Milk, b.u.t.ter, Cholesterol, and Heart Disease.

LET'S RECALL THE GIST of the cholesterol theory of heart disease: eating cholesterol and saturated fat raises blood cholesterol and clogs arteries. If so, the milk critics have a case, because milk is rich in cholesterol and saturated fat. Milk is 87 percent water; the rest is protein, fat, and lactose. An eight-ounce (250 ml) gla.s.s of whole milk (typically 3.5 percent fat) contains about 9 grams of fat, most of it saturated- about 66 percent. About 30 percent is monounsaturated, and there's a bit of polyunsaturated fat, too. The typical gla.s.s also contains about 35 milligrams of cholesterol, mostly in the fat. (By the way, I never count grams of fat, cholesterol, protein, or anything else- nor do I recommend it- but I offer these figures for complete information.) This nutritional profile has been enough to indict milk on charges of causing heart disease, but abundant evidence exonerates real milk, b.u.t.ter, and cheese. Many traditional diets include whole milk and b.u.t.ter without adverse effects. In Swiss dairy and Masai shepherd communities, Weston Price found people eating whole milk, cream, and b.u.t.ter to be in excellent health. In the 1960s, long after Price studied the Masai diet, Professor George Mann went to Kenya to test the hypothesis that a diet rich in saturated fat and cholesterol raises blood cholesterol.12 The Masai are almost pure carnivores, eating mostly milk, blood, and meat. A Masai man drinks up to a gallon of whole milk daily, and on top of that he might also eat a lot of meat containing still more saturated fat and cholesterol. Mann expected the Masai to have high blood cholesterol but was surprised to find it was among the lowest ever measured, about 50 percent lower than that of the average American.

Like the Swiss and Masai diets, the traditional American diet was once rich in whole milk, cream, b.u.t.ter, and meat. At the turn of the last century we ate plenty of b.u.t.ter and other saturated fats. The Baptist Ladies Cookbook (1895) and The Boston Cooking School Cookbook (1896) include recipes for creamed liver, lamb fried in lard, creamed fish, and oyster pie with a quart of cream and a dozen egg yolks. About 40 percent of the calories in these menus come from fats, with slightly more saturated than unsaturated fats. An English Jewish cookbook in 1846 is similar, but it calls for beef fat instead of lard. These menus would be unremarkable- after all, everyone's grandmother cooked that way- except for one curious, highly relevant fact. In 1900, when these recipes were used and saturated fat was a regular part of the diet, heart disease was rare. The first case of heart disease as we know it was identified by Dr. James B. Herrick in 1912.

In the next hundred years, traditional fats were replaced by industrial fats. The 1931 Searchlight Recipe Book reflects the transition in American cooking. This, too, contained recipes with b.u.t.ter and cream, but it also called for vegetable oil and "b.u.t.ter subst.i.tute" or margarine. Cooks began to change their recipes, no doubt gradually at first. According to the lipids expert Mary Enig, from 1910 to 1970, b.u.t.ter consumption plummeted from eighteen pounds per person per year to four. During the same period, the percentage of vegetable oils in the diet- including margarine, shortening, and refined oils- soared by 400 percent.

As the table shows, from 1935 to 1985, the percentage of saturated fats in the American diet fell, while consumption of polyunsaturated vegetable oils more than doubled. (Note, too, that we ate more total fat in 1985, possibly due to larger portions. Not only did the low-fat campaign fail to reduce obesity and heart disease; it simply failed.) The changing face of the most popular fats in the diet tells the same story in a different way. In 1890, the main fats we ate were the traditional farm fats: b.u.t.ter, lard, and chicken and beef fat. A hundred years later, the top three fats were polyunsaturated vegetable oils such as soybean and canola oil, rarely found in traditional human diets.

DAILY FAT INTAKE BY TYPE OF FAT, 1930-85.

The most dramatic change in the American diet is the increase in polyunsaturated fats, up by 127 percent. The percentage of saturated fats fell. Many of the polyunsaturated fats shown are hydrogenated vegetable oils, which raise LDL and reduce HDL.

FATS IN THE U.S. FOOD SUPPLY (IN DESCENDING ORDER OF MARKET SHARE).

Note that all the nineteenth-century fats are unrefined with a long history in the human diet. The top three oils in 1990 were unknown in traditional diets.

With this record of fat consumption- fewer saturated fats, more polyunsaturated vegetable oils- proponents of the cholesterol theory would not have predicted this: by the 1950s, heart disease was the leading cause of death in the United States. It's a striking fact, worth restating in another way: as consumption of saturated fats fell in the first half of the twentieth century, heart disease rose. This suggests that something other than b.u.t.ter and other traditional saturated fats is to blame for unhealthy cholesterol and heart disease.

That something is the trans fat in hydrogenated vegetable oils like margarine. As the world now knows, trans fats lower HDL and raise LDL, among other things. Real dairy foods, it appears, are innocent. Back in 1991- when heart doctors were touting vegetable oil spreads- Nutrition Week reported that men eating b.u.t.ter ran half the risk of developing heart disease as those eating margarine. 13.

