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tjp5036

Dairy: Acne demon or clear skin friendly?

Background: Got rid of my acne over a decade ago through diet and lifestyle changes. Acne.org provided me with hope when I thought all hope was lost.

In fact, these very forums are what changed everything for me. I had NO IDEA the impact food had on my skin until I read about it here.

I am back to add as much value as I can because I know what it feels like to suffer with acne.

I'm no MD, so please don't take this as medical advice. I'm just sharing some things that have worked for me and doing my best to back any claims with scientific research.

Enjoy :)

-------------------------------------------------

Dairy!? Nooooooooooooo.

Tell me it ain’t so!

Hold on there, buddy. Not so fast.

If you came here looking for me to give you a strict YES or NO when it comes to whether or not you should consume dairy with acne, you will be disappointed.

On the other hand, if you came here looking to educate yourself on the relationship between dairy and acne so that YOU can make an educated decision on whether or not consuming dairy is right for YOU, then this post is for you.

Right now you might be asking yourself questions like...

  • “But wait a second… isn’t milk healthy? Doesn’t it provide a great source of calcium?”
  • “I wanna cut out milk but I feel like I’ll miss out on growth.”
  • “My derm says there is no connection with acne and milk intake - I brought it up a few years ago when I read something about the connection. What gives?”
  • “I was taught in school that milk is the ‘holy grail’ of drinks. Is this not true?”

I will answer ALL of these questions (and more) in this post.

First off, it’s important to keep in mind that selling milk and other dairy products is a business. And we’re not talking small peanuts like selling lemonade at a yard sale.

We’re talking BIG business… big to the tune of $38.1 billion in 20171

Remember the “Got Milk?” advertisements on TV where bigtime celebrities would be on display with their milk mustaches? This was advertising from the Milk Processor Education Program (MilkPEP), which is an advertising arm for the dairy industry.

gotmilk-milkhawk.jpg

"Got Milk?" was a large advertising campaign in the late 90's and early 2000's that encouraged the consumption of milk2.

In fact… right on the MilkPEP website it states, “The Milk Processor Education Program (MilkPEP), Washington, D.C., is funded by the nation’s milk companies, and dedicated to educating consumers and increasing consumption of fluid milk.”

It says it right there in black and white… their goal is to increase the consumption of fluid milk and that they are funded by milk companies.

Of course the dairy industry has an interest in you consuming milk and other dairy products… otherwise they wouldn’t be in business! Whether or not consuming their dairy products comes at the expense of your health (or acne) is largely irrelevant to them.

Now… let me be perfectly clear: I am NOT saying that you should avoid dairy altogether. I simply want you to be aware that the prime motivation of the dairy industry and other dairy lobbyists is to make their wallets fatter, not to make you healthy.

With that said, I personally consume some dairy products in moderation… but they’re not the conventional dairy products you might find at your local supermarket.

Back in the day, yes, I guzzled milk like it was going out of style. I might as well had been drinking it through a beer bong. It was simply a part of life as I was growing up (there was ALWAYS a gallon of 2% milk in the refrigerator).

By the way, my favorite was chocolate milk. I’d mix about a cup of milk and a cup of Hershey’s chocolate syrup. 50/50 ratio baby. YUM!

We’ll dig into all of this and more in this post. But for now… let’s start with the basics.

What is dairy?

What the heck is dairy, anyway?

In short, it’s any product with milk or milk products in it. Food groups include (but are not limited to)3:

  • Milk itself (duh), but also includes buttermilk, powdered milk, and evaporated milk
  • Butter
  • Cheese (including cottage cheese)
  • Cream (including sour cream)
  • Custard
  • Yogurt
  • Ice cream
  • Pudding

Pretty much anything yummy, right?

Luckily you won’t have to deprive yourself of all these foods if you don’t want to (but in some cases it might be necessary - more on this below).

If you are actively trying to avoid dairy altogether, you have to be careful both when you are eating out and when you are consuming packaged foods. In these scenarios dairy can make its way into your mouth like a ninja in stealth mode.

For example, here's a box of popular brand name snack food bars:

IMG_3709-e1547382951943-768x1024.jpg

Packaged foods very often contain added dairy.

A closer look at the ingredients of the "Caramel Almond & Sea Salt" bars reveals that these bars contain dairy:

IMG_5959-1024x838.jpg

The only real way to know if the food you are eating contains dairy is to read the ingredient label!

