Tag Archives: Milk

Breast Milk | The Paleo Diet

Hello Dr. Cordain and Team,

My wife and I are Paleo adherents ever since we learned of the Paleo diet about 5 years ago. We have a 9 month old little daughter who we are trying to raise according to Paleo principles as best we can with regards to diet and lifestyle. Initially, our daughter would not take to latching and very quickly decided that she just wanted to drink her mother’s milk straight from a bottle. So, from roughly 2-3 months, she has been eating pumped breast milk (Paleo) received from her own mother or another trusted Paleo milk donor. Now, both mother and the donor have stopped their supply of milk and our daughter is, as I said, only 9 months old.

She has been eating solid foods, squash, zucchini, chicken, lamb, turkey, spinach, etc. (basically an awesome Paleo diet like mommy and daddy) for the last 3 months. Along with such awesome whole foods (which we blend up nicely and she eats most of the time without concern) we were still supplementing her food diet with Paleo breast milk. Now, as a stop-gap because the donor suddenly informed us of her inability to meet our needs, we have been supplementing our daughter’s diet with almond milk (pure organic almond milk made by a small batch farmer which includes just almonds and water). We chose almond milk for the positive fat it would provide but understand that the nutritional makeup does not even come close to resembling mother’s milk or even dairy milk with lactose etc.

We take our daughter to a holistic, organically inclined, and progressive pediatrician, but when we asked the doctor her advice, she suggests our best option is to give our daughter the ‘best’ formula that we can find. She suggested an organic dairy based formula that also contains soy products (soy-like products frankly) in it as well. On the face of it, this doesn’t sit well with us as we believe in adhering to Paleo principles as best we can and the idea of soy and various hormone/thyroid issues that can arise from ingesting soy concern us. Soy’s high phytic acid levels also concern us for nutrient absorption reasons as well.

So, we find ourselves in a unique situation and we are leaning towards finding some sort of 100% grass-fed (potentially raw) dairy solution, such as supplementing with a Whole Fat – Bulgarian yogurt that my wife uses sparingly on her ‘off days.’ The main reason we are considering dairy is because we have read that babies need lactose (which is in mother’s breast milk as well as cow’s milk) to help with their developing brains.

Now, for concerned yet incredibly lay parents when it comes to the world of nutrition, we feel overwhelmed and at a loss for what might be the right or best balance we can find with the variables that we have at hand. Of course, we understand that sometimes choices need to be made that are less than optimal, but provide the best chances of success, but we’d also like to make sure we feel confident that whether we go ahead with our Dr.’s recommendation or we find another alternative (supplementing the almond milk with lactose?) we are making the best choice available to us.

So, if you have any personal advice or can point me in the right direction towards some answers regarding our situation, my gratitude would know no bounds.

Thanks in advance!

A Grateful Paleo Poppa

Dr. Cordain’s Response:

First and foremost, I don’t have all of the definitive answers on how to raise infants into healthy toddlers, into healthy children, into healthy adolescents and finally into healthy young adults.

Nevertheless, Lorrie and I somehow managed to overcome the obstacles of contemporary, western world living and diets, as we raised our three sons (now 18, 22, and 24) who all grew up with parents who not only followed the Paleo diet, but probably were the very first parents in the western world who raised their children with this concept in mind. By the way, all three boys ended up being tall, strong, athletic, good students, free of acne, myopia, and dental carries. Moreover, they all became calm, happy children, adolescents, and young men.

Like your wife, we did not have the option of nursing for an extended period, as there was no mother’s milk available for each of our three sons. Hence, we were stuck with the commercial formulas available at the time (early to mid 90s). At this juncture, the USDA did not allow infant formula to be supplemented with long chain fatty acids (DHA and AA) that are normally found in mothers milk. Fortunately, I had scientist friends at the National Institute’s of Health (NIH) who had access to formulas containing DHA and AA which we gave to our first son. Our other two boys simply received commercial formula without these long chain fatty acids. Today, many baby formulas contain DHA and AA which have been shown in clinical trials to improve cognitive performance.

For all three infant boys, after formula and the little mother’s milk we could provide for (~3-6 months), we included freshly puréed fresh fruits and veggies (via our home blender) into their diets and also started them on commercially puréed baby meats, as we didn’t have the machinery to puree fresh meats ourselves. We did not give our children cow’s milk or dairy products during their first 3-5 years of life and rarely or never wheat or cereal containing products. Instead of iron fortified cereals (as suggested by most pediatricians), we gave them commercially available, pureed baby meats which provided their little bodies with the iron that was gradually being depleted after birth, but did not cause constipation or colic.

