Week 7: Food Dollars - How our Choices are Making us Sick

Penny Wise and Pound Foolish.

While Robert Burton, the Oxford Professor and author, first coined the idiom in 1621 in reference to the English Pound, the enduring expression, currently defined by www.dictionary.com as 'stingy about small expenditures and extravagant with large ones', is perfect for describing our food priorities, including those that have landed us in an increasingly global health crisis, fueled by diet-induced obesity and related medical expenditure. 

In simple terms, the US Government - through its policies and subsidies, and individual Americans - through our choices in how we spend our dollars, are partners in the paradoxical creation of a food desert in the world's richest country.

The reason is twofold.

First, we have drastically reduced the amount of money we spend (or are willing to spend) on food. In a 2012 article in The Atlantic, writer Derek Thompson provides some startling graphs on the shifting nature of the American budget. In the 103 years between 1900 and 2003, family food expenditure dropped a whopping 30%, from 43% to 13% of total income. Ditto clothing, which today consumes just 4% of our budget, a 10% reduction from 1900 levels. Three questions arise from this data. Ignoring clothing for a moment, the first is: what has transpired that caused us to spend that much less on food? Part of the answer is, we have become a lot richer - 68 times richer - than we were in 1900, when over half the country worked in agriculture and there were more servants than sales workers. Thus food prices, which have dropped dramatically while wages have increased - especially since WWII, when manufacturing buoyed the American middle class, simply represent a smaller amount of an increasing budget. The other major reason for our reduced spend can be addressed with a second question: why have food prices dropped? The answer here is less benign: as family farming has withered and factory farming has emerged, in large part due to federal subsidies, the focus on food yield has overwhelmingly replaced the focus on food quality, for reasons of commercial gain. Put another way, we used to grow food to maximize our family's nutrition-based health - or buy it from someone who did so for us. Today, however, we have outsourced that job to large companies whose sole charge is to maximize shareholder profit. This is accomplished two ways: driving down costs by maximizing volume (yield) while using the least expensive source ingredients; and finding increasing ways of parting consumers with their dollars by creating new food products. We will come back to factory farming and the US Government in a minute.

But first, regardless of what Big Ag and Uncle Sam are up to, I can't help but dwell on the fact that we used to readily spend 43% of our precious income on eating; and yet today, as rich as we have become as a country by contrast to our earlier selves, we spend just 13% and complain about food prices vociferously. To understand the full picture, we need to look at where we are spending those dollars, if not on foods that prioritize our long term health.

Which brings us to our third question: what are we doing with the 'extra' 40% in discretionary income? The answers may or may not surprise you. First, housing has become more expensive, and accordingly we have increased our housing spend by 10%, according to Derek Thompson's chart. Income spent on health care costs, by contrast, have risen just 1% over a hundred year period. How? The US Government, both directly and via your employer, has picked up the tab - to the tune of three times what we as individuals spend, according to Thompson. Health care spending today comprises 16% of the entire US economy - a rate that has quadrupled in the past 50 years. In 2005, the US spent $190 Billion treating obesity-related conditions alone, according to a study cited by Harvard's School of Public Health. That money comes from taxes. In other words, we are spending more on healthcare - via taxation - to treat the conditions we have created through our dietary choices.  

But that still leaves roughly 18% more income on the table, once you neutralize the so-called necessities. Where is it going? Chart 43, on page 67 of the linked 2006 report by the Bureau of Labor Statistics, shows us that we have increased our spend on non-necessities by 28% since 1900. To quote the final paragraph in the study: 

In the 21st century, households throughout the country have purchased computers, televisions, iPods, DVD players, vacation homes, boats, planes, and recreational vehicles. They have sent their children to summer camps; contributed to retirement and pension funds; attended theatrical and musical performances and sporting events; joined health, country, and yacht clubs; and taken domestic and foreign vacation excursions. These items, which were unknown and undreamt of a century ago, are tangible proof that U.S. households today enjoy a higher standard of living.

So we've chosen iPods over pea pods. But at what cost?

