The Milk Myth

When I was growing up, milk and other dairy products were considered to be among the healthiest of foods. Kids, in particular, were encouraged to drink milk liberally. It was even considered to be healthier for babies than their mother's milk and breastfeeding was generally discouraged. This was largely in response to the propaganda machine of the dairy industry which targeted parents, doctors, and heavily lobbied governments to make sure that milk was on the top of the list of healthy food choices in their various official food guides. Our society was a lot more patriarchal in those days and almost no one would ever question someone in authority like a doctor. So, if your doctor told you not to nurse your baby and put her/him on a dairy-based infant formula instead, and all through their childhood and adolescence to make sure they drank lots of the white stuff, that was what you did. It didn't matter that doctors received extremely little, if any, schooling in nutrition (not that it would have mattered much as there was very little good science behind nutrition until the last 10-20 years). They were the experts!

When it comes down to it, most doctors, even if they are among the few who are more open-minded and less stuck in a narrow reductionistic paradigm, really don't have a lot of time to keep on top of the latest research. As a result, they get most of their info from product literature provided by pharmaceutical companies and other commercial interests. Of course they have the Canadian and American Food Guides to fall back on when it comes to nutrition. But these are hugely influenced by lobbying efforts on behalf of major commercial sectors such as the dairy and meat industries.

Now, to be fair, the natural health product industry plays the same game, although they don't have the size, money and influence to do it as well as the larger, better established industries. If you go looking for information from people who work in health food stores or from many natural health practitioners (especially if they sell products), no matter how good their intentions you'll find that they are getting most of their information from biased product literature provided by the natural health product industry.

Anyway, getting back to milk, until recently most of the research out there was largely funded by the dairy industry. However, more recently there have been some decent independent studies that have been coming to very different conclusions than what the dairy industry would like us to believe. As a result, some pretty high profile researchers have begun to poke holes into some of the milk myths. For instance, see:

http://blogs.scientificamerican.com/talking-back/2013/07/03/got-milk-maybe-a-recipe-for-obesity-and-cancer/

Some of the myths that are questioned here are: skim milk is healthier than whole milk; milk is the best source of calcium; most of the supposed health benefits of milk are unproven. They also point out that milk consumption is associated with a number of potential negative health consequences and recommend that whole milk be consumed rather than skim milk and it should be considered an optional part of our diet (no minimum daily requirement as the various official food guides recommend) and consumed in small quantities, if at all.

I would add to that to only consume certified organic dairy products. It's interesting that many people are more inclined to purchase organic fruits and veggies but aren't as concerned about dairy and meat products. The rationale is that chemicals are sprayed directly on to plants, but this is not the case with animals. I'm sure cost is one of the factors behind these attitudes. Dairy and meat tend to be among the more costly food products and when you add the organic premium they can get pretty expensive. My answer to that is to buy organic but eat less. Most North Americans eat far too much meat and dairy anyway. Aside from the fact that commercially raised animals are unhealthy from being stressed out, fed diets that are unnatural for their species, being raised in inhumane conditions, and pumped full of drugs and hormones, toxins such as agricultural chemicals become more concentrated as you move up the food chain. Although it varies depending on the chemical and the animal, on average it is about ten times at each level. That means that, since commercially raised livestock are fed commercially grown feed, the levels of agricultural chemicals in the tissues of these animals is approximately ten times the level of the plants that they are fed. Also, many animals (even herbivores) are given feed that contains animal products which will raise the levels of these chemicals in their tissues to even more than ten times. As a result, animal products are the most important foods to eat certified organic!

Dandelion greens (Taraxacum officinale) are an excellent source of calcium,

magnesium, potassium, iron and other important trace minerals.