Once their teeth came in, we pretty much fed them any and all foods Lorrie and I ate. However, we were not “Paleo Police” and allowed them non-Paleo foods at parties, school functions, and elsewhere while encouraging them to eat fresh fruits, veggies, meats, fish, seafood, nuts, eggs, etc. We never stocked bread, cereals, candy, ice cream, soda or processed foods in our house. However, we also had an incredible cornucopia of fresh food available at all times which they could eat ad libitum.

After nearly 25 years of promoting Paleo, but not requiring or enforcing it, our children (now men) are adherents to Paleo, not because of their parents’ earlier admonitions and suggestions, but rather their own choice.

Q & A on Milk: mTORC

Dear Professor Cordain,

In regards the review paper of which you were co-author: “The impact of cow’s milk-mediated mTORC1-signaling in the initiation and progression of prostate cancer,” could you please inform me whether you are aware of any country’s medical community who has responded to your conclusive statement that: “…the medical community urgently needs to re-evaluate dietary milk recommendations.”

This has not occurred thus far in my country of Australia.

Please excuse me for further taxing your valuable time, but could you also inform me of the details leading to the changing of the designation of the ‘m’ in the mTORC acronym from ‘mammalian’ to ‘mechanistic’, as it appears in your co-author Bodo Melnik’s 2013 paper: “Milk is not just food but most likely a genetic transfection system activating mTORC1 signaling for postnatal growth.

Many thanks in anticipation.
Kind regards,

Dr. Ross Partington

Bodo Melnik’s Response:

Dear Dr. Partington,

Mammalian target of rapamycin (mTOR) has been renamed in an mTOR consensus conference to mechanistic target of rapamycin. The official nomenclature according to OMIM.org is now:

601231 MECHANISTIC TARGET OF RAPAMYCIN; MTOR

Alternative titles; symbols MAMMALIAN TARGET OF RAPAMYCIN FKBP12-RAPAMYCIN COMPLEX-ASSOCIATED PROTEIN 1; FRAP1 FK506-BINDING PROTEIN 12-RAPAMYCIN COMPLEX-ASSOCIATED PROTEIN 1 FRAP FRAP2 RAFT1

The mTOR protein or function has not changed also there are various synonyms, a matter of history in molecular biology.

Best regards,

Bodo C. Melnik, Ph.D
Department of Dermatology
Environmental Medicine and Health Theory
University of Osnabrück, Sedanstrasse
Germany

Does Non-Allergenic Milk Exist? | The Paleo Diet

Dear Paleo Diet Team,

In the 1997 work entitled “Food and Low Incidence of Insulin Dependent Diabetes Mellitus (IDDM) in Iceland” (L. Thorsdottir and O. Reykdal) have suggested that the incidence of IDDM is lower in Iceland than in other human genetic related nations of Scandinavia.

Since milk proteins alleles frequencies in the Nordic cattle breeds varies and preliminary (at that time) results indicated that Beta Casein A1 was particularly low in Iceland milk, they have speculated that IDDM was caused by Beta Casein A1 and its bioactive peptide BCM-7.

My opinion is that Diabetes mellitus is not caused by one single factor alone, but perhaps there are also other factors involved.

I would like to know your opinion on that matter if possible, since cattle breeding association in Brazil, of a particular breed that produces A2 milk, is applying to official agencies to market their milk with the allegation of “non-allergenic milk.”

One of their main allegations is based on data that BCM-7 alone would be the “villain” in the milk, with which I totally disagree, since milk allergies are a multifactorial health problem.

Your attention would be greatly appreciated.

Jose Luiz M Garcia

Pedro Carrera Bastos’ Response:

Dear Mr. Garcia,

Cow’s milk (CM), as you know, has several proteins, but we can group these proteins into two major ones: whey proteins and caseins. 1 Caseins represent about 80% of the total protein content of CM, as seen in this table. 1

6.12.14-table1Caseins in CM (and also in goat’s milk) are divided into: alphaS1, alphaS2, beta and kappa.2

Following digestive proteolysis of beta-caseins in the human gut (and also after food processing, such as milk fermentation and microbial cheese ripening) there will be a release of bioactive peptides called beta-casomorphins (BCMs). 3 BCMs contain 4-11 amino acids and, more importantly, they are resistant to further proteolysis and express opioid like activity. This means they could potentially bind various opioid receptors in the human nervous system, and also in the gastrointestinal, immune and endocrine systems.3

