Mr. Cox of the Farm-to-Legal Defense Fund (FTCLDF) informed me (through several emails that he says are just from him, not on behalf of FTCLDF – although he is General Counsel for FTCLDF) that I was mistaken and I agree with him. 

I assumed that the farmer in a 2008 raw goat milk E. coli O157:H7 outbreak that nearly killed two children, who claimed that he consulted with FTCLDF, had also consulted with FTCLDF about disclosing communications between the farmer and the FTCLDF.  According to Mr. Cox, FTCLDF did not at all work on this case and did not have an attorney client relationship with the farmer.  I accept that from Mr. Cox. 

I expect to see the documents the Court ordered disclosed that the farmer – not FTCLDF – tried not to disclose in the next few days.  Here is the recent Court Order:

But, on to more important issues:

Comparing the Food Safety Record of Pasteurized and Raw Milk Products – Part 1

“Milk and milk products—particularly those that are unpasteurized—are potentially hazardous; even pasteurized products have been implicated in outbreaks. Contamination may occur after pasteurization, and no process works perfectly 100% of the time.” John M. Leedom

A week or so ago I posted, "Raw Milk Debate Set to Heat Up." 

Over the last years I have tried to bring some level of rationality to the debate over the consumption of raw milk. I first published on my blog a summary of the findings of my review of peer-reviewed literature on the topic of the "pros" of the consumption of raw milk. Several people from both sides of the raw milk debate have told me that the “pros” review is one of the most comprehensive compilations of peer-reviewed literature examining the potential benefits of raw milk beyond basic nutrition. I then posted about the "cons." What about the “cons?” As I said, the overwhelming “con” of drinking raw milk according to the literature relates to food safety hazards.

Since publishing these reviews last year, many readers have asked how the safety of pasteurized milk compares with raw (unpasteurized) milk. The Weston A. Price Foundation (WAPF) went so far as to produce an extensive, highly repetitive, 132 page response to my paper, "Raw Milk Cons: Review of the Peer-Reviewed Literature." WAPF claims that there is a systematic bias against raw milk. In reality, pasteurized milk-related outbreak reports were not analyzed in the raw milk cons review. In response to the erroneous statements by WAPF, and in an effort to provide consumers with accurate information, I examined the food safety record of both pasteurized and raw dairy products.

This 4-part series begins with an overview of the history and definitions that are important to know in order to understand how dairy food safety became a lightening rod for controversy.

Historical Perspective

Early last century milk products caused approximately 1 out of every 4 outbreaks due to food or water in the United States (Weisbecker 2007). As we begin the 21st century in this country, dairy products cause the fewest outbreaks of all the major food categories (e.g, beef, eggs, poultry, produce, seafood) (CSPI 2008). This drastic improvement in the safety of milk over the last 100 years is believed to be due primarily to pasteurization, and improved sanitation and temperature control during the processing, handling, shipping and storage of fresh milk products.

In 1948, Michigan was the first state in the US to require pasteurization. In 1987, the FDA mandated pasteurization of all milk and milk products for human consumption effectively banning the shipment of raw milk in interstate commerce with the exception of cheese made from raw milk, provided the cheese has been aged a minimum of 60 days and is clearly labeled as unpasteurized. A recent survey conducted by state agriculture departments found that 29 states currently allow some form of on- or off-farm raw milk sales, but only 13 permit retail sales (Oliver et al, 2009).

Definitions: Milk is Milk?

A typical dairy case at a major grocery store today contains numerous choices for the customer. There is milk labeled with different levels of fat content, and where retail raw milk sales are allowed, the consumer may choose between conventional, organic, and raw milk products, as well as homogenized or non-homogenized. In addition to fluid milk, other dairy products include butter, cheese, cream, ice cream, colostrum, yogurt, kefir, and other fermented dairy products.

Below are some basic definitions of raw and pasteurized milk.

Raw (unpasteurized): for disease surveillance purposes, “raw” or “unpasteurized” refers to a dairy product that has received no heat treatment to destroy pathogens or spoilage organisms. WAPF promotes a more refined definition for raw milk, termed “real milk,” that also includes organic, non-homogenized, “grass fed,” and produced from certain breeds of cattle as criteria.

Pasteurized: Pasteurization was named after Louis Pasteur, who discovered the process for the preservation of wine. When talking about milk, pasteurization refers to the heating of milk or milk products to a certain temperature for a specific period of time. The purpose of pasteurization is to destroy disease causing and spoilage organisms. The Grade A Pasteurized Milk Ordinance allows for different combinations of time and temperature:

• High Temperature Short Time (HTST): uses metal plates and hot water to raise milk temperatures to at least 161° F for not less than 15 seconds following by rapid cooling

• High Heat Short Time (HHST): similar to HTST, but uses slightly different equipment and higher temperatures for a shorter time

• Ultra Pasteurized (UP): milk is heated to not less than 280° F for two seconds

• Ultra High Temperature (UHT): milk is heated until sterile

Among these methods, only UHT milk is sterile (shelf stable), and does not require refrigeration. The other methods of pasteurization do not destroy all organisms, thus milk whether raw or pasteurized eventually spoils, and must be refrigerated to prevent the growth of pathogens.

Homogenization: Homogenization is a process that breaks the fat globules in milk into smaller particles, which prevents the cream layer from separating and floating to the top of the milk. Most conventional pasteurized milk is homogenized whereas organic pasteurized milk and raw milk are often non-homogenized.

The Debate

The controversy over banning raw milk sales has raged since pasteurization was first introduced over 100 years ago. Throughout decades of debate, the public health and medical communities have remained steadfast in their support of pasteurization as a key measure to protect the public health. In the 1980’s, a fierce legal battle was fought in California, which culminated in the closure of the largest raw milk dairy in the nation at the time and a Citizen’s Petition that successfully banned interstate shipment of raw milk. Today, the Campaign for Real Milk created by WAPF is currently among the most vocal of the groups that promote consumption of raw dairy products and eschew pasteurization.

WAPF has made bold claims that raw milk produced by “clean grass fed cows” is safer than any other food. Public health officials have made similarly bold claims that raw milk is an inherently dangerous food. In the next segment of this review, the mechanisms by which milk can become contaminated, and the occurrence of food borne pathogens in the dairy environment, are described.

References

CSPI. 2008. Outbreak Alert! 2008: Closing the gaps in our Federal food safety net. Available at: http://www.cspinet.org/new/pdf/outbreak_alert_2008_report_final.pdf

Leedom, J. M. 2006. Milk of nonhuman origin and infectious diseases in humans. Clin Infect Dis 43:610-5.

Oliver, S. P., K. J. Boor, S. C. Murphy, and S. E. Murinda. 2009. Food safety hazards associated with consumption of raw milk. Foodborne Pathog Dis 6:793-806.

Weisbecker, A. 2007. A legal history of raw milk in the United States. J Environ Health 69.