Recent studies cast doubt on the link between dairy foods, high cholesterol, and heart disease. Consider the Finns, who have the highest cholesterol in the world. "According to the [cholesterol theory], this is due to high-fat Finnish food," writes Dr. Uffe Ravnskov, author of The Cholesterol Myths and a leading researcher in a group known as the Cholesterol Skeptics. "The answer is not that simple." Within Finland, cholesterol levels vary greatly. In one study, Finns who ate twice as much margarine and half as much b.u.t.ter as other Finns had the highest cholesterol. Those with the highest cholesterol also preferred skim milk to whole milk.14 WHY I DON'T DRINK SKIM MILK.

Let me count the ways. The first reason I don't drink skim milk is flavor- it's in the fat. Second, b.u.t.terfat helps the body digest the protein, and bones require saturated fats in particular to lay down calcium. Third, the cream contains the vital fat-soluble vitamins A and D. Without vitamin D, less than 10 percent of dietary calcium is absorbed.15 In the American diet, whole milk was the traditional source of vitamins A and D and calcium. Skim milk- especially industrial skim- is an inferior source of both. Skim and 2 percent milk must, by law, be fortified with synthetic vitamin A and synthetic vitamin D3. There is some evidence that both synthetic vitamins are toxic in excess. Finally, whole milk contains glycosphingolipids, fats that protect against gastrointestinal infection. Children who drink skim milk have diarrhea at rates three to five times higher than children who drink whole milk.16 In 2005, researchers reported on a twenty-year study of Welsh men. The high milk drinkers had a lower risk of heart disease than those who drank the least, even though cholesterol and blood pressure were similar in high and low milk drinkers. "The present perception of milk as harmful in increasing cardiovascular risk should be challenged," wrote the authors, "and every effort should be made to restore [milk] to its rightful place in a healthy diet."17 As researchers demonstrate every day, many other factors- sugar, lack of B vitamins, too many refined vegetable oils, lack of exercise, smoking- are at work in heart disease. But these anomalies about milk and b.u.t.ter- facts that don't fit the orthodox theory- cry out for explanation.

Meanwhile, I should mention that some studies have linked milk consumption and high cholesterol. What could account for that? According to Dr. Kilmer McCully, a student of cholesterol metabolism and the author of The Heart Revolution, industrial powdered milk is one culprit. Dried milk powder is created by a process called spray-drying, which creates oxidized or damaged cholesterol. Researchers in 1991 wrote, "Oxidized low-density lipoprotein (LDL) is more atherogenic than native [unoxidized] LDL."18 In other words, oxidized LDL causes atherosclerosis.

Milk powder containing oxidized cholesterol is a common ingredient in industrial processed foods including milk, yogurt, low-fat cheese, cheese subst.i.tutes, infant formula, baked goods, cocoa mixes, and candy bars. Nonfat dried milk is also added to industrial skim and 2 percent milk. In fact, skim milk may be made entirely of dried milk powder mixed with water. Unfortunately, the label is misleading. It will simply say "skim milk," not "skim milk powder." The better dairies don't use powdered milk; they make skim milk from whole fresh milk simply by skimming off the cream.

My conclusion that traditional milk is a good thing is not original. In the 1930s and '40s, Dr. Francis Pottenger ran tuberculosis clinics where he treated patients with raw milk from gra.s.s-fed cows. A professor at the University of Southern California and president of the American Academy of Applied Nutrition, he published dozens of peer-reviewed articles and founded a hospital for the treatment of asthma. In his day, experts were already blaming milk for high cholesterol, but Pottenger believed traditional milk was falsely accused. In his now cla.s.sic studies on raw and pasteurized milk, Pottenger's Cats, the doctor wrote: "The charge that milk produces high cholesterol in humans is largely based on the premise that the ingestion of cholesterol and the deposit of cholesterol are the same. Extensive use of quality raw milk, cream, and farm eggs with tuberculosis patients failed to produce a single case of hypercholesterolemia [high blood cholesterol] and atheroma [plaque]. A life-time consumption of clean, fresh raw milk from healthy cattle does not produce metabolic diseases. Cholesterol is not the villain; the villain is what man does to his cattle and milk."

I like the way Pottenger put that. As I sorted through the facts about milk and health, it was helpful to keep asking: which milk? Many things aren't what they used to be, and milk is one of them.

Traditional and Industrial Milk Are Different.

ONE OF MY FAVORITE children's books is Maj Lindman's Snipp, Snapp, Snurr, and the b.u.t.tered Bread, about Swedish triplets who are hungry for bread and b.u.t.ter. Alas, there is no b.u.t.ter. They go to the family cow, Blossom, who "stood munching her dry hay and looking very sad." When the boys ask nicely for milk with "plenty of cream" so their mother can make b.u.t.ter, Blossom shakes her head sadly; she has none to give. "I know what she needs," says one boy. "Fresh green gra.s.s." When spring comes and the pasture turns "green and juicy," they give Blossom a basket of fresh gra.s.s. Delighted, she gives back rich cream, and the equally delighted boys have b.u.t.ter for their bread.

First published in the United States in 1934, The b.u.t.tered Bread is a sweet story, but it's more than that. It nicely ill.u.s.trates the point- once well known to farmers in Sweden, America, and all over the world- that cows produce the most cream and the best b.u.t.ter when eating lush green pasture, particularly the fast-growing gra.s.s of spring and fall. In the Swiss dairy villages Weston Price visited, spring b.u.t.ter was so highly prized it was blessed by priests and used in religious ceremonies. Spring b.u.t.ter from gra.s.s-fed cows has been tested in the lab (by Price and others) and found to be superior. Blossom's story is poignant because so few cows today eat fresh gra.s.s.

