Back Forty: ‘The milk-drinking cult’

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Students at Woodhill Primary School, south London, drink milk, 1971. Photo by Evening Standard/Getty Images.

By Christopher Ketcham

In 1964, a young resident at Johns Hopkins Medical School named Pedro Cuatrecasas made a startling discovery about the dietary preferences of Black people: They had an intense dislike of milk. Thirty-one of 41 Black subjects he interviewed reported that drinking milk gave them diarrhea, stomach cramps, and colicky pain — the classic symptoms of what has come to be called lactose intolerance. Only three of the 19 white subjects reported similar intolerance.

Prior to Cuatrecasas’s groundbreaking study, published in The Lancet in 1965, the medical consensus was that healthy people generally maintained into adulthood the ability to produce lactase, the enzyme secreted in the small intestine that breaks down lactose and that allows infants to digest breast milk. This phenomenon of lactase persistence, as it’s known, was assumed for centuries to be a common trait of the human race.  Cuatrecasas was the first in a line of modern researchers to reveal the ignorance behind this assumption. Adult lactase persistence, we now know, occurs with frequency only in a certain genetic contingent: white people of northwest European ancestry.  

It is a fact of history that dietary regimens can be hegemonic, the result of imperial power, colonial settlement, the subjugation of people and, by extension, their food preferences. So it is with the hegemony of milk, a food long proffered as an elixir, essential for healthy bones and heart and childhood development. Fresh cow’s milk has been called “nature’s perfect food” for babies weaned off their mother’s breast. 

None of these claims has any veracity, however, as milk is no better than other foods that provide equal amounts of things like calcium and protein. “Milk myths abound in our culture,” reports the Physicians Committee for Responsible Medicine, a nonprofit in Washington, D.C.  “But science doesn’t support them.”

In Spoiled, her excellent new book, culinary historian Anne Mendelson unpacks the origins of the “myth of milk as a superfood” and explains why it has proved so tenacious. The answer will come as a surprise to those of us — including me — who would never have considered a glass of milk a holdover of northern European, notably white Anglo-Saxon, dominance in world affairs. 

In Mendelson’s account, it was the peculiar fate of central European herders during the Neolithic period to acquire a gene that provided lactase persistence and allowed adults to digest unfermented milk. Those herders migrated north and populated the British Isles, among other places, where, thousands of years later, drinking milk as a dietary preference took hold in popular culture. By contrast, in most ancient dairying cultures in Europe and Asia — Balkan, Turkish, Persian, Indian — fermented milk, in which the lactose has been dissolved by lactic acid bacteria, was commonly consumed in the form of yogurt.   

Elsewhere in the Old World, similar genetic variations produced lactase persistence in other groups, but what set the northern European deviation apart, Mendelson writes, is that

two nations in which a majority of the population possessed [lactase persistence] became world powers on a scale dwarfing imperial Rome. Great Britain, and later the United States of America, came to enjoy not only global military and economic preeminence but the privilege of setting scientific agendas (including theories of nutrition) for the rest of the planet, long before anyone knew that most humans did not share Britons’ or North Americans’ common ability to digest large amounts of fresh milk.

By the 18th century, reports Mendelson, a “milk-drinking cult” had arisen among the English dairying aristocracy that critically influenced medical theories (some of them quackish) about the nutritional value of fresh milk.    By the middle of the 19th century, milk for the masses was deemed an absolute necessity. With the rise of unsanitary industrial dairies that targeted distant urban markets, however, pathogen-attracting raw milk became a disease vector, especially in warmer months. Milk was implicated in “summer diarrhea” — most likely E. coli infections — the spread of typhus and tuberculosis, and a rise in infant mortality when it was added to baby formula. As the science of microbiology and the germ theory of disease emerged, scientists discovered that raw milk could carry numerous germs harmful to human beings, including campylobacter, listeria, cryptosporidium, and salmonella.  

Still, milk’s praises were sung at the highest levels of lactase-persistent societies, and often with more than a hint of white-supremacist, eugenicist zeal. Addressing the World Dairy Congress, in 1923, future U.S. president Herbert Hoover declared, “Upon this industry, more than any other of the food industries, depends not alone the problem of public health but there depend on it the very growth and virility of the white race.” To the rescue came pasteurization, which would soon alleviate the growing public-health concerns, and then refrigeration, which allowed milk to be transported long distances without spoiling. (Even today, despite these advances, milk consumption causes 4 percent of all foodborne zoonotic diseases in the world, and the worst hit are the poor in low- and middle-income countries.) 

Much of Mendelson’s narrative — and where the book bogs down a bit — is devoted to explaining the industrial apparatus and technological complexity that has arisen to combat the ineluctable problem of milk as a market commodity. “No other food product,” she asserts, “is as staggeringly difficult and expensive to get from source (in this case, a cow) to destination (milk glass on table) in something loosely approximating its first condition.”  

The dairy-industrial complex includes professors at agriculture schools, experts at state extension schools, and public-health advocates who drill into farmers the need for capital-intensive improvements that strain the budgets of smallholders. Dairy operators have had to employ increasingly rigorous sanitation, with massive use of expensive soaps, disinfectants, and increasing volumes of water that tax water supplies. They have to abide by rules for “scientifically approved field crops and scientifically calculated feed rations, scientifically bred cows and bulls, scientifically designed milking machines hooked up to elaborate piping and refrigeration systems,” Mendelson writes. And to little avail: the dairying system in the U.S. survives only because of government price supports and subsidies.  

The industry is “now on the thin edge of sustainability,” observes Mendelson. “No matter how frantically drinking-milk producers and processors have pushed themselves to cancel out the biological inconveniences of milk and pursue economies of scale … they’ve never really managed to square the circle.” The “obtuse, inflexible public mentality” toward dairying — driven by elites in lactase-persistent societies — has produced “financial ruin for numberless farmers in the 20th century and continues to do so today.” 

And all this expenditure, effort, and heartbreak to maintain an industry for a world in which an estimated 68 percent of the population lacks the whites-only gene of lactase persistence — a world sickened, that is, from consuming milk. The National Institutes of Health has specifically identified four groups in the U.S. (where about 36 percent of the population is lactose intolerant) for whom milk is bad news: Blacks, Native Americans, Asian-Americans, and Hispanics/Latinos.

In what Mendelson calls a “horrific irony,” China and India — places of widespread lactose intolerance — are now converting to the drinking-milk gospel. In China, she reports, “nutritional policy-setters have built monumentally polluting mega-dairy operations.” But the ultimate irony is in India, with its rich tradition of fermenting milk into yogurt sidelined to make way for pouring fresh liquid milk into the mouths of children whose stomachs will revolt.