, vitamins, is of course a large group of nutrients<\/em>. Even with UHT, no changes are seen in the amount of the major milk vitamins<\/a>.<\/p>\n\n\n\n

        The fourth, trace metals, includes calcium, but also other metals such as zinc and iron<\/em>. As with vitamins, there are no detectable change in these compounds even after UHT treatment of milk<\/a>. That said, it is worth noting that calcium does undergo some microcrystalization after pasteurization. Essentially, free calcium ions end up binding to compounds such as phosphate and come out of solution. These tiny crystals remain in suspension – and we digest them just fine – so there is no change in the nutrients provided to us by the milk. <\/p>\n\n\n\n

        For cheese makers this microcrystallization can be an issue, as that crystalized calcium cannot be used by enzymes such as rennet. Insufficient calcium will impede the setting of curd. This is why it is common practice to add a small amount of calcium chloride to milk during cheese making. It restores the soluble (non-crystalline) calcium content, allowing rennet to work. In the context of human nutrition, the addition of calcium chloride will produce a cheese with a slightly higher calcium content than one made without added calcium.<\/p>\n\n\n\n

        The final – sugars – is lactose<\/em>. Lactose is a disaccharide: a sugar made of two simpler sugars connected together. Lactose is a very stable compound, and doesn’t degrade unless heated well above the boiling point of water<\/a>. Meaning that you’d have to boil nearly all the water out of the milk before there would be any change in the lactose composition. This means that there is no change in the lactose composition of the milk, or in its digestablity. <\/p>\n\n\n\n

        To digest lactose our bodies first need to split the lactose into its component sugars, which is done by the intestinal enzyme lactase. All infants have lactase (so they can consume milk), but in most adults this activity is lost. This is why the majority of humans cannot consume milk unless it’s been processed to remove the lactose (e.g. through making cheese<\/a> or yogourt<\/a>). A few human populations evolved to retain lactase activity into adulthood, and it is only those people who can consume milk into adulthood.<\/p>\n\n\n\n

        Myth 3: <\/b><\/span>Pasteurized milk lacks key enzymes.<\/strong><\/em> This is one of those myths which is true, false, and irrelevant at the same time. While milk protein is mostly casein – a specialized protein that helps dissolve fat into the milk – a small portion of milk protein are enzymes. The major enzymes are alkaline phosphatase, lactoperoxidase, lysozyme, lipase, and proteinases. Alkaline phosphatase removes phosphate groups from other chemicals, and helps to regulate the solubility of compounds in milk. Lactoperoxidase produces peroxides, which are antibacterial, while lysozyme punches holes in bacterial cells. Lipase degrades lipids, while proteinases break down proteins.<\/p>\n\n\n\n

        These latter three help young animals digest the milk. Of these, alkaline phosphatase is partially inactivated by pasteurization. In fact, the decrease in this enzymes activity is used as a measure to make sure that milk has been pasteurized properly<\/a>. Lactoperoxidase<\/a> and lysozyme<\/a> are unaffected by pasteurization. There are multiple lipases and proteinases, and the effect of pasteurization on these vary<\/a>. Generally, lipases are more sensitive to pasteurization than proteinases.<\/p>\n\n\n\n

        So there are differences in the activity of some enzymes in milk…but this is also irrelevant from the perspective humans over the age of 2. The reason this is irrelevant is that our stomachs efficiently degrade proteins, meaning the active enzymes are destroyed before entering your intestinal tract. It is worth noting that until over the age of 1 infants have weaker protein-degrading capacity. Which is why these enzymes are in milk – to aid the infants. But, because of this, you should also never give animal milk to an infant as the active enzymes may have deleterious effects. <\/p>\n\n\n\n

        Coming back to cheesemaking, the inactivation of lipases by pasteurization may require that additional lipase be added to a cheese if the flavour provided by lipase is desired. Luckily, lipase powder is cheap and readily available.<\/p>\n\n\n\n

        Myth 4: Raw milk protects <\/em><\/strong>against lactose intolerance<\/strong><\/em>. Lactose persistence (the ability to consume lactose into adulthood) is a genetic trait determined by a well known and understood genetic mechanism. This mechanism is not affected by the things we eat<\/a>. It’s a hard-wired genetic trait, as immutable as the colour of your eyes.<\/p>\n\n\n\n

