Fasting is an ancient practice that is now enjoying a resurgence, due in part to growing scientific evidence on the positive health impacts of both intermittent and prolonged fasting (defined here as a fast of 48 hours or longer). I wrote about the benefits of the various forms of fasting in a previous blog – Fasting: Some Things You Should Know. In this post, I focus on prolonged fasting and in particular the Fasting Mimicking Diet® (FMD), based on the work done by Professor Valter Longo and associates.
Longo, one of the world’s foremost experts in the science of aging, has found that prolonged fasting can significantly increase health and longevity. The benefits of periodic prolonged fasting led Longo to advocate regular five day fasts to enhance cellular health and minimise biological aging for those in good health below the age of seventy. Longo and his team also found that fasting can be an effective treatment for cancer used alongside standard medical practices. Fasting can enhance the effectiveness of chemotherapy for some cancers as it preferentially protects healthy cells and increases the mortality of cancerous cells. Human clinical trials on cancer patients are ongoing but in the meantime some people have adopted fasting while on chemotherapy with some success.

While acknowledging the benefits of fasting, many health care practitioners and patients have been reluctant to undertake a classic non-caloric fast (NCF) for a variety of reasons. This motivated Longo to develop the “fasting mimicking diet.” This consists of a low calorie, low protein and high micronutrient combination, which reproduces biochemical effects of fasting while minimising the risk of nutrient depletion. “ProLon”, a precise combination of foods and supplements, has been commercialised as a package by L-Nutra, of which Longo is the founder. Longo does not personally profit from the venture, thus helping to ensure that his scientific integrity is not compromised.

At $249 per box, ProLon is quite pricey and, of necessity, the food on offer is processed. In an effort to provide the benefits of an FMD using whole foods Chris from Gen X Life is Good!, has developed a DIY version of ProLon, approximating its nutrient mix from Longo’s patents and publications. Many thanks to Chris for all her hard work and her very useful accounts of her experiences on her website.
Julie and I are big fans of a twice-yearly five-day non-caloric fast (drinking mostly water, a little herbal tea and the odd black coffee) but decided to give the DIY FMD a go as our second fast of 2019. We pretty much followed Chris’s meal plans as laid out on her website but incorporated her snacks (potatoes mostly) into either lunch or dinner.

Please bear in mind Valter Longo's caution: He does not recommend doing a “DIY” version of the FMD because it may be ineffective and potentially harmful. If you plan on doing a fast, do your own research and check with your healthcare provider.

It is also important to note that what we are documenting here is anecdotal. It does not represent an objectively designed experiment with randomisation, replication, a control (non-treatment) group for comparison, and measures of health indicators before, during and after the fast.

With the above caveats in mind, here is a summary of our experiences of the DIY FMD and a comparison with the non-caloric fast (NCF) we undertook in July 2019.

Hassle:
NCF: No food = no hassle. We found lots of spare time to do other things and to free ourselves from the “tyranny” of food preparation, mealtimes, and washing, drying and putting away.

DIY FMD: We still had to do all the food-related stuff, while catering for those in the family who were eating normally, so the hassle was doubled. The hassle would have been less had we been using ProLon as all the portions are already packaged, but the DIY version meant precise weighing and combining of all ingredients. The recipes were simple so the cooking itself was uncomplicated, but it might be a bit of a challenge for those with less cooking experience than Julie (who made most of the meals) and me (who chipped in on occasion).

Verdict: NCF was the least hassle for us.

NCF: No food = no hassle. We found lots of spare time to do other things and to free ourselves from the “tyranny” of food preparation, mealtimes, and washing, drying and putting away.

DIY FMD: We still had to do all the food-related stuff, while catering for those in the family who were eating normally, so the hassle was doubled. The hassle would have been less had we been using ProLon as all the portions are already packaged, but the DIY version meant precise weighing and combining of all ingredients. The recipes were simple so the cooking itself was uncomplicated, but it might be a bit of a challenge for those with less cooking experience than Julie (who made most of the meals) and me (who chipped in on occasion).

Verdict: NCF was the least hassle for us.

NCF: We experienced some headaches on Days 1 and 2 and some dizziness at various times, notably upon standing. This was reflected in our low blood pressure readings (my minimum morning blood pressure was 100/66 and it is normally about 110/70). We both felt very hungry on Day 2.

DIY FMD: We also experienced some headaches on days 1 and 2 but no dizziness despite the fact that my blood pressure readings were lower than normal (minimum morning blood pressure of 102/65). We did not feel very hungry throughout. Although low in calories the food was, in many instances, high in volume and there were times when we found it difficult to finish what was on offer.

Verdict: DIY FMD had the fewest side effects.

​Our energy levels dipped on Day 2 of the NCF but were very high from day 3 onwards. The increased energy was accompanied by strong feelings of wellbeing. We experienced neither the highs nor the lows with the DIY FMD.
​
Verdict: A tie.

Julie entered ketosis on Day 2 of the NCF and Day 3 of the DIY FMD. It was the reverse for me: ketosis on Day 3 of the NCF and Day 2 of the DIY FMD. 
​
Verdict: A tie.

