Hi Dr. Cordain,
My sister is a few weeks pregnant and has been following the Paleo Diet for a couple months now. Her doctor just told her to consume lots of milk during her pregnancy. My assumption is that they want to make sure she’s getting plenty of vitamin D and calcium. I have her on a 2000 IU/day vitamin D supplement as well as a calcium/vitamin D supplement. What are your thoughts/suggestions?
Pedro Bastos’ Response:
There is good evidence that up until 9,000 years ago in the Middle East1 and 7,000 years ago in Northern Europe,2 no human being on the planet consumed non-human milk or dairy products.
So, on an evolutionary time scale non-human milk is a relative newcomer to the human diet.
By using the evolutionary template, and knowing that milk is species-specific, we would expect this new habit to have unintended consequences, which go much beyond lactose intolerance, which is, actually very common, since only a minor percentage of the world’s population continues to produce lactase into adulthood.3
Indeed there are several lines of evidence raising concerns with milk and dairy intake, such as:
1) Milk and fermented milk (yoghurt, for instance), despite having a low Glycemic Index and Load, elicit a very high insulin response and this has been shown repeatedly in intervention studies.4-9
As you may be aware, constantly increasing insulinemia may down-regulate the insulin receptor and hence lead to insulin resistance.10-12 Thisin turn is the primary metabolic defect underlying The Metabolic Syndrome,13 and may be a driving force in Obesity.14, 15 It should also be mentioned that a chronic state of Hyperinsulinemia may initiate a hormonal cascade that ultimately results in Cancer, Acne and Juvenile Myopia, among other diseases13 (as thoroughly documented in Dr.Cordain’s scientific paper Hyperinsulinemic diseases of civilization: more than just syndrome X which you can download here.
Indeed, a high bovine milk diet has been shown to cause insulin resistance in boys.9 Moreover, dairy intake is strongly associated with a higher incidence of Acne16-18 and moderately associated with Prostate Cancer.19-23
2) Cow’s milk appears to be involved in certain Autoimmune diseases (AD):
- Various epidemiological studies have associated it with Type 1 Diabetes,24-31 especially when the initial exposure begins in the first months of life.
- Epidemiological studies have repeatedly shown a strong correlation between Multiple Sclerosis and cow’s milk consumption.32-36
- There is molecular mimicry between Bovine Serum Albumin and Human Collagen Type 1, which has implications for Rheumatoid Arthritis.37 Indeed, case studies have shown that elimination of milk and dairy products from the diets of patients with RA improved symptoms, and the disease was markedly exacerbated on re-challenge.37
- Bovine Milk is also implicated (or appears to have adverse effects) in other auto-immune diseases, such as Crohn’s disease,38 Sjögren’s syndrome,39 IgA nephropathy,40-42 Behçet’s disease,43 and even Celiac Disease.40
3) Hormones in Milk:
In addition to proteins, fats, lactose, vitamins and minerals, Milk contains various growth-stimulating steroid and peptide hormone and also catalysts, transporters and stabilizers that ensure their maximum bioactivity.45
Here’s a short list of some hormones present in cow’s milk that could be problematic for humans:
- Betacellulin (BTC)
- Estrogens (particularly Estrone Sulfate)
- Precursors of Dihydrotestosterone (DHT)
Cow’s milk, as well as human milk (and presumably milk from all mammals) contains insulin,46-49 and we know that bovine insulin – BI (which differs from human insulin by three amino acids50) survives pasteurization, because immunity to this hormone is common in children who consume cow’s milk or who have been exposed to infant formulas containing cow’s milk.51-54
This not only confirms that BI is present in commercial pasteurized milk, but also in infant formulas and perhaps other dairy products (although direct evidence is lacking). Moreover, these studies provide evidence that BI survives the human digestive processes and crosses the gut barrier intact, although this could be related to the fact that infants have higher intestinal permeability than older children and adults.50 Nevertheless, various factors may cause the so called “leaky gut” in virtually everyone, so we shouldn’t dismiss bovine insulin altogether.
Cow’s milk contains active IGF-155, but this has been largely dismissed as irrelevant, since pasteurization (time and temperature are crucial factors) and fermentation appears to reduce its content.56, 57 Yet cow’s milk consumption, compared to various foods, is associated with higher plasma IGF-1 concentrations in humans (both children58-61 and adults,62-66 which could be due to calcium in milk (which has been shown to increase IGF-1 in boys and girls67), the effect of milk upon insulinemia (the high elevation of plasma insulin caused by milk drinking4-9 could lead to a higher plasma IGF-113) or indeed residual IGF-1 in casein68 (the major protein in milk).