        Myth 5: Raw milk protects against milk allergy (or allergies in general):<\/em><\/strong> This one is based on a tiny nugget of truth, but ignores the bigger picture. There are a few studies<\/a> which have shown that people who consume raw milk have fewer allergies. Seems like a slam-dunk, doesn’t it? But these studies forgot to do one key thing – to address confounders. Confounders, in simple terms, are other factors that may account for the results. In the case of these studies, that confounder was where the people lived. Raw milk consumers were almost exclusively rural residents who lived on farms, while pasteurized milk consumers were almost entirely urban dwellers. Studies have since shown that raw milk has nothing to do with the rates of allergies. Rather, its living in a rural environment that is protective (examples: 1<\/a>, 2<\/a>, 3<\/a>).<\/p>\n\n\n\n

        Myth 6: Raw milk is almost <\/b><\/em>certainty deadly<\/em><\/strong>. Most of the myths I’ve tackled up to this point are ones spread by raw milk proponents. But they’re not the only ones guilty of using hyperbole to argue their case. It is not uncommon to see raw milk treated as though all of it was dangerous. That any consumption is taking your life into your own hands. There is an increased risk to consuming raw milk compared to pasteurized milk, which I’ll discuss in detail below, but while there is an increased <\/em>risk, it is not an universal<\/em> risk. This is milk we’re talking about here, not cyanide.<\/p>\n\n\n\n

        Myth 7: Raw milk is probiotic.<\/em><\/strong> I’ve written about probiotics before<\/a>, so I’m not going to rehash everything again. As a quick reminder, a probiotic is a living microorganism, which when administered in sufficient numbers, has a beneficial effect on the host<\/em>. While most probiotics are lactobacilli<\/em>, most lactobacilli<\/em> are not probiotics. Less than 1% of tested lactobacilli<\/em> – and far, far less than that of other genera of bacteria – have been found to have probiotic effects. <\/p>\n\n\n\n

        So the likelihood that random milk from a random animal having a probiotic effect is pretty small. But even if every bacterium in a bottle of raw milk is a probiotic, you’re still out of luck. Most probiotics have a minimum effective dose of over a billion bacterial cells per day, with >10 billion typically required. Quality raw milk contains around 10,000 bacteria per millilitre – meaning you’d have to drink about a thousand litres of raw milk a day<\/em> to get a probiotic effect! And again, that’s making the absurd assumption that every bacteria in the milk is probiotic.<\/p>\n\n\n\n

        Myth 8: The dangers of milk are due to modern farming.<\/em><\/strong> This is also a common claim, but one which does not stand up to scrutiny of the historical record. In reality, unfermented milk was rarely consumed prior to the industrial age. Both classical and medieval cultures had a very negative view of the consumption of milk. Our image of a pastoral past, where farmers lived off of fresh milk from cows wandering the dells and hills of medieval and renaissance Europe, simply did not exist. This is a big topic, so the entirety of the next section is centred on this history.<\/p>\n\n\n\n

        \n\n\n\n

        A History of Milk Consumption & Fermented Milk Foods<\/h2>\n\n\n\n

        Before I go into a detailed look at modern milk safety, its worth looking at how milk was consumed and perceived historically. Much of the rhetoric surrounding raw milk is based on misconceptions of how milk was used and perceived before modern times. Raw milk proponents often claim that consuming raw milk is a return to historical norms, while pasteurization advocates will point to the lethal milk of the Victoria era as an all-encompassing example of historical “reality”.<\/p>\n\n\n\n

        Both, of course, are wrong.<\/p>\n\n\n\n

        The history of milk consumption is actually two histories. The first is the story of the peoples of the Middle East, Europe and of the western Eurasian steppe. The second is of the peoples of western Africa. The details of the latter poorly studied, so I’m going to focus on Eurasian history. <\/p>\n\n\n\n

        Milk in Pre-History<\/h4>\n\n\n\n

        Milk producing animals (goats and sheep) were first domesticated in the area round Iran sometime around 10,500 years ago<\/a>. Aurochs (cattle) were domesticated in Anatolia soon thereafter<\/a>. The farming of these animals spread quick quickly into southern Europe and the steppe, and it was shortly after this time<\/a> that the lactase persistence gene evolved. As a reminder, this is the form of the lactase gene which allows us to consume lactose into adulthood. This timeline has led some to think this a simple story: some people domesticated milk animals and developed the genes to allow them to consume milk into adulthood, and then these people (or their genes and farming practices) spread across Eurasia.<\/p>\n\n\n\n