Modern industrial milk and the milk we drank ten thousand years ago- even the milk most Americans (including Great-Aunt Esther in Milford, Illinois) drank fifty years ago- are different. Traditional milk comes from cows fed mostly on fresh gra.s.s and hay; it is raw and unh.o.m.ogenized. Industrial milk comes from cows raised indoors and fed mostly on a corn, grain, and soybean ration, typically with a dose of synthetic hormones to boost milk production. Industrial milk is then pasteurized and h.o.m.ogenized. Real milk is healthier than the industrial kind, and its superior flavor is unmistakable.

Because cows eat gra.s.s, traditional milk is seasonal. Ancient shepherds moved animals frequently to fresh pasture for the best grazing. In the winter, the traditional cow was " dry"- pregnant and not producing milk- and in the spring she gave birth to a calf and began giving milk again. Traditional dairy foods naturally reflect this seasonal pattern. In the spring, when fresh pasture for grazing was plentiful, early shepherds had fresh milk, yogurt, and young cheeses. In the winter, when the cows were dry, they ate aged cheeses made the previous summer and fall. The best dairy farmers still raise cows, goats, and sheep on gra.s.s- they are known as gra.s.s farmers - and the better cheese shops offer seasonal cheeses made from the milk of gra.s.s-fed animals.

Compared to industrial milk, dairy foods from gra.s.s-fed cows contain more omega-3 fats, more vitamin A, and more beta-carotene and other antioxidants. b.u.t.ter and cream from gra.s.s-fed cows are a rare source of the unique and beneficial fat CLA. According to the Journal of Dairy Science, the CLA in gra.s.s-fed b.u.t.terfat is 500 percent greater than the b.u.t.terfat of cows eating a typical dairy ration, which usually contains grain, corn silage, and soybeans.19 A polyunsaturated omega-6 fat, CLA prevents heart disease (probably by reducing atherosclerosis), fights cancer, and builds lean muscle. CLA aids weight loss in several ways: by decreasing the amount of fat stored after eating, increasing the rate at which fat cells are broken down, and reducing the number of fat cells. Most studies of CLA and cancer have been conducted on animals, and more research is needed, but findings are encouraging. CLA inhibits growth of human breast cancer cells in vitro. A Finnish team found that women eating dairy from pastured animals had a lower risk of breast cancer than those eating industrial dairy.20 The dairy industry is well aware of the commercial opportunity presented by the words cancer fighting or aids weight loss on milk cartons, and scientists are working on ways to increase CLA in milk without going to the trouble of putting cows on gra.s.s. In 2003, the Journal of Dairy Science reported that feeding fish oil and sunflower seeds (containing linoleic acid, which cows convert to CLA) raises CLA in milk. There are CLA-fortified milk products in the works, but problems with taste and texture linger. "The addition of CLA to milk decreased overall acceptability, overall flavor, and freshness perception of milk," reported one study coolly.21 If imitation is the sincerest form of flattery, these "functional foods" or "nutraceuticals," as the industry calls them, pay a high compliment to traditional foods.

Traditional milk is free of synthetic growth hormones. Most industrial milk comes from cows treated with a genetically engineered bovine growth hormone called rBGH (or rBST) to boost milk production. Industrial cows are milked three times a day. Unfortunately for the cow, the hyperproduction stimulated by rBGH increases her risk of mast.i.tis (udder infections) and shortens her life dramatically, from about ten years to five.

Milk from cows treated with rBGH contains higher levels of IGF-1, a naturally occurring growth hormone that is identical in cows and humans. When you drink a gla.s.s of milk from a cow treated with rBGH, you get a dose of IGF-1, one of the most powerful of many insulinlike hormones that prompt cells to grow and proliferate. IGF-1 is linked to cancers of the reproductive system, including breast cancer. Because the FDA regards rBGH as safe for human consumption, it does not permit dairy farmers to print "hormone-free" on milk labels, but most dairy farmers who don't use hormones find a way to say so. If the label is silent, it's a safe bet the cows were treated with rBGH.

What kind of milk should you buy? Traditional milk is ideal and organic milk second-best. Both are better than industrial milk. Unfortunately, most commercial organic milk comes from cows fed grain, not fresh gra.s.s. (All cows must eat some hay for roughage.) Organic cows must have "access" to pasture, but on many large organic dairies, cows spend very little time outside. Gra.s.s-fed milk is best, even if it's not organic. Most gra.s.s farmers feed cows on gra.s.s and hay with a small grain supplement at milking, as I fed Mabel. That's acceptable, because even an ancient wild cow would have eaten some grain from seed heads.

INDUSTRIAL, COMMERCIAL ORGANIC, AND TRADITIONAL MILK.

The best choice is traditional milk, but it's not easy to find. Farmers who supply two organic brands, Organic Valley and Natural by Nature, raise cows on pasture. By law, no milk includes antibiotics. If a cow needs antibiotics, her milk is discarded until the drugs have cleared her system.