Let's return to what we eat. About 90% of the dollars Americans spend on food goes to buying processed food products, according to Eric Schlosser, author of the seminal Fast Food Nation. But how come there's so much junk food on the shelves in the first place, and where are all the vegetables, fruits and other healthy produce we should be eating instead? To understand this, we need to first look at the American farm. Farming, which before WWII comprised 50% of all US jobs, accounts for less than 1% today. Of the 2.2 million farms that remain, according to the group Farm Kind, 90.5% of those are family-run, small to medium sized farms that produce in total 32% of our food. The remaining 9.5% of farms are large to extra large - what we would term agri-businesses. These mega-farms produce over two thirds of our food, at nearly 67%. Their operations are heavily underwritten by the US Department of Agriculture, which spends $30 billion per year on subsidies to farms - more than half of which goes to the tiny share of mega-farms that are supplying most of our food. Shockingly, over 90% of all funding - for small or mega-farms alike, according to the Cato Institute, goes to just five crops: corn, rice, wheat, soybeans and cotton. Ignoring the last non-food crop, the United States Government, through its subsidies, is in essence paying businesses to grow a very specific set of nutrients - nutrients that are unsurprisingly the foundation of the junk foods on which we spend 90% of our food dollars. We will come back to one of these - corn - in a moment.

So, in summary: we are spending less on food and more on lifestyle products and services; what we do spend is overwhelmingly spent on junk foods comprised of corn, soy, wheat and rice created by mega-farms, refined beyond recognition into calorie-empty food products by mega-companies; and the US Government is aiding and abetting the whole enterprise through subsidies, while admonishing us (on occasion) for not eating enough vegetables.

Hmm.

So how much more expensive is it to eat healthy, anyhow, assuming we can resist the temptation of snack foods, we are willing to spend money on real foods, and we will spend time to prepare our own meals with that nutritious produce after a long and exhausting day at work?

As reported in a 2007 New York Times article, Americans spend an average of $7 a day on food - $4 for the lowest income individuals. A 2,000 calorie diet of junk food averages just $3.52, according to the study cited in the article, while they posit that an equal calorie day's worth of high-nutrient, low-calorie foods would cost over ten times that amount - or $36.32. But to stop reading there would be to miss the big picture, for two reasons: first, calorie-empty (junk) foods leave our bodies less satisfied than whole foods, making us consume (far) more of it than we otherwise would, increasing our relative spend; and second, a calorie is not just a calorie, when it comes to nutrition. As we saw in Week 5's post, a 'Double Gulp' from Seven-Eleven, at 750 calories, is the caloric equivalent of 15 servings - or 5 lbs. - of broccoli. The soda delivers zero nutrition - not one vitamin or mineral - starving our body and making it ask for more 'food'. The (hypothetically possible) consumption of that much broccoli, on the other hand, provides 100-3,000% of our daily requirement of eighteen different vitamins and minerals. Besides the insanity of the comparison, the roughly $5 worth of broccoli would provide both nutrition and fullness well in excess of three times the cost of the roughly $1.75 soda, making it a clear value for money, from a nutrition perspective. So when we compare dollars and food choices, we need to look at the correlation between calories and nutrition. In that sense, the numbers don't support a dire conclusion.

A 2008 study by the USDA here used Nielsen Homescan Data to determine the average cost of 153 commonly consumed fresh and processed fruits and vegetables. They found that the average American could satisfy the USDA's dietary recommendation for fruits and vegetables for just $2 to $2.50 per day. At the bottom of each list: watermelon - at $0.17 per cup, and pinto beans, at $0.13 per cup. The 244-calorie beans are an excellent source of 7 vitamins and 9 minerals; while the watermelon is a good source of 6 vitamins and 3 minerals. And that nutritional powerhouse, broccoli? A single 55-calorie serving would cost about $.30. In short, your $2 could go extremely far in supplying you with all of your dietary needs. 

It is not expensive to eat well. It is simply a choice.

Now that we've determined it's possible to eat healthy foods on a budget, we need to look at how those good foods are produced, shipped and sold, to fully appreciate their true cost. While all fruits and vegetables are better for you, on balance, than any other food category, there are several considerations with regard to each food that greatly affect its nutritional value to us as consumers, as well as its price. These include classifications (conventional, organic, pasture-raised...) farming (pre-harvest) practices (fertilization, pre-peak harvesting, mono-cropping...), post-harvest practices (food coatings; chemical bio-retardation; food handling...), food transportation (distance, method...) and finally point of sale practices (handling, pre-processing, storage...). 

