Article

The Milk Mucus Belief: Sensations Associated with the Belief and Characteristics of Believers

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Abstract

The belief that milk produces mucus is widespread in the community and is associated with a significant reduction in milk consumption. Sensations associated with milk drinking were reported by otherwise healthy believers and non-believers in the milk-mucus effect (N = 169) in an unstructured interview, with further responses prompted about the duration, type and amount of milk causing the effect. The site predominantly affected was the throat, with sensations related to difficulty in swallowing and perceived thickness of mucus and salivary secretions, rather than excessive mucus production. The effect required only a small amount of milk and was reported to be of short duration. The chronic respiratory symptom history and dairy product intake of 130 of these subjects were also assessed. Milk-mucus believers were different from non-believers, reporting more respiratory symptoms and consuming less milk and dairy products. Symptoms consistent with the known effects of food allergy or intolerance were not reported.

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... In a 2015-2016 ICDC survey among 5,300 adolescents, 10-14% reported complete milk avoidance [3]. Data from Australia showed that almost 30% of the population believed that milk produces mucus [4,5]. Balfour-Lynn recently reported that in their department, parents often claim that drinking milk increases mucus production and, therefore they omit milk from their children's diet. ...
... Indeed, elimination of milk products has become popular, mainly among parents of asthmatic children, under the assumption that avoiding dairy products will improve their children's symptoms and reduce the occurrence of exacerbations [8,9]. Despite this popular belief, no effect of cow's milk on respiratory status was detected in several studies in adults [5,10,11]. To the best of our knowledge, no interventional study has similarly explored the effect of milk on respiratory symptoms and function in children. ...
... Our findings correlate with the observations on these issues in adults. One study from Australia reported that participants who believed in the relationship between cow's milk and mucus production were more likely to report sensations related to difficulty in swallowing and to perceived thickness of mucus and salivary secretions compared to non-believers [5]. Notably, these subjective sensations occurred regardless of whether they drank cow's milk or soy milk, with no significant difference between them. ...
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Background: A commonly held public belief is that cow's milk products increase mucus production and respiratory symptoms. Dietary milk elimination is often attempted despite lack of evidence. Our objective was to investigate whether a single exposure to cow's milk is associated with respiratory symptoms and changes in pulmonary functions in asthmatic and non-asthmatic children. Methods: We conducted a prospective double blind, placebo-controlled trial on non-asthmatic and asthmatic children aged 6-18 years evaluated at a pediatric pulmonology unit. The children were randomly challenged with cow's milk or soy milk substitute. Symptoms, spirometry, fractional-exhaled nitric-oxide (FeNO), and pulse oximetry findings were obtained at baseline and at 30, 60, 90, and 120 min following challenge. A two-way ANCOVA (with repeated measures when required) was used to compare the performances of all groups and subgroups over time. The outcome measures of each participant were compared to his/her own variables over time and in relation to his/her baseline values. In case of missing data points, missingness analysis was performed using Little's missing completely at random (MCAR) test. Results: Fifty non-asthmatic children (26 assigned to the cow's milk group and 24 to the soy substitute group), and 46 asthmatic children (22 in the cow's milk group and 24 in the soy substitute group) were enrolled. Age, gender, and body mass index Z-score were comparable between the two groups. No changes in symptoms, spirometry, FeNO, or oxygen saturation measurements were observed following challenge in any of the participants in both groups, at any time point compared to baseline. Conclusions: A single exposure to cow's milk is not associated with symptoms, bronchial inflammation, or bronchial constriction in both non-asthmatic and asthmatic children. Our findings do not support the strict elimination of dairy products from a child's diet for the prevention of respiratory symptoms. Trial registration: This study was approved by the Tel Aviv Sourasky Medical Center Institutional Review Board and the Israeli Ministry of Health review board (Helsinki Committee, NIH #NCT02745899). Registered April 2016 https://clinicaltrials.gov/ct2/show/NCT02745899?cond=milk+asthma&rank=1 .
... According to some Australian investigations the belief that milk consumption stimulates mucus production is held by approximately 30% of the population and is accordingly associated with a 38% reduction in their liquid milk intake [10, 11]. The authors identified a milk mucus belief [12]. One study was conducted among 345 randomly-selected Australian shoppers. ...
