Paleo Diet and Paleolithic Diet Questions & Answers

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Dairy is rejected by vegans and many in Paleo. Some consider it "your mileage may vary" (Kurt Harris). I've been examining the argument against dairy from both angles. Not surprisingly, the arguments against dairy are fairly similar (at least until you deal with animal proteins). Here's one area where the two camps might join forces! To summarize, here're the arguments against dairy. I've included counterarguments where there seem to be confusion or weak claims.

Dairy promotes cancer by increasing IGF-1 (Insulin like Growth Factor 1). IGF-1, like leptin, is elevated during puberty, but it should be much lower in adults. The dairy industry uses recombinant bovine growth hormone (genetically engineered growth hormone) to produce more milk. This hormone elevates IGF-1, which stimulates cell division and multiply cancer cells. Cordain mentions this in his first edition of "The Paleo Diet" (pp. 78-81). So do many cancer prevention groups: http://www.preventcancer.com/press/editorials/march20_94.htm . Three major types of cancer (breast, prostate, and colorectal) are all associated with elevated IGF-1. Also, IGF-1 accelerates aging: http://www.drmcdougall.com/misc/2007nl/mar/dairy.htm

Counterargument: is it IGF-1 or insulin? Elevated insulin is implicated in angiogenesis. If so, it may not be just dairy but high-glycemic carbohydrates, that is, grains and starches, including "safe starches" (white rice, yams, sweet potatoes). Indeed, Cordain makes this argument: "Many women ... have adopted vegetarian diets in an attempt to reduce their risk. Unfortunately, it may be that ... [g]rain and starch based diets actually increase the risk of breast cancer, because they elevate insulin -- which in turn increases IGF-1 .. A large epidemiological study of Italian women ... has shown that eating large amounts of pasta and refined bread raises the risk of developing both breast and colorectal cancer" (p. 79). So we are dealing with the familiar problem in epidemiology, where the association studied (dairy vs. cancer) may be warped by substitute, comfort foods (high glycemic carbs) consumed in the absence of (in addition to) the subject.
Cow hormones also promote cancer. Dairy accounts for 60-80% of the female sex hormone, estrogen, consumed from food. In a typical year, dairy farmers force cows to be pregnant via artificial insemination to produce milk 10 out of 12 months. In other words, factory farming has turned cows into "milk pumps", who are forced into a constant state of gestation and stress to produce hormone-filled milk. (This contrasts with the practices of herding socieities in Mongolia, where cows are milked 5 out of 12 months and only during early pregnancy.) As cows move to later pregnancy, even more hormones (estrogen, progesterone) appear in the milk. These hormones have been linked to cancer, especially prostate / testicular cancer: http://news.harvard.edu/gazette/2006/12.07/11-dairy.html . For example, dairy is linked to the emergence of prostate cancer in Japan: 50 years ago, there was virtually no prostate cancer in Japan. For men, milk and cheese consumption is strongly associated with testicular cancer: the rates are highest in Switzerland and Denmark, where dairy consumption is universal, and lowest in countries like Algeria, where dairy is not widely consumed.

Counterargument: Is it excess cow hormones or IGF-1 or insulin? It's not clear. Also, if it's true that excess cow hormones cause cancer, the same should be accorded to conventional beef and pork -- these are fed antibiotics and growth hormones so they can mature fast to be slaughtered early. Without growth hormones, the supply of beef and pork would fall, and the spot prices of live cattle and pork bellies would skyrocket. No one would be able to afford beef or pork, let alone grass-fed beef or pasture-bred pork. Also, you can drink skim milk since hormones reside in milk fat.
Dairy does not promote bone density or prevent osteoporosis by providing dietary calcium, as claimed. This is a myth created by the dairy industry. Bodily calcium levels are dictated by calcium absorption and calcium loss. IGF-1 and the above hormones have the effect of building bones for children and teenagers. However, the favorite vegan argument has been that animal proteins "leach" calcium from the bones, leading to calcium excretion. So the net effect is nugatory or even negative for dairy. What you need is calcium from plant sources (kale, spinach, broccoli, bok choy), which do not cause "calcium spills" and are net positive when considering both absorption and excretion. Also, Vitamin A in dairy can weaken bones. Countries that have the highest dairy consumption (OZ, NZ, Scandinavia) typically have very high rates of osteoporosis -- thus, dairy promotes net calcium loss or even lower bone density via excess Vitamin A.