        But this is not what happened – the story is more complex and interesting than that! While farming and farm animals spread across Eurasia like wildfire, lactase persistance did not. As one example, sequencing of of skeletons in central Europe found that the lactase persistence gene arrived somewhere around 2500 BCE<\/a> – five thousand years after<\/em> animal agriculture arrived<\/a> in the area, and four thousand years after<\/em> the first unambiguous evidence of cheese making<\/a> in the area. A recent study <\/a>has found evidence that lactase persistence most likely spread during a period of frequent famine and disease, potentially as people with this trait could consume milk products without aggravating diarrheal disease. Amazingly, the same study found that lactase persistence didn’t appear in most regions of Europe until between 1000 and 500 BCE<\/a>!<\/p>\n\n\n\n

        In other words, Europeans found ways to remove the lactose from milk (and to preserve it) long before they developed the biochemistry needed to consume large amounts of lactose after infancy. It was thousands of years from when our ancestors figured out how to preserve milk and convert it into a consumable form, to when they received the genetic tools to consume milk itself. And this isn’t unique to Europe. In fact, today there are cultures where milk is a major source of nutrition despite these cultures’ people being entirely lactose intolerant<\/a>. Genetic analysis of the organisms used to make cheese and yogourt show that the microbes we use to prepare these foods evolved as unique organisms around 10,000 years ago<\/a>. That this microbial domestication occurs at the same time that animals were domesticated, but long before the genes for consuming milk were common, is unlikely to be a coincidence.<\/p>\n\n\n\n

        In other words, we domesticated microorganisms which could remove the lactose from milk (and also preserve the milk as cheese, yoghurt, and related product), thousands of years before we had the capability to drink unprocessed milk.<\/p>\n\n\n\n

        The Classical Period<\/h4>\n\n\n\n

        Fast-forward a few thousand years and we run into the first written record of milk consumption. This was in the form of cheese making, and was recorded by Homer in the Odyssey. By the Roman era cheese making was commonplace<\/a>, and somewhat interestingly, so was a very strong bias against<\/em> drinking milk<\/a>. Romans derided the milk-drinking culture of Germanic and Celtic tribes. They were particularly aghast at the large volumes of “curdled milk” those barbarians would quaff. While the “barbarian” tribes didn’t leave written records of their own, Roman sources are clear that they consumed large amounts of curdled<\/em> milk. We don’t know exactly what this was, but the fact it was curdled indicates that it was fermented, and likely something akin to yoghurt or kefir.<\/p>\n\n\n\n

        The Medieval Period<\/h4>\n\n\n\n

        In the medieval period there was a strong link between a persons social class and the foods they would consume, with chroniclers diligently recording the foods “worthy” of different classes. In some cases there are even recorded laws dictating what can be consumed, and by whom. As in the classical era, while fermented milk products (especially cheese) were central to the diet of medieval Europeans of all social stations, milk was looked upon negatively. It was considered a food for the very poor and very sick. And even then, people were generally drinking whey or soured milk<\/a>, rather than milk straight from an animal.<\/p>\n\n\n\n

        So for most of European history humans consumed fermented or cooked milk products, but not milk itself. Moreover, milk had generally negative connotations starting at least in the early Roman period if not before.<\/p>\n\n\n\n

        So when did this change?<\/p>\n\n\n\n

        The Modern Era<\/h4>\n\n\n\n

        The widespread consumption of unfermented milk didn’t really take off until the mass urbanization of the industrial era<\/a> that took place in the mid-1800’s. The need for a cheap protein source that could be easily transported by rail<\/a> was the driver of this change. This also led to many issues. A mixture of poor storage, adulteration, and outright fraud led to mass infection – largely of poor people – with several foodborne diseases. The worst of these was bovine tuberculosis<\/a>, which killed an estimated 3,000<\/a> people a year in the city of London alone! Once this link had been established, laws mandating that all milk be pasteurized became commonplace, with these laws first appearing in the early-1900’s<\/a>.<\/p>\n\n\n\n