Getting back to milk, the dairy is the best source of calcium myth is being questioned as well. For instance, apparently bone fractures are more common in countries that have the highest dairy consumption! The authors point out that significant levels of calcium can also be obtained from leafy greens, nuts and seeds. Many herbs are a good source of calcium as well as other minerals that are necessary for the proper assimilation and utilization of calcium. These include the leaves of dandelion (Taraxacum officinale), chicory (Cichorium intybus) and nettle (Urtica dioica). Although I usually prefer to use herbs in the form of fresh plant tinctures for medicinal purposes, when they are being used for their nutritive properties it is best to take them as a tea because the amount of actual herb per unit dose is much higher to make a cup of tea than what is necessary for a dose of tincture. Most nutrients need to be consumed in much larger quantities than other more pharmacological constituents of herbs. Of course, you'll get even more minerals and other nutrients if you eat them! Many green leafy herbs are both edible and very nutritious.

Although calcium is a very important nutrient, the whole issue of how much we need is now being questioned as well. Some recent research has demonstrated that too much calcium is associated with negative health consequences, especially cardiovascular disease. For instance, check these out:

http://www.sciencedaily.com/releases/2013/02/130212192030.htm

http://www.sciencedaily.com/releases/2013/02/130204184306.htm

I included both of them because although one of the studies only found this association in men, but not women, the other one focused exclusively on women. It is interesting to note that there seems to be a stronger correlation when people take calcium supplements. It would have been interesting to see what they would have found had they taken into account the different forms of calcium that were supplemented.

Our obsession with calcium is one of the factors behind the recommendation to consume more dairy products. However, we seem to be getting carried away with this. Calcium supplements are one of the most common supplements recommended by doctors.

When I see new clients, I am often shocked at how much calcium they have been told to supplement by doctors and even other natural health practitioners. I often see people taking 50-100% the recommended daily amount. This is absurd! It is true that our body does not absorb 100% of the calcium we consume, however, the efficiency of calcium absorption increases the more we need it. It is also true that calcium levels are only high in a small percentage of foods, nevertheless there is calcium in everything that we eat (except in some heavily processed junk foods and beverages). In addition, doctors in particular often recommend the worst calcium supplements. Firstly, they recommend forms that are poorly absorbed such as calcium carbonate, which is the most common form found in pharmaceutical brands. Secondly, they often recommend supplements that only contain calcium and possibly some vitamin D. The latter is necessary for proper calcium absorption. Most calcium supplements contain 200-400 IU of vitamin D. Recent research has demonstrated that many people are deficient in vitamin D, so these amounts are not enough for most people. In addition, our body has to maintain a very delicate balance between many minerals. If some minerals are taken in excess it disturbs this balance, both by the increased availability of the supplemented minerals, and because excessive intake of some minerals will actually deplete our body of others. As a result, calcium should not be taken on its own. Ideally, at the very least it should be taken with vitamin D, magnesium, zinc and copper, but preferably with manganese, silicon and possibly a few other trace minerals as well. Usually the best way to take calcium is as part of a good multi mineral complex.

Here I am hugging a dolomite (dolostone) boulder. Dolomite is one of the sources of calcium carbonate.

I don't know about you, but I don't absorb rocks very well. However, I do enjoy hanging out with them!

In my practice, I rarely recommend calcium. If someone is a bit low in this mineral, it can usually be addressed through diet - even without dairy products. In some situations and for therapeutic purposes I may recommend it, but rarely more than 200-300 mg per day, always in a well absorbed form such as calcium citrate or ascorbate, and always in combination with a decent amount of vitamin D (at least 1,000 IU) and other minerals to balance things out.

So, lets get back to milk and other dairy products. Dairy is one of the most common food allergies or sensitivities in our society. This is related to a lot of factors that are common in our society: poor diet and lifestyle practices; lack of exercise; general toxicity; stress and other emotional and psychological factors. All of these predispose us to many chronic health conditions including allergies and food sensitivities. Add to this that most of the dairy products we consume come from sick animals; are laced with drugs, hormones, agricultural chemicals and other toxins; and that milk by nature contains proteins that are irritating to our digestive tract and, in general, is over-consumed (we are more likely to develop sensitivities to foods that we consume in excess), and it's not surprising that so many people don't tolerate it well or at all. In my practice I often find dairy allergies or sensitivities associated with obesity, diabetes, and chronic inflammatory conditions of the digestive tract, skin and respiratory system. As a result, I usually have people with these kinds of conditions reduce or even eliminate dairy from their diet, depending on the individual case.