In both cases, the lost weight was regained after a week. We felt no ill-effects following either fast. Nor did we feel any sustained increase in positive energy, but we are both in good health anyway so it is unlikely that we would feel much change even if there are some subtle underlying shifts. To learn more, we would have needed to test for a variety of biomarkers such glucose, CRP (a marker of inflammation and risk factor for cardiovascular disease), and triglycerides, which is something we may do in the future. In both the NCF and the DIY FMD, our normal diet tasted amazing when we resumed eating, but this effect was greatest following the NCF. 

Verdict: No verdict as we did not have the necessary data.

​In answer to the question, “which is the best?” I’ll give the classic evaluator’s response, “It depends…” On balance, Julie and I prefer the non-caloric fast because of its convenience and the fantastic energy from days 3-5. It eliminates any residual nagging doubts about the authenticity of the DIY FMD. However, the DIY FMD might be a better option for those who fear fasting, and those with pre-existing conditions including nutrient deficiencies. 

Click here for a PDF version
Contents
  Fasting: The revival of an ancient practice

1. Not all things called a fast are actually a fast
2. Fasting has a huge range of mental, physical and spiritual benefits
3. Fasting is natural for all animals… including humans
4. Fasting facilitates powerful physiological changes
5. Intermittent and prolonged fasting are both beneficial
6. Fasting and starvation are not the same
7. Hunger during a fast is not as bad as people anticipate
8. Some groups should not undertake a prolonged fast while others should fast only under health care supervision
9. Fasting will bring minimal lasting health benefits if it is not incorporated into a healthy lifestyle
10. Prolonged fasting sometimes induces uncomfortable symptoms
11. Successful fasts should be planned

  Further Reading

Fasting, simply defined as an extension of the normal non-feeding window, is the oldest dietary intervention known to humanity. Traditionally, fasting has been better known for its religious, spiritual and political dimensions that its effectiveness as a body-mind health practice. But this is changing, and interest in health-related fasting has enjoyed a recent resurgence, with books by luminaries such as Jason Fung and Joseph Mercola becoming best sellers.

Fasting, as part of a healthy lifestyle, is a powerful healing modality. Unlike some other health promoting practices, it is simple, time-saving, natural, flexible, sustainable, convenient, and free. In fact, it can even save you money.

The processes through which the food we eat turns into you and me is very demanding. Our bodies need to break down, absorb, transport, and store nutrients, and eliminate waste products including toxic chemicals. Most of the benefits of fasting come from giving these processes a rest thus liberating energy for healing. In the words of Joel Fuhrman, fasting provides an opportunity for the internal organs and digestive system to take a physiological vacation.

The need for this vacation is now greater than ever. We are in the midst of a tragic global epidemic of food-borne diseases caused by the spread of the Western Mainstream Diet (WMD) , a diet that is too high in calories, fat, animal protein, additives and processed foods, and too low in fibre, vitamins, minerals and phytochemicals.

Fasting can be divided into three categories – intermittent fasting, prolonged fasting and therapeutic fasting. Intermittent fasts involve skipping 1-3 meals on a regular basis. A prolonged fast lasts longer and is not undertaken as frequently. The longest prolonged fast on record lasted 382 days! There is no hard and fast dividing line between intermittent and prolonged fasting. I have arbitrarily drawn this line at two-days which approximately equates to skipping four consecutive meals. Regular PFs generally last between two days and one week. Medically supervised fasting as part of a treatment regime for a chronic health condition (‘therapeutic fasting’) often lasts for several weeks.
​
In this blog, I summarise eleven things you should know about fasting that will help you maximise its health benefits. This blog focuses on fasting for healthy people for five day of less and without supervision. This information is covered in detail in my forthcoming book: The Little Book of Fasting: What, Why, When, How, Where, and Who. This book, which should take a couple of hours to read, provides a stepping off point for those who are interested integrating fasting into a healthy lifestyle programme. The book cites over 140 sources, mostly from peer reviewed scientific journals, that the reader can consult if they want to go into more depth. 

The term fasting is used differently by different people and groups. In this blog, I focus on fasts that do not involve eating. The main drink during a fast should be purified, distilled or reverse osmosis treated water. The contaminants as well as the natural minerals in tap water are believed to interfere with the body’s natural healing response.

Some thought leaders in the field insist on water-only fasting but others include the occasional drink of non-caloric drinks such as herbal teas, black sugarless tea and coffee. The use of non-caloric drinks can be thought of as a transition to water-only fasting which is the gold standard. Limes, lemons, vinegars, and salt may be added to the water. The limes or lemons should not be eaten. Including milk in you tea, herbal tea, or coffee will break the fast. Drinks containing zero calorie sweeteners are not recommended. They are not healthy options and studies have shown that these sweeteners may trigger the desire for energy dense foods thus making the fasting process more difficult.
Fasting categories that are not considered include:

• A juice fast, which is actually a low calorie dietary modification, which can have benefits, but which does not lead to the physiological changes that occur under true fasting conditions.
• Exclusion of specific foods, e.g. animal products. As above, food exclusion is more properly considered to be a dietary modification rather than a fast.
• Eating a restricted number of foods, e.g. a chocolate fast. Does not involve caloric restriction. May have benefits but there is no peer reviewed scientific evidence to support the efficacy of these diets.