Something as seemingly innocent as a can of tomato soup may contain dairy.

The solution? Read the ingredient labels of the food you are buying and eating!

The clues are to look for any mention of milk, milk powder, cheese, etc. in the ingredient list. Oftentimes food manufacturers will list milk under the "Allergen Information" section like you see above.

Investigate “creamy” food items in greater detail. Typically dairy is used to make foods creamier or “fluffier.” For example, packaged mashed potatoes likely contain dairy.

It’s also a good idea to exercise caution when eating out at restaurants.

For example, if you order scrambled eggs for breakfast, there’s a pretty good chance dairy will be added to make the eggs “fluffier.” Also, some restaurants cook with butter (which is better than vegetable oil, but still an issue if you are trying to avoid dairy).

The solution? Communicate with your waiter!

If you want to keep it simple, just tell them you have a dairy allergy and leave it at that. Then they will BE SURE not to use dairy (they wouldn't want a lawsuit on their hands).

You don’t have to be neurotic about it, but if you are serious about eliminating or at least cutting down on your dairy intake, these are all things to keep in mind.

The purpose of milk & dairy

Before we dive into the nitty-gritty of how dairy potentially triggers acne, we need to set some context.

My daughter was born back in February 2018 and her primary food source since she was born has been breast milk from her mother. We just recently started introducing real foods into her diet, but for the first 6 months or so she was essentially on breast milk alone.

Babies grow EXTREMELY fast. In fact, they double their weight by 6 months and triple their weight by 12 months4.

Think about if you and I doubled or tripled our weight in a year’s time. We’d be HUGE!

But this is normal for a baby. And breast milk contains almost all of the essential vitamins and nutrients that a baby needs to grow FAST.

This concept is no different for a calf (which is a baby cow).

Calves grow EXTREMELY fast… much faster than human babies. In fact, they grow about two pounds per day5!

So the milk the calf drinks from its mother serves one purpose and one purpose alone: To make the calf grow fast as hell.

Somewhere along the way in human history someone thought it would be a good idea to drink this liquid gold coming out of a cow. So milking cows for human consumption was born.

But there’s a few issues with drinking milk from a cow:

    1. The milk we drink from the grocery store is vastly different than the milk that comes straight out of the cow. I call most milk from the grocery store mutant milk.
    2. Milk is LOADED with things like hormones, lactose, etc. It might be great for a growing baby cow, but is it great for someone with acne?

We’ll dig into each of these issues in a bit more detail later in this post. But first, we need to understand what milk is even made of in the first place.

The constituents of milk (wtf is it even made of?)

At the end of the day milk is basically just water with some other stuff mixed in with it. For example, take a gander at Figure 1 below:

unnamed-1.png

Figure 1 - The composition of raw milk6.

These numbers will vary from cow to cow depending on their diet, lifestyle, etc. But for the purposes of this post this breakdown is fairly accurate.

As you can see almost 90% of milk is just pure water. The rest (the milk solids) is a fairly balanced ratio of carbs, protein, and fat:

  • The protein in milk consists of both casein and whey, with the majority (~80%) being casein protein.
  • The fat in milk consists of saturated fat, monounsaturated fat, and polyunsaturated fat, with the majority (~65%) being saturated fat.
  • The carbohydrate in milk is lactose, also known as “milk sugar.”

There are also a fairly significant amount of minerals and trace minerals in milk6:

  • Calcium (everyone knows this one)
  • Magnesium
  • Phosphorus
  • Sodium
  • Potassium
  • Chloride
  • Sulfate
  • Carbonate
  • Citric Acid
  • Other trace minerals (iron, zinc, copper, etc.)

On the surface it looks like milk is pretty healthy. So why worry about it?

How dairy potentially triggers acne

Bear with me here… things are going to get a little nerdy as we dig into the science.

Most (although not all) scientific studies agree that dairy and other milk products can irritate or even cause acne. This is why I use the term potentially.

For example, a meta-analysis from 2018 found "a positive relationship between dairy, total milk, whole milk, low-fat and skim milk consumption and acne occurrence.” Funny enough they didn’t find any association between yogurt / cheese and the development of acne7.