All of these have two primary points of influence: 1 - the people creating our food, and the choices they make with regard to what to grow and how; and 2 - the post-harvest life of that food, and its influence over nutrient retention and cost to consumer. 

There has been no shortage of discussion around the subject of 'local' vs. 'global' eating. If anything, the 'locavore' movement is gaining in speed and popularity, with countless restaurants sourcing their entire menu within the 100-mile accepted standard for 'local', and listing individual farms from which they purchase their foods, treating meals like artisanal labors of love. There is also no shortage of studies around the subject. One, by Kathleen Frith - the former Managing Director of the Center for Health and Global Environment at Harvard Medical School - echoes the conclusions we have read in a number of reports: as a general truth, factory (global) farms focus primarily on yield to maximize profit, at the expense of nutrient density (breed selection and soil richness being two major factors), while small (local) farms focus primarily on taste (which correlates strongly with nutrient density and variation) in order to ensure a strong customer base. On the cost side, large factory farms are production dynamos, using scale and efficiency to reduce expenses, while the inefficiencies of a small family farm has neither the scale nor costly machines of their mega-competitors, driving their prices upward. Conversely, the mega-farms rely invariably on costly transportation - by plane, boat, train and truck - to distribute their goods to consumers to a wide network of buyers, while small farms tend to travel fewer miles to sell their produce, reducing their operating costs in that regard. In the end, however, food bought at a farmer's market, from an upscale grocer or from a food co-op (the three primary outlets by which these farms to reach customers) will most likely cost more money - perhaps significantly - than conventional produce sold to mega-corporations like Costco or national supermarket chains like Kroger. The same goes for an 'organic' product vs. a 'conventional' one: the former costs more because the labor, acreage, supplies and, in the case of livestock, the physical environment that supports the animals' own health - all consume additional capital. So, if dollars spent directly on food are your only consideration, by need or by choice, you can write off the world of small farm, organic, heirloom, wild-caught, small batch, hand-picked, lovingly raised foods as conceits for those with the disposable income to care about these things. And perhaps, you can spend just enough to choose factory-farmed vegetables over snack foods, because in the end, it really is affordable to eat good food, and the gulf between the two food groups' nutrient values to you as a biological machine is the fundamental difference between health and sickness. So if that's all you take away from this, we've done our job. 

But.

There are two additional considerations we must recognize before making that decision. The first of these has solely to do with our health - in terms of nutritional value. Produce crops grown by small-farm, local business owners are by every measure more nutritious than their conventional counterparts. From soil charging to mono-culturing to doubling crop cycles to breeding nutrient-inferior breeds to using synthetic pesticides to harvesting 'sub-ripe' foods to transporting long distances to pre-processing foods, the choices made by factory farms at every step diminish the nutrition in their food products. An excellent report from the Organic Center called Still No Free Lunch - one we encourage you to read - illuminates dozens of studies across the US and UK on the subject of nutrient decline in our food system over the decades. One such UK study found that we would have to eat three apples in 1991 to supply the same iron content as one apple in 1940; and that broadly, British spinach's potassium content dropped by 53%, its phosphorous by 70%, iron by 60% and copper by 96% over the same period. In the US, a 2004 University of Texas study sifted through 50 years of USDA food composition data for 13 nutrients in 43 garden crops - comparing what we grew at home with what is now commercially farmed. Their conclusion? Declines in concentrations of 6 key nutrients: 6% for protein; 16% for calcium; 9% for phosphorous; 15% for iron; 38% for riboflavin (B2); and 20% for vitamin C. By contrast, not one nutrient in any food measured over a 50-year period increased in value.