One interesting side note, in ayurvedic and siddha medicine, two ancient healing traditions from India, they extol the benefits of milk, considering it to be one of the most perfect foods. They sometimes even recommend that herbs be boiled in milk! I once had a conversation with an ayurvedic practitioner about this. I explained that I so often see milk consumption associated with chronic health conditions. It was his belief that this is because the milk we consume in the West is from sick animals, full of chemicals, pasteurized and refrigerated. He believed that the processes of pasteurization and refrigeration denature (alter the structure of) the proteins in milk making it more harmful than beneficial. I don't know if this is true, but it's something worth considering. In India, until recently, very few people had refrigeration. They usually obtained their milk fresh each day from free ranging cattle, boiled it and either used it right away or cultured it to make curd. When I was in India in the early 80's, I still had a very severe allergy to dairy products (which I eventually overcame). Although I could not tolerate dairy products in any quantity when I was at home in Canada, I could tolerate them in small amounts over there. Apparently, there is (or was) something very different about their dairy products.

Many people in India obtain their milk from Brahma cattle (Bos indicus).

Of course, you won't get much milk from this one!

The bottom line here is that milk and other dairy products are not as beneficial as they are promoted to be; are particularly problematic for a growing segment of our population who have various kinds of sensitivities to them; and can have some serious negative health consequences when over-consumed. For those who can tolerate them, it is best to consume only certified organic dairy products, and only in moderation.

The Pros and Cons of Vitamin Supplementation, Part 2 of 3

This is the second of three posts on this topic. Part 1 was posted on November 20th.

Let's continue this discussion by considering Walter Willett's recommendation that we take a low potency multivitamin and mineral supplement. I qualify that recommendation to mean a good quality low potency multivitamin. The first thing we need to realize is that pretty much the only thing that changes in potency between low, medium and high potency multivitamins is the amount of the B complex vitamins. These are among the most widely supplemented vitamins. They are often marketed as "stress" vitamins because our requirements for B vitamins increases when we are under greater stress – and people today experience a lot of stress! B vitamins are not easy to obtain in high doses from foods. There are a few foods, like liver and certain kinds of yeast, that are relatively high, but eating large quantities of these foods is not necessarily ideal. Firstly, the liver is an organ of detoxification and one of the most toxic organs in the body. Eating the liver of various mammals and fish was a good source of many important nutrients in the past, but these days I don't recommend eating liver or other organ meats on a regular basis or even at all due to their toxicity. Eating brewer's yeast or other kinds of nutritional yeast is also not necessarily the best solution. They need to be eaten in fairly large amounts to provide similar doses of nutrients to those found in supplements and are not a normal component of the human diet in these quantities. Also, many people have sensitivities to yeasts, and they don't necessarily provide B vitamins in the correct ratios that match our daily requirements. I'm not saying that we should never eat these foods, only that it probably isn't ideal to eat them in large quantities or too regularly. Also, if we do eat liver, we should only eat liver from healthy, organically raised livestock. Liver from wild animals is less desirable. Even in the remotest regions it has been known to contain significant quantities of mercury, PCBs and other toxins that come from the activities of the logging and mining industries or arrive in the air, rain and snow. Also, wild game tends to be contaminated with lead if it is killed using bullets that contain lead. Although traditional peoples used as much of an animal as possible to honour the spirit of the animal and because it makes practical sense, unfortunately it is no longer a good idea to eat the organs of wild game on a regular basis.

