Dairy and Disease

Marketing Milk and Disease

www.drmcdougall.com

The Dairy Industry is really big business – with sales of over $11 billion for milk and $16 billion for cheese annually in the USA alone – so you might expect hard line marketing from them – but would you expect them to aggressively sell their products if they were known to be harmful to people – especially to women and children?

The Dairy Management Inc.™, whose purpose is to build demand for dairy products on behalf of America’s 80,000-plus dairy producers, has just released the Dairy Checkoff 2003 Unified Marketing Plan (UMP) with a budget of $165.7 million.1The United Marketing Plan explains, “This ongoing program area (referring to the section Dairy Image/Confidence) aims to protect and enhance consumer confidence in dairy products and the dairy industry. A major component involves conducting and communicating the results of dairy nutrition research showing the healthfulness of dairy products, as well as issues and crisis management.”1 (Most likely, I fall under the heading of “issues and crisis management.”)

A significant portion of the money from the 2003 Unified Marketing Plan is specifically targeted to children ages 6 to 12 and their mothers. The goal is “to guide school-age children to become life-long consumers of dairy products, 2003 activities will target students, parents, educators and school foodservice professionals.”1 (Similar words and intentions have been attributed to the tobacco industry.) All this marketing is working, too: annual fluid milk consumption among kids 6 to 12 increased to 28 gallons per capita – the highest level in 10 years. Children under 18 drink 46% of the milk consumed in the USA.

Realize that when I say milk in this article, I'm also implicating all dairy products that are made from milk: non-fat milk, low-fat milk, buttermilk, cheeses, cottage cheese, yogurt, ice cream, whey, kefir, and butter. All of them share a similar nutritional profile (plus or minus the fat, protein, and sugar), and as a result, all of them contribute to a wide range of health problems.

Will the UMP Inform You of the Contamination? E. Coli, AIDS and Leukemia Viruses?

Last month I left you with some very disturbing facts about the contamination of milk with loads of bacteria and millions of white blood cells (pus cells) which are there to help fight off the infections found in cows and milk (see the April 2003 Newsletter found atwww.drmcdougall.com). Will the 2003 Unified Marketing Plan specify money to inform you of this upsetting information? You will never see an advertisement with a famous movie star proudly wearing a white mustache, properly labeled as containing 300,000 white blood cells and 25,000 bacteria.

Dairy products were the foods most often recalled by the U.S. Food and Drug Administration (FDA) from the period October 1, 1993 through September 30, 1998 because of contamination with infectious agents, mostly bacteria.2They are commonly tainted with disease-causing bacteria, such as salmonella, staphylococci, listeria, deadly E. coli O1573 and Mycobacterium paratuberculosis4 (possibly one of the agents causing Crohn's disease; a form of life-threatening chronic colitis) – as well as viruses known to cause lymphoma and leukemia-like diseases, and immune deficiency in cattle.

AIDS and Leukemia Viruses

Dairy cattle are infected with bovine immunodeficiency viruses (BIV) and bovine leukemia viruses (BLV), worldwide. (Bovine immunodeficiency viruses can also be properly referred to as bovine AIDS viruses.)

In the United States, results show an average 40% of beef herds and 64% of dairy herds are infected with BIV.5
In Canada6-7, the infection rate is 70% and in Argentina8 the rate is 84% for BLV.
Herds infected with the BIV are usually infected with the leukemia virus (BLV) also.5
Both viruses can cross species lines thus infecting other animals, like sheep, goats, and chimpanzees – and they develop disease.5
Nationwide and worldwide, leukemia is more common in the higher dairy consuming populations.9,10
An increased incidence of leukemia has been found among dairy farmers in multiple studies.11-14
BIV infection has been reported in a person.15
The bovine leukemia virus has been classified in the same group as the Human T-cell Leukemia/Lymphotropic virus type 1 (HTLV-1), which is known to cause leukemia and lymphomas in humans (Adult T-cell leukemia/lymphoma).16
BIV is structurally and genetically closely related to human immunodeficiency virus (HIV) type-1 (the virus causing human AIDS).17
Pasteurization kills many types of microorganisms, but it is not foolproof. There is also concern that pasteurization may break the viruses into fragments that may become even more dangerous.18