Perhaps the greatest difference between traditional and modern milk is pasteurization, routine since the middle of the twentieth century. The French chemist Louis Pasteur invented pasteurization, a form of heat sterilization, in the 1860s to improve the keeping qualities of wine and beer. Gentle pasteurization heats the milk to 145 degrees Fahrenheit for thirty minutes, and standard pasteurization heats it to 161 degrees for fifteen seconds. Ultrapasteurized milk is held under pressure at 280 degrees for two seconds. Milk labeled UHT- ultra high temperature- is ultrapasteurized and then packaged in aseptic boxes sterilized with hydrogen peroxide.

Pasteurization is generally regarded as a sign of progress, a boon for public health- and there is much truth in that. Pasteurization does destroy certain pathogens, including salmonella, E. coli, and campylobacter. However, pasteurization also destroys vitamins, useful enzymes, beneficial bacteria, texture, and flavor.

The push for pasteurization in the United States began in the late 1800s and the early 1900s. It was a response to an acute and growing public health crisis, in which infectious diseases like tuberculosis were spread by poor-quality milk. Previously, milk came to the kitchen in buckets from the family cow or in gla.s.s jars from a local dairy, but soon, urban dairies sprang up to supply the growing populations in or near cities such as New York, Philadelphia, and Cincinnati.

Owners put the dairies next to whiskey distilleries to feed the confined cows a cheap diet of spent mash called distillery slop. For distribution, the whiskey dairies were efficient: in 1852, three quarters of the milk drunk by the seven hundred thousand residents of New York City came from distillery dairies. The last one in New York City (in Brooklyn) closed in 1930.

The quality of "slop milk," as it was known, was so poor it could not even be made into b.u.t.ter or cheese. Some unscrupulous distillery dairy owners added burned sugar, mola.s.ses, chalk, starch, or flour to give body to the thin milk, while others diluted it with water to make more money. Slop milk was inferior because animal nutrition was poor; cows need gra.s.s and hay, not warm whiskey mash, which is too acidic for the ruminant belly. Recall from Blossom that cows on fresh gra.s.s produce more cream, a measure of milk quality.

Conditions were unhygienic, too. In one contemporary account cited in The Complete Dairy Foods Cookbook, distillery cows "soon become diseased; their gums ulcerate, their teeth drop out, and their breath becomes fetid." Cartoons of distillery dairies show morose cows with open sores on their flanks standing or lying in muck in cramped stables. Bovine tuberculosis and brucellosis were common, and cow mortality was high. The people milking the cows were often unsanitary and unhealthy, too. Dairy workers could taint milk with human tuberculosis and other diseases.

A public health crisis was brewing. As distillery dairies became common around 1815, contaminated milk caused fatal outbreaks of diseases including infant diarrhea, scarlet fever, typhoid, tuberculosis, and undulant fever (the human version of brucellosis). Infant mortality, often due to diarrhea and tuberculosis, rose sharply, accounting for nearly half of all deaths in New York City in 1839. Reformers blamed the outbreaks of disease on slop milk. The distillery dairies were like the sausage factories later exposed as dirty and unsafe by Upton Sinclair in his 1906 novel The Jungle. Regulation was desperately needed.

Reformers suggested pasteurization to kill pathogens carried in milk. At first, no one suggested that raw milk itself was unsafe, according to Ron Schmid in The Untold Story of Milk - merely that milk should be clean. "Demands for pasteurization allowed for the continued production and sale of clean raw milk," writes Schmid, a naturopathic physician. "No one was claiming that all milk should be pasteurized, as even the most zealous proponents of pasteurization recognized that carefully produced raw milk from healthy animals was safe."

This view prevailed, briefly. When a raw milk ban was proposed in New York City in 1907, a coalition of doctors, social workers, and milk distributors defeated it, arguing that safe milk should be guaranteed by inspections, not pasteurization. In 1908, however, a panel of experts appointed by President Theodore Roosevelt concluded that raw milk itself was to blame for food-borne illness. That was the final blow. In 1914, New York required pasteurization of milk for sale in shops. Other states followed suit, and by 1949, pasteurization was the law in most places.

The moral of the tale is clear: the trouble starts when you take a cow away from her natural habitat and healthy diet and force her to become a mere milk machine. By abusing the hapless cow, the distillery dairy owners put human health at risk. Slop milk was responsible for thousands of cases of illness and death- most of them preventable by improving cow health and dairy hygiene. But mandatory inspections were not the expedient solution to the crisis; pasteurization was.

Today, thanks to better animal nutrition, hygiene, and widespread testing, the tuberculosis and brucellosis that ravaged nineteenth-century populations (bovine and human) are rare. Yet even now, when slop milk is long gone, pasteurization plays a vital role in the commercial dairy industry. FDA rules say that "raw dairy products shall not be shipped across state lines for direct human consumption." Every day, tankers of raw milk rumble down American highways, but the milk is pasteurized before it's sold to you or me. "For the purpose of current commercial distribution of milk, pasteurization is an undoubted necessity," writes Grohman, a lively advocate for raw milk, in Keeping a Family Cow. Why?

The typical dairy farmer pours warm milk into a refrigerated tank after milking. Every few days, a truck goes from dairy to dairy collecting raw milk. Thus the milk of thousands of cows is blended before being shipped to the bottling plant or cheese factory. Pasteurization after collection can prevent contaminated milk from one sick cow, unhygienic dairy worker, or dirty nozzle from tainting the clean milk of dozens of other dairies.