In this sense, we are incontestably getting more for our money when buying foods grown by the small farm. I could fill an entire blog with examples and data comparing the levels of vitamins and minerals of any crop grown each way. To make the point, I will offer one example for one of the many key decision stages in the life of a food crop: varietal selection. Corn is the biggest crop in the United States, comprising 30% of all US farmland. More than 25% of supermarket foods contain corn, according to author and health guru Michael Pollan. Rick Sietsema, a corn farmer from Allendale, pegs it at 75%. Perhaps more shocking still, a strand of hair belonging to Dr. Sanjay Gupta - CNN's telegenic health reporter - was tested with a mass spectrometer, which can evaluate tissue on a molecular level to pinpoint its sources: 69% of his hair's carbon molecules were made of corn. He is an 'average American' in this regard. Thus, corn's nutritional value is perhaps more important than that of any other food crop. This stunning chart shows the comparison of non-GMO to GMO corn - the latter comprising 88% of all corn produced in the US. The upshot: within the same cultivar (that is, comparing yellow corn to yellow corn), non-GMO corn contains between 6 and 438 times the nutrient levels of phosphate, calcium, magnesium, potassium, manganese, copper, sulfur, cobalt, iron, zinc and molybendum as that in GMO corn. The graphic below reviews the toxicity and nutrient decline in GMO corn in detail. Between cultivars (that is, comparing yellow corn to its more historically plentiful cousins, blue and purple, for example), there are also differences. Blue corn contains almost 30% more anthocyanin - a key phytonutrient. This chart from a 2013 New York Times article demonstrates how, through cultivar selection across dozens of popular crops - not to mention their genetic modification - our agri-businesses have overwhelmingly opted to grow crops for maximum yield and robustness, at the significant expense of nutrition. 

Copyright FFFL

The bottom line is this: to maximize nutrient levels per calorie consumed - which does translate to dollars spent, since organic and/or small-farm foods are more nutritious than conventional - we should opt for the least industrial varietals and sources for each. As we've already discussed, the farmer's market is your best bet, while the organic section in your supermarket is a decent second choice.

Our final consideration for spending more money on food than we as a population do today examines the hidden costs - that $190 Billion in annual US spending on obesity-related chronic disease for which we pay via taxes or direct personal expense - that we discussed earlier. Even if you, personally, are 'healthy' - by which I mean you haven't had surgeries such as bypass, bariatric, liver or kidney transplant, colectomy, etc. - you have paid for it regardless via taxes on behalf of the hundreds of thousands of Americans who have. This money, if redistributed equally among the two thirds of the US population that qualifies as overweight today, would add $2.36 per day to each of their food wallets - enough to pay in full for the USDA's daily recommended intake of fruits and vegetables, in perpetuity.

By several measures, then, we cannot afford not to eat nutritious foods:

  • We used to spend four times as much money on food 100 years ago as we do today, with all our newfound wealth
  • We pay for this privilege with our health, costing US taxpayers an obscene amount of money on disease control - five times what we spent on the same modern diseases just 30 years ago
  • We pay for it with the decline in nutrient values - nutrients which are absent in processed snack foods - but which even for fruits and vegetables are plummeting at mega-farms due to their choices and practices, requiring us consumers to eat an ever greater amount of both to deliver the same nutrients as those foods' pre-engineered, pre-industrialized selves

We strongly encourage you to prioritize healthy eating over non-necessity spending. It's less expensive than you think, in direct outlay; and the hidden costs of not doing so are exorbitant and shared by all of us.

Put down the iPod. Pick up that pea pod.


Week 4: Food Words - Science or Snake Oil?

What's in a name?

Aside from being one of Shakespeare's most famous lines, it's also one of the most vexing questions for a modern eater who is looking beyond the price tag for food that best supports their family's health.

Let's start with eggs. Farm fresh. All Natural. Cage-Free. Free-range. Vegetarian Diet. No antibiotics/hormones. Omega-3 enriched. Organic. Pasture-Raised. All of these terms can be found on egg cartons, alongside friendly fonts, colorful logos, photographs of hens on lawns and even 'personal letters' written by farm owners, folded and inserted into the carton, like a message in a bottle. The underlying message: We're family farmers. You can trust us. 

So which words matter, and which have been devised simply to move product?