Has it been shown that the bovine AIDS and/or leukemia viruses will infect you and cause disease? No. Nor has it been proved that they will not. Compared to the efforts to try to convince you of the bone-building benefits of milk, almost nothing has been spent to establish whether or not it is safe to feed your family dairy products teeming with bovine immunodeficiency and bovine leukemia viruses (and/or viral fragments). Some countries take this matter very seriously. For example, in many European countries, health officials have conducted programs to eradicate infected herds – Finland’s program has successfully eradicated BLV from its cattle.19

If you live in a region with a high incidence of herd infection with these viruses you can be pretty sure you will be consuming dairy products containing whole viruses or fragments of these viruses, since the milk from many dairy farms is mixed in large vats at the dairy factory before processing and packaging. Since the industry will not act responsibly in many countries, consumers are left with one choice – eliminate all dairy products from their diet. If eliminating dairy products would prevent even a small risk of human disease, it would be well worthwhile, especially since, as you learned in the April 2003 McDougall Newsletter, they are completely unnecessary for excellent health.

Will the UMP Market the Pain and Suffering Caused Children?

The Dairy Management Inc.™ has specifically targeted children in their campaign.1This will raise no public concern, because most people consider cow’s milk the healthiest of all food choices, especially when it comes to children. Over 25% of children are overweight in Western countries and cow’s milk, cheese, yogurt, ice cream, butter, and sour cream, with all their fat and calories, contribute greatly to this deadly epidemic. Many of these overweight children are now developing type-2 diabetes. However, the most common variety of diabetes found in children is still type-1 or insulin dependent diabetes (IDDM).

Type-1 Diabetes

The evidence incriminating cow’s milk consumption in the cause of type-1 diabetes is sufficient to cause the American Academy of Pediatrics to issue these warnings, "Early exposure of infants to cow's milk protein may be an important factor in the initiation of the beta cell (insulin-producing cells of the pancreas) destructive process in some individuals."20 "The avoidance of cow's milk protein for the first several months of life may reduce the later development of IDDM or delay its onset in susceptible people."20

Exposure to cow’s milk protein early in life, when the intestinal tract is immature, sometimes results in the milk protein entering the blood stream where antibodies to this foreign substance, cow’s milk, are made by the immune system. Unfortunately, these same antibodies also attack the insulin-producing cells of the pancreas. By glassful of milk after spoonful of ice cream, over a period of about 5 to 7 years, the child destroys his or her own pancreas – and is left with a lifelong, life-threatening, handicap: diabetes. The pancreas is forever destroyed and the child will have to take insulin shots daily. Complications, such as blindness, kidney failure, and heart disease will be a real threat during his or her shortened lifespan. (See my July 2002 McDougall Newsletter for a discussion of type-1 diabetes).

Constipation

Not as life-threatening as diabetes, but for some as mentally and physically distressing, is chronic constipation. As a doctor who has cared for hundreds of children, I can tell you they suffer with pain, bleeding, hemorrhoids, and embarrassment. The causal effects of cow’s milk were clearly demonstrated in a study of 65 severely constipated children published in the New England Journal of Medicine.21These boys and girls complained of only one bowel movement every 3 to 15 days and many didn’t even respond to strong laxatives (lactulose and mineral oil). Forty-four of the 65 (68%) found relief of their constipation when taken off the cow’s milk. Evidence of inflammation of the bowel was found on biopsy, and anal fissures and pain were commonly associated with the constipation – elimination of the cow’s milk solved these problems. When cow’s milk was reintroduced into their diet 8 to 12 months later, all of the children developed constipation within 5 to 10 days. For constipation alone cow’s milk should be banned from the School Milk Programs, worldwide.

Rhinitis and Otitis Media

The multitude of snotty-nosed kids frequently visiting the pediatrician’s office for ear infections is much more obvious than the constipated crowd, and these problems less devastating than type-1 diabetes, but these complaints also can be due to consuming the foreign proteins intended for calves.22-25 In addition, these same children are likely to suffer from gastroesophageal reflux, asthma and/or eczema from their unnatural habit of drinking cow’s milk.

Diseases of Foreign Protein

Many conditions can be traced back to reactions to cow’s milk. Milk contains more than 25 different proteins that can induce adverse reactions in humans.26 Our immune system perceives these foreign proteins as alien invaders, like a virus or bacteria, and launches an attack in response, as in the case of type-1 diabetes discussed above and many other allergic and autoimmune diseases.

DISEASES CAUSED BY, OR LINKED TO, DAIRY PROTEINS

General:

Loss of appetite, growth retardation.