Pasteurization also has practical benefits for the dairy industry: it permits more handling, long-distance shipping, and longer storage. Fresh milk doesn't travel well. Jostling damages its delicate fats and sugars and causes milk to sour. Raw milk lasts about a week, but standard pasteurization extends the shelf life of milk to two or three weeks. Ultrapasteurized milk keeps for eight weeks, and aseptic UHT milk can last ten months without refrigeration.

In practice, pasteurization can have an unsavory effect on hygiene in the dairy. It allows less scrupulous dairy farmers to be lax with cow health and milk handling because they count on pasteurization to destroy pathogens- at least the heat-sensitive ones- that may taint milk. Many dairy insiders believe that dairy inspections, despite the lessons of slop milk, are still inadequate. I've seen some not very clean dairies myself.

Nor does pasteurization guarantee protection against food poisoning. Pathogens such as Listeria can survive gentle pasteurization.22 According to the Ohio State University Extension Service, Listeria is slightly more heat-resistant than many other bacteria such as salmonella and E. coli, and will grow at temperatures as high as 140 to 150 degrees Fahrenheit. (Recall that gentle pasteurization heats milk to 145 degrees.) Finally, like any food, both raw and pasteurized milk can carry pathogens. Milk may be contaminated at any point after pasteurization- in handling, transportation, storage, or cheese making- just as easily as before. Indeed, the majority of dairy-related food-poisoning cases are traced to pasteurized milk and cheese.

WHY IS FOOD POISONING ON THE MARCH?.

Outbreaks of food-borne illness caused by salmonella and other pathogens have risen steadily since pasteurization became standard. The reasons aren't well understood, but salmonella and E. coli thrive under the conditions typical in factory farms, including grain feeding, overcrowding, and rapid, mechanized slaughter. Overuse of antibiotics on factory farms has also led to resistance to common antibiotics in strains of salmonella, campylobacter, and E. coli. Whatever the cause, the recent advances of these pathogens cannot be blamed on raw milk. When raw milk was the norm, these threats were less common. (For more on a dangerous form of E. coli that thrives in grain-fed beef cattle.) Traditional milk differs from industrial milk in one other important way: it is not h.o.m.ogenized. If unh.o.m.ogenized milk is left to stand overnight, the cream, which is lighter, rises to the top. This is good, because the amount and color of the cream (the yellower, the better) have always been the measure of milk quality, and even today farmers are paid more for more b.u.t.terfat.

h.o.m.ogenization forcefully blends the milk and cream, so they never separate. Devised in France around 1900 to emulsify margarine, h.o.m.ogenization pumps milk at high pressure through a fine mesh, reducing its fats to tiny particles. Industrial milk (and even cream) are h.o.m.ogenized during or after pasteurization.

In the United States, h.o.m.ogenization became common soon after pasteurization, largely because it solved two practical problems for the dairy industry. The first was the inconvenient separation of the milk and cream. With pasteurization it was possible to ship milk long distances, but the cream rose in transit, which meant the most valuable part of the milk- the fat- was unevenly distributed from one customer to another. h.o.m.ogenization spreads the cream throughout the milk, so everyone gets a share. The second problem was cosmetic. After pasteurization, dead white blood cells and bacteria form a sludge that sinks to the bottom of the milk. h.o.m.ogenization spreads this unsightly ma.s.s throughout the milk and makes it disappear.

For many years after its introduction, many Americans declined to buy h.o.m.ogenized milk. "Skeptical consumers were disturbed both by the change in flavor and the absence of the cream line at the top of the bottle," writes Schmid in his milk history. But dairy companies persisted with a campaign to win the public over, and by the 1950s, most milk was h.o.m.ogenized.

h.o.m.ogenization is entirely unnecessary. It's also ruinous for flavor and texture. It breaks up the delicate fats, producing rancid flavors and causing milk to sour more quickly. According to McGee, it takes twice as long to whip h.o.m.ogenized cream, because the fat particles are smaller and more thickly coated with milk protein. I would only add that unh.o.m.ogenized whipped cream is noticeably more delicious. The best cheeses, too, are made with unh.o.m.ogenized milk. Happily, unh.o.m.ogenized milk is perfectly legal, and a few smaller dairies still sell it, sometimes labeled "cream top" or "cream line." If you find that whole milk with cream on top is too rich to drink straight, just pour off the cream and put it on apple pie.

I Describe the Virtues of Raw Milk.

BERNARR MACFADDEN WAS A body builder of the rippling-chest variety you see in old comics. Born in 1868, he was a sickly child but overcame his weak start to become a champion of outdoor activity and fitness. Like many reinvented Americans, he changed his name (choosing a funny spelling) and transformed his body by lifting weights. Macfadden kept fit by walking the twenty-five miles from his house in Nyack to New York City- barefoot. In a long, flamboyant career, he became rich and famous selling exercise equipment and publishing fitness manuals, often using his own splendid physique to ill.u.s.trate poses akin to Greek statuary. At the age of sixty-five- if pictures don't lie- Macfadden had the sort of body readers of Men's Health dream of: a hulking, inverted-pyramid torso atop narrow hips and bulging thighs. Macfadden attributed his fine form to raw milk.