The flesh of wild game such as white-tailed deer (Odocoileus virginianus) can contain significant toxicity, even in remote areas.

Because consuming B vitamins in larger doses helps people to better deal with the affects of stress, B complex vitamins are very often supplemented, usually in medium to high potencies. This is not something that I recommend, and if we want to approach this from a "holistic" perspective, it is not very holistic. Most B vitamin supplements have the same dose of every B vitamin, usually 25, 50, 75 or 100 mg (mcg for a couple of them). However, our body doesn't use them all in the same amounts and these dosages are grossly in excess of what we need. A good quality B complex will have a range of doses of the individual B vitamins corresponding roughly to the relative amounts that we require. Ideally the dosage range should be between 5-10 mg (or mcg) for the lower dose B vitamins, and 15-25 mg (or mcg) for those required at a higher dose. It depends on the individual vitamin. Even at this dose, no matter how stressed out we are, our urine will still turn bright yellow after we take them. This means that the dose has exceeded our requirements and the excess is being flushed out by our kidneys. Technically, it is only riboflavin that produces this colour in our urine, but if the dose of riboflavin that we are taking is excessive enough to change the colour of our urine, we can be pretty certain that the dose of the others is similarly excessive. We don't want to exceed our requirements by too much because it puts stress on our kidneys to have to filter them out of our blood in large quantities on a daily basis.

Secondly, in order to be efficiently utilized, B vitamins need to be taken together with other nutrients, particularly vitamin C and some of the essential minerals. This is why it is much more "holistic" to take B vitamins in the context of a multivitamin and mineral supplement rather than on their own. In addition, there are probably other nutrient and nutrient-like substances in food that interact with B vitamins and all of the other nutrients in a multivitamin in ways that we haven't even begun to understand. For this reason vitamin supplements should always be taken with a meal so that they are taken together with their natural counterparts and all of the co-factors that work together with them. In particular, fat soluble vitamins like vitamins A, D and E can not be efficiently absorbed unless they are taken with a meal that contains some lipid (oil or fat).

The other rationale for taking a multivitamin and mineral supplement is that some of the most common nutrients that are deficient in our diet are trace minerals. This is because trace minerals are not replenished by the synthetic fertilizers used in commercial farming. Also, the soils of some regions are naturally deficient in certain trace minerals because they don't occur in the bedrock that underlies the soil, which is where most of the minerals in soil come from.

A multivitamin is not a replacement for a good diet. It is a supplement to a good diet. A good diet is essential. However, people in our society tend to experience chronic stress of a moderate to high intensity. This can significantly increase our nutrient requirements. A good quality, low potency multivitamin and mineral supplement is recommended to make sure that we are getting all of the nutrients that we need in sufficient, or preferably optimum amounts on a daily basis.

In addition to a relatively low dose of B vitamins that are in ratios that approximate our daily requirements, a good multivitamin and mineral supplement should also contain the major trace minerals such as zinc, manganese, selenium, copper and molybdenum. The minerals should be in a form that is easily absorbed such as amino acid chelates, citrates and malates. Some forms such as carbonates and gluconates are not as well absorbed. Oxides are particularly not recommended because they promote tissue oxidation. Also, it is preferable to use a multivitamin that does not contain iron. This is because iron is a very powerful oxidizing agent and too much iron in our blood and tissues promotes oxidation and contributes to many chronic health problems. Most people in our society get too much iron because they eat too much meat. Many kinds of meat are very high in iron and it is in a form that is more absorbable than the iron in plant foods and water. Another issue with iron is that the forms of iron found in supplements are usually difficult to absorb. So, the iron in multivitamins isn't the best form to take. As a rule, I recommend iron-free multivitamins and, if there is reason to believe that someone needs an iron supplement, I give it to them separately in a highly absorbable form taken together with vitamin C, which also increases the absorption of iron. Fortunately, most companies offer iron-free alternatives these days.