Betacellulin (BTC) belongs to the Epidermal Growth Factor family of hormones,69 and it is found not only in cow’s milk70 and whey,70 but also in cheese,70 so it survives pasteurization and processing. Although no direct evidence exists yet, bovine milk contains peptidase inhibitors which prevent human gut enzymes from degrading EGF5 (and most likely BTC) and a low ph, such as may be found in the gut, does not impair or prevent BTC from binding its receptor.71 Finally, there is a luminally expressed EGF receptor in the gut, through which BTC may enter circulation.69
The major sources of animal-derived estrogens in the human diet are believed to be milk and dairy products, which presumably account for 70–80% of the total estrogens consumed.72-73 Furthermore, it has been pointed out that most milk for human consumption is obtained from cows in the latter half of pregnancy, when estrogen metabolite levels are greatly elevated.72-74 Confirming this, US researchers have measured estrogen metabolites in various milks and found that buttermilk contains the highest total amount of estrogen metabolites, followed by skim milk, 2% milk and whole milk.72 So, estrogen metabolites appear to survive pasteurization, and Estrone sulphate, which comprises 45% of the conjugated estrogens in Premarin and Prempro, the most frequently prescribed hormone replacement therapy for menopausal women73 has high oral bioactivity73 and is the most prevalent form of estrogen in cow’s milk.72, 73
There are also other steroid hormones in commercial pasteurized cow’s milk, such as progesterone, 5α-androstanedione and 5α-pregnanedione that are dihydrotestosterone (DHT) precursors.75
As expected from the evidence presented, dairy intake is strongly associated with a higher incidence of Acne,16-18 moderately associated with Prostate Cancer,19-23 and mildly associated with ovarian cancer.76, 77
Dairy consumption was also associated with an increased incidence of testicular,78-79 kidney80 and head and neck cancer,81 but very few studies looking at this have been conducted to draw more significant conclusions.
Although epidemiological evidence can’t show cause and effect and clearly many more studies need to be conducted, the current evidence strongly suggests that cow’s milk may be implicated in a variety of autoimmune diseases, certain cancers, as well as Acne.
4) Milk has a very high calcium/magnesium ratio and may contribute to some micronutrient imbalances.
Finally, there is evidence of higher fracture incidence rates in countries with higher milk and calcium intake82, some long term prospective studies have failed to show a benefit from drinking milk or taking calcium supplements,83-85 and a recent meta-analysis, which analyzed 7 prospective cohort studies (170 991 women), 5 prospective cohort studies68 (606 men), 5 clinical trials, (5666 women, and 1074 men), and 4 clinical trials with separate results for hip fracture (6504 subjects), concluded that calcium intake doesn’t decrease the risk for fractures.86 And calcium intake is only part of the story – we need to consider the GI absorption and the renal excretion, and in these regards, vegetables from the brassica family have a clear advantage over milk.
I know this may sound overly alarming and exaggerated, but given what I know about milk, I have a hard time recommending it, even though it has some positive effects, such as being a cheap source of high quality protein and various micronutrients.
For those who are fortunate and have access to good (real) food and supplements (such as Vitamin D, which, by the way, may be needed in much higher doses than the ones provided by 3 or 4 servings of dairy a day) and adopt a diet more in line with the Paleo Diet, I believe milk is not necessary.
I hope this helps.
Pedro Bastos MA MS Ph.D. candidate in Medical Sciences at Lund University, Sweden
- Evershed RP, Payne S, Sherratt AG, Copley MS, Coolidge J, Urem-Kotsu D, Kotsakis K, Ozdoğan M, Ozdoğan AE, Nieuwenhuyse O, Akkermans PM, Bailey D, Andeescu RR, Campbell S, Farid S, Hodder I, Yalman N, Ozbaşaran M, Biçakci E, Garfinkel Y, Levy T, Burton MM. Earliest date for milk use in the Near East and southeastern Europe linked to cattle herding. Nature. 2008 Sep 25;455(7212):528-31.