Upper Gastrointestinal:

Canker sores (aphthous stomatitis), irritation of tongue, lips and mouth, tonsil enlargement, vomiting, gastroesophageal reflux (GERD), Sandifer's syndrome, peptic ulcer disease, colic, stomach cramps, abdominal distention, intestinal obstruction, type-1 diabetes

Lower Gastrointestinal:

Bloody stools, colitis, malabsorption, diarrhea, painful defecation, fecal soiling, infantile colic, chronic constipation, infantile food protein-induced enterocolitis syndrome (FPIES), Crohn’s disease, ulcerative colitis.

Respiratory:

Nasal stuffiness, runny nose, otitis media (inner ear trouble), sinusitis, wheezing, asthma, and pulmonary infiltrates.

Bone and joint:

Rheumatoid arthritis, juvenile rheumatoid arthritis, lupus, Behçet’s disease, (possibly psoriatic arthritis and ankylosing spondylitis).

Skin:

Rashes, atopic dermatitis, eczema, seborrhea, hives (urticaria)

Nervous System (Behavioral):

Multiple sclerosis, Parkinson’s disease, autism, schizophrenia, irritability, restlessness, hyperactivity, headache, lethargy, fatigue, "allergic-tension fatigue syndrome," muscle pain, mental depression, enuresis (bed-wetting).

Blood:

Abnormal blood clotting, iron deficiency anemia, low serum proteins, thrombocytopenia, and eosinophilia.

Other:

Nephrotic syndrome, glomerulonephritis, anaphylactic shock and death, sudden infant death syndrome (SIDS or crib or cot death), injury to the arteries causing arteritis, and eventually, atherosclerosis.

References are available through the National Library of Medicine, www.nlm.nih.gov. Search “cow’s milk” and any ofthe diseases listed above.

All dairy products contain milk proteins, including skim milk, yogurt, cheese, and butter, and many butter substitutes. Milk proteins are listed in packaged food products with a variety of names, such as milk solids, skim milk powder, casein, caseinates, whey, and albumin. Milk is also often put into packaged foods and not declared on the label – this is illegal and punishable by FDA action.

Even with all of this disease in children the American School Food Service Association and the dairy industry have developed a School Milk Pilot Test to demonstrate that kids will drink more milk in school if certain product enhancements are made.27 The result was milk sales increased by an average of 18 percent and consumption increased by 35 percent when schools provided flavored milks and other package enhancements.28

The UMP Will Try to Deceive You about the Fattening Nature of Dairy Foods

“Independent research confirming dairy’s role in weight reduction is mounting,” said Dr. Greg Miller, senior vice president of nutrition and scientific affairs for the Dairy Checkoff.29 “This helps to position dairy foods as part of the solution to America’s growing obesity epidemic.” And Miller added, “Informing the public about dairy’s role in the fight against obesity will help increase consumption of milk, cheese and yogurt, among other dairy products.”

Shouldn’t the idea of milk acting as an “antiobesity” food strike you as fundamentally contradictory? – After all, the biologic purpose of cow’s milk is to provide large amounts of energy and nutrients to grow the young animal from 60 to 600 pounds. So how does milk become a weight loss product in the 21stcentury? This idea began with the observation that underprivileged people, who have poor diets in general, are often obese, and also consume few dairy products.30Some experiments that followed showed people and animals on calorie-restricted diets lost a small amount of extra weight when calcium or dairy foods were part of their diet. The “antiobesity” effects of dairy are difficult to explain, but may be due to calcium binding fat in the intestine, preventing its absorption.30

A thorough search of the literature for properly designed studies shows only one of 17 randomized studies found weight loss in people taking calcium pills, and of the nine randomized studies where fluid milk was added, two showed significant weight gain, and none showed significant loss.31In one study funded by a grant from the International Dairy Foods Association, 204 healthy men and women were asked to increase their intake of skim or 1% milk by three cups a day for 12 weeks; those consuming the extra milk gained an average of 1.32 pounds (0.6 Kg).32Can you imagine what their weight gain would have been if they had been asked to add whole milk, cheese, butter, and ice cream to their diet, instead of skim and low-fat 1% milk? The result of all this research was well summed up by one of the dairy industry’s frequent spokespersons at the Dairy Management Inc. sponsored Symposium: Dairy Product Components and Weight Regulation, held April 21, 2002 in New Orleans, with this statement, “In conclusion, the data available from randomized trials of dairy product or calcium supplementation provide little support for an effect in reducing body weight or fat mass.”31 Yet the consumer will hear from Dr. Miller and the rest of the industry, “eat more dairy products and you will lose weight.”