​Dry fasting, where no food or drink is consumed, is certainly a true fast and there is some information on its health benefits, but there are no peer reviewed studies. Dry fasting is potentially hazardous and should only be undertaken under health care supervision. 

​Fasting has been used as a treatment for a vast array of conditions. This should not be surprising as fasting affects the body-mind as a whole and is, therefore, not disease specific. The following is a (non-exhaustive) list of conditions for which fasting has been claimed to be beneficial:

Other benefits of fasting include:

• Reversal of aging and extension of life. Caloric restriction (CR) has health and longevity benefits for a wide variety of species. CR may extend life by up to 50% in rodents, with progressively less impact the later in life it is started. Fasting appears to have similar effects to CR in humans via various mechanisms that improve energy efficiency and reduce oxidative damage. It has been widely suggested that a fasting/non-fasting regime may be easier to maintain than daily CR so increasing the odds of a successful outcome. It is important to note that all calories are not created equally and restricting calories at the expense of nutritional quality must be avoided.
• Decoupling yourself from the tyranny of food. For example, maintaining a healthy diet can be a challenge when flying but if you chose to fast during a long haul flight you can eat a substantial nutritious meal before leaving home and eat good food once again after you have reached your destination.
• Enhancing the appreciation of the occasional feast. A lifestyle of dietary prudence, accompanied by fasting, builds resilience which buffers against occasional dietary excess. Special occasions under these circumstances are truly special because of their rarity.
• Building certainty or conviction. Because fasting removes all food, people with food-related diseases (which is just about every chronic disease) can rapidly witness the impact of diet on their health. This can help to convince them of the healing power of nutrition. This conviction can enhance their compliance with a regime of dietary excellence in their day-to-day life.

​Fasting is the norm in nature, while eating three meals every day and snacks in between is an unnatural state. All animals, including humans until modern times, go through prolonged periods without food and our bodies are adapted to this reality. In addition, all animals naturally fast and rest when ill or injured. Many people nowadays do the opposite and continue to eat and be active when ill while taking symptom-suppressing drugs. These very symptoms, such as a runny nose, fever, inflammation and fatigue, are the body’s healing mechanisms in action. Masking these symptoms and ‘keeping calm and carrying on’ with our busy lives can prolong the illness and transform a minor ailment into a major disease. 

Major physiological changes associated with the fasting process include

• Fat burning and ketosis – as the fast proceeds the body’s carbohydrates reserves are used up and the body prioritises fat burning while preserving muscle mass. By day 2-3 of the fast, a state of elevated ketone levels, known as ketosis, kicks in. Short term ketosis appears to have a range of health benefits including protection against neurodegenerative diseases such as Alzheimer’s and Parkinson’s.
• Autophagy – which literally means “self-eating” can actually be a good thing. Autophagy is a critical part of the continual process of cellular maintenance, renewal and rejuvenation. When we don’t eat, the body has the chance to get rid of worn out cellular components which are recycled to generate energy and new cellular machinery.   
• Changes in hormones, neurotransmitters and trophic factors – the levels of critical signalling molecules such as insulin are regulated during fasting thus improving functions such as blood sugar control.
• Improved cellular function - fasting improves cellular function in various ways including the following: increased insulin sensitivity; enhanced cellular stress resistance, and improved energy efficiency.
• Improved brain and nervous system function – fasting promotes stress resistance by stimulating the parasympathetic nervous system, promotes the ability of nerves to change and adapt to new information, improves the ability of nerves to regenerate, and reduces inflammation which is a major component of declining brain and nerve health.
• Improved cardiovascular function - The response of the cardiovascular system to fasting - a reduced resting blood pressure and heart rate, and increased heart rate variability - is similar to the training effect of aerobic exercise.
• Improved immune system function - Fasting exerts a positive effect on immune system function for a variety of reasons including: elimination of allergenic food; normalised blood sugar levels, and enhanced immune cell activity.
• Reduced oxidative stress - We power our bodies using chemical reactions that oxidise (‘burn’) molecules derived from the food we eat. This process produces unstable by-products called free radicals which can damage cell structures unless they are neutralised by antioxidants. An imbalance between oxidation and antioxidant activity can contribute to many chronic diseases. By suspending the digestion process, fasting reduces oxidation levels.
• Detoxification - Our body’s cells house the molecular remnants of every restaurant meal, takeaway, and processed food snack we have ever eaten. On top of this, we are immersed in a sea of toxic chemicals from air, water and land pollution and many of us have consumed pharmaceutical or recreational drugs on a more or less regular basis. All of our body’s cells contain detoxification mechanisms and we also have organs that specialise in detoxification, notably the liver. The liver converts toxic compounds into products that can be eliminated from the body by various routes such as through faeces, urine, sweat, other skin secretions, the breath, finger and toenails, and hair. These detoxification mechanisms are over-extended by our constant exposure to toxins – and fasting gives these mechanisms much needed space to catch up. Fasting can liberate emotional as well as physical toxins in a process of emotional detoxification in which feelings surface when the numbing effect of food is removed. This process can lead to physical, mental, and spiritual breakthroughs.
• Recovery of the microbiome - The microbiome comprises of all the microorganisms (bacteria, viruses, protozoa and fungi) that live in or on us. The vast majority of a healthy microbiome is composed of beneficial bacteria that live in our digestive tract. Fasting, which reduces the food supply for gut microorganisms, represents an ‘energy crisis’; and a ‘housing crisis’ as our intestines shrink in response to fasting. Animal studies have shown decreased numbers but increased microbial diversity in response to fasting. This process could help to heal the microbiome by altering the relative abundance of different types of bacteria. Microbial imbalance (dysbiosis) is associated with a number of disorders including obesity, diabetes, irritable bowel syndrome, inflammatory bowel disease, depression, and cardiovascular disease.
• Weight loss - Fasting triggers an initial period of rapid weight loss. For those eating the WMD, much of this initial weight loss is due to the release of water in response to a reduced salt load. To dilute the effect of a high salt diet, the body retains water which causes bloated tissues and poor muscular definition. The water weight will not be entirely regained if the fast is followed by a whole food plant-based diet, but the weight and bloating will quickly return if the you go back to eating the WMD. Most of the remainder of this initial weight loss is due to the loss of faecal matter. It is believed that fasting aids sustainable weight loss by a variety of means including improving the body’s fat burning ability, increased insulin sensitivity, increased energy levels, and by helping to break food addictions.

