“Fear of consumer reaction” led the U.S. dairy industry to suppress the discovery in retail milk of live paraTB bacteria, a pathogen linked to type 1 diabetes.
Does Paratuberculosis in Milk Trigger Type 1 Diabetes?
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Type 1 diabetes “arises following the autoimmune destruction” of the insulin-producing cells of the pancreas. It’s “often diagnosed in children and adolescents,” who usually present with “a classic trio of symptoms”—excessive thirst, hunger, and urination—as their blood sugars spike. And, they need to go on insulin for the rest of their lives, since their own immune system attacked and destroyed their own ability to produce it. What would cause our body to do such a thing?
Whatever it is, it has been on the rise around the world, starting after World War II. “Understanding why and how…the [current] pandemic of childhood diabetes” was produced “would be an important step toward reversing it.” A plausible guess involves so-called “molecular mimicry,” whereby a foreign antibody generator (like a bacterium or virus) “provokes an immune response, which cross-reacts with a similar”-looking protein on our own pancreas—such that when we attack the bug, our own organ gets caught in the cross-fire.
Okay, so, what pancreatic proteins are type 1 diabetics self-attacking? In the 80s, a protein was identified, which, in the 90s, we realized looked an awful lot like a certain mycobacterial protein. Mycobacteria are a family of bacteria that cause diseases like tuberculosis and leprosy. And, all newly diagnosed type 1 diabetic children were found to have immune responses to this mycobacterial protein. But, that didn’t make any sense. I mean, type 1 diabetes is going up in the industrialized world, where TB and leprosy rates are going down. Well, there is one mycobacterial infection in livestock that’s shot up with the industrialization and globalization of animal agriculture—called paratuberculosis—which causes Johne’s disease in animals, now recognized as a global problem for the livestock industry.
Huh, weren’t there like a dozen studies suggesting that exposure to cow’s milk may be “an important determinant of subsequent type 1 diabetes” in childhood? Putting two and two together, an idea was put forward in 2006. Could mycobacterium paratuberculosis be a “trigger” for type 1 diabetes? It was a compelling enough idea that researchers decided to put it to the test.
They attempted to test the association of MAP, the full name for the bug—mycobacterium avium paratuberculosis—with type 1 diabetes, by testing diabetics for the presence of the bacteria in their blood. And, lo and behold, most of the diabetic patients were found positive for the bug, compared to only a minority of the healthy control subjects. This evidence of MAP bacteria in the blood of patients with type 1 diabetes “might provide an important foundation in establishing an infectious” cause for type 1 diabetes. “These results…might have…implications for countries that have the greatest livestock populations and [a] high incidence” of both MAP and diabetes, like the United States. Johne’s disease is what you call the disease when livestock get infected by the bug. The reason the researchers chose Sardinia, an island off the coast of Italy, is because “[p]aratuberculosis is present in more than 50% of Sardinian herds.”
If they think that’s bad, the last national survey of dairy herds in the U.S. shows 68% are infected with MAP, especially those big industrial dairies. 95% percent of operations with more than 500 cows came up positive. It’s estimated the disease costs the U.S. industry more than a billion dollars a year.
How do people become exposed? “The most important routes of access of MAP [in]to the [human] food chain appear to be contaminated milk, milk products, and meat from infected [cattle, sheep, and goats]. …MAP or MAP DNA [has been] detected in raw milk,…pasteurized milk,…infant…formula,…cheese, ice cream,…muscle and organ tissues…and retail meat.”
How do we know paraTB bacteria survive pasteurization? Because Wisconsin researchers bought hundreds of pints of retail milk off store shelves from three of our top milk-producing states, and tested for the presence of viable (meaning living) MAP bacteria in retail milk. And, 2.8% came back positive for live paraTB bacteria, with most brands yielding at least one positive sample. So, it can survive pasteurization.
If paraTB does end up being a diabetes trigger, then “these findings indicate that retail milk [in the United States] would need to be considered as a transmission vector.” Why hasn’t the public heard about this research? Perhaps because the industry isn’t too keen on sharing. This is from the Journal of Dairy Science: “Fear of consumer reaction can impede rational, open discussion of scientific studies.”