Dairy products are loaded with fats that are easily stored under your skin as “body fat.” The fats in the cold glass of milk, the little bite of cheese, and that small bowl of ice cream will move from your lips to your hips effortlessly. In fact, it moves with so little effort that the chemical structure of the fat isn’t even changed. Cow’s milk contains a unique kind of fat with double bonds located at the C-15 and C-17 position on the fat’s carbon chain. Examination of a person’s fatty (adipose) tissues following a biopsy will show the amount of this kind of fat present, which will be in direct proportion to the amount of dairy products the person consumes.33

All that fat the dairy industry asks us to eat is associated with higher risks of heart disease, diabetes, hypertension, and breast, prostate, uterine and colon cancer. Yet, as a marketing scheme, the dairy industry has teamed up with the National Medical Association to write articles about “the role of dairy in helping reduce the risk of heart disease, hypertension, and other serious health issues.”34The National Medical Association promotes the collective interests of physicians and patients of African descent. Please explain to me how this association came about when the vast majority of people of African descent (80% to 90%) cannot drink milk because of lactose intolerance; causing them diarrhea, stomach cramps and gas.35

Not only is this dairy fat unattractively worn and a health hazard, but it is also a source of large quantities of environmental chemicals, like dioxins and DDT, that affect your health and the health of a mother’s offspring during pregnancy and nursing.36One reason a young girl needs to start thinking about a healthier diet early is because the accumulation of these chemicals in her own body fat occurs over her entire lifetime.

The UMP Will Try to Confuse You about Bone Health and Animal Protein

Osteoporosis is caused by several factors; however, the most important one is diet – especially the amount of animal protein and acid in the foods we eat.37-39 The high acid foods are meat, poultry, fish, seafood, and hard cheeses – parmesan cheese is the most acidic of all foods commonly consumed.40Once consumed, this food-derived acid must be neutralized in the body. Fruits and vegetables can do this neutralizing (these foods are alkaline in nature). However, because the diet of the average Westerner is so deficient in fruits and vegetables and so high in acid foods, the primary neutralizer of dietary acid becomes their bones – the bones dissolve to release alkaline materials.

Worldwide, the highest rates of hip fractures are among populations that consume the most animal food (including dairy products) – like people from the USA, Canada, Norway, Sweden, Australia, New Zealand, etc.41,42The lowest rates are among people who eat little or no dairy foods (these people are on lower calcium diets) – like people from rural Asia and rural Africa.41,42 The basic experiments published in the 1980s clearly show protein causes bone loss, and calcium offers little or no protection.43

Even the foremost scientists hired by the dairy industry know protein is harmful to the bones.44In my April 2003 Newsletter I explained there was only one properly designed study testing the effects of fluid milk on the bone health of postmenopausal women – and the results were: those who received the extra milk for a year lost more bone than those who didn’t drink the milk.44The authors, funded by the National Dairy Council®, explained in their paper, “The protein content of the milk supplement may have a negative effect on calcium balance, possibly through an increase in kidney losses of calcium or through a direct effect on bone resorption.” Trying to explain why those receiving the milk were in worse calcium balance, they said, “…this may have been due to the average 30 percent increase in protein intake during milk supplementation.”

Unfortunately, all this damning information does not sit well with the powerful dairy industry, so they have started the “3-A-Day of Dairy” program to battle the calcium crisis in America by promoting milk, cheese and yogurt for stronger bones – and they have been busy doing their own research to prove protein is good for the bones.45-48

Regrettably for them, their designing means were just revealed in the May 2003 issue of the American Journal of Clinical Nutrition.49The article in this journal exposed the way they made the results show protein is good for the bones. To devise research that appears to contradict hundreds of articles published over the past 35 years, you only have to provide sufficient alkaline material in the diet of the people being studied to neutralize the acid from the animal foods. This was accomplished by studying populations that have diets high in neutralizing fruits and vegetables; the other approach employed was to add a strong alkali source to the experiment, such as an antacid pill (wafer), calcium citrate (like Citracal).