        TL:DR<\/h4>\n\n\n\n

        From the start of human agriculture until ~200 years ago milk was generally not consumed unless fermented or cooked. It was considered an unsafe – and often uncouth – food. Drinking of milk is very much a modern development. It’s also a development which was fatal to hundreds of thousands of people until pasteurization became common.<\/p>\n\n\n\n

        \n\n\n\n

        A Microbiological & Epidemiological Look at Raw Milk<\/h2>\n\n\n\n

        So that was a lot of writing to get to this point – a look at what recent scientific and epidemiological research tells us about modern <\/em>raw milk.<\/p>\n\n\n\n

        The Microbiological Perspective<\/h4>\n\n\n
        \n
        \"\"<\/figure>\n<\/div>\n\n\n

        Don’t forget, the point of milk is to provide young animals with an energy and nutrient dense food source. Which means that bacteria also find it an energy and nutrient dense food source. We microbiologists often take advantage of this fact and use milk as part of microbial growth media<\/a>. If you’ve ever had milk spoil you’ve experienced this growth first hand. But this fact alone doesn’t make milk dangerous. You can just as easily grow harmless bacteria in milk as you can pathogens.<\/p>\n\n\n\n

        The other thing to remember about milk is where it comes from – the udders of ruminants. Which are located below the anus of the animal, and we all know what comes out of there. The positioning of the udders under the anus may not even be accidental, with some studies identifying the fecal-udder-milk-calf transmission route to be critical for colonization of a calf’s intestinal tract with the proper microbiota<\/a>. Whether this is something that evolved specifically for this purpose, or is a “happy accident” remains unclear. In either case, fecal bacteria are commonplace on the udders of milk animals, and indeed, makeup the majority of a healthy udders microbiota<\/a>.<\/p>\n\n\n\n

        Risk from Resident Bacteria<\/h5>\n\n\n\n

        This brings us to the first danger of raw milk – resident fecal (gut) bacteria. While these bacteria are a safe and critical part of the ruminants microbiota, we humans are not ruminants. Bacteria which are perfectly safe (and even necessary) in a cow can be deadly to us. As one example, E. coli<\/em> O157:H7<\/a> is a common bacteria in the guts of cows. Here, it is a harmless and normal part of the cow’s microbiota. In us, it produces shigga toxin, leading to kidney failure and death in 2-7% of infected people. Fecal and udder-resident bacteria like E. coli<\/em> are found in the majority of raw milk samples tested<\/a>. Campylobacter<\/em> is another kind of bacteria which can be transmitted in this fashion, and causes a food poisoning illness that lasts about a week. In some cases, long-term injury or illness can result<\/a>.<\/p>\n\n\n\n

        Unfortunately, it is very difficult to control these bacteria at the level of a farm as they are normally present on the udder, and are a very normal and important part of the animals gut microbiome.<\/p>\n\n\n\n

        Risk from Animal Pathogens<\/h5>\n\n\n\n

        The second danger of raw milk is infectious bacteria – as in bacteria which make both the animal, and people, ill. This includes some of the “scarier” foodborne bacteria including Listeria<\/em>, Staphylococcus<\/em> aureus<\/em>, Salmonella sp.<\/em>, and Brucella<\/em>. <\/p>\n\n\n\n

        Listeria<\/em> is probably the most dangerous of these, and quite frighteningly, can even grow in refrigerated milk. It is the deadliest forms of food poisoning, on average killing 20% of infected people<\/a>. Listeria<\/em> is a master at invading and killing immune cells, allowing it to disseminate throughout the body.<\/p>\n\n\n\n

        Brucella<\/em> is much less of a concern than it was historically, as it has been exterminated from cattle herds throughout much of the developed world. It does remain an occasional infectious agent amount sheep and goat herds. Brucella<\/em> is rarely deadly<\/a>, but it can cause vomiting, diarrhea, liver damage, and in some patients establish chronic infections that can lead to arthritis and other issues.<\/p>\n\n\n\n

        Staphylococcus aureus<\/em> is the most common cause of mastitis (infection of the udder), and is also a common infection in humans. Staphylococcus<\/em><\/em> can infect many tissues, causing everything from minor skin infections, through to lethal infection of bones and heart valves. When consumed orally (e.g. in milk) it can cause an acute (appearing in hours) and usually short-lived (hours to a few days) food poisoning. While unpleasant, this form of food poisoning rarely leads to severe complications or death<\/a>. <\/p>\n\n\n\n