Counterargument: This is where Paleo and vegan positions diverge. If it's high protein diets that cause negative calcium balance, then dairy isn't the sole culprit. Eggs and fish would be more responsible for this calcium spill than dairy, based on their higher protein content. A meat-heavy diet seems to be more responsible for higher rates of osteoporosis than dairy consumption, as countries that heavily consume dairy also heavily consume beef, pork, and poultry. Indeed, this is exactly the position of the vegan troika, T. Colin Campbell, Neal Barnard & John McDougall: http://www.news.cornell.edu/chronicle/96/11.14.96/osteoporosis.html . (What is the Paleo argument? Is "calcium spill" legit? Them vegans keep accusing our beloved Inuits of hobbling from osteoporosis!)
Dairy promotes autoimmune diseases, especially T1 diabetes, Crohn's, Ulcerative Colitis, eczema, psoriasis, and acne. Vegans have claimed that dairy promotes T1 diabetes. Cordain claims that T1 diabetes is probably caused by gluten, dairy, legumes or grains. The evidence against T1 diabetes is particularly compelling: early introduction to dairy seems to cause an autoimmune reaction that damages the islet cells in the pancreas, among those genetically susceptible. You end up not being able to make insulin endogenously. While there may be other triggers, dairy certainly seems to be one of those triggers. I have personally experimented with dairy by eliminating and reintroducing it. With a lag of some 3-5 days, dairy does seem to worsen my Sjogren symptoms. I was a heavy dairy consumer before all this (heavy Vit D pasteurized milk, cheese, ice cream, flavored yogurt, frappucinos, sour cream).

Conclusion: Dairy seems to be strongly "associated" with most commonly occuring forms of cancer. However, because of dietary lifestyles and the lack of rigor in epidemiological studies, it is hard to allocate blame specifically to dairy (rather than high-glycemic carbs or meat consumption). On the other hand, clinical (animal) studies do confirm the association between dairy and cancer (via elevated IGF-1), and dairy and autoimmunity (esp. T1 diabetes). The relationships seem to be stronger than mere "association."

Here, I agree with Cordain. There is enough circumstantial evidence. Dairy is at least allergenic and at worst cancer-forming. It took me a while to forego sour and heavy cream, but it seems wise to stay away from dairy if you have an autoimmune condition. You may not agree. What is your argument?

Edit: all of the above points (except #3) are covered in more detail by Pedro Bastos in his Ancestral presentation: http://vimeo.com/27671369 ; http://www.slideshare.net/ancestralhealth/ahs-slidespedro-bastos-8827808

edited Sep 6 2011 at 4:39

Namby Pamby

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Namby Pamby 96%

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Well done, Namby Pamby. Great post. Two considerations (argument & counter-argument) I would add though: 1) Who is eating this dairy? Asian or Northern European? Does it make a difference? 2) What sort of dairy are we talking about? Milk? Butter? Fermented dairy? – Patrik♦ Sep 5 2011 at 23:39

Fantastic summary Namby Pamby - I think I might need to print this out and carry it around with me! – Suz - Paleo Oz Sep 6 2011 at 0:06

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what about heavy cream vs milk? – WayfinderAli Sep 6 2011 at 0:21

Ah right, Bastos. I'll take a look at that tomorrow. And probably other videos. Somehow I just watched Emily Deans and Jaime Scott, and then Chris Masterjohn and forgot about AHS. Weird. – Stabby Sep 6 2011 at 5:31

Thanks for the question and all of the responses! – Eric Sep 6 2011 at 6:25

Stabby · Answer 1 · 2011-09-06 00:36:56Z UTC

Hi, Namby. Ever the Persian messenger into Spartan territory you are :-)

First bullet: Magnesium raises serum IGF-1, and prevents cancer. The evidence for magnesium preventing all sorts of cancers including prostate cancer is extensive. Just pubmed it. Clearly this is an overly simplistic view of the issue. http://www.ncbi.nlm.nih.gov/pubmed/21675994

Second bullet: It isn't a universal finding. In this study from Finland And Sweden only low-fat milk was associated with prostate cancer, not high fat milk http://cebp.aacrjournals.org/content/16/5/956.long.

Norway and breast cancer http://www.ncbi.nlm.nih.gov/pubmed/20658314

"Total dairy, adult, and childhood milk consumption was not associated with either pre- or postmenopausal breast cancer risk. Premenopausal women with the highest consumption of white cheese had half the risk of breast cancer compared to those with the lowest consumption (hazard rate ratio in the 4th quartile vs. the 1st quartile 0.50, 95% confidence interval 0.29-0.87). "

It isn't enough to compare countries, these sorts of practices are prone to confirmation bias and confounding factors, it to important to look within countries to see if the association holds true. Clearly we can't use epidemiology here. I share contradictory epidemiology so that people won't think that results are consistent. They are not. There are confounding factors, probably going both ways.