The last point I would like to make about multivitamins is that many of the companies who like to market themselves as "higher quality" add herbs to their vitamins. This has become a common practice these days and it is bad news for consumers. It is getting very difficult to find decent multivitamins that don't contain herbs. Here I am not referring to concentrated plant-based antioxidant extracts like flavonoids, anthocyanins and carotenoids. These are excellent ingredients to include in a multivitamin and highly recommended. What I am referring to is the addition of popular medicinal herbs like ginseng, Ginkgo and Echinacea to vitamins. For the most part this is a gimmick. Usually the herbs are in forms and quantities that will not provide any medicinal benefit. They are included because they are popular. It is a selling feature that can increase sales and help justify charging higher prices for these products. Sometimes they are included in general multivitamins because the public (with the manufacturers help) will perceive some value to including them. In other cases they are used to give a product a more specialized function, like including traditional female reproductive herbs in multivitamins "for women". Unfortunately, most supplement manufacturers don't consult with experienced herbalists when developing their formulations. So, regardless of their intentions, they often end up including herbs in ways that are inappropriate.

Medicinal herbs such as common purple coneflower (Echinacea purpurea) should not be ingredients in vitamin supplements.

Although foods – especially plant foods – are medicinal to some degree, we have always made a distinction between plants that we eat and those that we reserve for specialized use when we need a more powerful medicinal action than what can be obtained from foods. Even though the herbs in these products are usually in quantities that will not provide any medicinal benefits, ingesting them in these small quantities can still cause our body, or microorganisms living in our body, to adapt to them so that when we really need their medicinal benefits they won't work as well even in the appropriate forms and doses. Medicines should never be abused. They can lose their effectiveness and in some instances they may even be harmful.

I have occasionally come across multivitamins that do contain concentrated extracts of herbs in therapeutic doses. This is still not desirable. Herbs are not meant to be used this way. We use them only when we need them and in the appropriate way. The moral of the story is that any vitamins that we purchase for use on a regular basis should not contain medicinal herbs.

Another issue concerning the use of vitamin supplements is that some vitamins in these supplements are in slightly different forms than those found in foods. In fact, the whole notion of "natural" vitamins is also for the most part an advertising gimmick. The only really natural vitamins are those in whole foods together with all of the other nutrients and co-factors with which they naturally occur. When you buy a "natural" vitamin, if it is a relatively good product the word "natural" really means "relatively complete, in more-or-less natural relative proportions with plant-based co-factors, a few ingredients from natural sources, mostly synthetic". There is a lot of misinformation out there about natural vitamins and manufacturers often go out of their way to promote it. For example, there are many products on the market called "Rosehips Vitamin C 500 mg". Most relatively educated consumers of natural foods have probably read that rosehips are very high in vitamin C. When they see a product called "Rosehips Vitamin C 500 mg" they tend to think that either each capsule contains enough rosehip powder to provide 500 mg of vitamin C or it contains 500 mg of vitamin C that was extracted from rosehips. What it really means is that it contains 500 mg of synthetic vitamin C with some amount of rosehip powder. It could be a very small amount, in which case the ingredient list will say something like "in a base containing rosehips". If it is a more substantial amount, it will specify some quantity, usually 50 or 100 mg. This is very different from how most consumers perceive the product. Although rosehips are a very rich source of vitamin C or ascorbic acid, they still only contain 0.03-1.3%, depending on the source. Therefore the amount of rosehip powder necessary to provide 500 mg of vitamin C is between 38 g (1.3 oz) and 1.67 kg (3.7 lb)! Even at the higher concentration it just wouldn't be possible for someone to eat that every day. It probably wouldn't be good for them either as rosehips have lots of other properties that are potentially problematic at this dose. Extracting vitamin C from rosehips is not practical either. Not only would it be prohibitively expensive, it would be extremely unsound from an ecological point of view to have to use that much rosehip powder to make every capsule of vitamin C. As it turns out, the ascorbic acid molecule is closely related to monosaccharides and can be manufactured very cheaply from glucose. The molecular form of synthetic ascorbic acid is identical to the natural form.