There are benefits to both intermittent and prolonged fasting, and a lifestyle that combines them both; but the two fasting ‘currencies’ are not fully interconvertible – in other words, a five-day fast is not equivalent to five one-day fasts. 
​
IF has many benefits: helping to prevent overeating, thus addressing dietary excess; helping the body to tap into its glycogen and fat reserves which facilitates metabolic flexibility, reducing food cravings, and assisting with detoxification by resting the digestive system. However, relatively short fasts do not induce the same physiological changes as long-term fasting. The full range of physiological changes over a longer fast underpin the power of PF to achieve clinical outcomes.   
It is likely that the combination of both IF and PF provides a long term regime to prevent, arrest and reverse the diseases of excess and to sustain and build upon these gains over time. 

​A simple definition is that fasting is voluntary and starvation is involuntary. However, this is not quite true as anorexics and those on hunger strike voluntarily risk starving themselves. Physiologically speaking: you are fasting when you are utilising available non-essential nutrient reserves; and you are starving when you have exceeded those reserves and you are breaking down essential body tissues for energy, which results in muscle wastage, organ failure, and death if feeding is not resumed. The body goes into starvation mode when body fat levels fall below about 4%. The vast majority of people have considerably more than 4% body fat, so have plenty of reserves for a prolonged fast.

Fasting tends to be difficult at first but, like most things, it becomes easier with practice. The main thing that puts a lot of people off fasting is the fear that they will face an overwhelming and cumulative hunger as they fast. Actually, hunger comes in waves and does not simply build inexorably the longer you fast. It peaks around mealtimes and diminishes in between. Hunger is partly a learned phenomenon and salivation, pancreatic fluid secretion, and insulin production increase upon the expectation of food at regular mealtimes. Hunger is also stimulated by cooking, seeing, and smelling food; so it is best to remove minimise contact with food as much as possible, especially in the early phases of the fast when hunger is at its most extreme. Hunger diminishes once ketosis sets in. Reduced hunger is also associated with hormone changes. 
​
Understanding that fasting will not condemn you to perpetual hunger helps you to ride the hunger waves in the knowledge that they will pass. You can also employ tactics to manage the hunger such as drinking a cup of herbal tea or black tea or coffee, or doing something to distract you from the hunger such as going for a walk, watching a TV programme, or having a conversation with a friend.

Nearly everybody can fast and would benefit from it. This is even true of many people who are chronically ill, who can gain spectacular benefits from fasting. But for this group, a prolonged fast should only be done under strict health care supervision. However, there are those that should absolutely avoid prolonged fasting. The following belong to this group:

• Children under 18
• Pregnant and breastfeeding women
• People who are underweight or malnourished
• People with eating disorders
• People with MCAD deficiency
• People recovering from operations
• People with advanced medical disorders
• Athletes during training or sporting competition
• People taking medications they cannot stop
• People with severe anxiety related to fasting

Those who should only undertake a prolonged fast under supervision include:

• Type 2 diabetics
• Type 1 diabetics
• People with gout
• People taking medications for chronic diseases

Fasting can give us a much-needed break from the incessant dietary assault that comes from the WMD, bringing spectacular benefits in its wake. However, like a vacation of the more conventional kind, the benefits of fasting will only be fleeting if we do not address the stresses from which we temporarily escaped. Fasting is effective as part of a healthy lifestyle and cannot be considered as an isolated intervention. A variety of health regimes fit the bill. The seven pillars of a healthy lifestyle incorporates a set of evidence-based practices that that can be combined into a personalised health programme. It is the regime Julie and I have developed for ourselves and our clients and which we cover in depth in our weekend health workshops. 
​
The seven pillars are:

1. Eat a whole food plant-based diet
2. Hydrate properly
3. Move frequently
4. Sleep soundly
5. Breathe effectively
6. Manage psychosocial health
7. Create a healthy environment

It must be emphasised that most of the symptoms listed below are unlikely to affect somebody on an intermittent fast, and no single individual will experience all the uncomfortable symptoms listed.

