The Pancreas – Under Attack by Cow-Milk
The McDougall Newsletter July 2002 -The Pancreas
Most likely you will never know you have a pancreas, yet
without it you would become very sick, and likely die. So this little
organ is working 24/7 for you, most of the time without a single
complaint. Anatomically, the pancreas is about six inches long and two
inches wide, weighs about 3 ounces, and is situated in the posterior,
upper left part of your abdomen. In the butcher shop this organ is sold
as sweetbread (from a cow). Based on its functions, the pancreas would
best be thought of as two separate organs: the organ that makes
digestive juices (the exocrine pancreas) and the one that makes hormones
for the whole body (endocrine pancreas).
The “exocrine pancreas” produces enzymes (delivered
through a duct to the first part of the small intestine) that digest
proteins, fats and carbohydrates, so they can be absorbed through the
intestine. The “endocrine pancreas” produces hormones, like insulin,
which regulate the use and storage of the body's main energy sources,
glucose (sugar) and fats. These hormones (delivered through the blood
stream) are produced in very specific clumps of cells (islets). The
insulin-producing cells are called beta cells.
Type 1 (Childhood) Diabetes – The Milk-Drinkers
Type 1 diabetes is often referred to as childhood type
diabetes, because this has historically been the most common kind of
diabetes in children, and also as insulin dependent diabetes mellitus (IDDM),
because patients must take daily injections of insulin for the rest of
their lives. However, this relatively common disease is not restricted
to children and many times appears for the first time in adulthood. Over
1.6 million Americans have type 1 diabetes.
A more common form of diabetes is called type 2 (adult
onset and non-insulin dependent). This type 2 form is due to the
high-fat Western diet and resulting obesity, and occurs at least nine
times more frequently than type 1.
The evidence incriminating cow-milk consumption in the
cause of type 1 diabetes is sufficient to cause the American Academy of
Pediatrics to issue this warning, "Early exposure of infants to cow's
milk protein may be an important factor in the initiation of the beta
cell destructive process in some individuals." and "The avoidance of
cow's milk protein for the first several months of life may reduce the
later development of IDDM or delay its onset in susceptible people."
(The American Academy of Pediatrics Work Group on Cow’s Milk Protein and
Diabetes Mellitus – 1994).
The Milk-Invader and Molecular Mimicry
The problems all begin because of the natural
condition of the intestine of a very young infant. Proteins produced by
mother, and found in human mother’s breast milk, serve to promote an
infant’s health and immunity from disease. During the first few months
of life the intestinal wall of an infant is quite permeable in order to
allow the passage of these intact proteins into the infant’s body.
Unfortunately, serious health problems can develop when foreign proteins
are allowed into the infant’s permeable intestinal tract. Cow-milk
proteins are unique in that they are usually the first foreign proteins
entering an infant’s gut and body, because most baby formulas are
usually cow-milk based.
Once the cow-milk proteins are absorbed into the
bloodstream, our immune system recognizes them as invaders, which as far
as our bodies are concerned, could be the foreign protein of a virus’s
coat or a bacteria cell wall. The immune system responds with an
appropriate defense – antibodies are made against the foreign protein,
and immune cells, called T-cells, are directed to find and destroy these
Unfortunately, in an effort to do the right thing,
some people’s immune systems become slightly confused and attack not
only the foreign cow-milk proteins, but also the insulin-producing beta
cells of the pancreas.
The reason this happens in only some people, and not
everyone, is unknown. One explanation has to do with the difference in
the permeability of intestinal walls. Some intestines allow proteins
into the body more easily, because of injuries caused by viruses,
environmental chemicals, medications (NSAID, like Motrin and Advil), and
the unhealthy, high-fat, high cholesterol diet. This condition is
sometimes called a “leaky gut.” A very “leaky gut” will indiscriminately
allow the influx of foreign proteins into the body.
Once the cow-milk protein is in the blood then a
phenomenon, known as “molecular mimicry,” occurs. Foreign proteins, like
cow-milk, stimulate the production of antibodies directed against small
segments of their proteins – specific sequences of amino acids.