In 1924, Macfadden published The Miracle of Milk: How to Use the Milk Diet Scientifically at Home. Having studied nineteenth-century European milk cures, he began to treat people with gra.s.s-fed, whole raw milk. He found it useful for a range of conditions from neuralgia to bronchitis to heart disease, but he was particularly enthusiastic about milk's ability to help the scrawny build muscle and the flabby lose fat. He gushes about the "plump cheeks," "firm and shapely b.r.e.a.s.t.s," muscle tone, and symmetry of patients who took his milk cure, which involved drinking two to six quarts of raw milk daily.

Raw milk has modern fans, too. A surprising number of commercial dairy farmers prefer it. According to a 1999 survey in h.o.a.rd's Dairyman, 60 percent of dairy farmers drink raw milk at home. When Schmid, author of The Untold Story of Milk, asked dairy farmers why, they told him, it "tastes good" or "makes me feel better" or "I don't like store-bought food." Many dairy farmers tell me the same. Barbara King, who raises Ayrshires in Cayuga County, New York, says, "Raw milk straight from the bulk tank has the best flavor." Another dairyman, a former engineer, told me he's raising ten kids on raw milk. Perhaps they're onto something.

It's no secret that raw milk is more nutritious than pasteurized milk. Pasteurization destroys folic acid and vitamins A, B6, and C. In 1941, the U.S. government issued a report stating that "the cows of this country produce as much vitamin C as does the entire citrus crop, but most of it is lost as the result of pasteurization." Pasteurization inactivates the enzymes required to absorb the nutrients in milk: lipase (to digest fats); lactase (to digest lactose); and phosphatase (to absorb calcium). Phosphatase explains why raw milk contains more available calcium.23 Pasteurization also creates oxidized cholesterol, alters milk proteins, and damages omega-3 fats.

Heat destroys or damages lactic acid bacteria in raw milk- the same beneficial bacteria in yogurt that aid digestion and immunity. When left alone in raw milk, the good bacteria kill off harmful bacteria which may taint milk during handling, according to Madeleine Vedel, an American expert on the traditional raw milk cheeses of Provence. When staphylococcus is introduced to warm pasteurized milk, it proliferates quickly and dangerously, but when added to warm raw milk, it grows much more slowly and may even be eliminated by good bacteria. "By pasteurizing milk we turn it into the ideal medium for dangerous bacteria," concludes Vedel, who owns the Cuisine et Tradition School of Provencale Cuisine in Aries with her husband, Erick, a French chef.24 My friend Joann, the dairy farmer, keeps her arthritis at bay by drinking a cup of raw milk at each milking. The arthritis cure is due to the anti-inflammatory Wulzen factor, identified by the researcher Rosalind Wulzen in raw cream and b.u.t.ter in the 1941 American Journal of Physiology. The Wulzen factor also prevents calcification of the joints, hardening of the arteries, and cataracts. Raw b.u.t.ter contains myristoleic acid, a monounsaturated fat that fights pancreatic cancer and arthritis.25 THE VIRTUES OF RAW MILK AND CREAM.

* Raw milk contains heat-sensitive folic acid and vitamins A, B6, and C.

* Raw milk contains important heat-sensitive enzymes: lactase to digest lactose; lipase to digest milk fats; phosphatase to absorb calcium, which, in turn, allows for the digestion of lactose.

* Raw milk has beneficial bacteria, including lactic acids, which live in the intestines, aid digestion, boost immunity, and eliminate dangerous bacteria.

* Raw cream contains a cortisonelike agent (the Wulzen factor), which combats arthritis, arteriosclerosis, and cataracts.

* Raw b.u.t.ter contains myristoleic acid, which fights pancreatic cancer and arthritis.

Sources: Thomas Cowan, M.D.; Weston A. Price Foundation; Joann Grohman, Keeping a Family Cow.

Dr. Thomas Cowan, a physician in San Francisco, treats many conditions with raw milk, including eczema, diabetes, and arthritis. He is following a long and respectable medical tradition. In the 1920s, the Mayo Foundation, forerunner of the prestigious Mayo Clinic, in Rochester, Minnesota, prescribed an all-milk diet known as "the Milk Cure." In a 1929 article, "Raw Milk Cures Many Diseases," a Mayo doctor described milk as an easily digestible food, rich in enzymes, vitamins, and minerals, with a perfect balance of protein, fat, and carbohydrate. Like Macfadden, the body builder, the Mayo doctors found raw milk effective for weight loss and for many ailments, including poor digestion, inflammation, rheumatism, asthma, skin conditions, bronchitis, high blood pressure, kidney disease, and even heart disease.26 Today, in the age of pasteurization, old literature on the benefits of raw milk makes interesting reading. In 1916 and 1917, the American Journal of Diseases of Children reported that raw milk prevents scurvy in babies, probably because heat destroys vitamin C. In 1933, the Ohio Agricultural Experiment Station Bulletin reported that raw milk promotes growth and calcium absorption. In 1937, the Lancet said that children on raw milk had greater resistance to tooth decay and tuberculosis. The Drug and Cosmetic Industry reported in 1938 that certain pathogens do not grow in raw milk but proliferate in pasteurized milk. The good bacteria in raw milk- dubbed natural antiseptics by the authors- killed the dangerous ones. Sadly, this science is neglected today.