        Salmonella<\/em> are, unfortunately, rather common. Salmonella <\/em>also come in two major forms – non-invasive and invasive (the latter is also known as typhoid fever). Non-invasive Salmonella<\/em> is probably the most common form of food poisoning among humans, accounting for most cases of “stomach flu” that people experience. Salmonella<\/em> food poisoning is unpleasant, but rarely leads to severe complications or death<\/a>. Invasive Salmonella<\/em> is a much more dangerous disease, but thankfully this bacterium is almost unheard of throughout North America and Europe, where people tend to be vaccinated for this disease and where this bacterium is uncommon.<\/p>\n\n\n\n

        A critical note:<\/strong><\/em> For several of the diseases I wrote but rarely leads to sever complications or death<\/em>. Some people tend to interpret this as meaning that they are harmless<\/em>, but this is not the case. Infections put an immense burden on our bodies which have long-term consequences. The stress from a bout of food poisoning can accelerate the development of heart disease<\/a>, promote cognitive decline<\/a>, complicate diseases such as diabetes<\/a>, and even causes some forms of cancer<\/a>. So while you may survive the initial infection seemingly unscathed, your risk of developing oft-fatal diseases later in life has increased.<\/p>\n\n\n\n

        Because these bacteria also cause disease in farm animals, the risk they present to people is directly proportional to the attention and care a farmer puts into their animals. All of these produce signs of disease, meaning an observant farmer can avoid milking these animals. Signs of disease can vary depending on the organism, but most of these either produce diarrhea or mastitis (inflammation of the udder and teats). Never consume milk from a sick animal, even if it has been pasteurized<\/em>.<\/p>\n\n\n\n

        The Epidemiological Perspective<\/h4>\n\n\n\n

        The above section defines and describes the major pathogenic organisms that can be present in raw milk. These represent the hazards <\/em>that are potentially present in raw milk. But what that doesn’t tell you about is the likelihood of exposure <\/em>to those bacteria. At the end of the day it is the risk<\/em> to us that we’re worried about. Risk is determined by the combination of hazard <\/em>and exposure<\/em>. After all, a great white shark is a deadly hazard…but if you’re standing in a corn field in Iowa the risk to you is zero.<\/p>\n\n\n\n

        Complicating this further is that risk is not consistent between regions due to regulatory differences, differences in enforcement, and the use of testing. I mentioned in the beginning that France has a very rigorous monitoring and safety program for their raw milk market. This makes their market one of the safest in the world. Canada represents the opposite of France, in that it does not allow raw milk sales or use outside of some very limited commercial cheese making applications. This means that all raw milk sales are illegal, and as such there is a lack of a safety framework and there are deliberate attempts by raw milk producers to avoid detection by the Canadian Food Inspection Agency. The USA falls somewhere in the middle and has a patchwork of regulations, ranging from no legal sales, to “farm gate” sales…but with no overarching regulatory or testing system like that in France. Thus, these three countries give us some very different “lenses” to use to look at risk.<\/p>\n\n\n\n

        France: <\/strong>The regulatory environment in France offers us an excellent opportunity to see what a well-regulated and safety-conscious raw milk industry looks like. ANSES (the French Agency for Food, Environmental and Occupational Health and Safety) recently performed a detailed analysis of the association of foodborne illness from raw milk cheeses <\/a>over the decade spanning from 2008-2018. Note that these are outbreaks only – e.g. events that affected multiple people, not individual cases. I’ve summarized their findings below.<\/p>\n\n\n\n

        Organism<\/th>From Raw Milk<\/th>Other\/Unknown<\/th><\/tr><\/thead>
        E. coli<\/em><\/td>6<\/td>4<\/td><\/tr>
        Listeria<\/em><\/td>14<\/td>23<\/td><\/tr>
        Salmonella<\/em><\/td>18<\/td>32<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

        About half of those raw milk associated outbreaks were linked back to poor or failed hygienic practices. The remainder were not ascribed to an underlying cause. In either case, those numbers clearly show that raw milk cheese is a major source of foodborne illness in France. Unfortunately, while France is quite rigorous in regulating their raw milk industry, they don’t do a great job of tracking what portion of products sold are raw versus pasteurized. As such, while they have shown that 48.4% of outbreaks are from unpasteurized products<\/a> (with an additional 20% of outbreaks from products with an unknown pasteurization status), we cannot easily convert that to risk. The NYT claims that 18% of milk products in France are unpasteurized<\/a> (I couldn’t find verification of this). Assuming this is true, French raw milk products are 270 to 380 times more likely <\/em><\/strong>to cause foodborne illness than French pasteurized products.<\/p>\n\n\n\n