... The most common symptoms mentioned were clearing of the throat (52.8%), cough (50.0%), swallow (21.4%), spit (21.4%) and catarrh (10.0%). The terms used by the believers to describe this sensory perception were: thick (35.7%), blocked (20.0%), clogged (12.8%), sticky, coating, choked, heavy (each 10.0%) [12]. In another part of the survey, prompted questions were used. ...
... In an additional trial conducted as part of this study 130 individuals completed a " health " questionnaire. The believers (n 45) reported more respiratory symptoms related to hay fever, bronchitis or asthma than the non-believers (n 85) [12]. ...
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There is a belief among some members of the public that the consumption of milk and dairy products increases the production of mucus in the respiratory system. Therefore, some who believe in this effect renounce drinking milk. According to Australian studies, subjects perceived some parameters of mucus production to change after consumption of milk and soy-based beverages, but these effects were not specific to cows' milk because the soy-based milk drink with similar sensory characteristics produced the same changes. In individuals inoculated with the common cold virus, milk intake was not associated with increased nasal secretions, symptoms of cough, nose symptoms or congestion. Nevertheless, individuals who believe in the mucus and milk theory report more respiratory symptoms after drinking milk. In some types of alternative medicine, people with bronchial asthma, a chronic inflammatory disease of the lower respiratory tract, are advised not to eat so-called mucus-forming foods, especially all kinds of dairy products. According to different investigations the consumption of milk does not seem to exacerbate the symptoms of asthma and a relationship between milk consumption and the occurrence of asthma cannot be established. However, there are a few cases documented in which people with a cow's milk allergy presented with asthma-like symptoms.
... Un estudio realizado en Nueva Zelanda encontró que el consumo de leche y huevos en los 12 meses previos se asociaba con una reducción significativa de la incidencia de enfermedades sibilantes 10 . En la misma línea, se ha descrito una mayor incidencia de síntomas respiratorios, principalmente los relacionados con bronquitis y asma, en personas con una menor ingesta de leche [11][12] . En cuanto a la producción de mucosidad, no se han encontrado diferencias entre el placebo a base de soja y la leche de vaca 13 . ...
... La falta de resultados que sugieran una asociación entre el consumo de lácteos en general y las infecciones estudiadas son consistentes con otras investigaciones 2,12,13,17 . En el análisis de cada uno de los derivados lácteos por separado encontramos estimaciones puntuales de OR que sugerían una posible asociación inversa para los yogures y los quesos. ...
... Agreement that whole milk causes allergies was widespread, though only about one fifth of respondents thought that low fat milk caused allergies. This is consistent with previous work by Arney and Pinnock (1993) who found that among 'milk produces mucus' believers, most were certain that whole milk produces mucus, while they were less sure about the reduced fat types of milk. This belief, which is associated with a significant reduction in milk consumption (Arney & Pinnock, 1993), remains a potent threat to the dairy industry. ...
... This is consistent with previous work by Arney and Pinnock (1993) who found that among 'milk produces mucus' believers, most were certain that whole milk produces mucus, while they were less sure about the reduced fat types of milk. This belief, which is associated with a significant reduction in milk consumption (Arney & Pinnock, 1993), remains a potent threat to the dairy industry. ...
Article
To identify consumer perceptions of whole milk, reduced-fat milk and soy milk, and to investigate demographic influences on perceptions and types of milk consumption. Questionnaires covering nutritional and sensory perceptions of three types of milk. Three hundred and sixty-one randomly selected shoppers in Melbourne, Australia. Generally, respondents held positive perceptions about milk. Milk was considered as having good sensory properties, providing a good source of nutrients, and being a convenient and safe product. However, despite these findings, misperceptions and unawareness about the nutrient content of milk were prevalent. Negative perceptions were most common for whole milk and were mostly related to its perceived high fat, cholesterol and energy contents. Soy milk received lower ratings on sensory quality and convenience than dairy milk. There were few sociodemographic differences in consumers' perceptions. Although reduced-fat milk consumption was more frequent among elderly people and type of milk consumption was related to parenthood, no other significant effects of demographic variables were found on the consumption of specific milk types. Although positive perceptions were common, negative perceptions and misperceptions appear to be prevalent, presenting a challenge for nutrition education. Sociodemographic factors were not shown to be important predictors of perceptions and type of milk consumption.
