Pasteurization has evoked a serious ‘blind spot’ among many journalists, scientists, and industry and professional organizations who believe that there is no ‘downside’ to pasteurizing milk.
Pasteurization is falsely perceived as a silver bullet, killing pathogens and causing no adverse effects. However, neither raw nor pasteurized milks are ‘risk-free’. Communications by pro-pasteurization advocates commonly leave out evidence, limitations, and inconvenient truths, in order to perpetuate pro-pasteurization myths and maintain status quo to preserve the dominance of pro-pasteurization ‘blind spots’. Beware of entrenched beliefs masquerading as scientific facts that in reality are not supported by scientific evidence.
FACTS LEFT OUT BY PRO-PASTEURIZATION ADVOCATES
Below are some relevant facts that are often left out of public communications about milk, each with supporting evidence and references that you are encouraged to review and fact-check.
1. Neither pasteurized nor raw milk is ‘risk-free’.
a. See Table below for summary of the burden of illness from CDC outbreak data for 2005-2020 and the peer-reviewed manuscript on this dataset (Stephenson, Coleman, and Azzolina 2024).
1b. FDA/FSIS assessed pasteurized milk as high risk of severe listeriosis per annum and unpasteurized milk as high risk per serving (FDA/FSIS, 2003); however no listeriosis outbreaks associated with raw milk were confirmed in the CDC dataset for 2005-2020 (Stephenson et al., 2024).
c. More deaths are reported from leafy greens (23), pasteurized milk (4), and oysters (2) than the death of an adult with severe underlying illness associated with consumption with raw milk (Davis et al. 2016). Note that another death in an adult with severe underlying illness reported in this time period could not be attributed to raw milk consumption.
d. Higher burdens of illness are reported from leafy greens (16,434 illnesses), oysters (2,408), pasteurized milk (2,111), and many other foods than for raw milk (1,696).
2. Pasteurized milk is a highly processed food that is linked to adverse health effects.
a. Significantly higher outbreaks, hospitalizations, and deaths were associated with listeriosis in pasteurized dairy from 2007-2020 compared to raw dairy (Sebastianski et al. 2022).
b. Stillbirths, miscarriage, premature delivery were reported for pasteurized dairy, not raw dairy (Sebastianski et al. 2022).
c. Heating milk (boiling and pasteurization) denatures milk proteins, increasing allergenicity and contributing to inflammatory disease (Abbring et al. 2019; 2020).
d. Allergy to and intolerance of pasteurized milk is estimated to have a substantial public health burden in the US, with 30-37% intolerance of thermally treated milk from recent US surveys (C. M. Warren et al. 2022; C. Warren et al. 2024). Approximately 15 million US consumers (4.7% or nearly 1 in 20) are affected by thermally-treated/pasteurized milk.
e. Industrial processing of milk (heating, filtration, pressure, drying, freezing) causes denaturing, aggregation, and loss of function of cow milk antigens (α-lactalbumin, β-lactoglobulin, serum albumin, caseins, bovine serum albumins, and others), reductions in concentrations of bioactives (immunoglobulins, cytokines, peptides, lipophilic components, and microbiota), and impairs immunologic tolerance mechanisms (Jensen et al., 2022).
3. Approximately 15 million raw milk consumers benefit from access.
a. A recent government survey estimated 4.4% of US population consumes raw milk (Lando et al., 2022).
b. Multiple sources report consumption of raw milk is increasing, not decreasing (NielsenIQ figures cited by (Aleccia 2024; Lyubomirova 2024); Figure below included in Coleman manuscript under review in Risk Analysis).
c. CDC reported 1,696 raw milk illnesses for 2005-2020 (Stephenson et al., 2024) but not inflammatory disease (Dietert et al. 2022).
d. Raw milk was tolerated by children with allergy to pasteurized milk, and pasteurized milk induced adverse effects (Abbring et al. 2019).
e. Raw milk has a dense and diverse microbiota, similar to the breastmilk microbiota, both inducing benefits to gut microbiota, immune system function, and suppressing growth of pathogens (Coleman et al. 2021; Dietert et al. 2022; Coleman et al. 2023; Coleman, submitted).
f. Raw milk was associated with increased functional richness of the gut microbiota (notably genus Lactobacillus and Lactococcus and the short chain fatty acid valerate) and participants with higher than median anxiety scores showed significant score reduction for stress and anxiety (Butler et al., 2020).