Unfortunately, these same sequences of amino acids are also found on the
body’s own tissues (a copy or mimic of the foreign protein segment).
In the case of type 1 diabetes, a segment of 17 amino
acids has been identified on the cow-milk protein that is identical to a
segment on the surface of the insulin-producing beta cells of the
pancreas.1 Antibodies appropriately produced to attack and destroy the
cow-milk protein find the beta cells first -- they attach to the cell
surfaces, activating T-cells, which then attack and destroy these
insulin-producing cells. Once these cells are destroyed, the pancreas
can no longer produce sufficient amounts of insulin for the body’s
The Handicap of Diabetes
Even though the process of beta cell destruction may
take three to five years on the average, the onset of the disease
usually appears to be sudden and is often catastrophic. The apparently
well child (or adult) becomes very ill with symptoms of excessive
thirst, urination, and fatigue – many times followed by coma, and
sometimes death. The lifesaving treatment is very specific: replacement
of insulin by daily injections.
Once the beta cells are destroyed they will not grow
back, therefore the disease is permanent and the patient will always
require insulin (unless some future technology changes this). Insulin
replacement therapy is far from perfect and does not correct all of the
underlying metabolic problems. A patient living with a damaged pancreas
has an increased risk for premature development of serious
complications, such as kidney failure, blindness, heart attacks,
osteoporosis, and cancer. As you will recall, these are also the
problems faced by people without diabetes who are on the Western diet.
But the threats to a diabetic’s health are much greater.
Diabetics are metabolically handicapped people,
hampered in their ability to defend and repair themselves from outside
injuries, like an infection or an unhealthy diet (the high-fat,
high-cholesterol Western diet). Therefore, to help counteract this
disadvantage, people with this disease must be cared for with vigilance
– and that means very careful control of their blood sugars with insulin
injections, a wholesome lifestyle, and most-importantly, a
health-supporting diet. This is a diet of starches with vegetables and
fruits – the less meat, dairy, processed foods and vegetable oil the
By this effort, the type 1 diabetic has the best
chance to avoid premature death and serious complications. In fact, the
only people I have met with long-standing diabetes who still have all
their parts working after 40 years of disease, have been those following
a low-fat nearly vegetarian diet – the best example are those few
fortunate people following the Kempner Rice Diet from Duke University –
sometimes for 50 years.
Inherited by an Education
There is some inherited tendency to develop type 1
diabetes, but it is only a tendency, and actually most people (90%) who
develop this disease do not have close relatives with it. In about 30%
of identical twins, both get diabetes. To bring out this genetic
tendency requires an environmental toxin. Infectious agents, like
viruses, have been suspected to cause type 1 diabetes. More likely, when
an infection like a virus is involved, it acts as a nonspecific stress,
late in the process of disease development, that increases the body’s
needs for insulin and precipitates a rise in blood sugar earlier than
would have occurred otherwise. Rather than through genetic inheritance
or a transmitted virus, the past 20 years of accumulated evidence has
shown the tendency to run in families is largely fostered by mother and
father teaching sons and daughters to consume dairy products. Since the
cow-protein is the culprit activating the immune reaction, low-fat dairy
products would cause at least as much harm as the full-fat versions.
Evidence Incriminating Cow-Milk:
1) Population Studies (Epidemiology):
When populations of people who are genetically similar
have a different incidence of disease then something in the environment
must be suspected as the cause. The strongest contact we have with our
environment is our food. This environmental relationship is further
confirmed when people migrate from an area of low incidence to high
incidence, and increase their risk of developing disease. This migration
phenomena has been seen, for example, when Samoan children move to New
Zealand and when Asians move to England.2
There is a strong correlation between total cow-milk
consumption and type 1 diabetes, worldwide.3 For example, Finland, a
high milk-consuming population, has 36 times more type 1 diabetes than
does a country of low consumption, like Japan.4 A similar relationship
has been found within a single country, for example, between 9 regions
of Italy – regions consuming the most milk have the most diabetes.5
Type 1 diabetes is one of the fastest growing diseases
in the world. There has been a rapid increase (greater than 10-fold) in
type 1 diabetes in European countries in the past few decades,
especially in children under five years.6 This rise clearly points to an
environmental, rather than a genetic cause. This rise has been
paralleled by an increase in fluid milk intake.