Beta caseins (as well as the other caseins in CM) are encoded by genes found on bovine chromosome 63 and there are 12 recognized genetic variants of beta-casein: A1, A2, A3, B, C, D, E, F, H1, H2, I and G. A1 and A2 are the most common forms of beta-casein found in dairy cattle in western countries.3

Beta-caseins are proteins with 209 amino acids and the difference between A1 and A2 lies in just one amino acid at position 67: histidine in A1 and proline in A2.3, 4 Apparently, “ancestral cattle” (as well as goats, yak and most sheep) contained the A2 version of beta-casein gene and not the A1 version, which is a single nucleotide polymorphism (SNP) that appeared 5,000 to 10,000 years ago only in Bos taurus, being present today in breeds, such as Holstein, Friesian and Ayrshire.4, 5

The main premise behind the A1/A2 hypothesis is that beta-casein A1, but not A2, will originate the opioid like peptide beta-casomorphin-7 (BCM-7).3, 4 BCM-7 (which contains 7 amino acids) resists further digestion in the human gut, could be absorbed by some individuals, like babies and people with intestinal hyperpermeability, and can influence gut function without being absorbed into the bloodstream.3, 4 The proponents of this hypothesis claim that after being absorbed, BCM-7 could increase low-density lipoprotein oxidation and bind to opioid receptors in the nervous, immune and endocrine systems.3-6

This in vitro and animal data combined with epidemiological studies led to the hypothesis that beta-casein A1 is implicated in Autism and Schizophrenia,3, 4 Type 1 Diabetes,3-5 Cardiovascular Disease,3-6 Sudden Infant Death Syndrome,3 and perhaps even in Metabolic Syndrome (because it could cause insulin resistance).6

In the last years, some important scientific papers have been published criticizing the epidemiological and animal data, and particularly the lack of intervention studies supporting the above causality.5, 7, 8

Having said that, I believe the A1/A2 hypothesis should not be readily dismissed. It deserves to be better studied in animal models and, more importantly, in randomized controlled trials. Nevertheless, when it comes to Type 1 Diabetes (T1D), multiple lines of evidence strongly suggest various CM proteins, and not just beta-casein (which could yield BCM-7), are involved.

Beta-lactoglobulin (BLG)

BLG is a protein found in the whey fraction of CM (but apparently not in the whey of human’s milk) that has structural homology with the human protein glycodelin, which is responsible for the modulation of T-lymphocytes.9 This means that BLG could generate antibodies to glycodelin, and indirectly lead to autoimmunity in genetically susceptible children,9 especially if introduced early in life when there is increased intestinal permeability.9, 10

Bovine serum albumin (BSA)

This is another protein present in the whey fraction of CM. Antibodies against a specific peptide derived from BSA, called ABBOS, have been found repeatedly in the majority of patients with T1D.11-13 This is relevant because there is molecular mimicry between the peptide ABBOS and a beta-cell surface protein p69, one of the autoantigens attacked by T cells in T1D patients.11

Bovine insulin (BI)

CM, human’s milk, and presumably milk from all mammals contains insulin.10 Immunity to BI is common in children who consume cow’s milk or who have been exposed to infant formulas containing cow’s milk.10 Because BI differs from human insulin by only three amino acids, it can generate antibodies against human insulin in genetically susceptible individuals with increased intestinal permeability and other gut dysfunctions10 and/or enteral virus infections in their early years.10, 14

A recent randomized controlled trial (RCT) confirmed the role of BI in T1D.15 In this pilot trial, infants with genetic susceptibility for T1D were assigned to either a “normal” CM based formula, a whey-based hydrolyzed formula, or a whey-based formula “essentially free of bovine insulin” and it was found that the insulin-free formula reduced the cumulative incidence of autoantibodies by age 3 years.15

Interestingly, the RCT gives more support to the role of CM proteins in T1D. In this trial, 230 infants with genetic susceptibility to T1D and at least one family member with T1D received either a casein hydrolysate formula or a conventional, CM-based formula (control) whenever breast milk was not available during the first 6 to 8 months of life. The casein hydrolysate formula, as compared with the control, was associated with a decreased risk of positivity for at least one diabetes-associated autoantibody.16

In conclusion, the available evidence cannot firmly confirm or refute a causal role of BCM-7 in T1D. Nevertheless, even if a causal role is confirmed, drinking CM without beta-casein A1 could still represent a risk for people with genetically susceptibility for T1D, since there are various other potential problematic proteins in CM.