- Copley MS, Berstan R, Dudd SN, Docherty G, Mukherjee AJ, Straker V, Payne S, Evershed RP: Direct chemical evidence for widespread dairying in prehistoric Britain. Proceedings of the National Academy of Sciences of the United States of America 2003, 100(4):1524-1529.
- Swallow DM. Genetics of lactase persistence and lactose intolerance. Ann Rev Genet 2003;37:197-219
- Gannon MC, Nuttall FQ, Krezowski PA, Billington CJ, Parker S. The serum insulin and plasma glucose responses to milk and fruit products in type 2 (non-insulin-dependent) diabetic patients. Diabetologia. 1986 Nov;29(11):784-91.
- Holt SH et al. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr. 1997 Nov;66(5):1264-76
- Ostman EM, et al. Inconsistency between glycemic and insulinemic responses to regular and fermented milk products. Am J Clin Nutr 2001;74:96 –100.
- Liljeberg Elmstahl H & Bjorck I. Milk as a supplement to mixed meals may elevate postprandial insulinaemia. Eur J Clin Nutr 2001; 55:994–999.
- Hoyt G et al. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. Br J Nutr. 2005 Feb;93(2):175-7
- Hoppe C et al. High intakes of milk, but not meat increase s-insulin and insulin resistance in 8-year-old boys. Eur J Clin Nutr. 2005 Mar;59(3):393-8
- Rizza RA, Mandarino LJ, Genest J, Baker BA, Gerich JE. Production of insulin resistance by hyperinsulinaemia in man. Diabetologia. 1985 Feb;28(2):70-5.
- Treadway JL, Whittaker J, Pessin JE. Regulation of the insulin receptor kinase by hyperinsulinism. J Biol Chem 1989;264:15136–15143
- DelPrato S, Leonetti F, Simonson DC, et al. Effect of sustained physiologic hyperinsulinaemia and hyperglycaemia on insulin secretion and insulin sensitivity in man. Diabetologia 1994;37:1025 -1035.
- Cordain, l.; Eades, M.R.; Eades, M.D. Hyperinsulinemic diseases of civilization: more than just syndrome X. Comp Biochem Physiol Part A; 136:95-112, 2003
- Thomas DE, Elliott EJ, Baur L. Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005105
- Nishino N, Tamori Y, Kasuga M. Insulin efficiently stores triglycerides in adipocytes by inhibiting lipolysis and repressing PGC-1alpha induction. Kobe J Med Sci. 2007;53(3):99-106.
- Adebamowo, C.A. et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol; 52(2):207-14, 2005.
- Adebamowo, C.A. et al. Milk consumption and acne in adolescent girls. Dermatol Online J; 12(4):1, 2006.
- Adebamowo CA, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008 May;58(5):787-93
- Kurahashi N, Inoue M, Iwasaki M, et al. Dairy product, saturated fatty acid, and calcium intake and prostate cancer in a prospective cohort of Japanese men. Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):930-7.
- Mitrou PN, Albanes D, Weinstein SJ et al. A prospective study of dietary calcium, dairy products and prostate cancer risk (Finland). Int J Cancer; 120(11):2466-73, 2007.
- Rohrmann S, Platz EA, Kavanaugh CJ, et al. Meat and dairy consumption and subsequent risk of prostate cancer in a US cohort study. Cancer Causes Control. 2007 Feb;18(1):41-50.
- Gao X, LaValley MP, Tucker KL. Prospective studies of dairy product and calcium intakes and prostate cancer risk: a meta-analysis. J Natl Cancer Inst. 2005 Dec 7;97(23):1768-77.
- Qin LQ, Xu JY, Wang PY, Kaneko T, Hoshi K, Sato A. Milk consumption is a risk factor for prostate cancer: meta-analysis of case-control studies. Nutr Cancer.2004;48(1):22-7.
- Virtanen SM, Räsänen L, Ylönen K, Aro A, Clayton D, Langholz B, Pitkäniemi J, Savilahti E, Lounamaa R, Tuomilehto J, et al. Early introduction of dairy products associated with increased risk of IDDM in Finnish children. The Childhood in Diabetes in Finland Study Group. Diabetes. 1993 Dec;42(12):1786-90
- Kostraba JN, Cruickshanks KJ, Lawler-Heavner J, Jobim LF, Rewers MJ, Gay EC, Chase HP, Klingensmith G, Hamman RF. Early exposure to cow’s milk and solid foods in infancy, genetic predisposition, and risk of IDDM. Diabetes. 1993 Feb;42(2):288-95.