I prefer to use the term ‘uncomfortable symptoms’ than ‘adverse effects’ or ‘side effects’ as these symptoms are not necessarily adverse. Like all symptoms, they are a reflection of the body-mind’s response to a stimulus and they require some kind of response. The minimum response is mindful observation, noting the nature of the symptom(s) and its progression, while the maximum response is to end the fast and seek the advice of a health practitioner.
​
Common uncomfortable symptoms include: hunger; headaches; fatigue and weakness; dizziness, light-headedness and fainting; diarrhoea; localised pain; skin rashes; body odours; discharge from mucous membranes; nausea and vomiting; acid reflux; feeling cold; a foul taste in the mouth; bad breath and a coated tongue; and irritability. People also occasionally report being constipated during a fast. Many of the symptoms combine as part of a classic ‘healing crisis’ in which chronic problems become acute as the body heals. This can be very distressing and should be a signal to stop a non-therapeutic fast. People who experience this response are likely to benefit greatly from a therapeutic fast in a specialist facility.
 
Various uncomfortable symptoms commonly occur during fasting, especially for inexperienced fasters who are in less than perfect health. In most cases they become less of a problem as your lifestyle becomes healthier and your body becomes more adjusted to fasting. The following factors can influence the severity of uncomfortable symptoms:  If it has been a very long time since you have fasted; if you are middle-aged or older; if you are in a difficult life transition; if you have been under high stress for some time; if you are doing a deep, spiritual, wilderness fast; if you have high levels of toxins in your body (e.g. if your job entails any contact with synthetic chemicals on a regular basis); and, if you have taken a lot of pharmaceuticals during your life.

In fasting as in life, preparation is key, and the longer the intended fast the more thorough the preparation should be. Thorough preparation is especially important if you have never fasted, not fasted for a long time, or not fasted in a long time. The preparation checklist below is intended for a prolonged fast but it can be valuable to consider these factors for intermittent fasting as well.

• Why you want to fast - What are your fasting goals?
• Expectations – what pearls, perils and pitfalls do you anticipate and how will you deal with them?
• When to fast – What will be the best time to schedule your fast?
• Location(s) - Where will you be during the fast?
• Duration and frequency - How long and how often do you intended to fast for?
• Preparatory diet – What will you eat before fasting to maximise the success of the fast
• Activities – How will you spend your time during the fast?
• Support - What support and/or supervision will you have in place?
• Additional therapies – What other healing modalities could be pursued while fasting?
• Monitoring - What things do you intend to monitor during your fast? – body weight, ketosis status, mood, blood pressure, blood sugar, specific disease symptoms, etc.
• Breaking the fast - How do you intend to break the fast?

The checklist can be used informally or as the basis for a formal written fasting plan. A customisable fasting planning template can be downloaded from the New Paradigm Health website.

Click here for a PDF version
Contents

1. There is only one dairy product designed to be eaten by human beings… mother’s milk
2. Dairy products do not build to strong bones
3. Dairy consumption can promote cancer
4. Dairy consumption can promote autoimmune disease
5. Dairy consumption can give you zits
6. The dairy industry is a major environmental concern
7. The dairy industry is a major animal welfare concern
8. The promotion of infant formula milk has contributed to millions of deaths worldwide
9. Dairy consumption provides a source of iodine
10. Dairy’s demise is possible, but the industry won’t go down without a fight

References
Further reading from Viva!

​As a long-time vegetarian, I continued to consume milk, cheese and yoghurt while buying into the myth that dairy was much more benign than other forms of animal agriculture. A deep dive into the literature disabused me of this notion. Dairy consumption is not good for your health unless you are starving. This applies to dairy in any form, whether it is milk (of whatever fat content), butter, yoghurt, cheese or kefir. Dairy consumption also has adverse ethical and environmental impacts. 

The fact that it has such a wholesome reputation is testimony to the power vested interest and marketing. However, the tide is finally turning.

This article is my small contribution to lifting the veil that has obscured the truth about dairy; a veil that has been expertly woven by a mixture of slick PR, lobbying power, and marketing masquerading as science.

Before we dive in, here are a couple of points to bear in mind: 1) Although the focus here is dairy, specifically products from cow’s milk which is the most common and well-studied commercial dairy group, the lack of attention given to milk from other (non-human) animals is not meant to imply that they are necessarily better than cow dairy from any standpoint – we should not be consuming the milk of other animals; 2) Health and disease develop because of dietary and lifestyle patterns, not individual nutrients/food items or behaviours independent of their context. So please bear this in mind. We cannot reduce things down to isolated heroes and villains. Dairy is certainly not a health food, but neither is it single-handily responsible for all the dietary disasters that permeate the toxic brew known as the BAD (British Average Diet).

,Every species of mammal produces milk that is designed for the unique dietary needs of their offspring until they are weaned. Logically, therefore, nutrient composition varies considerably between the milk of different species. For example, milk fat content ranges from 0·2% for the black rhino to 60% for some species of seals.[1]

Cow’s milk, designed to feed a calf that doubles in weight every 47 days, has 3.3 grams of protein per 100 millilitres. Contrast this with human mother’s milk, which is designed to feed a baby that doubles in weight every 180 days, with 1.2 grams of protein per 100 millilitres.[2] To help grow large cow bones, cow’s milk has over three times more calcium content than human breast milk.[3] All the nutrients in cow’s milk are designed to grow a cow, not a human being. This simple truth has many health implications.