Best wishes,

Pedro Bastos, MA, MS, Ph.D. candidate in Medical Sciences at Lund University, Sweden;

Pedro Bastos | About The Paleo Diet TeamPedro Bastos provides consultations, research, and advice to The Paleo Diet community. He is a member of the New York Academy of Sciences, the International Society for the Study of Fatty Acids and Lipids, and the Nutrition Society. Pedro is a certified personal trainer and strength and conditioning instructor, and he holds post-graduate diplomas in exercise and health (from School of Sport Science of Rio Maior, Portugal) and in biochemistry and orthomolecular medicine (from Fernando Pessoa University, Portugal). He received his master’s degree in human nutrition and food quality through Universitat de les Illes Balears (Spain). His research interests are dairy products and human health, nutrition and chronic inflammatory/auto-immune diseases, role of micronutrients in human health, prevention of osteoporosis and sarcopenia, nutrition and liver adenomas, and the role of nutrition in sports injury prevention.

REFERENCES

1. Chandan RC. Milk composition, physical and processing characteristics. In Hui YH, Chandan RC, Clark S, et al. Handbook of Food Products Manufacturing – Health, Meat, Milk, Poultry, Seafood, and Vegetables. John Wiley & Sons; 2007: 347-377

2. Park YW, Haenlein GFW. Handbook of milk of non-bovine mammals. Blackwell Publishing; 2006

3. Kamiński S, Cieslińska A, Kostyra E. Polymorphism of bovine beta-casein and its potential effect on human health. J Appl Genet. 2007;48(3):189-98.

4. Woodford K. Devil in the Milk: Illness, health and politics of A1 and A2 milk. Craig Potton Publishing; 2007.

5. Merriman TR. Type 1 diabetes, the A1 milk hypothesis and vitamin D deficiency. Diab Res Clin Pract. 2008:1–8.

6. Lindeberg. Food And Western Disease: Health and Nutrition from an Evolutionary Perspective. Wiley-Blackwell; 2010.

7. Truswell AS. The A2 milk case: a critical review. Eur J Clin Nutr. 2005; 59: 623–631.

8. Clemens RA. Milk A1 and A2 peptides and diabetes. Nestle Nutr Workshop Ser Pediatr Program. 2011;67:187–195.

9. Goldfarb MF. Relation of time of introduction of cow milk protein to an infant and risk of type-1 diabetes mellitus. J Proteome Res. 2008 May;7(5):2165-7

10. Vaarala O. Is it dietary insulin? Ann N Y Acad Sci. 2006 Oct;1079:350-9.

11. Karjalainen J, et al. A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Engl J Med. 1992 Jul 30;327(5):302-7.

12. Pérez-Bravo F, et al. Duration of breast feeding and bovine serum albumin antibody levels in type 1 diabetes: a case-control study. Pediatr Diabetes. 2003 Dec;4(4):157-61.

13. Banwell B, et al. Abnormal T-cell reactivities in childhood inflammatory demyelinating disease and type 1 diabetes. Ann Neurol. 2008 Jan;63(1):98-111.

14. Mäkelä M, et al. Enteral virus infections in early childhood and an enhanced type 1 diabetes-associated antibody response to dietary insulin. J Autoimmun. 2006 Aug;27(1):54-61.

 15. Vaarala O, et al. Removal of Bovine Insulin From Cow’s Milk Formula and Early Initiation of Beta-Cell Autoimmunity in the FINDIA Pilot Study. Arch Pediatr Adolesc Med. 2012 Jul 1;166(7):608-14.

 16. Knip M, et al. Dietary intervention in infancy and later signs of beta-cell autoimmunity. N Engl J Med. 2010 Nov 11;363(20):1900-8.

Paleo Babies | The Paleo Diet

If you’re a young couple raising your first kiddos Paleo, you may be asking what can I introduce and when? Trust us, you’re not alone. Many parents find it difficult to keep their kids eating healthy Paleo foods from infancy to the time they move out! So, let’s address these questions starting at the beginning.

If you are just setting out on the parenting journey, you are fortunate to be able to introduce foods your baby will love right from the start. At about 4 to 6 months solid foods are introduced and the most common of these in a household following a Standard American Diet (SAD) is cereal. A better approach is to start your Paleo babies off with fresh, organic fruits and veggies that you have pureed in a food processor or blender.

Introduce one at a time allowing your baby to become accustomed to them. When our children were at this stage of development, we found it best to steam extra veggies for dinner and then puree the leftovers and refrigerate for our children’s meals. It was a very simple process with little labor involved and the health benefits were well worth the effort!