- Fava, D.; Leslie, R.D.G.; Pozzilli, P. Relationship between dairy product consumption and incidence of IDDM in childhood in Italy. Diabetes Care 1994;17: 1488-1490,
- Gimeno SG, de Souza JM. IDDM and milk consumption. A case-control study in São Paulo, Brazil. Diabetes Care. 1997 Aug;20(8):1256-60.
- Hyppönen E, Kenward MG, Virtanen SM, Piitulainen A, Virta-Autio P, Tuomilehto J, Knip M, Akerblom HK. Infant feeding, early weight gain, and risk of type 1 diabetes. Childhood Diabetes in Finland (DiMe) Study Group. Diabetes Care. 1999 Dec;22(12):1961-5.
- Kimpimäki T, Erkkola M, Korhonen S, Kupila A, Virtanen SM, Ilonen J, Simell O, Knip M. Short-term exclusive breastfeeding predisposes young children with increased genetic risk of Type I diabetes to progressive beta-cell autoimmunity. Diabetologia. 2001 Jan;44(1):63-9.
- Wahlberg J, Fredriksson J, Nikolic E, Vaarala O, Ludvigsson J; The ABIS-Study Group. Environmental factors related to the induction of beta-cell autoantibodies in 1-yr-old healthy children. Pediatr Diabetes. 2005 Dec;6(4):199-205.
- Wahlberg J, Vaarala O, Ludvigsson J; ABIS-study group. Dietary risk factors for the emergence of type 1 diabetes-related autoantibodies in 21/2 year-old Swedish children. Br J Nutr. 2006 Mar;95(3):603-8.
- Agranoff BW, Goldberg D . Diet and the geographical distribution of multiple sclerosis. Lancet 1974;2:1061-66
- Butcher PJ. Milk consumption and multiple sclerosis–an etiological hypothesis. Med Hypotheses. 1986 Feb;19(2):169-78
- Malosse D et al. Correlation between milk and dairy product consumption and multiple sclerosis prevalence: a worldwide study. Neuroepidemiology. 1992;11(4-6):304-12.
- Malosse D, Perron H. Correlation analysis between bovine populations, other farm animals, house pets, and multiple sclerosis prevalence. Neuroepidemiology. 1993;12(1):15-27
- Lauer K. Diet and multiple sclerosis. Neurology. 1997 Aug;49(2 Suppl 2):S55-61.
- Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Brit J Nutr 2000, 83:207-217.
- van den Bogaerde J et al. Immune sensitization to food, yeast and bacteria in Crohn’s disease. Aliment Pharmacol Ther. 2001 Oct;15(10):1647-53
- Lidén M, Kristjánsson G, Valtysdottir S, Venge P, Hällgren R. Cow’s milk protein sensitivity assessed by the mucosal patch technique is related to irritable bowel syndrome in patients with primary Sjögren’s syndrome. Clin Exp Allergy. 2008 Jun;38(6):929-35.
- Fornasieri A, Sinico RA, Maldifassi P, Paterna L, Benuzzi S, Colasanti G, D’Amico G. Food antigens, IgA-immune complexes and IgA mesangial nephropathy. Nephrol Dial Transplant. 1988;3(6):738-43.
- Yap HK, Sakai RS, Woo KT, Lim CH, Jordan SC. Detection of bovine serum albumin in the circulating IgA immune complexes of patients with IgA nephropathy. Clin Immunol Immunopathol. 1987 Jun;43(3):395-402.