Once the acid from the food is neutralized, then any bone building factors that might be present in meat and dairy can exert their effects. High protein foods, and especially dairy foods, raise the levels of a powerful growth-stimulating hormone in the body, called insulin-like growth factor-1 or IGF-1. Stimulation of bone growth by this hormone is now being offered as the reason dairy products build strong bones. It has long been necessary for them to find a more scientifically supportable explanation, because the bulk of the research shows the calcium in dairy foods has little or no benefit for bone health.50-52

The UMP Will Not Promote the Fact that IGF–1 is a Powerful Cancer Promoter

Consumption of animal products increases the levels of insulin-like growth factor-1 in your body. However, modern dairy technology has made dairy products an even more potent source of this growth stimulant. Since 1985, U.S. dairy farmers have been allowed to inject cows with recombinant bovine growth hormone (rbGH), a genetically engineered bovine growth hormone that increases milk production. RbGH treatment produces an increase in IGF-1 in cow’s milk.53,54IGF-1 is not destroyed by pasteurization.53 The overall effect is that milk seems to raise IGF-1 levels in people more than any other component of our diet.55

The direct evidence of the effects of cow’s milk on IGF-1 levels in people has been provided by the dairy industry’s own efforts. Two recent studies, one on adolescent girls and the other on postmenopausal women, showed increasing milk consumption actually raises plasma levels of IGF-1 in the person’s body by an average of 10%.56,57Their take on this is, “this is a beneficial effect” because IGF-1 stimulates bone growth. But, the actual lasting consequences should deliver the final deathblow to dairy products:IGF-1 promotes the growth of cancer. This growth promoter has been strongly linked to the development of cancer of the breast, prostate, lung, and colon.58Excess IGF-1 stimulates cell proliferation and inhibits cell death – two activities you definitely don't want when cancer cells are involved.58

There is more to cancer promotion by dairy foods than IGF-1. Most dairy products are high in saturated fat – and fat is the number one suspect when it comes to the cause of most common cancers in Western societies (for example, breast, prostate, colon, kidney, pancreas). Recent studies have linked the sugar (lactose) and fat in milk with ovarian cancer,59,60and the calcium in milk lowers concentrations of a specific form of vitamin D that protects against prostate cancer, raising men's overall risk.61,62(See my February 2003 Newsletter for more information on diet and prostate cancer.) Hormones (estrogens) are also involved in cancers of reproductive organs, like breast and uterine cancer. There are several reasons dairy products raise a woman’s hormone levels – causing a variety of hormone-dependent problems from early onset of menstruation (menarche) to PMS and uterine fibroids – but one is unique to cow’s milk. Cows are milked even while they are pregnant. As a result of the pregnancy, cows secrete high levels of estrogen into their milk.63

Will the UMP Advertise that Dairy Is Simply Liquid Meat?

Red meat has become a “dirty word” when it comes to health. At the opposite end of the spectrum of opinions on food is cow’s milk – one of the world’s most trusted foods. Do you remember the “Basic Four Food Groups?” Dairy was usually placed first in this chart which was hung in every schoolroom (and by no coincidence the dairy industry also provided the chart). If you compare closely the nutritional make up of meat and dairy you will see why I call dairy products “liquid meats.”64

Dairy products are deficient in iron and beef is deficient in calcium; both contain too little dietary fiber, essential fat (linoleic acid), and vitamin C and B3 (niacin) to meet human nutritional requirements.64Heavy consumption of either of these food groups – loaded with fat and cholesterol – will result in the diseases common to affluent societies, such as obesity, heart disease, strokes, type-2 diabetes and cancer, to name just a few serious problems.65

If a patient bargained with me, “I’ll give up only one of the first two food groups – meat or milk – in hopes of getting well,” my recommendation for almost all common health problems in Western society would be, “You’re likely to get the most benefits if you give up the dairy products.”

References:

By going to the National Library of Medicine at www.nlm.nih.gov you can view the abstracts of most of these studies, and many times secure the original paper.

1) Dairy Management Inc.™. http://www.dairycheckoff.com/news/release-012403.asp

2) Wong S. Recalls of foods and cosmetics due to microbial contamination reported to the U.S. Food and Drug Administration. J Food Prot 2000 Aug;63(8):1113-6

3) Chapman PA. Sources of Escherichia coli O157 and experiences over the past 15 years in Sheffield, UK. Symp Ser Soc Appl Microbiol. 2000;(29):51S-60S.