Other studies seem to link the consumption of low fat / skim milk (but not whole milk) to the development of acne8 9.

Finally, another study concluded that any dairy (such as milk, yogurt, and cheese) was associated with an increased risk of developing acne10.

The question is how? How does dairy and other milk products lead to the development of acne?

This is where the research gets even murkier. However, two mechanisms lay at the forefront:

  1. Hormones
  2. Carbohydrate content

Hormones

Milk naturally contains anabolic steroids, growth hormones, and other growth factors11. These constituents are there to help the baby cow grow FAST as mentioned above.

However, these hormones have been shown to potentially aggravate acne12.

To make matters worse, some cows are injected with synthetic hormones such as bovine growth hormone (sometimes referred to as rbST) to help them yield more dairy. These synthetic hormones are passed along to you when you drink milk from that cow (which may further aggravate acne).

Carbohydrate content

Acne itself is sometimes considered a disease of western civilization.

The United States typically follows what is known as the Standard American Diet (SAD) or “Western Diet” as it is sometimes called. The SAD diet truly is a sad diet because the rates of obesity, diabetes, and other diseases (like acne) have skyrocketed over the past few decades (mainly attributed to this diet).

For example, one study took a look at the prevalence of acne is two non westernized societies: The Kitavan Islanders of Papua New Guinea and the Ache hunter-gatherers of Paraguay.

After examining over 1300 people in these societies they found no cases of active acne13.

None. Nil. Zero.

WHAT!?

That’s right…

Why?

It’s genetics. Specifically... it's epigenetics.

But without going down the rabbit hole of epigenetics, let’s look at one of the main potential triggers in the SAD diet that is absent in other diets: the consumption of copious amounts of high glycemic carbohydrates.

The glycemic index is a measure of how fast your body processes different carbohydrate foods. The higher the number on the glycemic index, the faster your body processes the carbohydrate (and the worse it is for your acne)14.

Dairy itself contains lactose, which is milk sugar (a carbohydrate). Although milk isn’t super high on the glycemic index, some studies suggest that the carbohydrates found in dairy affect serum insulin and insulin-like growth factor-1 (IGF-1).

Both insulin and IGF-1 promote “increased production of available androgens and the subsequent development of acne11.”

Although the carbohydrates in dairy itself may or may not be fully responsible for the development of your acne, when you combine it with the consumption of lots of other high glycemic carbs in the SAD diet (such as sugar) you have a recipe for acne disaster.

So what can we take away from all of this nerdy research? The science is clear:

  • There is almost surely some relationship between the consumption of dairy and the development / aggravation of acne.
  • The mechanisms by which dairy causes / aggravates acne still isn’t clear, but two theories are hormones and carbohydrate content.
  • The extent that dairy affects any one individual varies from person to person.

And finally, any derm that tells you there is no relationship between dairy and acne simply isn’t keeping up with the latest research (and you should probably think about firing them).

Now that you understand the relationship between dairy and acne, as well as a few potential mechanisms by which dairy may trigger acne, let’s look at one final issue before digging into the solutions.

Are you drinking mutantmilk?

As human beings we like to f**k with mother nature. So what do we do? We shoot dairy cattle up with extra hormones and stuff them full of crummy food for one reason and one reason alone: the almighty dollar.

Dairy cattle given this junk produce more milk, plain and simple. More milk means more dollars for the dairy producers.

But just because these dairy cows produce more milk doesn’t mean that milk is good for you.

Last time I checked cows like to eat grass. They don’t eat corn, soy, and other genetically modified food items.

In fact, how could a cow even shuck corn without human help? They don’t have 10 digits on their hands like we do. They have hooves.

Mutant milk is a recipe for acne disaster. This is primarily due to the crummy food the cow eats and the added hormones it is given.

All of this is passed along to you when you drink its milk. And remember above when we said hormones from milk = acne. So more hormones = more acne.

To help you better understand the quality of the milk you are drinking, here’s a little “milk vocabulary” for ya...

Pasteurized milk

Milk that has been subjected to a process of partial sterilization, especially one involving heat treatment or irradiation. This process kills any potentially harmful bacteria and improves the shelf life of milk. During pasteurization raw milk is heated to about 161 degF. Ultra pasteurization heats milk to 280 degF.