... Excessive milk consumption has a long association with increased respiratory tract mucus production and asthma. However while large proportions of the population believe this123, the published medical evidence documenting these links is limited. People who believe that milk increases mucus production have more respiratory tract symptoms, consume less milk and complain that milk increases throat secretions [1] . ...
... However while large proportions of the population believe this123, the published medical evidence documenting these links is limited. People who believe that milk increases mucus production have more respiratory tract symptoms, consume less milk and complain that milk increases throat secretions [1] . Such an association cannot be explained using a conventional allergic paradigm. ...
Article
Excessive milk consumption has a long association with increased respiratory tract mucus production and asthma. Such an association cannot be explained using a conventional allergic paradigm and there is limited medical evidence showing causality. In the human colon, beta-casomorphin-7 (beta-CM-7), an exorphin derived from the breakdown of A1 milk, stimulates mucus production from gut MUC5AC glands. In the presence of inflammation similar mucus overproduction from respiratory tract MUC5AC glands characterises many respiratory tract diseases. beta-CM-7 from the blood stream could stimulate the production and secretion of mucus production from these respiratory glands. Such a hypothesis could be tested in vitro using quantitative RT-PCR to show that the addition of beta-CM-7 into an incubation medium of respiratory goblet cells elicits an increase in MUC5AC mRNA and by identifying beta-CM-7 in the blood of asthmatic patients. This association may not necessarily be simply cause and effect as the person has to be consuming A1 milk, beta-CM-7 must pass into the systemic circulation and the tissues have to be actively inflamed. These prerequisites could explain why only a subgroup of the population, who have increased respiratory tract mucus production, find that many of their symptoms, including asthma, improve on a dairy elimination diet.
... Milk restriction complicates the debate on the appropriateness of recommended supplements for all breastfeeding women because the consequences of this self-directed practice are unknown and may occur more often than health care providers estimate [16]. Breastfeeding women particularly, may selfimpose milk restriction during lactation for reasons that include the perception that their food intake contributes to infant distress or colic [17][18][19], their own gastrointestinal distress [20], elevation of cholesterol [16], or an increase in the production of mucus [21]. They may also yield to social influences suggesting milk restriction will improve baby's behaviour [22]. ...
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Currently there are no recommendations for vitamin/mineral supplementation for lactating women but supplementation may be important, particularly for those women who choose to restrict milk intake during lactation. The objective of this study was to assess nutrient adequacy for lactating women and compare their dietary intake, including supplements, between those who restrict milk and those who do not. A cohort of 175 healthy exclusively breast-feeding women (19-45 yrs) recruited from prenatal classes were divided into milk restrictors (RS) defined as milk intake < or = 250 ml/day and non-restrictors (NRS) (>250 ml/day) and followed for six months postpartum. Participants provided repeated 24-hr dietary recalls, detailed use of vitamin/mineral supplements and reasons for restricting milk. Statistical Analyses: Observed intakes were adjusted to remove day-to-day variability. Nutrient intakes were estimated for macronutrients and vitamins C, D, thiamin, riboflavin, niacin, and minerals, calcium and zinc, with and without vitamin/mineral supplements. Chi-square was used to compare the number of RS and NRS with intakes less than the Estimated Average Requirement (EAR). Milk restriction was practiced by 23% of the sample. Sixty per cent of RS reported protein intakes <EAR compared to 38% of NRS (chi(2) = 6.22, p < 0.05). Prior to supplementation, mean levels of calcium and vitamin D intakes for RS were below the adequate intake level (AI) and lower than NRS estimated intakes (p < 0.05). Following supplementation, mean levels of these nutrients reached AI for both groups. RS remained lower than NRS. RS had lower energy intakes than NRS (p < 0.05) but no difference in weight loss at 6 months was noted. A higher proportion of RS were below the EAR for thiamin, riboflavin and zinc. Milk restriction compromised protein and nutrient intakes in lactating women who restricted milk to <250 mL. Vitamin/mineral supplements helped exclusively breastfeeding milk restrictors improve their vitamin D and calcium intakes. Milk restriction is not recommended during lactation and where unavoidable, nutrients provided by milk should be compensated for by other foods or supplements.