        USA:<\/strong> A recent review by the CDC sought to assess risk<\/a>, drawing from data recorded in the national database of foodborne<\/a> illness. This was a more complex analysis that the one done in France, as in addition to looking at the number of outbreaks, the CDC also used population and consumer data to determine the risk to individuals who consume versus do not consume raw milk products. The findings are striking – 96% of foodborne illness caused by dairy products were from raw milk and raw milk-derived products, despite raw milk representing only 3-5% of the total dairy market! In terms of relative risk, raw milk and raw milk products were 840 times more likely<\/em><\/strong> to cause foodborne illness than were pasteurized products.<\/p>\n\n\n

        \n
        \"a
        Actual footage of a Canadian mountie apprehending a raw milk distributor.<\/figcaption><\/figure>\n<\/div>\n\n\n

        Canada: <\/strong>That brings us to my home country of Canada – where, as a reminder, raw milk sales are illegal. This makes estimating risk extremely hard as researchers are tracking what amounts to a criminal activity. A recent study attempted to do just this<\/a>. 62.5% of milk-product associated outbreaks identified in this study were due to unpasteurized products, and accounted for 78% of disease cases (e.g. raw milk outbreaks were both more common, and larger, than outbreaks from pasteurized products). Taking into account the estimated size of the Canadian raw milk industry (1.2% to 2.3% of total milk sales), this makes raw milk between 1,400 times and 2,600 times more dangerous <\/em><\/strong>that pasteurized products.<\/p>\n\n\n\n

        The Bigger Picture<\/h4>\n\n\n\n

        Clearly regulation makes raw milk products safer. Raw milk products in France are up to ten times safer than they are in Canada, with the USA falling somewhere in the middle. But it is also clear that even with a rigorous regulatory and testing regime, raw milk remains significantly more dangerous than pasteurized products. In the broader context of food safety, raw milk is by most measures, the most dangerous food product consumed in the Western world<\/a> on a per-serving basis.<\/p>\n\n\n\n

        \n\n\n\n

        Being Safe as You Can with Raw Milk<\/h2>\n\n\n\n

        Pasteurizing is the best way to be safe when using milk products. But what can be done if you want to use raw milk, but don’t live in a country with a secured and regulated supply? The answer is “not much, unless you own your own animals”. Keep in mind, a trusted supplier only has to make a minor mistake for milk to become contaminated. If you own your own animals, you can collect raw milk in a manner which should produce a relatively safe product. For that matter, a lot of this advice is good for maintaining healthy and safe animals even if pasteurizing your milk.<\/p>\n\n\n\n

        Maintain healthy animals and a clean environment<\/h3>\n\n\n\n

        This one is rather obvious, but still needs to be stated. Keep your barn (or wherever your animals live) as clean as you can. Feces and soiled bedding should be removed daily. Areas where the animals urinate should be allowed to dry completely each day, and if the area is sand or soil, the sand\/soil replaced annually. Animals should be inspected before each milking for signs of disease, looking for things such as:<\/p>\n\n\n\n

          \n
        1. Soiled rump, anal area, udder, or area between the hind legs. This can be a sign of diarrheal or other intestinal disease. <\/li>\n\n\n\n
        2. Inspect the barn for unusual feces (e.g. clumped feces in animals that normally produce pellets). Again, this can be a sign of diarrheal or other intestinal disease. <\/li>\n\n\n\n
        3. Sores on the teats or udder, or patches of hair loss on the udder. These are signs of cellulitis (bacterial skin infection).<\/li>\n\n\n\n
        4. Red, swollen, or sensitive teats, or signs of solid material or blood in the first milk expelled when milking is started. All of these are signs of mastitis (infection of the mammary gland\/udder).<\/li>\n\n\n\n
        5. Lethargy, excessive coughing, poor eating, or general signs of malaise. All of these are general signs of infection.<\/li>\n<\/ol>\n\n\n\n