The truth is likely murkier than you think, so the first order of business is to help parse words dreamt up in a boardroom from those that are legally regulated. The fact is that in all cases, regulation is minimal. As a result, a large contingent of poultry farmers who practice a holistic, pre-industrial approach to their craft have established their own grass-roots terms to distinguish the trade's highest quality product - to the benefit of health-minded eaters - at least for the time being. More on that shortly.

Let's start with a statistic. According to the Coalition for Sustainable Egg Supply, 95% of all eggs sold in the US are from chickens raised in so-called battery cages that provide 67 square inches of floor space per bird - roughly the size of an iPad. In their lives, these chickens never see sunlight; will never walk or spread their wings; are fed a mixture of cornmeal and animal byproducts (the heads, intestines, gizzards and feet of of other chickens) and live in 'houses' numbering tens of thousands of birds, amid the roar of giant fans whose job is to minimize the overwhelming stench of ammonia and feces. Unlike their cage-free friends, chickens that cannot move do not need to be de-beaked, since they can't reach around to attack one another. Thus, according to Janice Swanson, an animal scientist at Michigan State University, 'only' 5% of egg-laying hens die prematurely in battery cages, versus 11% in cage-free environments.

Let's visit the life of the typical US commercial chicken. Those raised as meat are commonly referred to as broilers, portending their end state. PETA cites a 2006 Consumer Reports study in which an overwhelming majority - 83% - of grocery store broilers tested positive for salmonella, campylobacter or both - which is not surprising, given their living conditions. This is in spite of the fact that each broiler is given ungodly amounts of antibiotics during its short 5-7 week life in an attempt to minimize risk of dying from the diseases caused by their 'living' conditions before reaching optimal slaughter weight. Each 5 1/2 lb. broiler is administered four times the dose that is typically given to a 150 lb. human or a 1,200 lb. steer. The comparison is staggering, and the high percentage of bacteria-infected grocery chickens is yet more troubling. Egg-laying hens don't fare much better. On average, the comparatively longer-lived laying hens spend a year in similar conditions to broilers, unable to move, before being slaughtered and fed to other hens. From a human health standpoint, we needn't worry about males: they neither lay eggs nor become food. Thus the 250 million that are born each year to hens are thrown upon hatching into large grinders called macerators and thus efficiently culled, alongside slow-hatching or defective eggs of either sex.

The conditions listed above, and the bacterial risks passed from chicken to meat or chicken to egg - and from them to us - makes sourcing this food and understanding the different labels they wear all the more pressing. Let's start with eggs.

Farm FreshPaul Shapiro, Vice President of Farm Animal Protection at the Humane Society, says "It literally means nothing." Ditto All Natural, which he says is ironic, "because conventional chickens live in the least natural conditions imaginable."

Cage Free and Free Range. The first of these two designations mandates removal of the battery cages and doubles the space available per hen - to that of a large laptop. This gives hens just enough room to stand, move, spread wings and peck at each other, which accounts for the 6% increase in deaths of cage-free hens when measured against caged birds. The conditions within the thousands-strong hen houses are no different from conventional ones: full of disease, ammonia, feces, feathers, dust and dead birds. The term Free Range is, in practice, no different. It is not regulated by the US Government for egg-laying hens, apart from the need to provide them with access to the outdoors. According to Mark Kastel of the Cornucopia Institute, the vast majority of hens never go outside, because of the wind tunnel effect at the hen doors caused by the industrial fans we have already discussed.

Eggs from hens fed a Vegetarian Diet are fed corn - often fortified with amino acids. Given that chickens are natural omnivores, getting much of their nutrition from worms and insects in addition to grasses and seeds in the wild, the term is perplexing, and doesn't provide the optimal diet for hen or egg. Omega-3 enriched eggs are from hens whose corn feed generally includes a flaxseed supplement, since flaxseeds are Nature's single best source of these important anti-inflammatory nutrients, or krill oil. This provides dietary advantages to us, since a chicken's feed does influence the nutrient composition of its eggs, the benefits of which we reap when we eat them. However, let's keep in mind that 95% of hens whose eggs carry these labels alone live in the conditions described above. Thus, to our minds, without additional classifications like organic or pasture-raised (see below), it's a small leap to say that we should be concerned about how the rampant disease, ammonia-laden atmosphere, industrial feed and antibiotics affects the eggs that we consume, and in turn our own health, omega-3's or otherwise.