... 15 16 Initially, they were asked to describe sensations associated with drinking milk. 16 The throat was the predominant site affected followed by the nose then mouth. The reported issue was difficulty in swallowing and the perceived thickness of saliva and mucus, but not actually increased amounts of mucus. ...
... They reported more chronic respiratory symptoms and a 39.5% lower dairy product intake than nonbelievers. 13 Out of these respondents, 130 participated in a randomized, double-blinded trial comparing the same-day effects of a disguised cow's milk drink to a disguised nonmilk (soy) drink, which were added to their usual diet. The effectiveness of the disguising of the test drink was validated in the article and showed the participants were unable to identify which drink they had taken. ...
Article
Objectives/Hypothesis To examine the effects of dairy versus nondairy diets on self‐reported levels of nasopharyngeal mucus secretion. Study Design Prospective, randomized, double‐blinded controlled study. Methods Twenty‐six men and 82 consecutive women over the age of 15 years attending the otolaryngology department at East and North Hertfordshire NHS Trust who reported experiencing increased levels of nasopharyngeal mucus secretions were selected for a double‐blinded trial of dairy versus dairy‐free dietary supplementation for the last 4 days of a 6‐day dairy‐free diet. Main outcome measures were comparisons of mean daily reporting of subjective levels of nasopharyngeal secretions by linear scoring (1–100) and by an ordinal scale of 1 to 4. On each day, t tests were used to compare differences. Results There was a significant reduction in the reported linear secretion score seen from day 1 to 4 in nondairy (t[53] = 4.39, P < .01) and in dairy (t[53] = 3.94, P < .01) arms. There was a significant increase in secretion score days 4 to 7 in the dairy arm (t[53] = −2.56, P = .01), and a continued but nonsignificant reduction in the nondiary arm (t[53] = 1.54, P = .13, with an overall significant reduction between day 1 and 7 in the nondairy arm (t[53] = 4.79, P < .00). In the ordinal secretion scale, both dairy arm (t[53] = 2.754, P < .01) and nondiary arm (t[53] = 5.52, P < .01) scores decreased significantly from days 1 to 4. There was a significant decrease in scores from days 1 to 7 in the nondairy group (t[53] = 5.12, P < .01). Conclusions In this blinded trial, a dairy‐free diet was associated with a significant reduction in self‐reported levels of nasopharyngeal secretions in adults who previously complained of persistent nasopharyngeal mucus hypersecretion. Level of Evidence 1b Laryngoscope, 2018
... The TPB-based interview guide allowed us to identify people or groups with a strong influence on participants' milk and cheese consumption (i.e., normative beliefs), including family and friends, health professionals and advisors (e.g., doctors, physical trainers, dietitians/nutritionists) and influences in the communications domain (e.g., advertisements, internet, celebrities, TV shows). In parallel, we noted the persistence of several beliefs in relation to milk and cheese consumption which run counter to evidence found in the nutrition science literature (e.g., milk as mucus producing) [37][38][39] but that were propagated for years by some health professionals [40]. Perhaps in reaction to loss of confidence in agri-food industry and almost unlimited access to unregulated information sources, some participants in our study seem to feel that the verification of food sources and its quality are their own personal responsibility. ...
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Background In spite of multiple efforts by public health authorities to promote consumption of milk and alternatives in the Canadian adult population, consumption of these healthy foods is still suboptimal. This study aimed to explore salient beliefs underlying the consumption of fluid milk and cheese among adults. Methods The qualitative descriptive research design was based on the Theory of Planned Behaviour framework, using 20 focus groups. A total of 161 men and women (19 to 50 years old) from Quebec City, Montreal and Toronto (Canada) were recruited to participate in focus groups. A hybrid approach (deductive and inductive) to qualitative methods of thematic analysis was used during coding of focus group transcripts to draw out participant’s salient beliefs regarding milk and cheese consumption. ResultsFor both milk and cheese, most groups cited advantages or disadvantages with regards to health effects, nutritional value, taste, socio-affective aspects and practicality. Family and friends, health professionals and advisors, and communications domain (e.g. advertisements, TV programs, well-known personalities) were cited as major influences affecting consumption. Price reduction, product improvements, supply increase and variation, favourable food/drink combinations and access were among the most commonly cited facilitators for milk and cheese consumption. Major barriers included high price, reduced confidence in the product (reasons/contexts that reduce perceived safety of the product), health status, problems linked to supply (varieties/formats which are not available), and habits and cultural values. Gender and level of milk and cheese consumption differences were observed between groups: men referred more often to industry and politics as factors influencing their milk consumption, while women expressed more animal and environmental concerns. Differences were also noted between high and low consumer’s groups in relation to the themes of taste, pleasure and emotions for milk and cheese consumption. Lastly, low consumers expressed more distrust and disgust relating to milk consumption than high consumers. Conclusions The majority of beliefs observed are consistent with earlier studies on milk or dairy product consumption. Consumers’ concerns about origins of milk, however, have never been reported. These findings will help optimize approaches for promoting consumption of these foods among different segments of Canadian adults.