Once your child is able to eat meats, you can do the same. Just be sure that you puree to a consistency that eliminates a choking hazard. If time is an issue and you prefer to buy baby food at your grocery store, there are many healthy, organic products to choose from. Be sure to carefully read the labels and avoid any non-Paleo additives.

Typically, mothers who are breastfeeding their infants continue to do so well beyond the introduction of solid foods. Whenever the baby is fully weaned, there is no need to feed your child milk or milk-based products. Remember, we are not meant to ingest the milk of other animals and the same Paleo principals that apply to adults, apply to children. Water is always appropriate to serve with meals. If you want to give your baby something a little more interesting and with more nutrients, try purchasing a fruit and veggie juicer. Our little ones drank lots of carrot juice as well as other freshly juiced fruits and veggies on a regular basis. We recommend that you buy organic produce to ensure that your child gets the cleanest nutrients possible.

From the minute your child is born, you embark on a nutritional journey that builds the foundation for a lifetime of health and wellness. With childhood obesity having become an epidemic, it is encouraging to see an upward trend in awareness and action on the part of new parents. As we make conscientious and healthy decisions for our children on a daily basis, we are helping to reverse the obesity epidemic for future generations. Next we will address the challenges of raising teenagers and young adults in a not-so-Paleo world.

All the Best,

Lorrie Cordain, M.Ed., Co-Author of The Paleo Diet Cookbook

Clarification On Cow's Milk In Baby Formula | The Paleo Diet

My wife and I started eating Paleo about 9 months go. I really enjoyed your most recent book and bought extra copies to give to friends and coworkers. In your most recent book you mentioned that they stopped putting cow’s milk in baby formula in the 1980’s due colic (pg 98).

When I mentioned this to my brother he showed me that milk was still the first ingredient in his babies formula which was a major name brand. I was just wondering where you got the information that milk is no longer in baby formula?

-Aaron

 

Dr. Cordain’s Response:

Hi Aaron,

Thanks for you kind words and support of the Paleo Diet.  Also, thanks for bringing this issue to my attention.  I’ll post my comment on my blog to clarify the statement (p 98) in my book which was:

“You may ask why this information is relevant in 2011 when cow’s milk-based formula is no longer commercially available, and no pediatrician in his/her right mind would recommend giving cow’s milk to your infant”.

This statement is somewhat misleading as it currently reads and needs a caveat to be completely correct.  Pure, unadulterated cow’s milk is unsuitable as an infant formula for a variety of reasons, but the most important is that the casein (a protein) content of cow’s milk is much too high and the whey (another protein) is too low which puts a strain on the infant’s kidney and additionally may cause intestinal bleeding.  Starting in the 1920s and 30s evaporated cow’s milk began to be used in infant formulas and became the most popular formula protein ingredient by the 1950’s .  Many of these early formulas made no attempt reduce the casein content of evaporated cow’s milk and increase the whey content.  By the 1970’s evaporated milk formulas were almost totally replaced by commercial cow milk formulas in which the casein to whey ratio was altered to approximate human milk.  So to clarify my statement, pure, unadulterated cow’s milk is no longer used in infant formulas, however cow’s milk in which the casein to whey ratio has been altered represent the most common protein source in commercially available infant formulas.

Cordially,

Loren Cordain, Ph.D., Professor Emeritus

REFERENCES:

Brady JP. Marketing breast milk substitutes: problems and perils throughout the world. Arch Dis Child. 2012 Jun;97(6):529-32.

Castilho SD, Barros Filho AA. The history of infant nutrition. J Pediatr (Rio J). 2010 May-Jun;86(3):179-88.

Koletzko B. Innovations in infant milk feeding: from the past to the future. Nestle Nutr Workshop Ser Pediatr Program. 2010;66:1-17

Stevens EE, Patrick TE, Pickler R. A History of Infant Feeding. J Perinat Educ. 2009 Spring;18(2):32-39.

 

Aaron’s Response:

Loren, thanks for getting back to me so quickly. My wife and I are
distance runners and have been doing great on the diet. While
following the diet I ran PR’s in 10k-Marathon on the diet, running a
2:55 marathon at Twin Cities in October. My wife has taken 9 minutes
off her Half Marathon, running a 1:43 in October. Your new book took
us to a new level of Paleo and we have been fine tunning our diets to
get the best results. I had IBS for 15 years and it has almost
completely gone away. My wife had persistent acne and intestinal
bloating that is now gone. Thank you!

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