- Soylu A, Kasap B, Soylu OB, Türkmen M, Kavukçu S. Does feeding in infancy effect the development of IgA nephropathy? Pediatr Nephrol. 2007 Jul;22(7):1040-4
- Triolo G, Accardo-Palumbo A, Dieli F, Ciccia F, Ferrante A, Giardina E, Licata G. Humoral and cell mediated immune response to cow’s milk proteins in Behçet’s disease. Ann Rheum Dis. 2002 May;61(5):459-62
- Kristjansson G, Venge P, Hallgren R. Mucosal reactivity to cow’s milk protein in coeliac disease. Clin Exp Immunol 2007;147:449–55
- Walzem RL, Dillard CJ, German JB. Whey components: millennia of evolution create functionalities for mammalian nutrition: what we know and what we may be overlooking. Crit Rev Food Sci Nutr. 2002 Jul;42(4):353-75
- Ballard FJ, Nield MK, Francis GL, Dahlenburg GW, Wallace JC. The relationship between the insulin content and inhibitory effects of bovine colostrum on protein breakdown in cultured cells. J Cell Physiol. 1982 Mar;110(3):249-54
- Malven PV, Head HH, Collier RJ, Buonomo FC. Periparturient changes in secretion and mammary uptake of insulin and in concentrations of insulin and insulin-like growth factors in milk of dairy cows. J Dairy Sci. 1987 Nov;70(11):2254-65
- Oda S, Satoh H, Sugawara T, Matsunaga N, Kuhara T, Katoh K, Shoji Y, Nihei A, Ohta M, Sasaki Y. Insulin-like growth factor-I, GH, insulin and glucagon concentrations in bovine colostrum and in plasma of dairy cows and neonatal calves around parturition. Comp Biochem Physiol A Comp Physiol. 1989;94(4):805-8
- Aranda P, Sanchez L, Perez MD, Ena JM, Calvo M. Insulin in bovine colostrum and milk: evolution throughout lactation and binding to caseins. J Dairy Sci. 1991 Dec;74(12):4320-5
- Vaarala O. Is it dietary insulin? Ann N Y Acad Sci. 2006 Oct;1079:350-9
- Vaarala O, Paronen J, Otonkoski T, A ° Kerblom HK. Cow milk feeding induces antibodies to insulin in children—a link between cow milk and insulin-dependent diabetes mellitus? Scand J Immunol 1998: 47: 131–135.
- Vaarala O, Knip M, Paronen J et al. Cow’s milk formula feeding induces primary immunization to insulin in infants at genetic risk for type 1 diabetes. Diabetes 1999: 48: 1389–1394.
- Paronen, J. et al. The effect of cow milk exposure and maternal type 1 diabetes on cellular and humoral immunization to dietary insulin in infants at genetic risk for type 1 diabetes. Diabetes 2000;49: 1657–1665.
- Vaarala, O. et al. The effect of coincident enterovirus infection and cow’s milk exposure on immunization to insulin in early infancy. Diabetologia 2002; 45:531–534.
- Blum JW, Baumrucker CR. Insulin-Like Growth Factors (IGFs), IGF Binding Proteins, and Other Endocrine Factors in Milk: Role in the Newborn. In Bosze Z. Bioactive Components of Milk, Springer, 2008, Pgs 397-422
- Collier RJ, Miller MA, Hildebrandt JR, Torkelson AR, White TC, Madsen KS, Vicini JL, Eppard PJ, Lama GM. Factors affecting insulin-like growth factor-I concentration in bovine milk. J Dairy Sci 1991; 74:2905-2911.
- Kang SH, Kim JU, Imm JY, Oh S, Kim SH. The effects of dairy processes and storage on insulin-like growth factor-I (IGF-I) content in milk and in model IGF-I–fortified dairy products. J Dairy Sci 2006; 89:402-409.
- Hoppe C, Mølgaard C, Michaelsen KF. Cow’s milk and linear growth in industrialized and developing countries. Annu Rev Nutr. 2006;26:131-73.
- Rogers IS, Gunnell D, Emmett PM, et al. Cross-sectional associations of diet and insulin-like growth factor levels in 7- to 8-yearold children. Cancer Epidemiol Biomarkers Prev 2005; 14: 204-212.
- Hoppe C, Udam TR, Lauritzen L, et al. Animal protein intake, serum insulin-like growth factor I, and growth in healthy 2.5-yold Danish children. Am J Clin Nutr 2004; 80: 447-452.
- Hoppe C, Mølgaard C, Juul A, et al. High intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boys. Eur J Clin Nutr 2004; 58: 1211-1216.
- Ma J, Giovannucci E, Pollak M, et al. Milk intake, circulating levels of insulin-like growth factor-I, and risk of colorectal cancer in men. J Natl Cancer Inst 2001, 93:1330-1336.
- Giovannucci E, Pollak M, Liu Y, et al. Nutritional predictors of insulin-like growth factor I and their relationships to cancer in men. Cancer Epidemiol Biomarkers Prev 2003, 12:84-89.
- Norat T, Dossus L, Rinaldi S, et al. Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women. Eur J Clin Nutr 2007; 61: 91-98.
