The Satya Interview
Milton Mills on Ethnicity, Milk, and
Intolerance By Angela Starks
Milton Mills, M.D.
is associate director of preventative medicine at the Physicians
for Responsible Medicine (PCRM). He has been instrumental in PCRMs
campaign to highlight the dairy bias in the U.S.s Dietary Guidelines
[see sidebar], particularly in the context of lactose intolerance and racial
Q: How did you become aware of the issue of lactose intolerance and ethnicity,
and why did you feel it was important to raise awareness of this issue?
A: It grew out of both my personal experience and my experience as
a clinician. In my early 20s I became profoundly lactose intolerant. Within
one to two hours of eating a frozen yogurt I would be very sicknot
just uncomfortable. I mean severe cramps, lots of gas and bloating, followed
by diarrhea. When this first started happening, it was quite scary as I
thought something was wrong with me. I talked to my mother and she said,
You probably just cant tolerate milk...many blacks cant. That
was my introduction to the fact that there were some major differences
based on ethnicity with respect to the ability to tolerate dairy foods.
After I became a physician,
not infrequently I would get patients complaining of gastrointestinal
distress. On questioning, it was clear that they were still consuming
dairy foods, so Id ask them to do an experiment where they would
avoid all dairy for two weeks and see if the problem resolved. In 70 to
80 percent of the cases the problem was resolved. That told me there are
a lot of people experiencing needless illness, and who are carrying diagnoses
that are completely inaccurate and are probably medicating themselves
for problems that are entirely avoidable.
It was at that point that I approached
PCRM, telling them what a major problem this is, that its a problem
for specific groups, and its entirely inappropriate for the Dietary
Guidelines to be recommending that dairy be a regular part of the American
diet, since its clearly not appropriate for a large number of individuals.
Q: Perhaps the phrase lactose intolerance
is a misnomer. Is lactose intolerance actually the norm?
A: Absolutely. Worldwide, the majority of humans lose the ability
to digest lactose after they become adults, which is actually natural
for all mammals. Only a small proportion of humans have retained the ability
to digest lactose throughout their lifetime and that is presumably an
adaptation to a culture that included dairy foods. It is most noticeable
in people of northern European ancestry. So yes, it [lactose intolerance]
is a misnomer. In fact, some recent scientific papers use the term lactose
non-persisters to point out that the ability to continue digesting
lactose is the exception rather than the rule.
Q: Some people think that if they keep
drinking milk they will develop the ability to digest lactose. Can this
A: I dont know where that idea came from, but its ridiculous.
Thats like saying if you jump off a building enough times, flapping
your arms, you are going to develop wings. The ability to digest lactose
is governed by your genes, and if your genes decide you will no longer
make the enzymes, you are not going to. So, no, that is not true.
Q: Because of all the advertising and conditioning, might lactose intolerant
individuals, especially those at risk of osteoporosis, be reluctant to
avoid milk for fear of becoming calcium deficient?
A: First, we have to get over this idea that dairy foods are the best
source of calcium. The inclusion of dairy in the human diet is a very
recent development from an evolutionary standpoint. We do not need dairy
foods. Human beings evolved eating plant foods from which they can, and
continue to obtain, more than adequate amounts of calcium.
Dairy foods have never been shown
to prevent osteoporosis. In fact, worldwide, the incidence of osteoporosis
correlates closely with per capita dairy intake. Part of the problem stems
from the fact that the high protein content of dairy foods ends up causing
more calcium to be lost in the urine than they supply.
Furthermore, dairy foods can be very
high in fat unless they are the artificially produced ones that have all
the fat and crap removed. That ought to make some bells go off. Clearly
this is not natural, and if its not natural it is not necessary.
So the idea that people have to or ought to eat these foods is absurd.
Worldwide, the majority of humans get all the calcium they need from plant
Q: One reason given for the high profile of dairy
in the Food Pyramid is the idea that people wont eat more leafy
green vegetables as an alternative calcium source.
A: That points out another major problem with the Dietary Guidelines
Advisory Committee (DGAC), which is that the committee is woefully short
on minority representation. Kale and other dark green leafy foods are
an integral part of the diet of many minority populations. Included in
the Asian diet are seaweed and other leafy greens, and traditionally no
dairy. The U.S. has attempted to export dairy to Asia but it has had very
limited success; yet we are pushing these foods on Asian-Americans.