4) Lund BM. Pasteurization of milk and the heat resistance of Mycobacterium avium subsp. paratuberculosis: a critical review of the data. Int J Food Microbiol. 2002 Jul 25;77(1-2):135-45.

5) Gonda M. Bovine immunodeficiency virus. AIDS. 1992 Aug;6(8):759-76

6) Sargeant JM. Associations between farm management practices, productivity, and bovine leukemia virus infection in Ontario dairy herds. Prev Vet Med. 1997 Aug;31(3-4):211-21.

7) VanLeeuwen JA,. Seroprevalence of infection with Mycobacterium avium subspecies paratuberculosis, bovine leukemia virus, and bovine viral diarrhea virus in maritime Canada dairy cattle. Can Vet J. 2001 Mar;42(3):193-8.

8) Trono KG. Seroprevalence of bovine leukemia virus in dairy cattle in Argentina: comparison of sensitivity and specificity of different detection methods. Vet Microbiol. 2001 Nov 26;83(3):235-48.

9) Hursting SD. Diet and human leukemia: an analysis of international data. Prev Med. 1993 May;22(3):409-22.

10) Howell MA. Factor analysis of international cancer mortality data and per capita food consumption. Br J Cancer. 1974 Apr;29(4):328-36.

11) Kristensen P. Incidence and risk factors of cancer among men and women in Norwegian agriculture. Scand J Work Environ Health. 1996 Feb;22(1):14-26.

12) Reif J. Cancer risks in New Zealand farmers. Int J Epidemiol. 1989 Dec;18(4):768-74.

13) Blair A. Leukemia cell types and agricultural practices in Nebraska. Arch Environ Health. 1985 Jul-Aug;40(4):211-4.

14) Donham KJ. Epidemiologic relationships of the bovine population and human leukemia in Iowa. Am J Epidemiol. 1980 Jul;112(1):80-92.

15)Jacobs RM. Detection of multiple retroviral infections in cattle and cross-reactivity of bovine immunodeficiency-like virus and human immunodeficiency virus type 1 proteins using bovine and human sera in a western blot assay. Can J Vet Res. 1992 Oct;56(4):353-9.

16) Johnson J. Molecular biology and pathogenesis of the human T-cell leukaemia/lymphotropic virus Type-1 (HTLV-1). Int J Exp Pathol. 2001 Jun;82(3):135-47.

17) Whetstone CA. Examination of whether persistently indeterminate human immunodeficiency virus type 1 Western immunoblot reactions are due to serological reactivity with bovine immunodeficiency-like virus. J Clin Microbiol. 1992 Apr;30(4):764-70.

18) Ferrer JF. Milk of dairy cows frequently contains a leukemogenic virus. Science. 1981 Aug 28;213(4511):1014-6.

19) Nuotio L. Eradication of enzootic bovine leukosis from Finland. Prev Vet Med. 2003 May 30;59(1-2):43-9.

20) Work Group on Cow’s Milk Protein and Diabetes Mellitus. Infant feeding practices and their possible relationship to the etiology of diabetes mellitus. Pediatrics 94:752, 1994.

21) Iacono G. Intolerance of cow's milk and chronic constipation in children. N Engl J Med. 1998 Oct 15;339(16):1100-4.

22) Yimyaem P. Gastrointestinal manifestations of cow's milk protein allergy during the first year of life. J Med Assoc Thai. 2003 Feb;86(2):116-23.

23) Juntti H. Cow's milk allergy is associated with recurrent otitis media during childhood. Acta Otolaryngol. 1999;119(8):867-73.

24) Tikkanen S. Status of children with cow's milk allergy in infancy by 10 years of age. Acta Paediatr. 2000 Oct;89(10):1174-80.

25) Oranje AP. Natural course of cow's milk allergy in childhood atopic eczema/dermatitis syndrome. Ann Allergy Asthma Immunol. 2002 Dec;89(6 Suppl 1):52-5.

26) Bahna S. Allergies to Milk. Grune and Stratton, New York.

27) School Milk Pilot Test: http://www.nationaldairycouncil.org/lvl04/nutrilib/relresearch/pilot_test2.html

28) Results of School Milk Pilot Test: http://www.nutritionexplorations.org/sfs/pilot.asp

29) Greg Miller’s Comments on Obesity: http://www.dairycheckoff.com/check/hl0103.asp

30) Parikh SJ. Calcium intake and adiposity. Am J Clin Nutr. 2003 Feb;77(2):281-7.