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- Gale EA. The rise of childhood type 1 diabetes in the 20th century. Diabetes. 2002 Dec;51(12):3353-61. https://www.ncbi.nlm.nih.gov/pubmed/12453886
- Atkinson MA. The pathogenesis and natural history of type 1 diabetes. Cold Spring Harb Perspect Med. 2012 Nov 1;2(11). pii: a007641.
- Gerstein HC. Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature. Diabetes Care. 1994 Jan;17(1):13-9.
- Dow CT. Paratuberculosis and Type I diabetes: is this the trigger? Med Hypotheses. 2006;67(4):782-5. Epub 2006 Jul 7.
- Cossu A, Rosu V, Paccagnini D, Cossu D, Pacifico A, Sechi LA. MAP3738c and MptD are specific tags of Mycobacterium avium subsp. paratuberculosis infection in type I diabetes mellitus. Clin Immunol. 2011 Oct;141(1):49-57.
- Sechi LA, Paccagnini D, Salza S, Pacifico A, Ahmed N, Zanetti S. Mycobacterium avium subspecies paratuberculosis bacteremia in type 1 diabetes mellitus: an infectious trigger? Clin Infect Dis. 2008 Jan 1;46(1):148-9.
- Atreya R, Bülte M, Gerlach GF, Goethe R, Hornef MW, Köhler H, Meens J, Möbius P, Roeb E, Weiss S; ZooMAP Consortium. Facts, myths and hypotheses on the zoonotic nature of Mycobacterium avium subspecies paratuberculosis. Int J Med Microbiol. 2014 Oct;304(7):858-67.
- APHIS Veterinary Services Centers for Epidemiology and Animal Health April 2008 Info Sheet. Johne’s Disease on U.S. Dairies, 1991–2007.
- Ellingson JL, Anderson JL, Koziczkowski JJ, Radcliff RP, Sloan SJ, Allen SE, Sullivan NM. Detection of viable Mycobacterium avium subsp. paratuberculosis in retail pasteurized whole milk by two culture methods and PCR. J Food Prot. 2005 May;68(5):966-72.
- Collins MT. Mycobacterium paratuberculosis: a potential food-borne pathogen? J Dairy Sci. 1997 Dec;80(12):3445-8.
- Stabel JR. Johne's disease: a hidden threat. J Dairy Sci. 1998 Jan;81(1):283-8.
- Jones DB, Hunter NR, Duff GW. Heat-shock protein 65 as a beta cell antigen of insulin-dependent diabetes. Lancet. 1990 Sep 8;336(8715):583-5.
- Baekkeskov S, Nielsen JH, Marner B, Bilde T, Ludvigsson J, Lernmark A. Autoantibodies in newly diagnosed diabetic children immunoprecipitate human pancreatic islet cell proteins. Nature. 1982 Jul 8;298(5870):167-9.
- Scheinin T, Tran Minh NN, Tuomi T, Miettinen A, Kontiainen S. Islet cell and glutamic acid decarboxylase antibodies and heat-shock protein 65 responses in children with newly diagnosed insulin-dependent diabetes mellitus. Immunol Lett. 1996 Jan;49(1-2):123-6.
- The 64 K question in diabetes. Lancet. 1990 Sep 8;336(8715):597-8.
- Kennedy D. International Efforts at Paratuberculosis Control. Vet Clin North Am Food Anim Pract. 2011 Nov;27(3):647-54, viii.
- Bakker D, Willemsen PT, van Zijderveld FG. Paratuberculosis recognized as a problem at last: a review. Vet Q. 2000 Oct;22(4):200-4.
Image credit: ponce_photography via pixabay. Image has been modified.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Type 1 diabetes “arises following the autoimmune destruction” of the insulin-producing cells of the pancreas. It’s “often diagnosed in children and adolescents,” who usually present with “a classic trio of symptoms”—excessive thirst, hunger, and urination—as their blood sugars spike. And, they need to go on insulin for the rest of their lives, since their own immune system attacked and destroyed their own ability to produce it. What would cause our body to do such a thing?