- Morimoto LM, Newcomb PA, White E, et al. Variation in plasma insulin-like growth factor-1 and insulin-like growth factor binding protein-3: personal and lifestyle factors (United States). Câncer Causes Control 2005; 16: 917-927.
- Holmes MD, Pollak MN, Willett WC, et al. Dietary correlates of plasma insulin-like growth factor-I and insulin-like growth factor binding protein-3 concentrations. Cancer Epidemiol Biomarkers Prev 2002; 11: 852-861
- Ginty F, et al. calcium carbonate supplementation is associated with higher plasma IGF-1 in 16-to 18-year old boys and girls. In Burckhardt P, Heaney R, Dawson-Hughes B. Nutritional Aspects of Osteoporosis. Elsevier, 2004, pp 45-57
- Hoppe C, Mølgaard C, Dalum C, Vaag A, Michaelsen KF. Differential effects of casein versus whey on fasting plasma levels of insulin, IGF-1 and IGF-1/IGFBP-3: results from a randomized 7-day supplementation study in prepubertal boys. Eur J Clin Nutr. 2009 Sep;63(9):1076-83
- Cordain L. Dietary implications for the development of acne: a shifting paradigm. In: U.S. Dermatology Review II 2006, (Ed.,Bedlow, J). Touch Briefings Publications, London, 2006.
- Bastian SE, et al. Measurement of betacellulin levels in bovine serum, colostrum and milk. J Endocrinol. 2001 Jan;168(1):203-12
- Rao RK, Baker RD, Baker SS. Bovine milk inhibits proteolytic degradation of epidermal growth factor in human gastric and duodenal lumen. Peptides. 1998; 19(3):495-504
- Farlow DW, Xu X, Veenstra TD. Quantitative measurement of endogenous estrogen metabolites, risk-factors for development of breast cancer, in commercial milk products by LC-MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci. 2009 Jan 31. [Epub ahead of print]
- Ganmaa D, Sato A. The possible role of female sex hormones in milk from pregnant cows in the development of breast, ovarian and corpus uteri cancers. Med Hypotheses 2005; 65: 1028-37
- Qin LQ, Wang PY, Kaneko T, et al. Estrogen: one of the risk factors in milk for prostate cancer. Med Hypotheses. 2004;62(1):133-42.
- Danby FW. Acne, dairy and cancer. Dermato-Endocrinology 1:1, 9-13; January/February 2009.
- Genkinger JM, Hunter DJ, Spiegelman D, et al. Dairy products and ovarian cancer: a pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):364-72.
- Larsson SC, Orsini N, Wolk A. Milk, milk products and lactose intake and ovarian cancer risk: a meta-analysis of epidemiological studies. Int J Cancer. 2006 Jan 15;118(2):431-41.
- Stang, A.; Ahrens, W.; Baumgardt-Elms, C. et al. Adolescent milk fat and galactose consumption and testicular germ cell cancer. Cancer Epidemiol Biomarkers Prev; 15(11):2189-95, 2006.
- Ganmaa D, Li XM, Qin LQ, et al. The experience of Japan as a clue to the etiology of testicular and prostatic cancers. Med Hypotheses. 2003 May;60(5):724-30.
- Bravi F, Bosetti C, Scotti L, et al. Food groups and renal cell carcinoma: a case-control study from Italy. Int J Cancer. 2007 Feb 1;120(3):681-5.
- Peters ES, Luckett BG, Applebaum KM, Marsit CJ, McClean MD, Kelsey KT. Dairy products, leanness, and head and neck squamous cell carcinoma. Head Neck. 2008 Sep;30(9):1193-205.
- Klompmaker TR. Lifetime high calcium intake increases osteoporotic fracture risk in old age. Med Hypotheses. 2005;65(3):552-8
- Owusu W, Willett WC, Feskanich D, Ascherio A, Spiegelman D, Colditz GA. Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 1997; 127:1782-7.
- Feskanich D, Willett W et al. Milk, Dietary Calcium, and Bone Fractures in Women: A 12-Year Prospective Study. Am J Public Health. 1997 Jun;87(6):992-7.
- Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003 Feb;77(2):504-11.
- Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Burckhardt P, Li R, Spiegelman D, Specker B, Orav JE, Wong JB, Staehelin HB, O’Reilly E, Kiel DP, Willett WC. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007 Dec;86(6):1780-90.