Traditional West African diets dont
include dairy either, yet we have no qualms about painting a milk mustache
on every famous black person we can find to convince black people they
ought to drink milk. In my household if you didnt eat greens you
werent considered black. These foods are a traditional part of African-American
diets and are quite common in the diets of other people of color, so it
is a sign of reprehensible ethnocentrism to say, Well, no one is
going to eat them.
Q: Why then does the DGAC continue
to recommend that dairy be included in the nations Dietary Guidelines?
A: The problem is that the DGAC is a joint venture between the Department
of Health and Human Services (DHHS) and the Department of Agriculture
(USDA). This represents an intrinsic conflict of interest because while
the DHHS is meant to promote the health of all Americans, the USDAs
Congressional charge is to find a market for agricultural output, which
in my opinion ought to have nothing to do with guidelines to promote Americans
health. One might argue that most of the political clout of the DGAC comes
from people appointed by the USDA who are beholden to the agricultural
industry, and as a result they push for foods to be included that in essence
will help agribusiness. The dairy industry is one of the most powerful
lobbies and largest of the agribusiness industries, and thats quite
unfortunate because it is harming the health of America, without question.
Q: Are resources emerging within African-American
communities to promote a plant-based diet?
A: Theres a slowly emerging consciousness, but, unfortunately,
in a population with a significant amount of poverty and people trying
to climb their way up, people assume that what they see in the majority
culture is whats best and they seek to copy that. This includes
what they eat. However, within the communities, there are now more people
of color who become educated about nutrition and disease, who are starting
to sound the alarm about what we are doing to ourselves via our diet.
Noteworthy is the role of the Seventh Day Adventist church, which has
a significant number of African-American members, and has traditionally
encouraged its members to adopt a plant-based diet.
I am trying to target media that
service and reach communities of color so we can get the message out,
as its particularly tragic for more recent immigrants, specifically
Hispanics and Asians. They come to this country with a basically good
diet but then start to abandon it for the Western diet, which then causes
their disease profile to skyrocket.
With respect to African-Americans,
I would encourage them to question what I call the plantation diet. When
they were brought over here as slaves they were essentially fed the garbage
of the plantation, and unfortunately when we were emancipated from slavery
we embraced that diet and called it soul food. We need to look back at
what the traditional West African diet is because studies have shown that
diets that are similar in composition will promote health.
Q: Dairy products also exacerbate a
range of diseases, dont they?
A: Indeed, such as diabetes and obesity because of the fat content.
Also, if someone is at all predisposed to developing kidney trouble or
already has some kidney dysfunction, the excessively high animal protein
content of dairy foods will tend to worsen it; multiple studies confirm
this. Also, if someone has heart disease, the very high fat and saturated
fat content of dairy foods is going to exacerbate it.
Q: Do you think people take the Dietary
A: Yes, I hear many women say, Ive got to have dairy because
I need calcium. The dairy industry has been successful in making
people think that its products are the best source of calcium. Also, one
of the first questions people ask me when they find out I am vegetarian
is, Where do you get your protein? I respond, The same
place elephants get theirsjust to make people aware that you
can be big, strong and powerful and never eat meat. You do not need meat
for protein but most people think you do because of the way the Dietary
Guidelines are constructed and because of the sort of popular education
people receive about nutrition.
Q: Might this campaign go on to challenge
meat and dairy?
A: We need to get the issue of dairy foods dealt with for now, but
as far as the Dietary Guidelines are concerned, its part and parcel
of our concern. Its impossible to discuss one without the other.
A PCRM article entitled Racial Bias in Federal Nutrition Policy
deals specifically with the lactose issue but then goes on to discuss
the issues of chronic disease. Thats where you get into the issues
of meat, because it increases the incidence of chronic disease.
Q: What do you hope will be the outcome
of this campaign?
A: I hope that the government says very emphatically and clearly that
dairy foods are an option and not a requirement or a recommendation. I
hope they highlight other sources of dietary calcium such as dark green
leafy vegetables, and state that dairy products may not be appropriate
for people with particular ethnic backgrounds because of widespread lactose
intolerance. In other words, the truth.
For more information, visit PCRMs
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