Up to this point, no term we've looked at establishes a healthy living environment for hens, a healthy diet for their eggs, and therefore optimal nutrition for us.

Which brings us to the first term that carries a legal definition - OrganicOrganic is regulated by the USDA and requires hens to receive organic feed - itself free of synthetic pesticides, receive no hormones and receive no antibiotics. This implies - although not legally mandated - that their living conditions that are less prone to rampant bacterial infection that would require antibiotics. In practice, Kastel says, organic hens are subject to similarly crowded densities, since farmers are free to determine their own practices, as long as they comply with these three criteria. Thus, while certainly better from a chemical standpoint, organic poultry farming is a bit of a Wild West, in terms of health, organic is an important term but on its own is no guarantee of a quality product.

Our final term - Pastured (or Pasture-Raised) - comes closest to what we all imagine when we think of eating eggs (or for that matter, hens): chickens exhibiting natural characteristics, in a natural environment and density, eating what they evolved to eat. Nicknamed beyond organicthis is a purely grass-roots term and carries no regulation, though it is endorsed by the American Pastured Poultry Producers' Association (APPPA). The term was championed by 'star' farmer Joel Salatin of Polyface Farms who is heavily featured in Michael Pollan's seminal book, The Omnivore's Dilemma. Since then, it has been adopted broadly by other farmers hoping to emulate pre-industrial practices: by rotating crops and livestock across poly-cultured landscapes in a symbiotic relationship of 'eat, clear, fertilize, grow'. A phenomenal resource exists here - courtesy of the Cornucopia Institute, in which egg producers across the country have been rated on a number of practices and given a star - or egg - rating. You can find out exactly what your favorite egg producers are doing at the farm, and find out whose eggs carry the least risk and greatest benefit to your health - to say nothing of humane treatment of the animals.

The bottom line: if you can afford them, seek out and buy pastured eggs. They're tastier than conventional eggs (we've done our own side by side taste tests), their yolks more colorful, and their nutrient and micro-nutrient levels higher. In fact, according to this study, pastured eggs trounce conventional eggs with 1/3 less cholesterol, 1/4 less saturated fat, 2/3 more vitamin A, two times more omega-3 fatty acids, three times more vitamin E and seven times more beta-carotene. For the cost of a single Starbucks latte, you can eat good eggs for a week. So drink water. Skip the overpriced brew. And eat good eggs. 

No fat, low fat, full fat... raw fat? 

It won't become a new Dr. Seuss book anytime soon, but it's a good starting point to explore these terms from the standpoint of marketing and successful infiltration into the American diet. We've already seen in Week 3 that fats are essential to your health, and that without an adequate intake of both saturated and unsaturated fats we would (or do) suffer from significant health problems.

In 1976, Senator George McGovern called a hearing to 'raise awareness to the links between diet and disease'. Two of the luminaries he summoned - a longevity guru and a Harvard Professor - suggested that lowering intake of dietary fat could reverse heart disease. The latter claimed in their 1977 'McGovern Report' that ever-increasing amounts of Americans were gorging on fat-rich, cholesterol-rich and sugar-rich meals, thereby increasing their waistlines. These observations posted a direct threat to the egg, dairy, sugar and beef associations, which for the first time banded together and rejected the findings, demanding a rewrite. The US Government caved to the pressures, removing the words 'reduced intake' from the report's recommendations. Instead, they advised Americans to buy more food that was lower in fat. Two things resulted: first, the creation of an entirely new market: the low-fat, fat-free and other variants of existing food product that drove sales up; and second, the widespread substitution of fats by the now fat-averse American consumers with carbohydrates, which were lower in calories and still provided us with fuel. Gary Taubes, author of Why We Get Fatsays, "In retrospect, it's kind of amazing, but this was the thinking at the time."