Homogenized milk

Milk subjected to extreme pressure in which the fat droplets are emulsified and the cream does not separate. This process improves appearance and taste.

Fermented milk

Milk that has undergone the process of fermentation. The most common example of fermented milk is yogurt. Fermented milk may be beneficial for those with lactose intolerance because the beneficial bacteria eat some or all of the lactose. The bacteria found in fermented milk are also beneficial to your gut microbiome.

Lactose

A sugar present in milk. An enzyme called lactase is required to properly digest lactose. The majority of people lose their ability to generate lactase after age 4 when they would normally be weaned off of breast milk. This results in lactose intolerance. However, a percentage of the population is still able to produce lactase into adulthood (and thus have no lactose intolerance).

Whole milk

Milk in which the fat has not been removed.

Skimmed (or partially skimmed) milk

Milk in which some or all of the fat has been removed. This is what’s commonly known has 2% or skim milk.

Raw milk

Milk that has not been pasteurized or homogenized.

Grass fed milk

Milk that comes from cows fed their natural diet (grass).

Organic milk

Milk from cows that were not shot up with antibiotics or added hormones. Organic does not necessarily mean the cow lives a natural lifestyle.

Now… I want to make one thing perfectly clear: I am not advocating for the consumption of raw milk!

And honestly… the science doesn’t support it.

I slogged through the research for hours trying to find evidence that supports some of the many claims about the benefits of raw milk:

  • Pasteurized milk has fewer nutrients
  • Pasteurizing milk destroys proteins
  • Raw milk protects against allergies and asthma
  • Raw milk is better for people with lactose intolerance
  • Etc.

Boys and girls, I’m all for eating natural, whole foods… so I WANT to believe these claims. But the truth is, there just ain’t science to support it.

Just about the only one that would hold any weight in a court of law is the claim that raw milk protects against allergies and asthma15There is also some limited evidence that the nutrients found in pasteurized milk may be slightly less than raw milk16.

If you want to dig deeper into this topic, here's an excellent evidence-based article that gets into the nitty gritty. I’m not gonna do it in this post.

For now, let’s get back to the topic at hand: dairy and ACNE.

What does all of this mean for you as an acne sufferer?

The point I’m trying to make here is that not all milk is created equal, folks.

Whole milk from healthy, organic, grass-fed cows given no extra hormones is light years ahead of mutant skim milk from a cow fed corn, soy, shot up with extra hormones / antibiotics, and kept in a tiny space with no room to graze.

Fat is not the enemy that so many believe it to be. If you are going to drink milk, I definitely recommend choosing whole over skimmed or partially skimmed.

Does pasteurization / homogenization make a difference? I’ll let you make that decision for yourself.

Personally, I’m not drinking any raw milk unless I have visited the farm that it’s coming from and verified the whole milking process is clean as a whistle.

Plenty of people drink raw milk with no side effects though.

Should you avoid dairy completely?

Now that you just received a Harvard education on the link between dairy and acne, let’s get into the solutions. How can you take action on what you just learned to finally get rid of your doggone acne?

Option 1: The “chuck dairy out the window” plan

The most accurate and fastest way to tell if dairy is the trigger for your acne is to simply eliminate it from your diet for 30 days. Cut it all out, even the “hidden” dairy you might find in packaged foods.

Exercise caution when eating out at restaurants. Tell your waiter or waitress that you have a dairy allergy if you’re afraid to tell them why you aren’t eating dairy.

After 30 days… heck, even after a week… you should be able to tell whether dairy is a trigger for your acne.

Is the battlefield on your face clearing up? If so, good! You just discovered one, if not THE trigger for your acne.

KEEP AVOIDING DAIRY!

If you want, you can slowly re-introduce dairy back into your diet after 30 days just to 100% confirm it’s an acne trigger for you. People have different "thresholds" for how much dairy they can tolerate.

If your face isn’t clearing up, or if it only got a little bit better, don’t worry. It just means there is something else triggering your acne.

Getting rid of acne is like solving a puzzle. It might take some time to find the right pieces, but when you do, you will achieve clear skin.

Do not lose hope. Some people with acne simply don’t respond to eliminating dairy. It’s not the missing puzzle piece for them.

THAT’S OKAY.

Keep experimenting and you will eventually figure out the missing pieces for your unique biology.