4. Illness associated with raw milk is not increasing in the US or any US state based on recent CDC data.
a. No significant increase was reported for illnesses associated with raw milk outbreaks from 1998-2018 or numbers of outbreaks from 2005-2018 (Koski et al. 2022).
b. No significant increase was reported for outbreaks or illnesses associated with raw milk, nor are rates by state increasing for any US state (Stephenson et al., 2024, Figures 12 and 13).
5. Regarding children, consuming raw milk complete with intact natural microbes (microbiota) is beneficial to health.
a. Just as children benefit from raw breastmilk and its protective microbiota, children (and adults) also benefit from raw cow milk complete with its protective microbiota that enhance health of gut, immune, nervous, and respiratory systems (Coleman et al., 2021; Dietert et al., 2022).
b. No child has died in the US from consuming raw milk in recent decades based on CDC data for 2005-2020 (Stephenson et al., 2024).
c. Children with allergies to pasteurized milk tolerated raw milk consumption with no adverse effects while smaller volumes of pasteurized milk triggered adverse effects (Abbring, 2019).
d. Children consuming raw milk in multiple large studies developed no diarrheal illness, significantly fewer respiratory and ear infections, protection from inflammatory disease including atopy, asthma, and eczema, and improved immunologic and lung function later in life (Perkin and Stranchan, 2006; Depner et al., 2013; Loss et al. 2015; von Mutius 2016; Wyss et al., 2018; Brick et al., 2020; Dietert et al. 2022).
6. Claims that raw milk is ‘inherently dangerous’ and that ‘risks exceed benefits’ are unfounded and not supported by the body of scientific evidence.
a. Recent trends in unpasteurized fluid milk outbreaks, legalization, and consumption in the United States (Whitehead and Lake, 2018). CDC data from 2005-2016 documents 1,903 illnesses associated with pasteurized milk and 1,735 illnesses associated with raw milk. The rate of raw milk related outbreaks is decreasing, meanwhile the consumption of raw milk is increasing. The authors concluded that, “Controlling for growth in population and consumption, the outbreak rate has effectively decreased by 74% since 2005.” The study suggested that the improving food safety record is the result of expanded safety training for raw milk dairy producers.
b. Examining Evidence of Benefits and Risks for Pasteurizing Donor Breastmilk (Coleman et al., 2021). Seventy-one studies were cited documenting evidence for benefits and risks of raw breastmilk for infants. Evidence of benefits was clear, convincing, and conclusive, while evidence for infectious disease risks to infants consuming raw breastmilk was limited. Supporting studies provided evidence of plausible mechanisms of benefits of ‘seeding and feeding’ the infant gut ecosystem, notably providing ‘colonization resistance’ or protection against pathogens and stimulating balanced development of infant immune systems.
c. Nourishing the Human Holobiont to Reduce the Risk of Non-Communicable Diseases: A Cow’s Milk Evidence Map Example (Dietert et al., 2022). The study cited 135 studies illuminating raw bovine milk as a superfood complete with its natural microbiota intact and chosen by humans for 12,000 years. Study noted consistent evidence of raw bovine milk benefits (promotion of gut, immune, and lung health; protection from infectious diseases and non-communicable diseases) but limited evidence of risks of infectious disease.
d. Trends in Burdens of Disease by Transmission Source (USA, 2005–2020) and Hazard Identification for Foods: Focus on Milkborne Disease (Stephenson et al., 2024). The study assessed trends for CDC data from all transmission sources for 2005-2020 and found that the burden of illness and mortality was dominated by person-to-person transmission. Foodborne disease accounted for 21% of the disease burden with no increasing trend. Foods representing the greatest hazards were identified for campylobacteriosis (pasteurized and raw milk), illness from Shiga toxigenic E. coli (leafy green vegetables and beef), listeriosis (melons and pasteurized solid dairy products), and salmonellosis (poultry and leafy vegetables). Fatal foodborne disease was dominated by fruits, vegetables, peanut butter, and pasteurized dairy. No increasing trend of raw milk illnesses were observed overall or for any state, nor did rates of illness increase after legislation to allow greater access to raw milk.
This is an excerpt from Peg Coleman’s article, “'Dread Reckoning' And 'Blind Spots' for Oral Transmission of H5N1”. Peg Coleman is a medical microbiologist, microbial risk analyst, and a Fellow of the Society for Risk Analysis. Peg Coleman is on the Advisory Board for Raw Milk Institute. You can view Peg’s full article here: https://www.colemanscientific.org/blog/2025/5/21/dread-reckoning-and-blind-spots-for-oral-transmission-of-h5n1
References
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