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Readers of Aaron's blog know of his beef with the milk industrial complex. Why does milk, of all beverages, get a pass in our efforts to reduce everyone's caloric intake? Why is it encouraged, when all others are shunned? Is it because you need the calcium? Is it because it makes your bones stronger? Watch, and learn why the milk emperor has no clothes.

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References can be found here: http://theincidentaleconomist.com/wordpress/?p=54205

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Aaron Carroll -- Writer
Mark Olsen - Graphics

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I know those milk moustache commercials are a hit. I know you’ve been told that milk does a body good. But at some point someone has to point out that the milk emperor has no clothes. In fact, we’re doing it today here on Healthcare Triage.

(Intro)

Seriously people, has it occurred to none of you that we’re the only mammals on the planet who consume milk after the early childhood period. We’re so obsessed with it that we steal the milk from other species in order to keep drinking it. Look, I’m all for breastfeeding. It’s what all the other mammals do and I believe that evidence shows that breastfeeding is good for infants. I also understand that we likely breastfeed for a shorter duration than nature intended and in those cases giving kids milk based formula and cow’s milk are fine. But after age two or so, or whenever the brain no longer needs the extra fat for development, there’s really no good reason for us to keep drinking the stuff.

Think about human history. Before we domesticated animals, we were getting along without any other animals milk. Lots of humans can’t even drink milk because they’re lactose intolerant. They do just fine. Here in the United States, there are recommendations all over the place trying to get kids and adults to limit their intake of calorie containing beverages – except milk! Milk gets a pass. In fact, lots of recommendations say that we should be drinking up to three cups of the stuff per day. Those three cups contain more than 240 calories and more than 36 grams of sugar. Ironically, non-fat milk contains more sugar than whole milk. What’s with these recommendations? Ostensibly, it’s because we need the calcium for bone strength, ‘cause more milk and the calcium it contains will make your bones stronger. You know where this is going, right? To the research!

In 2007, a meta-analysis was published in the American Journal of Clinical Nutrition looking at calcium intake and the risk of fractures. It included seven prospective cohort studies of more than 170,000 women and almost 3000 hip fractures. They found no association between total calcium intake and the risk of hip fracture. For men, they found five prospective cohort studies of more than 68,000 men and more than 200 hip fractures. No association there either. They also found five clinical trials seeking to prove that improving calcium intake would prevent fractures. More than 5600 women and 1000 men took part in these studies where they randomly got calcium supplementation or placebo. They looked at all kinds of fractures and the calcium did nothing significant. There were four trials that looked specifically at hip fractures and there they found that calcium supplementation increased the risk of hip fracture. Increased it!

But maybe milk is different. In 2011 a meta-analysis was published in the journal of bone and mineral research. Researchers tried to gather all prospective studies looking for an association between milk intake and the risk of developing a hip fracture. There were six studies that included data on more than 195,000 women who sustained more than 3500 hip fractures. Guess what? There was no association between milk intake and the risk of fracture. There were three studies of more than 75,000 men with 195 hip fractures. Analyses again could not establish a statistically significant relationship. No proof in protective affective milk. To repeat, milk isn’t going to stop you from breaking your hip. But there’s a more recent study published in JAMA Pediatrics just earlier this year. It was a prospective cohort study of 96,000 men and women in the long-standing Nurses’ Health Study and Health Professionals Follow-up study. They asked participants to rate their milk consumption as teenagers and then followed them to see if they got hip fractures over the next 25 years or so. Turns out that males who drank more milk as teens had a 9% higher risk of having a hip fracture later in life. When height was added to the analytic model the relationship wasn’t significant anymore.

So the good news is that the milk isn’t going to hurt you, but it’s not going to help you either. Drinking too much milk can be awful for your gut. It makes it bleed. Every single year of residency, I admitted at least one child who was drinking a ton of milk and then slowly bled from his or her G.I. tract to a level of anemia that would kill an adult. It was always shocking and the parents were always horrified to hear that it was excessive milk consumption that had put their child in the hospital for an extended stay. Here’s a news story. We’ll take the word of Duke University health system. ‘Cow’s milk is low in iron and can actually prevent iron from being absorbed from the diet. In addition, some children develop small amounts of bleeding from their intestines when they have too much cow’s milk.’

Am I saying milk is evil? No! It’s an important part of a small child’s diet and you should listen to your doctor about your toddler’s consumption. Moreover, like most things in moderation, it’s totally awesome. What else are you going to drink with hot apple pie? How else are you going to turn your bowl of Life cereal into a delicious paste? And Oreo without milk is close to a sin. But at some point, in older children and adults we should own that milk is a calorie laden beverage like many others. It holds no special place and you don’t need it. Phenomenal marketing and a lot of wisdom have convinced you otherwise. Get over it.