31) Barr SI. Increased dairy product or calcium intake: is body weight or composition affected in humans? J Nutr. 2003 Jan;133(1):245S-248S.

32) Barr SI. Effects of increased consumption of fluid milk on energy and nutrient intake, body weight, and cardiovascular risk factors in healthy older adults. J Am Diet Assoc. 2000 Jul;100(7):810-7.

33) Baylin A. Adipose tissue biomarkers of fatty acid intake. Am J Clin Nutr. 2002 Oct;76(4):750-7.

34) National Medical Association: http://www.dairycheckoff.com/check/hl0403.asp#c

35) Bertron P. Racial bias in federal nutrition policy, Part I: The public health implications of variations in lactase persistence. J Natl Med Assoc. 1999 Mar;91(3):151-7.

36) Schecter A. Dioxins in U.S. food and estimated daily intake. Chemosphere. 1994 Nov-Dec;29(9-11):2261-5.

37) Maurer M. Neutralization of Western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans. Am J Physiol Renal Physiol. 2003 Jan;284(1):F32-40.

38) Remer T. Influence of diet on acid-base balance. Semin Dial. 2000 Jul-Aug;13(4):221-6.

39) Frassetto L. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.

40) Remer T. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc. 1995 Jul;95(7):791-7.

41) Abelow B. Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcific Tissue Int 50:14-8, 1992.

42) Frassetto LA . Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods. J Gerontol A Biol Sci Med Sci. 2000 Oct;55(10):M585-92.

43) McDougall J. The Great Debate. High vs. low protein. www.drmcdougall.com

44) Recker RR. The effect of milk supplements on calcium metabolism, bone metabolism and calcium balance. Am J Clin Nutr. 1985 Feb;41(2):254-63.

45) Munger RG. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr. 1999 Jan;69(1):147-52.

46) Massey LK. Dietary animal and plant protein and human bone health: a whole foods approach. J Nutr. 2003 Mar;133(3):862S-865S.

47) Teegarden D. Dietary calcium, protein, and phosphorus are related to bone mineral density and content in young women. Am J Clin Nutr.1998 Sep;68(3):749-54.

48) Kerstetter JE. Low protein intake: the impact on calcium and bone homeostasis in humans. J Nutr. 2003 Mar;133(3):855S-861S.

49) New SA. Calcium, protein, and fruit and vegetables as dietary determinants of bone health. Am J Clin Nutr. 2003 May;77(5):1340-1.

50) Kanis JA. The use of calcium in the management of osteoporosis. Bone. 1999 Apr;24(4):279-90.

51) Weinsier R. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr. 2000 Sep;72(3):681-9.

52) Hegsted DM. Fractures, calcium, and the modern diet. Am J Clin Nutr. 2001 Nov;74(5):571-3.

53) Mepham TB. Safety of milk from cows treated with bovine somatotropin. Lancet. 1994 Jul 16;344(8916):197-8.

54) Juskevich JC. Bovine growth hormone: human food safety evaluation. Science. 1990 Aug 24;249(4971):875-84.

55) Holmes MD. Dietary correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations. Cancer Epidemiol Biomarkers Prev. 2002 Sep;11(9):852-61.

56) Cadogan J. Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. BMJ 1997;315:1255-1260.

57) Heaney R. Dietary changes favorably affect bone remodeling in older adults. J Am Diet Assoc 99:1228-33, 1999.

58) Yu H. Role of the insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst. 2000 Sep 20;92(18):1472-89.

59) Cramer DW, Harlow BL, Willet WC. Galactose consumption and metabolism in relation to the risk of ovarian cancer. Lancet 1989;2:66-71.

60) Mettlin CJ, Piver MS: A case-control study of milk-drinking and ovarian cancer risk. American Journal of Epidemiology 132(5): 871-876, 1990.

61) Giovannucci E. Calcium and fructose intake in relation to risk of prostate cancer. Cancer Res. 1998 Feb 1;58(3):442-7.

62) Chan J. Dairy products, calcium, and prostate cancer risk in the Physicians' Health Study. Am J Clin Nutr. 2001 Oct;74(4):549-54.

63) Janowski T. Mammary secretion of oestrogens in the cow. Domest Anim Endocrinol. 2002 Jul;23(1-2):125-37.

64) J Pennington. Bowes & Church’s Food Values of Portions Commonly Used. 17th Ed. Lippincott. Philadelphia- New York. 1998.