Sweetbriar rose (Rosa eglanteria) is a common wild source of rosehips.

In the case of other vitamins, there are a couple for which the synthetic version is slightly different than the natural form. This usually means that the synthetic form partially or completely consists of isomers of the natural form. These are molecules that have the same chemical formula but are a different shape. In these cases our body, usually our liver, can sometimes convert the alternative isomers to the natural form so they can be used by our cells. In some instances they may need to be converted in our intestines before we can absorb them. These processes are not 100% efficient. That means that for a few vitamins the absorption and utilization of synthetic forms might not be as efficient as their natural counterparts. However, because the amounts found in supplements are significantly greater than those found in foods, even allowing for poorer utilization of some of them, they are still going to contribute significantly to our daily intake. Fortunately, the main vitamin for which this is a concern is vitamin E and most better quality vitamins contain the natural form, d-alpha-tocopherol or d-alpha-tocopherol succinate, rather than the synthetic form, dl-alpha-tocopherol. You will note that I said that some synthetic vitamins "might not" be as efficiently utilized. This is because natural nutrients are not always absorbed efficiently from our food either. In addition, due to common dietary and lifestyle habits, most people in our society suffer from some degree of digestive deficiency. For many of them it is actually easier to absorb and utilize vitamins from supplements than from food. The exception is timed release vitamins. These are intentionally made more difficult to digest so that water soluble vitamins will be absorbed more slowly, otherwise they tend to be flushed out of our body by our kidneys pretty rapidly. Timed release vitamins are not recommended because they are not always digested efficiently. It is better to take smaller amounts of vitamins more often than to take larger amounts in a timed release form.

Still on the natural vs. synthetic and bioavailability issues, there is another kind of supplement that you will sometimes come across that I will briefly discuss. These are usually called "food form" or "food matrix" supplements. The basic philosophy behind these products is that nutrients are better absorbed when they are part of an organic multi molecular matrix similar to how they occur in foods. Supposedly these kinds of supplements are made by force-feeding certain kinds of yeast large amounts of a particular nutrient in its synthetic form and forcing them to convert it to a more natural, organic form. An extract is then made of the yeast which includes these nutrients in a "food form" along with other cofactors found in the yeast. Although the basic idea sounds good, I do not recommend these kinds of supplements for several reasons. Firstly, it is difficult to guarantee that these products actually contain what they claim to contain. Some manufacturers have been know to simply mix synthetic vitamins with yeast or other food extracts, in which case the vitamins haven't really been converted to an organic form. This is particularly an issue in the U.S. where quality control standards are not as stringent as in Canada. So far I am not aware of any companies manufacturing these products in Canada and I have yet to see any of the American products with an NPN (Natural Health Product Number) indicating that they have met Canadian standards. Another concern is that sometimes nutrients of this kind are manufactured by genetically engineering yeasts or other organisms to produce the nutrient in large quantities as a metabolic by-product. Even for those products that are what they say they are, there is no independent research that I am aware of that indicates that this form of nutrient is more bioavailable. In fact, in order for nutrients to be absorbed they must be separated from any organic molecules to which they are attached. For this reason nutrients are usually better absorbed when they occur as closely as possible to their free form state. Finally, these nutrients tend to be a lot more expensive than standard vitamins and minerals even though they contain much lower doses of nutrients. The rationale for the lower doses is that they are supposed to be better absorbed. However, this isn't necessarily the case and even if it is, you are still going to absorb more from a standard supplement that contains a much higher dose - at a fraction the price! The bottom line is, even if some of these products contain what they claim to contain and work as well as they are supposed to, you will get a lot more value for your money purchasing other forms of supplements.

This is the end of my second post on this topic. In Part 3 I will continue this discussion and then explain what I personally recommend as a basic supplement regimen.