Whatever it is, it has been on the rise around the world, starting after World War II. “Understanding why and how…the [current] pandemic of childhood diabetes” was produced “would be an important step toward reversing it.” A plausible guess involves so-called “molecular mimicry,” whereby a foreign antibody generator (like a bacterium or virus) “provokes an immune response, which cross-reacts with a similar”-looking protein on our own pancreas—such that when we attack the bug, our own organ gets caught in the cross-fire.
Okay, so, what pancreatic proteins are type 1 diabetics self-attacking? In the 80s, a protein was identified, which, in the 90s, we realized looked an awful lot like a certain mycobacterial protein. Mycobacteria are a family of bacteria that cause diseases like tuberculosis and leprosy. And, all newly diagnosed type 1 diabetic children were found to have immune responses to this mycobacterial protein. But, that didn’t make any sense. I mean, type 1 diabetes is going up in the industrialized world, where TB and leprosy rates are going down. Well, there is one mycobacterial infection in livestock that’s shot up with the industrialization and globalization of animal agriculture—called paratuberculosis—which causes Johne’s disease in animals, now recognized as a global problem for the livestock industry.
Huh, weren’t there like a dozen studies suggesting that exposure to cow’s milk may be “an important determinant of subsequent type 1 diabetes” in childhood? Putting two and two together, an idea was put forward in 2006. Could mycobacterium paratuberculosis be a “trigger” for type 1 diabetes? It was a compelling enough idea that researchers decided to put it to the test.
They attempted to test the association of MAP, the full name for the bug—mycobacterium avium paratuberculosis—with type 1 diabetes, by testing diabetics for the presence of the bacteria in their blood. And, lo and behold, most of the diabetic patients were found positive for the bug, compared to only a minority of the healthy control subjects. This evidence of MAP bacteria in the blood of patients with type 1 diabetes “might provide an important foundation in establishing an infectious” cause for type 1 diabetes. “These results…might have…implications for countries that have the greatest livestock populations and [a] high incidence” of both MAP and diabetes, like the United States. Johne’s disease is what you call the disease when livestock get infected by the bug. The reason the researchers chose Sardinia, an island off the coast of Italy, is because “[p]aratuberculosis is present in more than 50% of Sardinian herds.”
If they think that’s bad, the last national survey of dairy herds in the U.S. shows 68% are infected with MAP, especially those big industrial dairies. 95% percent of operations with more than 500 cows came up positive. It’s estimated the disease costs the U.S. industry more than a billion dollars a year.
How do people become exposed? “The most important routes of access of MAP [in]to the [human] food chain appear to be contaminated milk, milk products, and meat from infected [cattle, sheep, and goats]. …MAP or MAP DNA [has been] detected in raw milk,…pasteurized milk,…infant…formula,…cheese, ice cream,…muscle and organ tissues…and retail meat.”
How do we know paraTB bacteria survive pasteurization? Because Wisconsin researchers bought hundreds of pints of retail milk off store shelves from three of our top milk-producing states, and tested for the presence of viable (meaning living) MAP bacteria in retail milk. And, 2.8% came back positive for live paraTB bacteria, with most brands yielding at least one positive sample. So, it can survive pasteurization.
If paraTB does end up being a diabetes trigger, then “these findings indicate that retail milk [in the United States] would need to be considered as a transmission vector.” Why hasn’t the public heard about this research? Perhaps because the industry isn’t too keen on sharing. This is from the Journal of Dairy Science: “Fear of consumer reaction can impede rational, open discussion of scientific studies.”
Please consider volunteering to help out on the site.
- Gale EA. The rise of childhood type 1 diabetes in the 20th century. Diabetes. 2002 Dec;51(12):3353-61. https://www.ncbi.nlm.nih.gov/pubmed/12453886
- Atkinson MA. The pathogenesis and natural history of type 1 diabetes. Cold Spring Harb Perspect Med. 2012 Nov 1;2(11). pii: a007641.