Option 2: The “ditch the mutant milk” plan

I know there are a handful of you who aren’t ready to completely eliminate dairy from your life. You admit that you’re stubborn as a mule, and you want another option.

So for you we have the “ditch the mutant milk” plan.

How does this work, exactly?

If you’re currently eating mutant dairy, you want to switch over to consuming full fat dairy that comes from a healthy grass-fed cow and isn’t shot up with hormones and antibiotics. You could even go raw if that’s your thing (but again, don’t come a knockin’ on my door if you get sick).

Here are a handful of strategies to ditch the mutant dairy you are currently consuming:

  • Switch to a grass-fed brand. Kerrygold is a popular mainstream brand, but there are others. I personally consume no cow’s milk but do eat Kerrygold butter and cheese in moderation (I find it at Costco). Some people who cannot tolerate butter find that they can tolerate ghee (also known as clarified butter - an indian food).
  • Eat fermented dairy. Foods like yogurt and kefir are examples of fermented dairy. Fermented dairy provide probiotics that are great for gut health. Just keep an eye out for added sugar and other junk you might find at the grocery store. If you’re a true badass, you can make your own fermented dairy products.
  • Switch to goat or sheep milk. Some people find in particular that they can tolerate goat’s milk even if they cannot tolerate cow’s milk. Goat’s milk is naturally homogenized (meaning one less processing method it has to go through). It also contains less lactose and less casein which may help if you have digestive issues.
  • Drink A2 milk instead of A1 milk. The difference between A1 and A2 milk comes down to the types of proteins found in the milk. There is evidence out there that A2 milk may be more beneficial than A1 milk. For example, one study found that consumption of A1 milk was associated with "increased gastrointestinal inflammation, worsening of post-dairy digestive discomfort symptoms, delayed transit, and decreased cognitive processing speed and accuracy17." A2 milk did have not these affects. All goat's milk is A2 milk, while cow milk can be either A1 or A2 (depending on the type of cow it came from).
  • Switch to a non-dairy milk alternative. There are many excellent non-dairy milks on the market: Almond, coconut, other nut milks, etc. Coconut milk in particular is excellent because it contains healthy fats. Make sure you buy unsweetened as you don’t want products loaded with sugar (which can trigger acne breakouts).

Caution: Soy milk may not necessarily be a healthy alternative.

Soy milk lies in a bit of a gray area. I recommend avoiding it for several reasons:

  • Soy contains significant quantities of isoflavones, sometimes referred to as phytoestrogens18. These compounds mimic the effect of estrogen (a hormone) in the body. Anything that messes with your hormones is typically bad news bears for acne sufferers. It may also cause fertility issues in men19. Yikes!
  • Soy is typically heavily processed and genetically modified. In general, processed foods = acne disaster.
  • Soy contains phytates (also known as anti-nutrients) that can block the absorption of important nutrients like calcium, zinc, etc. (Note: most grains also contain these compounds). Soaking and/or properly preparing soybeans may help reduce the effect of these anti-nutrients19.

Although the science is conflicting (there may be some health benefits), there’s enough evidence out there to persuade me to avoid soy milk like the plague (especially because I’m a dude). I recommend you do the same, but don’t expect me to hold a gun to your head forcing you to do so.

If you are going to consume soy, I recommend consuming organic, unsweetened, and preferably fermented as well (fermentation may help to reduce some of the “negative” effects of soy).

Other frequently asked dairy and acne questions

Before we wrap things up, I want to answer some common questions I see from acne sufferers regarding dairy and acne.

Can I consume milk chocolate?

Ummm… hello! It has the word MILK in the name! Of course it’s going to have dairy in it, dude.

If you still want your chocolate fix (hey, I’m a chocolate addict myself) I recommend getting the good stuff:

  • 85% cacao content or greater
  • Unsweetened and/or very little sugar added
  • Non GMO
  • Preferably organic

Here’s the one I buy and love, but there are plenty out there on the market:

IMG_0705-507x1024.jpg

If you're going to eat chocolate, eat the good stuff!

One of my favorite snacks to this day is some dark chocolate topped with freshly made almond butter. YUM!

Will I miss out on my calcium requirements if I eliminate dairy?

That depends. Are you getting calcium from other food sources? Or is dairy your sole source of calcium?

Most sources recommend consuming between 1,000 - 1,300 mg/day depending on your gender and age20.