          Milk from animals showing these signs should never be consumed raw or<\/em> pasteurized. Infected animals should be quarantined to limit the spread of disease throughout the herd, and if necessary, a veterinarian consulted to ensure proper treatment.<\/p>\n\n\n\n

          Milk Collection<\/h3>\n\n\n\n

          While some contamination of raw milk occurs within the udder itself, contamination is also introduced during the milking process. This often occurs when debris fall into the milk as it is collected, or from bacteria on the skin of the teats. These risks can be mitigated fairly simply:<\/p>\n\n\n\n

            \n
          1. Use a milking machine, rather than hand milking. Milking machines are closed systems, making it impossible for materials to fall into the milk once it leaves the animal. In contrast, hand-milking into an open container leaves the milk exposed to contaminants falling off of the animal, or from the environment.<\/li>\n\n\n\n
          2. Pre-sanitize the milk collecting equipment before use. Contamination doesn’t just come from animals, it can also come from equipment. Sanitizing all parts of the milking machine that will contact milk will reduce this risk.<\/li>\n\n\n\n
          3. Hand-strip the teats before milking and closely inspect the stripped milk<\/em>. To hand-strip, manually milk a small amount of milk out of each teat onto a clean rag or shallow dish. Inspect the milk for white clumps or pink colourization. Animals showing either or both signs likely have mastitis. The milk from these animals is unsafe for consumption and should be discarded. Moreover, this milk should not be collected using equipment which will be used to collect milk for consumption (raw or pasteurized). Dispose of the pre-stripped milk – pre-stripping will expel the milk closest to the duct, which is the milk most likely to be contaminated.<\/li>\n\n\n\n
          4. Use a teat dip before milking. These contain skin-safe sanitizing agents which will reduce the number of potential contaminants on the teat. Teat dip should be used immediately before attaching the milking machine, but after hand-stripping.<\/li>\n\n\n\n
          5. Chill the milk as it is collected. E.G. by placing the receiving container in an ice-bath.<\/li>\n<\/ol>\n\n\n\n

            After collection<\/h3>\n\n\n\n

            Raw milk should be used quickly after collection as it is much less shelf-stable than pasteurized milk. Milk should be transferred from your milking machine to sanitized containers and chilled to 4C (39F) or cooler as quickly as possible after collection, and maintained at this temperature until used. Ideally, if making cheese, make the cheese the same day as the milk was collected. If you need multiple milking days to collect the milk for your planned batch size, make sure you are collecting this milk over the minimum time frame and that you make the cheese as soon as you have enough milk.<\/p>\n\n\n\n

            And most importantly, use your senses and dispose of any milk or milk product you think may have issues. Unusual colour, texture, or aroma may be a sign of contamination – if in doubt, throw it out!<\/strong><\/em><\/p>\n\n\n\n

            \n\n\n\n

            Conclusions<\/h2>\n\n\n\n

            I think at this point the conclusions are obvious, but are worth stating in a clear form:<\/p>\n\n\n\n

              \n
            1. There is no meaningful nutritional, gastronomic (flavour\/aroma), or health benefits to consuming raw milk compared to conventionally pasteurized milk.<\/li>\n\n\n\n
            2. There is no meaningful nutritional differences between raw milk and pasteurized milk – not even with UHT pasteurized milk.<\/li>\n\n\n\n
            3. Raw milk is much more likely to cause foodborne illness than is pasteurized milk.<\/li>\n\n\n\n
            4. While regulations and good practices can reduce the risk presented by raw milk products, they cannot eliminate this risk.<\/li>\n\n\n\n
            5. Pasteurization is a simple method of eliminating most of the risks present in raw milk.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

              There are a lot of claims regarding the safety and dangers of consuming raw milk. This article takes a critical eye to separate hype from reality.<\/p>\n","protected":false},"author":1,"featured_media":2826,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[353,12,236,235],"tags":[349,270,357,365,340,339],"class_list":["post-2802","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cheese_making","category-fact-or-fiction","category-fermented-foods","category-food","tag-cheese","tag-fact-or-fiction","tag-milk","tag-raw-milk","tag-yoghurt","tag-yogurt"],"yoast_head":"\nFact or Fiction - Safety and Health of Raw Milk - Sui Generis Brewing<\/title>\n<meta name=\"description\" content=\"There are a lot of claims regarding the safety of consuming raw milk. 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