Got Milk Might Not Be Doing You Much Good

Here's a comprehensive summary of the article "Got Milk? Might Not Be Doing You Much Good" by Aaron E. Carroll and David Leonhardt, based on the provided text:

The article challenges the conventional wisdom that milk consumption is essential for adult health, particularly for bone health, as heavily promoted by the dairy industry and many health organizations.

Key Arguments and Evidence Presented:

• Natural Lactation vs. Adult Consumption: The article begins by acknowledging the universal benefit of breast milk for infants and the widespread recommendation for breastfeeding until at least 1-2 years of age. However, it points out that humans are unique among mammals for continuing to consume milk into adulthood, often in significant quantities. Many people globally and historically do not consume milk as adults, often due to lactose intolerance, and thrive without it.

• Debunking Bone Health Claims:

  • The article critically examines the widely held belief that milk is crucial for strong bones and preventing fractures.
  • It cites a 2011 meta-analysis in the Journal of Bone and Mineral Research that found no association between milk consumption and lower rates of hip fractures in middle-aged and older women, despite examining six studies with nearly 200,000 participants.
  • More recent research is presented, including a JAMA Pediatrics study following nearly 100,000 individuals for over two decades, which also found no link between teenage milk consumption and reduced hip fracture risk later in life.
  • A Swedish study published in The BMJ, involving over 100,000 participants, reported no protective effect of adult milk consumption for men and an increased risk of fractures in women. This study also indicated an increased risk of death in both sexes associated with milk consumption, though the authors caution against assuming causality without randomized controlled trials.
  • The article also questions the benefits of calcium intake from all sources, referencing a 2007 meta-analysis in the American Journal of Clinical Nutrition that found no link between total calcium intake and bone fracture risk in studies involving over 200,000 people.
  • Furthermore, it highlights that randomized controlled trials on calcium supplements showed no reduction in fracture rates and, in some cases, a potential increase in hip fracture risk.

• Questioning Vitamin D Fortification:

  • While milk is often fortified with Vitamin D, believed to aid calcium absorption and bone health, the evidence for its significant benefit in the general population is deemed "sketchy."
  • A meta-analysis in The Lancet is mentioned, which found that extra Vitamin D supplementation generally did not improve bone mineral density in middle-aged and older adults, with only a statistically significant but clinically minor increase in bone density in one specific area of the thighbone.
  • The article clarifies that while supplementation is important for individuals with actual Vitamin D or calcium deficiencies, the majority of Americans are not clinically deficient, and milk is marketed to this broader population.

• Calorie and Other Considerations:

  • The article points out that milk is not a low-calorie beverage. Three cups of nonfat milk can add 250 calories, and lower-fat or whole milk contribute even more. It questions why milk is exempt from the "marginalization" of other caloric beverages due to obesity concerns.
  • While milk contains protein, the article states that most Americans are not protein deficient.

• The Role of Industry and Government:

  • The article suggests that political and economic factors influence milk promotion. Organizations like Dairy Management Inc., established by the U.S. government, exist to "increase dairy consumption" and are largely funded by dairy producers.
  • Government legislation like the 1983 Dairy Production and Stabilization Act solidified the government's role in promoting dairy products to strengthen the industry.

• Conclusion:

  • The authors conclude that while milk can be enjoyed in moderation and with certain foods (like cereal or cookies), there is little evidence to suggest that most adults need it or that it is providing significant benefits. They advise that people can do perfectly well without it, and for those who enjoy it, it's fine periodically, but not as a health necessity.