Rich sources of calcium outside of the dairy world include:

  • Seeds (chia, poppy, sesame, etc.)
  • Sardines and canned salmon
  • Beans and lentils (just make sure you properly prepare them by soaking)
  • Almonds
  • Leafy greens
  • Figs

Will I miss out on growth if I don’t consume dairy?

Similar to the last question, it depends. Are you meeting all of your nutritional needs through non-dairy foods?

If you are dependent on dairy to meet your nutritional needs, then yes, you could be missing out on growth.

When you decide to give up dairy, you have to replace it with something else. You can’t just eliminate it.

Eating lots of vegetables (especially leafy greens), nuts & seeds, and wild caught fish (especially salmon) will go a long way to helping you meet your nutritional needs while giving up dairy.

Why does my derm say there is no dairy-acne connection?

Your derm hasn’t kept up with the latest scientific research, plain and simple.

Derms (and most medical professionals in general) receive very little nutrition training in medical school. So unless they go out of their way to study this stuff themselves (most don’t), they are simply unaware.

I do think a derm can add value if you find one who is open to the idea of the diet-acne connection. Then you can experiment with your diet under their supervision.

Is there a difference between lactose intolerance and being allergic to milk?

Yes, the two are completely different.

Lactose intolerance is the inability to digest lactose.

In order to digest lactose, an enzyme called lactase needs to be present. Many people lose the ability to generate this enzyme after age 4 or so (from an evolutionary perspective this is when we would normally be weaned off of breast milk, which does contain some lactose).

However, some adults are able to continue generating lactase into adulthood, which is why they have no issues digesting lactose.

A milk allergy is an actual food allergy issue similar to how some people are allergic to peanuts. Typically with a milk allergy it is a protein found in milk that causes the allergic reaction, rather than the lactose itself (which is the milk sugar).

Conclusion

If you’ve made it this far, congratulations! You are a true warrior.

This was a heck of a post to read, and an even tougher one to write. It involved many mornings of me banging my head against the wall trying to figure out exactly what I wanted to say.

I hope that it has provided you with some great insights and ideas you can implement on your journey to clear skin.

To wrap things up, I want to summarize 10 key takeaways for you:

  1. Selling milk and other dairy products is BIG BUSINESS. Total U.S. milk production in 2017 added up to 38.1 billion dollars. Keep this in mind when you see milk advertisements.
  2. Dairy foods consist of milk and products derived from milk (cheese, butter, yogurt, etc.)
  3. The purpose of milk is to help a baby cow grow FAST. Because of this, milk typically contains high amounts of hormones and anabolic steroids.
  4. Milk is mostly made up of water. The remainder contains a fairly balanced ratio of protein, carbs, and fat. It also contains minerals, hormones, and steroids. If the cow is injected with antibiotics / added hormones, these get passed along in the milk.
  5. Although the scientific data isn’t crystal clear, most research seems to indicate that there is some connection between the consumption of dairy and acne. Two potential causes include hormones and carbohydrates found in milk.
  6. Not all milk is created equal. Milk from a grass fed cow that hasn’t been shot up with hormones / antibiotics is light years better than milk that comes from a cow fed crummy food and shot up with hormones / antibiotics. Also, skimmed milk may aggravate acne worse than whole milk.
  7. The consumption of raw milk is a topic of hot debate. Frankly, the science isn’t there yet to fully support raw milk. It may be healthier, but ultimately it’s up to you to decide if raw milk is right for you.
  8. The best strategy to tell if dairy triggers your acne is to eliminate it for 30 days and see what happens. Some people will get clear, but don’t get discouraged if you don’t. It just means there is something else at play.
  9. For people not ready to completely eliminate dairy from their life, there are many ways you can “upgrade” the dairy you are currently consuming. Just keep in mind that you may not be able to determine if dairy is an acne trigger for you with this method.
  10. Dairy is not necessary to consume. There are many other foods out there that will satisfy your nutrient requirements as long as you eat a balanced diet consisting of whole foods. 

If you found value in this post, tell a friend who you think would benefit!

References

1 How Big Is the Milk Industry? - Milk - ProCon.Org. 7 July 2018, milk.procon.org/view.answers.php?questionID=000843.

2 Durso, Chris. Got Milk? The (Almost) Complete Collection | Foodiggity. 24 Jan. 2011, foodiggity.com/got-milk-the-almost-complete-collection/.