Food companies began researching ways to remove saturated fats - which are solid at room temperature - from their products. They turned to unsaturated fats from vegetable oils, but these weren't solid and didn't provide the same mouthfeel or taste, so the process of hydrogenation was applied in order to (semi-) solidify them as suitable alternatives for the processing of food product. Thus trans-fats were born. Trans-fats, as we now know, raise your LDL (bad) cholesterol and lower the HDL (good). They're found in baked goods, fried foods, most snack foods, margarine and commercial dough. But since trans-fats still don't adequately substitute the mouthfeel of animal fats on their own, large amounts of sugar and salt are often added to trans-fats foods to augment their taste. The combination of these - and their market saturation in the United States and abroad - is perhaps the single greatest cause of the increase in obesity rates and epidemic chronic illness we face.

The reality of saturated fat is much more nuanced. Often, they are present in animal-based foods that contain other important nutrient sources like vitamins B12 and D, choline, protein and calcium. Thus, the avoidance of saturated fats in non-engineered foods robs your body of important nutrients.

Take milk. For a period of over fifteen years at the dawn of the 20th Century, no less than the co-founder of the Mayo Foundation (the future Mayo Clinic) - Dr. J.R. Crewe, M.D. - regularly prescribed raw milk (AKA unpasteurized) as a cure for a host of conditions, from cancer to weight loss to allergies to kidney disease to many, many more. He noted in a 1929 article how diseases that had no similarity improved rapidly on raw milk. His patients loved it because it worked and obviated the need for drugs and other medical procedures. Eventually, he stopped treating patients with it, because his colleagues were overwhelmingly in favor of 'modernizing' our approach to health. In his own words, "The chief fault of the treatment is that it is too simple... and it does not appeal to the modern medical man."

A word on raw milk. Almost all commercially available milk today is pasteurized to remove risk of harmful bacteria like E. Coli, lysteria and salmonella. Raw milk is illegal to sell across state lines, and each state sets its own rules for intra-state sale, both in retail stores and on farms, listed here. Raw milk is what was being prescribed by Dr. Crewe, from cows that fed on pasture before the invention of pesticides.  According to Dr. Mercola in a great web entry on the subject, several studies show that the consumption of raw full-fat milk may reduce your risk of heart disease, diabetes, bowel and colon cancer and may help prevent weight gain - a claim that comes up time and again with regard to unsaturated fats, since fats feed metabolic processes and muscle production. He goes on to say that saturated fats are the preferred fuel for your heart, and that different acids contained in full-fat, raw milk lower one's overall cholesterol, are anti-viral, anti-fungal and anti-plaque, and prevent some cancers. Lastly, raw milk is high in omega-3 and low in omega-6 fatty acids, helping to restore your body's balance of these essential nutrients. A good resource for finding raw milk is here.

Pasteurization, on the other hand, requires that raw milk heated (161°F) for at least 15 seconds to neutralize its bacteria. Beyond its bacteria, heat 'impairs the biological value of the food, destroys enzymes, diminishes vitamins, denatures fragile milk proteins, destroys vitamin B12 and vitamin B6, kills beneficial bacteria, and actually promotes pathogens,' according to Dr. Mercola. In his opinion, there is no reason to consume pasteurized dairy, ever. Beyond destroying many of milk's vitamins and our ability to absorb the few that remain, pasteurization deactivates enzymes that assist in the absorption of calcium in your bones as well as those that help you to digest it (aka tolerance). These enzymes break down above 120°F and are almost fully inactive at 150°F. To wit: lactose intolerance, which affects about 65% of us, may well disappear in those who consume raw dairy products in place of pasteurized ones, according to Dr. Mercola. 

Read this article for a 1938 British piece on the subject - before industrial farming existed.