Human beings are the only species that consumes the milk of other animals. This practice began in agricultural communities about 8,000 years ago. As a result, gene mutations that allowed some people to digest lactose (milk sugar) throughout their lives spread among northern Indians, Arabs, and inhabitants of Southwest Asia and Europe.[4]

Non-human milk consumption, therefore, must have had a survival advantage for some groups of people at some points in time. This does not, however, mean that dairy is a health food. More likely, dairy products were ‘survival foods’ that could help people bridge the hunger gap when other, more nutritious, foods were in short supply.

There are, nonetheless, health issues for those who can digest lactose, some of which are outlined here and more of which are extensively documented by Viva! in their excellent, fully referenced report on the impact of dairy on our health, entitled White Lies.[5] However, health issues are more severe for the approximately 75% of people who are unable to properly digest dairy products from 6-7 years of age; a problem known as lactose intolerance (lactose intolerance in the early years is, for obvious reasons, rare).[6]  Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. But symptoms are not restricted to gut issues and can include headache, vertigo, memory impairment, lethargy and cardiac arrhythmia.[6]

This is how many a conversation goes:
       Omnivore: I hear you’re a vegan. Where do you get the calcium for your bones?
       Vegan: Almonds, soy, oranges, figs, kale, broccoli, and many other plant foods.
The conversation has two principal endings:
      1. Curious omnivore: I never realised. 
      2. Dogmatic omnivore: You need milk.

The simple but flawed logic behind the ‘dairy for strong bones’ hypothesis goes as follows; our bones contain a lot of calcium, calcium loss is associated with osteoporosis and bone fractures, and dairy products are rich calcium. All of these statements are true, but the body is so much more complex than this simple cause-effect logic implies. 

The first nail in the coffin of this nutritional nonsense is the fact that people with a low rate of calcium consumption also have a low rate of osteoporosis and bone fractures.[7] Figure 1 is a graph of hip fracture rates for women in selected countries (standardised for age) against calcium consumption. 

It should not be concluded that calcium is unimportant for bone health nor for other body functions such as blood clotting and muscle function. But if some is good, it does not mean that more is better. A study published in the British Medical Journal found that women with both the lowest and the highest rates of calcium intake were at high risk of hip fractures while those with the lowest rates of hip fractures had intakes that were ‘just right’.[8]

In biology there are a lot of U-shaped curves like this. These ‘too little, too much, just right’ relationships are the basis for the “Goldilocks theory of life”.
​
So we have a pattern. How do we explain it? Well, the body’s organ systems are not passive sponges that absorb everything we consume. If this were not the case, the enormous quantities of calcium in dairy products would calcify our organs with fatal consequences. So most of the calcium in dairy comes in at one end and goes out the other. The missing piece of the puzzle is the impact of animal protein. Milk and other animal protein sources are highly acidic. However, the blood needs to be kept slightly alkaline at all times for the body’s chemical reactions to work. The body buffers this acidity by removing calcium from its main reservoir – the bones. This process is reflected in the fact that those with higher protein consumption tend to have higher bone fracture rates as shown in the chart below.[7]

Dairy is thought to promote cancer by a variety of potential mechanisms. Dairy products are high in oestrogens which have been linked to breast, prostate and ovarian cancers.[9,10] Diary consumption also significantly increases levels of insulin-like growth factor 1 (IGF-1). IGF-1, which is produced in the liver, is vital for normal growth and development, but in excess it can promote the growth of cancerous cells.[11] Several studies have demonstrated a link between increased IGF-1 serum levels and risk of breast, prostate, colorectal, and lung cancer.[11] Dairy products increase IGF-1 levels more than any other dietary sources of protein.[12] Dairy appears to supply IGF-1 directly and stimulates further IGF-1 production via the casein fraction of soluble milk protein (the major protein fractions of cow’s milk are casein (80%), and whey proteins (20%)). 

The immune system attacks and destroys cells in our body every day as part of its normal ongoing maintenance activities. However, when these attacks get out of hand the result is autoimmune disease. Common autoimmune diseases include rheumatoid arthritis, type 1 diabetes, Crohn’s disease, lupus, and multiple sclerosis. The 80+ named autoimmune diseases are all different manifestations of the same process, a failure of the immune system to distinguish self (bodily tissues) from non-self (bacteria, viruses, food fragments, mold, and other toxins).[13]

Genetic susceptibility, imbalances in the digestive system and environmental factors interact to trigger autoimmune disease.[14] Given that we cannot change our genes, the most logical response to an autoimmune diagnosis is to uncover the environmental triggers and remove them / minimise their impact, and heal the digestive tract. 