Plus, that factory farming might not be good doesn't mean we should be orthodox paleo or vegan. Grass-fed dairy is probably different. It certainly has less lactose and more nutrition. Raw dairy will probably be different as well.

Third bullet: That would be a hypothesis, that to this date has never been proven with a controlled trial and is most likely wrong.

Phosphate is the most abundant acid-forming mineral in the diet, but improves calcium balance. There is a good review of the hypothesis here http://www.nutritionj.com/content/8/1/41

This is a recent study done with whey that showed no difference between whey and the control group in bone health http://www.ncbi.nlm.nih.gov/pubmed/21590739 I would have liked to see all relevant nutrients supplied as well and then tested what protein does, but unfortunately they didn't do it.

Protein increases excretion of calcium, but only because it increases absorption, and it has no effect on markers of bone health http://jn.nutrition.org/content/141/3/391.abstract This is one of those things where the mechanism sounds plausible, but the hypothesis flounders upon critical examination. If green vegetables prevent osteoperosis it is because they supply important nutrients for building bones.

It is possible that far too much calcium could cause a magnesium deficiency. However that certainly doesn't mean avoid calcium at all costs. And doesn't apply to dairy fats.

As for vitamin A, you need a sufficiency in all fat-soluble vitamins to be able to say anything about the individual ones. I'll let Chris Masterjohn argue this one http://www.westonaprice.org/fat-soluble-activators/vitamin-a-on-trial

Forth bullet. Could it have something to do with the type of dairy and ability to digest it? A1 vs. A2 http://www.ncbi.nlm.nih.gov/pubmed/16407643 for example. I don't consume dairy because I can't find good dairy, and commercial does cause acne for me. But that doesn't lead me to proclaim that all-dairy-is-always-bad-so-there. I do not have a personal vendetta against dairy.

I agree that those with an autoimmune condition should probably try a dairy-free diet. Does that mean that everyone should? Could lactose intolerance have anything to do with it? Dairy quality?

I would have liked to see more references. If there is an animal study here or a controlled trial there, then I would be interested to read them. I'm not just going to take vegans' and Cordain's word for it!

Heather · Answer 2 · 2011-09-05 21:53:56Z UTC

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Okay, but I consume mostly raw dairy from pastured, happy cows, so the issues from factory farming are nil. It all depends on what kind of dairy you are consuming, methinks.

answered Sep 5 2011 at 21:53

Heather
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The IGF-1 and other hormones and growth factors are present in raw milk from pastured cows. – Travis Culp♦ Sep 5 2011 at 21:55

A know a veterinarian (a vegetarian who eats organic) that will not consumes non-organic milk products due to the sick untreated organic cows she sees in her practice. Eastern U.S. If you specifically know the farm, that's great. But in milk organic means little. Pastured in some places can means one hour a day in a small outside area. – Don Sep 5 2011 at 22:19

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I know the farm, and they have a HUGE space to roam and eat. Bottom line is know your farmer. – Heather Sep 5 2011 at 22:22

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Ask your dairy farmer how often his cows are in gestation for pumping milk and whether milk is pumped only in early pregnancy. See above regarding how raw milk from Mongolia is pumped only 5 out of 12 months. In other words, cows are not an oil well. You can't pump them 24/7 365/year. If you do, you have to feed them hormones and antibiotics, and the milk will be full of excess stress and sex hormones, not just IGF-1 – Namby Pamby Sep 5 2011 at 22:54

I think Heather's point is excellent and doesn't get made enough. When we talk about whether or not consuming dairy is good or bad it sounds a lot like conversations about whether consuming meat is good or bad. We should always be sure to ask What kind of dairy (pastured, raw, fermented, etc)? and in what context (i.e. metabolic derangement, lactose intolerance, etc)? – Grocket Sep 6 2011 at 14:43

Misty · Answer 3 · 2011-09-05 22:06:40Z UTC

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My main problem with this is that all the studies cited seem to have been done with commercially available pasteurized milk and not done with raw milk. I do not drink much milk anymore but when I do, I try to get full fat raw organic. It is some of the best tasting milk out there and it has been shown to not have the same effects as the crap at your local supermarket. Just my two cents ;).