- Gerstein HC. Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature. Diabetes Care. 1994 Jan;17(1):13-9.
- Dow CT. Paratuberculosis and Type I diabetes: is this the trigger? Med Hypotheses. 2006;67(4):782-5. Epub 2006 Jul 7.
- Cossu A, Rosu V, Paccagnini D, Cossu D, Pacifico A, Sechi LA. MAP3738c and MptD are specific tags of Mycobacterium avium subsp. paratuberculosis infection in type I diabetes mellitus. Clin Immunol. 2011 Oct;141(1):49-57.
- Sechi LA, Paccagnini D, Salza S, Pacifico A, Ahmed N, Zanetti S. Mycobacterium avium subspecies paratuberculosis bacteremia in type 1 diabetes mellitus: an infectious trigger? Clin Infect Dis. 2008 Jan 1;46(1):148-9.
- Atreya R, Bülte M, Gerlach GF, Goethe R, Hornef MW, Köhler H, Meens J, Möbius P, Roeb E, Weiss S; ZooMAP Consortium. Facts, myths and hypotheses on the zoonotic nature of Mycobacterium avium subspecies paratuberculosis. Int J Med Microbiol. 2014 Oct;304(7):858-67.
- APHIS Veterinary Services Centers for Epidemiology and Animal Health April 2008 Info Sheet. Johne’s Disease on U.S. Dairies, 1991–2007.
- Ellingson JL, Anderson JL, Koziczkowski JJ, Radcliff RP, Sloan SJ, Allen SE, Sullivan NM. Detection of viable Mycobacterium avium subsp. paratuberculosis in retail pasteurized whole milk by two culture methods and PCR. J Food Prot. 2005 May;68(5):966-72.
- Collins MT. Mycobacterium paratuberculosis: a potential food-borne pathogen? J Dairy Sci. 1997 Dec;80(12):3445-8.
- Stabel JR. Johne's disease: a hidden threat. J Dairy Sci. 1998 Jan;81(1):283-8.
- Jones DB, Hunter NR, Duff GW. Heat-shock protein 65 as a beta cell antigen of insulin-dependent diabetes. Lancet. 1990 Sep 8;336(8715):583-5.
- Baekkeskov S, Nielsen JH, Marner B, Bilde T, Ludvigsson J, Lernmark A. Autoantibodies in newly diagnosed diabetic children immunoprecipitate human pancreatic islet cell proteins. Nature. 1982 Jul 8;298(5870):167-9.
- Scheinin T, Tran Minh NN, Tuomi T, Miettinen A, Kontiainen S. Islet cell and glutamic acid decarboxylase antibodies and heat-shock protein 65 responses in children with newly diagnosed insulin-dependent diabetes mellitus. Immunol Lett. 1996 Jan;49(1-2):123-6.
- The 64 K question in diabetes. Lancet. 1990 Sep 8;336(8715):597-8.
- Kennedy D. International Efforts at Paratuberculosis Control. Vet Clin North Am Food Anim Pract. 2011 Nov;27(3):647-54, viii.
- Bakker D, Willemsen PT, van Zijderveld FG. Paratuberculosis recognized as a problem at last: a review. Vet Q. 2000 Oct;22(4):200-4.
Image credit: ponce_photography via pixabay. Image has been modified.
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Does Paratuberculosis in Milk Trigger Type 1 Diabetes?
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Content URLDoctor's Note
For a deeper discussion of other possibilities as to why cow’s milk consumption is linked to this autoimmune destruction of insulin production, see Does Casein in Milk Trigger Type 1 Diabetes? and Does Bovine Insulin in Milk Trigger Type 1 Diabetes?.
If it’s in the milk, what about the meat? That’s the subject of my next two videos in this three-part series: Meat Consumption and the Development of Type 1 Diabetes and Does Paratuberculosis in Meat Trigger Type 1 Diabetes?.
If we don’t drink milk, though, what about our bone health? See my video Is Milk Good for Our Bones?.
If you haven’t yet, you can subscribe to my videos for free by clicking here. Read our important information about translations here.