... En un estudio no controlado, realizado en un grupo de 13 niños en Malasia, el seguimiento de una dieta de exclusión de leche y huevo durante 8 semanas se tradujo en un pico espiratorio forzado (PEF) mejor 25 . Arney y Pinnock realizaron un brillante experimento en el que se instó a un grupo de sujetos que creían que «la leche produce moco» y a un grupo control a ingerir 300 mL de leche o una bebida de soja que actuaba como placebo, y encontraron una mayor proporción de síntomas en el primer grupo (el de los «creyentes»), independientemente de la bebida a la que fueran expuestos 26 . No existen datos científicos que relacionen directamente el consumo de leche y la aparición de mucosidad o de asma. ...
Article
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Cow' milk is a main food in human nutrition, even beyond the weaning period, at least in Causasian population. In the last few years, through the web or other non-conventional information technologies some negative ideas on the intake of cow's milk have arisen. Mostly they are aprioristic positions with little scientific evidence. In this paper we will review the role on cow's milk intake in the development of ferropenic anemia, the causes of lactose intolerance or the prevalence of cow's milk allergy beyond infancy. Some voices have pointed a disputable role of cow's milk in the development of metabolic syndrome or other chronic non-transmissible diseases. Even autistic disorders or mucous production have being associated with the intake of cow's milk. Strengthnesses and weaknesses of these arguments will be reviewed. Some practical points will be set at the end of the papers.
The belief has persisted for centuries that ingestion of milk causes excessive mucus, although the few studies on the topic have failed to demonstrate any effects of milk on mucus production.1- 3 The objectives of this study were to ascertain the prevalence and sources of this belief in parents; whether parents were more likely to believe that milk causes mucus if their children had allergies, asthma, or cystic fibrosis; and whether this belief altered their children's diets.
Article
A survey was conducted among 345 randomly selected shoppers in Melbourne, Australia, to identify their perceptions of the healthiness of whole milk, reduced fat milk and soy milk and to investigate demographic influences on health perceptions and types of milk consumption. The survey revealed major differences in shoppers' perceptions of the three types of milk along the themes of bone health, weight control, disease prevention, and, allergy and disease causation. Generally whole milk was perceived more negatively than soy or reduced fat milk. There were few demographic differences in the shoppers' perceptions of the three products. Reported consumption of reduced fat milk was more frequent among women and elderly people, and whole milk consumption was positively related to parenthood. The findings suggest that previous marketing and education campaigns have been effective but the widespread uncertainty and erroneous beliefs about milk products suggest that many consumers have not assimilated new findings about milk products. This represents a challenge for industry and public health practitioners.
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A questionnaire designed to measure the "milk mucus effect" was based on sensations and symptoms after drinking milk reported in interviews with 169 individuals, 70 of whom held the belief that milk produces mucus. This was used to measure responses in a randomized, double-blind trial of a flavoured UHT cow's milk drink, compared with a similarly flavoured and constituted UHT soy milk drink. The soy placebo was indistinguishable from cow's milk in a pretest of 185 individuals. Of 14 milk-mucus effect indicator variables, three showed significant increases after consumption of 300 ml of the test drink. These were "coating/lining over the mouth, throat or tongue" (39% increase), "need to swallow a lot" (31% increase) and "saliva thicker, harder to swallow than before" (42% increase). However, these increases occurred in both milk and placebo groups. It is concluded that the effect measured is not specific to cow's milk, but can be duplicated by a non-cow's milk drink with similar sensory characteristics.