Animal food consumption including dairy, has been correlated with the incidence of autoimmune diseases as have other factors such as the persistent use of pharmaceutical drugs including antibiotics, antacids, antibiotics, and nonsteroidal anti-inflammatory drugs (such as ibuprofen), bacterial and viral infections, smoking; and alcohol consumption.[14]

Dairy consumption has been linked with a range of autoimmune diseases, notably MS and type 2 diabetes.[15,16] In Canada, a high milk-consuming population, MS was 139 times more prevalent than in China, a low milk consuming country.[15] Finland, a high milk-consuming population, had 36 times more type 1 diabetes than Japan, a low milk consuming country.[17] 

One mechanism through which dairy may contribute to autoimmune disease is a process known as molecular mimicry.[18] Milk contains more than 25 proteins which have a similar structure to proteins in the human body. On exposure to these foreign proteins, if they are only partially digested, the immune system perceives them as foreign substances to be attacked, like a virus or a bacteria, and develops antibodies to them. In susceptible individuals, because of the similarities between these proteins and proteins in the body, the immune cells become confused and ‘go rogue’ attacking body tissues that resemble these ‘invaders’.[19] Another trigger through which dairy may contribute to autoimmune disease is through high oestrogen levels. The oestrogens in dairy may act in combination with other oestrogenic substances like pesticides, plastics, and detergents, and medications such as the contraceptive pill and HRT.[20]

This issue has recently been highlighted when an anonymous poster took to Reddit to detail an ‘experiment’ he conducted on his unsuspecting vegan girlfriend.[21] She believed that going vegan cleared up her acne but he was not so sure, stating that “… teenagers get acne and it goes away yeah, hers just went away a bit late. And now that we’re living together, I’ve been getting tired of all the vegan food… So I thought I would prove to her that the whole “dairy gives me acne” thing is in her head. For the past two months, I’ve been emptying the same soy creamer container and filling it with dairy creamer. I was gonna do a big reveal, like, ‘Surprise! You can eat whatever you want!’” 

Don’t you wish your boyfriend was sweet like him? 

But things did not go the way he planned, and the acne returned – in the words of the (hopefully soon to be ex-) boyfriend - “But she’s been wearing makeup both in and out the house lately… and last night, I saw her barefaced for the first time in a while and it is bad. Like insects about to hatch out of her face bad. So I figure I’ll just quietly throw out the dairy and her skin will go back to normal.” 

Does he feel guilty… not much!

“I feel bad but on the other hand, I was doing it for her own good.”

Righteous indignation aside, we have to bear in mind that this is just an anecdote. All such stories warrant the “so what response” which goes something like: “I know lots of people who consume dairy and don’t have acne” or “I know vegans who do have acne”. So does the science support the milk-acne connection? Seems like it does.

A 2018 review and meta-analysis of the link between dairy intake and acne in 78,529 children, adolescents, and young adults reported that those consuming dairy were more likely to be affected by acne than those who did not. The more milk consumed the greater were the odds of developing acne.[22]
​
There are various mechanisms that could explain the association. One possible mechanism is insulin-like growth factor 1 (IGF-1) which increases inflammation and the secretion of oil onto the skin.23 Other possible triggers include the hormones in dairy[24], and whey protein which has been linked with acne in body builders.[25] 

Livestock’s Long Shadow, a 2006, report supported by many international agencies including the World Bank, EU, and the UK Department for International Development, concluded that animal agriculture contributed very significantly to climate change, air pollution, land, soil and water degradation and to the reduction of biodiversity.[26] A 2018 study estimated that meat and dairy uses 83% of farmland and produces 60% of agriculture’s greenhouse gas emissions.[27] Joseph Poore, of Oxford University, who led the study, concluded that  “a vegan diet is probably the single biggest way to reduce your impact on planet Earth, not just greenhouse gases, but global acidification, eutrophication, land use and water use.”

To maximise milk production for human consumption, a mother cow must be separated from its baby shortly after birth. The calf is typically removed within 48 hours. This breaks the mother-infant bond which is fundamental for all mammals. Evidence for the strength of this bond is the wailing that is heard from mother cow’s for days after their calf is forcibly taken away.[28] Female calves are moved to the equivalent of a dog kennel where they spend up to eight weeks until they are housed with other young dairy cattle to ready themselves for their (short) lifetime as milk producing machines. The ‘surplus’ male calves are sold for beef or veal or killed and disposed of. 

A dairy cow spends at least seven months a year both pregnant and lactating from a previous pregnancy, and is milked twice a day yielding about 25 litres of milk, though 40-50 litres is possible at peak lactation. Yield has been increased by selective breeding with cows now producing up to ten times more milk than that needed for a calf. There are many health consequences for these animals that are bred to be milking machines. A cow’s natural lifespan is about twenty years, but a modern dairy cow is exhausted by age five to six, and fit only for slaughter for cheap beef when the bell finally tolls on her miserable life.
​
For more details on the welfare consequences of dairy farming go to the Viva! page – Scary Dairy​.[29]

Pretty much everybody in UK knows that “breast is best”, though it is not possible for all mother’s to breast feed. It is well established that breast feeding builds the baby’s immune system, enhances their neurological development, reduces their obesity risk and protects them against a wide range of diseases in later life.[30] Breast feeding also improves the bond between mother and child.[31] The maternal benefits of breast feeding are less well studied but there is evidence that long-term benefits include reduced risk for obesity, type 2 diabetes, cardiovascular disease, and breast and ovarian cancer.[30]

Perhaps this information has not made its way to the powers that be in the UK. In 2011, infant feeding coordinators were done away with and funding for National Breastfeeding Awareness Week was scrapped, and according to the Royal College of Midwives the NHS in England was short of the equivalent of around 3,500 full-time midwives in 2017.[32]

Formula milk is needed in some circumstances. In such cases, soya-based formula can be used to meet the child’s nutritional requirements without the detrimental effects of cow dairy. It is critical that formula is used and not ‘off the shelf’ cow’s, goat’s, soya or any other milk.