There are notable exceptions to this strong positive
correlation between cow-milk consumption and type 1 diabetes – but there
is also a scientific explanation for the discrepancies.7,8
Examples of this apparent inconsistency are seen in
Iceland, New Zealand, and the Maasai people of Tanzania, Africa. In
these populations there is high milk consumption and low diabetes.
The explanation is: cow-milks from different herds
have important differences in their proteins. The cow-milk found in
populations with a low incidence of type 1 diabetes has a much lower
fraction of A1 and B betacaseins (instead they have the A2 variant).
The A1 and B forms of betacaseins are believed to be the proteins that
cause the body to respond by destroying the insulin-producing cells of
the pancreas. When these variants of cow-milk are taken into
consideration then the correlation of cow-milk consumption and type 1
diabetes becomes evident. It is estimated that 80% of dairy cows have
this A1 and or B variant. One reason this may be so frequently found is
because cows have been selectively bred this way to increase the protein
content of the cow-milk (a quality desired by dairy producers).9
2) Case Studies:
Studies comparing populations of people with type 1
diabetes with healthy individuals indicate the risk of developing type 1
diabetes is 5.4 times greater in high milk consumers (3 or more glasses
a day) compared to those who drink less milk (less than 3 glasses a
3) Milk-induced Changes in the Immune System:
Children newly diagnosed with type 1 diabetes have
been found to have increased levels of antibodies directed to several
different cow-milk proteins.11-13
Antibodies against cow-milk protein (specifically
bovine serum albumin and an ABBOS peptide of 17 amino acids) were found
to react with a similar-looking sequence of amino acids on the beta
cells of the pancreas in 100% of children newly diagnosed with type 1
Antibodies to insulin often appear in children who
develop type 1 diabetes. This is caused by exposure of an infant (before
the age of three months) to cow’s insulin (bovine insulin) found in the
milk the child drinks.14 These antibodies to cow-milk also attack human
insulin and may be the trigger for the autoimmune response that causes
Immune cells, known as T-cells, have been found to
proliferate in response to cow-milk proteins in newly diagnosed type 1
diabetic children.9 These T-cells, once activated by cow-milk, then
attack the beta cells of the pancreas and destroy them. Molecular
mimicry appears to be involved.
Avoidance of cow-milk through exclusive breast feeding
prevents the development of antibodies to cow-milk protein (beta
casein).15 Only bottle-fed infants show reactions to cow-milk proteins.
Increased levels of antibodies to these cow-milk proteins are found in
children with type 1 diabetes.
Please note: A nursing mother consuming cow-milk can
pass the proteins to her infant through her breast milk.16 Whether this
kind of cow-milk protein consumption is a cause of type 1 diabetes is
not known, but it would be prudent for a nursing mother to avoid
cow-milk in her diet.17
4) Animal studies:
Experimental animals (mice and rats) fed cow-milk have
been found to develop diabetes.18-20 It is important to note that soy
protein and wheat protein have also caused experimental animals to
develop diabetes.21 This is another reason breast feeding exclusively is
the right choice and why soy-based infant formulas are not an acceptable
substitute for cow-milk based formulas (see next month’s newsletter for
even more compelling reasons to use soy with caution).
For maximum benefit for the young child, feed mother’s
breast milk exclusively for six months and then as a decreasing part of
the diet until the child is two years of age. (For a comprehensive
discussion of the importance of breast feeding read The McDougall
Program for Women).