answered Sep 5 2011 at 22:06

Misty
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	Raw milk would be preferred. But IGF-1 is in both. rBGH simply increases IGF-1, which is not eradicated via pasteurization. Also, excess cow hormones are in raw milk as well, especially if the cow is pumped year-around without regard to stages of pregnancy. This stems from the commoditization of the dairy industry: which farmer does not want "full utilization" of his cattle? Anyone into leaving cows idle 6 mos. out of the year so as to lower their hormones? If you forego rBGH, you'll get less milk from your cows than your competitor. You'll go out of business pretty quickly. – Namby Pamby Sep 6 2011 at 4:13
	In other words, the dairy industry doesn't operate like a charity. Neither does the raw milk industry, which I'm not that familiar with and seems to be a loose association of family farms, the legality of which seems questionable at times. But it takes an enormous charity on your part and dedication to something other than profits to operate a dairy farm that will churn out healthy, drinkable milk. A market for somethign like that will only emerge if and when the dangers of current milk consumption are made fully aware. Dont' hold your breath. – Namby Pamby Sep 6 2011 at 4:25
	maybe farmers would do it - if people were willing to pay... (way more) – smartcookie Sep 20 2011 at 19:16
	No business can afford to opperate as a charity, that would be silly. However I believe you do not have much personal experience with raw milk and you did not do your research before commenting here. Raw Organic milk does not contain rBGH. No one would buy it. Also, not all raw milk producers are a "loose association of family farms". Look up raw milk in California for an example. As for the last comment, people are willing to pay and do so everyday where organic raw milk is available. Half a gallon was a little over 8 bucks last time I bought some and that company is doing just fine. – Misty Oct 16 2011 at 13:12

Travis Culp · Answer 4 · 2011-09-05 21:53:29Z UTC

Counterargument: Is it excess cow hormones or IGF-1 or insulin?

If it were the insulin itself, you'd see high cancer rates in heavy (safe) starch-eating cultures like, dare I say, the Kitavans. No such thing has been observed. Insulin is highly anabolic, but to avoid insulin spikes altogether you'd have to eat 100% fat. We have a bad habit of singling out components of our physiology and demonizing them.

Dairy does not promote bone density or prevent osteoporosis by providing dietary calcium, as claimed.

In this case, I would disagree with the initial argument since dairy calcium is far more bioavailable than the oxalate-containing greens you mentioned. The calcium in spinach was found to be 5% bioavailable. This isn't to say that we need dairy calcium for strong bones, simply that we can use it for that purpose. No dairy study that I am aware of involved people with correct amounts of vitamin D3 and K2, the latter being crucial for proper mineralization. I'm of the opinion that correct levels of A, D and K2 would make osteoporosis impossible.

All things considered, however, I agree that dairy isn't necessary for optimal health unless it contains something that an individual would otherwise be deficient in. If that isn't the case, one may as well play it safe and avoid it. I personally consume no dairy.

Edward J. Edmonds · Answer 5 · 2011-09-06 09:26:29Z UTC

The needle in the haystack effect. If you build a house out of straw bails is one needle going to effect the structure? If all you eat is dairy products you'll probably run into trouble. But if your healthy and like to eat dairy perhaps in that context it doesn't matter. It's probably best not to rely on any one thing too much including dairy. I really wish we would get away from such debates and keep things in context, if you don't do well with dairy you know who you are, and if you're curious, go without and see how you feel. But just because one person doesn't do well with dairy doesn't mean we need to build up some sort of argument that anyone who drinks milk is doomed.

Evan · Answer 6 · 2011-09-05 21:37:38Z UTC

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Very convincing.

I'm transitioning from the vegan to paleo lifestyle, and I've slipped up, indulging in diary once or twice.

This is a powerful reminder to quit it. So thanks for that.

answered Sep 5 2011 at 21:37

Evan
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Well, I think "indulging in dairy" is still much much better than being vegan, for most people. – Olivia Sep 6 2011 at 4:51

greyman · Answer 7 · 2011-09-06 10:16:35Z UTC

So what is the "official" understanding here about the point 3 (calcium argument)? I am not sure if it is true, or rather something vegans promote. Just one experience: someone in my family, vegetarian, had a not-that-serious leg injury, which just wouldn't heal for months. She visited several doctors, and then it was discovered that her bones had very low calcium...how's that possible when she ate a lot of vegetables and no animal protein could "leach" it? Of course, that's not a proof, just wondering if the argument is correct (like Travis mentioned above).

Please comment on my summary of arguments/counterarguments against dairy

7 Answers