With all of the foregoing said, there is an equally vociferous lobby on the side of pasteurization that includes no less than the United States Centers for Disease Control (CDC), as well as popular food sites such as chef Marcus Samuelsson's Food Republic, which aggressively promotes pasteurization in this web article. The chief argument is one of safety from bacterial infection. Like any form of artificial processing, heat treatment kills those bacteria. What we also know is that while some bacteria are harmful, many others are helpful or invaluable, such as lactobacillus and acidophilus, to name just two. These are commonly added to yogurt and kefir, or found naturally in fermented foods like kimchi and pickles, and produce 'good' micro-flora in your gut. According to the American Journal of Clinical Nutrition here, these bacteria 'show promising health benefits for certain gastrointestinal conditions, including lactose intolerance, constipation, diarrheal diseases, colon cancer, inflammatory bowel disease, heliobacter pylori infection, and allergies.' These bacteria are also completely absent in pasteurized milk, though plentiful in raw milk. Mark McAfee, CEO of Organic Pastures Dairy and internationally recognized expert on raw milk production and safety, has continued to petition the CDC to recognize both raw milk's safety and nutritional superiority, which he and others believe is highly vested in the protection of CAFOs (confined animal feeding operations - AKA industrial milk production farms). Raw milk producers often pasture their cows (you know this by the label grass-fed), adopt stricter safety standards than CAFOs and product both healthier animals and milk. The CDC's (and FDA's) chief concerns derive from industrial farming practices, which lead to diseased animals, which may in turn produce contaminated milk. Says McAfee in a 2012 letter to the CDC:

"As a grade A producer of retailed-approved raw milk in California, I find your raw milk page filled with highly erroneous and very misleading information... In California, we have legal retail-approved raw milk in 400 stores consumed by 75,000 consumers each week. This retail legal raw milk is tested and state inspected and far exceeds pasteurized milk product standards without any heat or processing.

It is clean raw milk from a single source dairy. There have been no deaths from raw milk in California in 37 years. Two years ago, I submitted a FOIA request to the CDC to request data on the two deaths that the CDC database claims were from raw milk. The data I received back from the CDC showed that in fact there had been no death from raw milk at all.

The two deaths had been from illegal Mexican bath tub cheese and not raw milk from any place in America. Why does the CDC persist in publishing this erroneous information? ...The last people to die from milk died from pasteurized milk at Whittier farms in 2007, not from raw milk."

Copyright FFFL

Wherever the truth lies, research, empirical evidence and nutritional chemistry all favor the healthfulness of raw milk, but that milk also carries risks, since as with all raw foods, its 'prime' consumption period is highly limited. In short, it spoils, and must be consumed in an unspoiled state. Raw milk is also extremely hard to find in some states, though easier in others - as it is in Europe, where it is legal across the European Union and even sold in vending machines.

Leaving the debate aside for a moment, let's examine the sub-category of whole vs. low-fat or non-fat, which is unsurprisingly related. All three products are in abundance in the typical American supermarket. Time Magazine published an article this past March that largely echoes an overwhelming number of scientific studies and related articles: that full-fat dairy is in fact better for you than low-fat or lack thereof. A key reason, which should sound familiar by this point: dairy's fatty acids play a [positive] role in hormone regulation and metabolism, which govern how much fat your body stores. Studies have shown that the fewer fats we eat, the more carbohydrates we consume to make up for it. This is consistent with a 50-year trend toward eating more carbohydrates in place of fats (remember Senator McGovern?). When that happens, insulin levels rise. Insulin regulates nutrient partitioning, telling nutrients where to go. Lowering insulin levels allows your body to access fat stores and use them up as energy. 

Our recommendation for dairy: include raw milk/cheese products in your diet if you can find them from a clean, reputable source in lieu of pasteurized, and use them dligently, as you would with other highly perishable foods - like fish. If you cannot or prefer not to 'eat raw', opt for full-fat, organic, grass-fed (pastured) dairy, since low-fat or non-fat anything strips these dietary sources and our bodies of key nutrients.

If there is a consistency to food's story here, it is a simple one: the more that scientists alter a food source - whether an animal's natural habitat (in the case of hens) or its byproduct's chemical make-up (in the case of milk) - the more we are upending that which millions of years of natural selection kept in balance and deemed successful, allowing both consumer and consumed to thrive in a closed loop. In no way does this suggest that farming per se - the practice of creating favorable growing environments to maximize yield - is bad. In harnessing nature, agriculture has broadened the human diet and allowed both our number and our longevity to increase. But when a food is consistently exposed to controlled chemicals, an unnatural habitat and/or compositional manipulation, we are the ones left paying the price for the experiment - an experiment designed to drive business profits, our waistlines and our medical expenses ever upward.