Sensible Action: Cow-milk Avoidance:
The dairy industry makes attempts to argue against
their products causing type 1 diabetes. (You can view their very
selective use of the scientific literature to defend the safety of their
These arguments don’t fool the American Academy of
Pediatrics and hundreds of top scientists worldwide, and they don’t fool
me. I would suggest you take the less risky road for your family. Since
cow-milk is ideal for baby cows and was never intended for human
children, act naturally and avoid a potential tragedy. With the same
action you will be reducing the risk of constipation, arthritis, ear
infections, asthma, bed-wetting, eczema, lactose intolerance, and
obesity, as well as future cancers, strokes and heart disease. There is
no human nutritional requirement for cow-milk. It is deficient in
dietary fiber, essential fats, niacin, vitamin C, and iron, and
overloaded with calories, saturated fat, environmental chemicals, and
disease pathogens (bacteria and viruses).
The dairy industry’s main selling point is calcium;
however a thorough review by researchers at the Department of
Nutritional Sciences, University of Alabama, of 57 studies on cow-milk
and bone health came to this conclusion: “In fact, of the studies
providing strong evidence, only 29% showed favorable effects and 14%
showed unfavorable effects on bone status. These values suggest that
there is little risk of harm to the skeletal system if recommendations
to the general population to consume dairy foods are heeded. However,
these values do not provide a solid body of evidence to support this
By the way, most of the studies reviewed here were
paid for by the dairy industry – and they still failed to show their
products met the manufacturer’s multimillion dollar advertising claims.
No one has ever become ill or died from a lack of cow-milk. Without a
doubt, the opposite is true for billions of people.
Pancreatic cancer is the fifth leading cause of cancer
death in the United States. Because of the deep location of the pancreas
inside the abdomen, diagnosis of the disease is difficult, and as a
result it is nearly always fatal in a matter of months – 90% have died
within 12 months of diagnosis. Even with the best that modern medicine
has to offer, approximately 25,000 people die from this disease yearly.
Therefore, if you want to effectively win the war on cancer of the
pancreas you must do so by prevention.
The only well-established causative factor is
cigarette smoking. However, diet, I believe, is the most likely cause of
most cases. This is disease of developed countries – where the rich
Western diet is consumed. There are data that show a diet high in fruits
and vegetables is associated with a lower risk of pancreatic
cancer.23,24 Obesity, alcohol, coffee, saturated fat, animal protein,
high-fat dairy products, and low physical activity increase the risk.
There is also an association with chronic pancreatitis and diabetes –
both are diseases of the Western diet (discussed above and below).
Prevention is the key to dealing with pancreatic
cancer. But what can be done for those less fortunate patients already
with pancreatic cancer? A case control study demonstrated that patients
with metastatic pancreatic cancer who ate a diet of fruits and
vegetables (a macrobiotic diet) lived longer (17 months versus six
months) and enjoyed an improved quality of life.25
This study from researchers at Tulane University
showed half of those on the macrobiotic diet were alive after one year,
compared to only 10% on the regular diet. The researchers concluded that
the macrobiotic approach may be an effective treatment, writing "This
exploratory analysis suggests that a strict macrobiotic diet is more
likely to be effective in the long-term management of cancer than are
diets that provide a variety of other foods."
Pancreatitis is an inflammatory condition of the
pancreas that is very painful and at times deadly. The mortality rate of
acute pancreatitis is about 10%. Chronic forms of pancreatitis can
devastate a person’s life over many years. Patients suffer abdominal
pain and malnutrition, and have a higher risk of pancreatic cancer.
Chronic alcohol abuse and an unhealthy diet are known to cause acute and
A high protein ketogenic diet has been reported to
cause pancreatitis that killed a child.27 (The Atkins diet is a high
protein, ketogenic diet). Diets high in sugar and fat will cause the
level of blood fats, known as triglycerides, to rise in some people. The
elevated triglycerides seem to interfere with the circulation of the
pancreas and cause severe inflammation, known as pancreatitis. A
low-fat, complex carbohydrate diet and alcohol avoidance is the
foundation to preventing further attacks.
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2002 John McDougall All Rights Reserved
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