In the developed world, lack of breast feeding and use of formula milk has been directly linked to increased infant deaths but the numbers are tiny (though nonetheless tragic for all those affected).[33]

The impact in the developing world are much more dramatic, with numerous studies demonstrating increased infant illness and death as a consequence of substitution of breast milk for formula.[34] The main reason is poor access to clean water. According to a meta-analysis of 18 studies, the risk of dying from diarrhoea during the first 5 months of life was 10.5 times greater in those who were fed formula compared to those who were breast fed. The equivalent difference for babies from 6 to 12 months old was 2.2 times.[35] In summary, The scaling up of breastfeeding can prevent an estimated 823 000 child deaths and 20 000 breast cancer deaths every year.[35]

The seriousness of the situation has been recognised for some time. In 1939, Dr Cicely Williams, a medical officer in the British Colonial Service [36] was invited to address the Singapore Rotary Club where she stated that, ‘anyone who, ignorantly or lightly, causes a baby to be fed unsuitable milk, may be guilty of that child’s death’.

The chairman of the Singapore Rotary Club was also the president of Nestlé, who were exporting milk to the region and advertising it as "ideal for delicate infants". Despite campaigns, international agreements and codes of conduct, Nestlé and other manufacturers are still promoting infant formula in the developing world.[34]

Can a product which requires clean water, good sanitation, adequate family income and a literate parent to follow printed instructions be properly and safely used in areas where water is contaminated, sewage runs in the streets, poverty is severe and illiteracy high? ~ Edward M Kennedy, chairman of the USA Senate Subcommittee on Health and Scientific Research (1974).

At last, a positive note.

Not really.

It is true that iodine is an essential for many processes including thyroid function, a healthy immune system, and optimal neurological function.[37] It is also true that many people are not getting enough iodine.[38] Furthermore, milk and dairy products are major iodine sources in industrialised countries.[39]

So why don’t I recommend dairy as a source of iodine? First and foremost, dairy has so many negative consequences that recommending it for its iodine would be a bit like recommending chips as a source of vitamin C, or Coca Cola as a source of phosphorus... or milk as a source of calcium!

Secondly, iodine levels in milk are too variable to provide a consistent intake. van der Reijden et al. estimate milk and dairy contribute between 13 and 64% of the recommended daily iodine intake in industrialised countries.[39] As per the ‘Goldilocks Theory of Life’, excessive iodine intake can impair thyroid function.
​
Why so variable? Three important reasons are: people’s dairy intakes vary widely, soil iodine levels influence levels in milk for cattle that graze on pastures, and the degree to which teats are dipped with iodine-containing disinfectants is a major determinant of iodine content in non-organically raised animals.[39]  Teat dipping is used in industrialised dairy for management of mastitis, a painful inflammatory reaction of the udders to physical, chemical or thermal trauma or microorganism infection. Mastitis is endemic in dairy cattle throughout the world.  Depending on its severity, mastitis may cause milk to be watery, and contain flakes, clots and pus. So higher iodine in your milk is related to injured or diseased cows. Not a pleasant thought. There are healthier ways to ensure you get your iodine. 

The sacred dairy cow has stood on its pedestal for far too long, but it seems that the tide is finally turning. The truth about dairy is becoming more widely known and plant-based diets are gaining in popularity, especially among younger age groups.[40] Healthy, dairy substitutes are now commonly available with the global dairy alternatives market “projected to grow from USD 17.3 billion in 2018 to USD 29.6 billion by 2023, at a compound annual growth rate of 11.4%.”[41] Following the science, dairy is featuring less prominently in national dietary guidelines with the 2016 English Eatwell Guide replacing the 2007 milk and dairy foods group with dairy and alternatives.[42,43] The guidelines state that unsweetened calcium-fortified dairy alternatives like soya milks, soya yoghurts and soya cheeses also count as part of this food group and can make good alternatives to dairy products.
 
But the myth of dairy as a health food is being maintained by the multi-million pound dairy industry in the face of all the evidence to the contrary. Aping the five-a-day campaign to get people to eat more fruit and vegetables, the Global Dairy Platform launched a three-a-day campaign to get people to consume more dairy. In support of its efforts, a Dairy UK spokesman stated, “When it comes to promoting the benefits and strength of food products, all food sectors should have a robust evidence base, not just trendy claims or health gurus.”[40]

​Finally, we agree on something. 

Why you don’t need dairy by Juliet Gellatley, Viva!. An easy to read guide on the impacts of dairy on our health and animal welfare. Also gives plant sources of calcium and useful nutrition charts.
https://scarydairy.org.uk/resources/guides-and-reports/why-you-dont-need-dairy-guide.

White Lies by Dr Justine Butler, Viva!. A fully referenced report on the impact of dairy on our health. https://scarydairy.org.uk/resources/guides-and-reports/white-lies-report.

Everything you need to know about the impact of dairy and all the help you need to choose dairy-free: ScaryDairy.org.uk &  Veganrecipeclub.org.uk.