3 “Living With a Milk Allergy.” WebMD, Dec. 2016, https://www.webmd.com/allergies/milk-allergy.

4 Hoecker, Jay L. “Infant Growth: What’s Normal?” Mayo Clinic, 16 Aug. 2017, mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/infant-growth/faq-20058037.

5 Ringwall, Kris. “BeefTalk: 2 Pounds of Average Daily Gain Equals Grass Beef.” Drovers, 8 June 2012, drovers.com/article/beeftalk-2-pounds-average-daily-gain-equals-grass-beef.

6 “Properties of Milk and Its Components.” AACC International, 1997, aaccipublications.aaccnet.org/doi/pdf/10.1094/9780913250945.001.

7 M, Aghasi, et al. “Dairy Intake and Acne Development: A Meta-Analysis of Observational Studies. - PubMed - NCBI.” Clinical Nutrition, May 2018, ncbi.nlm.nih.gov/pubmed/29778512.

8 CL, LaRosa, et al. “Consumption of Dairy in Teenagers with and without Acne. - PubMed - NCBI.” Journal of the American Academy of Dermatology, Aug. 2016, ncbi.nlm.nih.gov/pubmed/27241803.

9 CA, Adebamowo, et al. “Milk Consumption and Acne in Teenaged Boys. - PubMed - NCBI.” Journal of the American Academy of Dermatology, May 2008, ncbi.nlm.nih.gov/pubmed/18194824.

10 CR, Juhl, et al. “Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. - PubMed - NCBI.” Nutrients, Aug. 2018, ncbi.nlm.nih.gov/pubmed/30096883.

11 FW, Danby. “Nutrition and Acne. - PubMed - NCBI.” Clinics In Dermatology, Nov. 2010, ncbi.nlm.nih.gov/pubmed/21034984.

12 Katta, Rajani, and Samir P. Desai. “Diet and Dermatology: The Role of Dietary Intervention in Skin Disease.” The Journal of Clinical and Aesthetic Dermatology, July 2014, ncbi.nlm.nih.gov/pmc/articles/PMC4106357/.

13 L, Cordain, et al. “Acne Vulgaris: A Disease of Western Civilization. - PubMed - NCBI.” Archives of Dermatology, Dec. 2002, ncbi.nlm.nih.gov/pubmed/12472346/.

14 “Glycemic Index for 60+ Foods - Harvard Health.” Harvard Health, Feb. 2015, health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods.

15 C, Braun-Fahrländer, and von Mutius E. “Can Farm Milk Consumption Prevent Allergic Diseases? - PubMed - NCBI.” Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology, Jan. 2011, ncbi.nlm.nih.gov/pubmed/21155907.

16 LE, Macdonald, et al. “A Systematic Review and Meta-Analysis of the Effects of Pasteurization on Milk Vitamins, and Evidence for Raw Milk Consumption and Other Health-Rel... - PubMed - NCBI.” Journal of Food Protection, Nov. 2011, ncbi.nlm.nih.gov/pubmed/22054181.

17 S, Jianqin, et al. “Effects of Milk Containing Only A2 Beta Casein versus Milk Containing Both A1 and A2 Beta Casein Proteins on Gastrointestinal Physiology, Symptoms ... - PubMed - NCBI.” Nutrition Journal, Apr. 2016, ncbi.nlm.nih.gov/pubmed/27039383.

18 K, Zaheer, and Humayoun Akhtar M. “An Updated Review of Dietary Isoflavones: Nutrition, Processing, Bioavailability and Impacts on Human Health. - PubMed - NCBI.” Critical Reviews in Food Science and Nutrition, Apr. 2017, ncbi.nlm.nih.gov/pubmed/26565435.

19 CR, D’Adamo, and Sahin A. “Soy Foods and Supplementation: A Review of Commonly Perceived Health Benefits and Risks. - PubMed - NCBI.” Alternative Therapies in Health and Medicine, 2014, ncbi.nlm.nih.gov/pubmed/24473985.

20 “Office of Dietary Supplements - Calcium.” National Institutes of Health, 26 Sept. 2018, ods.od.nih.gov/factsheets/Calcium-HealthProfessional/.

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