THE MILK DIET: A MODERN EXPLANATION.

Recent studies show that people who consume more milk, yogurt, and cheese lose fat (especially belly fat) and gain lean muscle. It's not clear why. The CLA and omega-3 fats from the milk of gra.s.s-fed cows prevent obesity and build lean muscle, but it's likely the subjects in these studies ate industrial dairy foods. In The Calcium Key, Professor Michael Zemel, director of the Nutrition Inst.i.tute at the University of Tennessee, argues that calcium is the secret. Zemel explains how low calcium elevates the hormone calcitriol, which causes the body to h.o.a.rd calcium and send it to fat cells, where it signals cells to store fat. A calcium-rich diet lowers calcitriol and stimulates weight loss. Zemel found that calcium from dairy foods is strikingly more effective than calcium from fortified foods or supplements.27 Whole raw milk is the best source of calcium; the body needs the enzyme phosphatase (destroyed by heat) and vitamins D (in the fat) to absorb calcium.

Is raw milk safe? Like vegetables or meat, milk can be contaminated with pathogens, but raw milk is not inherently more susceptible than pasteurized milk or any other food. Clean raw milk from a healthy cow, carefully handled by a conscientious farmer, is safe. Hygiene starts in the dairy. Crowded, poorly fed, and weak herds are more susceptible to disease. As we've seen, the cow's ideal habitat is outdoors and her best diet is gra.s.s. During milking and handling, the careful farmer avoids contamination from pathogens by using clean buckets, strainers, and other equipment. Milk must be rapidly chilled after milking and kept cold.

I grew up on raw milk, neglected it for years, and now go to some trouble to get it. If you fancy raw milk, find a sparkling clean dairy- ideally one you can visit- with healthy, gra.s.s-fed cows and a farmer who drinks raw milk. The best choice is a certified dairy, where the cows are regularly tested for tuberculosis and brucellosis. State law on raw milk sales varies widely, but in about two thirds of the states it is possible to buy raw milk legally in some fashion. California, Connecticut, and New Mexico permit certified raw milk in shops. In many states, including New York, raw milk may be sold at certified farms. Others allow raw milk to be sold as pet food (nod, wink). Some dairy farmers sell a "cow share," which ent.i.tles you to a few gallons of milk each week.

One caution: some traditional foods, like sauerkraut and wine, keep well and improve with age. Raw milk is not one of them. Fresh milk must be consumed- or made into yogurt or cheese- in a week or so. Aseptic UHT milk and other foods engineered to last forever have clear commercial advantages, but they come at the price of lost flavor and nutrients. Remember this rule of thumb: eat foods that spoil - hut eat them before they do.

Fortunately, shepherds long before us spent many hours perfecting a way to preserve perishable raw milk for a rainy day- or more precisely, for a long, cold winter. From fresh spring milk, they made cheese. Traditional pressed cheeses can mature for as long as ten years. The dense, b.u.t.terscotch flavor of an aged Gouda, the crunch of a two-year-old Parmigiano Reggiano, the melting saltiness of a cave-aged Gruyere- these are the treasures of raw milk transformed. "Cheese," said the editor and critic Clifton Fadiman, is "milk's leap toward immortality."

I Learn to Appreciate Proper Cheese.

WHEN I WAS LITTLE, the only thing I knew about cheese was that we didn't approve of the rubbery, individually wrapped slices I spied in the lunch boxes of other kids- that was not real cheese. We did buy undyed cheddar for grilled cheese sandwiches, but other than that, my ignorance was total. When I was about ten, we visited our friends Alan and Karen Furst on Bainbridge Island, and I was riveted when Karen grated a hunk of Parmesan over pasta. I had only seen it already grated, in jars.

Today I do grate Parmigiano Reggiano, but a cheese course after dinner is usually beyond my appet.i.te. Most of my friends are more experienced eaters than I am- with all foods, except, perhaps, tomatoes- and some, like Robin, who has a place in Provence- really know cheese. You can't be interested in raw milk or the b.u.t.terfat in Jersey milk, as I am, without getting to know cheese lovers. Turophiles- from the Greek tyros for cheese- are genial types, and some of their enthusiasm has rubbed off on me. I can almost find my way around a cheese counter, and now and then I'll even do my own little tastings, comparing, say, a couple of salty pecorinos on Robin's zucchini carpaccio.

If there is one obsession in the cheese world, it is- rightly I think- with the milk itself, from which all good cheese is born. The cheese is only as good as the milk, and if there is one mark of distinction for cheese, it is being made from raw milk. Like wine drinkers, cheese lovers do make other distinctions- about history, method, terroir. They're notably respectful of tradition ("Charlemagne's favorite cheese"). They talk dreamily of cows all but hand-fed a particular mix of herbs and gra.s.ses on a certain slope in a certain Swiss village at a certain time of the year. They swoon over the inspired cheese maker who gently bathes washed-rind cheese in the local apple brandy.

But raw milk is the hottest topic, and with good reason. Raw milk is important to cheese. The enzymes and beneficial bacteria in raw milk aid fermentation. Pasteurized milk limits the action of rennet and r.e.t.a.r.ds ripening. Though many good cheeses are made from pasteurized milk, cheeses made from raw milk often contain more complex, subtle flavors- sometimes richer, sometimes mellower. People also swear by raw milk cheese for its beneficial enzymes and bacteria, which are tonics for digestion and immunity.

