Is raw milk healthier than pasteurised milk?
Raw milk offers no proven health advantages over pasteurised milk, while its infection risk is considerably higher. For pregnant women, young children and people with weakened immune systems, the risk is large enough to warrant avoiding raw milk.
Pasteurisation measurably reduces the concentrations of several vitamins: B1, B2, C and folate fall in a statistically significant way, while vitamin A actually rises slightly. The practical significance of those reductions is small, however, because milk naturally contains little vitamin C and folate to begin with. The exception is vitamin B2, for which milk is an important source; how large that loss turns out to be in practice deserves further attention. The macronutrients, fat, lactose and protein, remain unchanged after pasteurisation.
The evidence for the most frequently cited health claims about raw milk is thin or absent. For allergies, six studies offer indications that raw milk drinkers suffer from them less, but that association probably runs through growing up on a farm, not through the milk itself. For lactose intolerance, the only available study showed no benefit. For cancer risk, an initially observed effect disappeared once researchers accounted for other explanatory factors. The authors of the review that brought all of this together themselves caution that the methodological quality of many of the included studies is moderate to poor.
The infection risk of raw milk is a different matter: the evidence there is solid and unambiguously negative. Although only 3.2 percent of the American population drinks raw milk and only 1.6 percent consumes unpasteurised cheese, those two groups together are responsible for 96 percent of all illnesses linked to contaminated dairy. Unpasteurised dairy products cause 840 times more illnesses and 45 times more hospitalisations than pasteurised products. Well-known causative agents include Salmonella, Campylobacter, E. coli and Listeria.
The risk does not affect everyone equally. The American Academy of Pediatrics explicitly warns against raw milk for pregnant women, infants, young children and people with weakened immune systems. In pregnant women, miscarriages and life-threatening infections have been documented. Pasteurised milk offers comparable nutritional benefits without the infection risk, according to that same organisation. If you fall into one of these groups, it is wise to discuss this with your doctor.
This answer draws on a review of multiple studies covering vitamins, allergies, cancer and lactose intolerance, supplemented by separate studies on infection risks and the pasteurisation of breast milk. The authors of the review on vitamins and health claims themselves rate the methodological quality of many of the included studies as moderate or poor, and urge caution when interpreting the findings. The evidence on infection risks is based on broader surveillance data and is substantially more robust.
Does milk really help against heartburn?
Milk does not demonstrably help with heartburn in practice, and can actually be a trigger for some people. If you regularly suffer from heartburn, milk is not a reliable remedy to reach for.
Which fermented foods are the healthiest?
Yoghurt and kefir have the most human evidence, so if you want to make one choice, start there. For kimchi, kombucha and miso, human evidence is not yet available, although they show promise in the laboratory.
Is eating organic really healthier?
Eating organic probably does not give you better nutritional value, but it does lower your exposure to pesticide residues and to antibiotic-resistant bacteria through meat. For pregnant women and young children, that is the strongest concrete argument.
Is wholegrain bread really that much better than white bread?
Large-scale observational research consistently points in the same direction: wholegrain is better for your heart, your weight and your longevity. Anyone who eats bread every day is best off choosing wholegrain.
Are smoothies and fresh juice just as healthy as whole fruit?
Whole fruit beats fruit juice: more fibre, greater satiety and fewer free sugars. Smoothies fall somewhere in between, but are not equivalent to whole fruit either.
Is coffee healthy or unhealthy?
For most healthy adults, three to four cups of filter coffee per day, without sugar and cream, does more good than harm. Pregnant women are a clear exception: limit intake and discuss it with your doctor.