Many of the best American farmstead cheeses- cheeses made from the milk of the farm's own herd- are made with raw milk, and in the better cheese shops, more than half the cheese for sale are, too. "Pasteurization destroys the natural enzymes essential to the production of aromatic compounds and kills the bacteria responsible for complexity," says Rob Kaufelt, the proprietor of Murray's Cheese Shop in New York City. "Flavor in cheese is related to complexity, and those with a pa.s.sion for cheese love complexity."

FLORAL MILK AND HERBAL CHEESE.

The diversity in well-managed pasture brings a vast array of aroma and flavor to milk and cheese. According to the cheese magazine Caseus, aromatic elements in milk called terpenes - the organic compounds in essential oils- can be traced to particular plants. For example, an increase from 11 to 35 percent of sweet woodruff in a cow's diet produces from 32 to 42 percent increase of a specific terpene in milk. Dovefoot geranium and orchard gra.s.s have a similar effect. Aromas vary by season, too. In the winter, gra.s.ses dominate and the aromas are less varied and intense. Come summer, weeds and herbs such as yellow bedstraw, common chicory, thyme, mint, and yarrow add measurably to aromas. In southern Italy- as on good pasture anywhere- meadows can contain more than seventy species. Says the writer Italo Calvino, "Behind every cheese there is a different pasture of a different green under a different sky."

For about four thousand years, all cheese was made with raw milk, the only milk there was. But in the age of industrial milk and cheese, raw milk cheese has come under the same cloud of suspicion as raw milk itself. In the United States, the law concerning raw milk cheese hasn't changed since 1949. Cheese makers must either use pasteurized milk or age their cheese for at least sixty days, beyond which time, presumably, all the deadly pathogens have given up. Young- or fresh- cheeses such as chevre, mozzarella, and ricotta must be made with pasteurized milk. The French, naturally, think that's foolish, and eat young raw milk chevre and Brie with impunity.

In the United States, the sixty-day rule applies to American as well as imported cheeses. That means that if you see a wheel of young raw milk Brie in an American shop, it is contraband. Fans of raw milk cheese love contraband. They are in the habit of bringing young raw milk cheeses home from Europe, palms sweaty as they try to conceal the aroma emanating from their suitcases at customs. Now and then cheesemongers succ.u.mb to the same impulse. In the cheekier shops, you might see a sign along these lines: GET THIS CHEESE BEFORE THE FDA GETS US. Good idea.

NOT QUITE RAW.

One very gentle method of pasteurization is of particular interest to turophiles: thermalization. The International Dairy Federation defines it as heating milk to 145 to 150 degrees Fahrenheit under "flowing" conditions- rather than in a vat- for fifteen to twenty seconds. Certain bacteria (good and bad) are destroyed, but some enzymes are left unharmed, which leads to better flavor in cheese. Several European cheeses- Berthaut Epoisses, a blue called Persille du Beaujolais, and II Fortetto, a pecorino- are made with thermalized milk. The import rules around thermalized cheese are murky, but they're usually regarded as raw milk cheeses under U.S. law.

The bureaucrats are mistaken. Raw milk cheese is very safe. The beneficial bacteria created by fermentation actually inhibit the pathogens everyone is so worried about. The acidity of cheese (a pH of four to five) kills harmful bacteria. Nor does pasteurization guarantee safety. Nearly all outbreaks of food poisoning from milk and cheese in recent decades involved pasteurized milk. A review of food-borne illnesses from 1973 to 1992 in the Journal of Food Protection found no outbreaks attributed to raw milk cheese aged more than sixty days.

Catherine Donnelly, a professor at the University of Vermont, also concluded that pasteurization does not ensure the safety of aged cheese and may, in fact, reduce safety. Donnelly found that raw milk itself is seldom, if ever, to blame when cheese contains pathogens such as campylobacter. Typically, contamination is the result of unsanitary or ill workers or poor cheese-making methods, such as too little salt or acidity. "Unpasteurized milk used in some cheeses (such as Swiss and Parmesan) may even r.e.t.a.r.d the growth of pathogens in aged cheese," writes Donnelly.

Nevertheless, from time to time officials- citing food safety- drop hints about outlawing raw milk cheese altogether. A ban on raw milk cheese would mean the end of cla.s.sic European cheeses such as Roquefort, Parmigiano Reggiano, Gruyere, Manchego, Montgomery cheddar, and American cheeses such as Thistle Hill Tarentaise, made in North Pomfret, Vermont, from gra.s.s-fed, raw Jersey milk- a bleak prospect.

At the mere suggestion of regulatory threats to traditional cheese making, however, artisan and farmstead cheese makers, cheesemongers, and cheese lovers rally. Gerd Stern, a past president of the American Cheese Society, says there is no scientific evidence to support claims that raw milk cheese is dangerous. In a very American way, Stern regards using raw milk as a question of liberty, not only for cheese lovers but also for cheese makers. "Unique microclimates and traditional variegated pastures with many wild flowers and herbs- rather than single-crop gra.s.s- give a rich variety of herbal and floral flavors to raw milk," he says. "We believe cheese makers should have the right to use it."

3.

Real Meat.

Why Even Vegetable Farms Need Animals.