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Authors (full names and academics degrees)
• Laura Moreno-Galarraga1 MD PhD
• Miguel Ángel Martínez-González2 MD PhD MPH
• Diego Mauricio Peñafiel Freire3 MD
• Elsie M Taveras4 MD MPH
1) Department of Pediatrics, Complejo Hospitalario de Navarra. IdisNa; Instituto de Investigación Sanitaria de Navarra, Health Research Institute of Navarra, Pamplona, Spain.
2) Department of Preventive Medicine and Public Health, University of Navarra Pamplona, Spain. Dpt. Nutrition, Harvard TH Chan School of Public Health, Boston, MA. CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.
3) Department of Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
4) Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
We have read the article about myths, milk and mucus, and we couldn’t agree more.1 We have observed the prevalence of the same myth and the same concern that many parents are limiting their child’s consumption of dairy products or replacing milk with vegetable drinks, despite the current recommendations.2
We conducted a study in 169 school-age children in Spain and we did not find any association between dairy products consumption (milk, cheese or yo...
We conducted a study in 169 school-age children in Spain and we did not find any association between dairy products consumption (milk, cheese or yoghurt) and respiratory diseases (OR=0.85 95%CI (0.44-1.64))3. Additionally studies conducted in various populations have not found evidence that this association exists1 and some studies even indicate that cow-milk consumption in early life is a protector factor against asthma4. In infant nutrition several scientific societies, as the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), maintain few indications for soy-based formula, and state that in healthy infants they have no nutritional advantages over cow's milk protein formulae, but their utilization rates keeps increasing.5
The question then remains: Why does the myth persist despite the evidence? Authors claim in their article: "Milk-mucus myth needs to be rebutted firmly by healthcare workers".1 But, how?
The perpetuation of this myth might be related to some commercial interests, that have been rigourously addressed by some investigators.6,7 We think that paediatricians should reinforce the current WHO recommendations on paediatric feeding, and specifically inform parents about this unsupported belief and the current scientific evidence. We think that the time has come to find a common ground on this issue; there probably is no need to conduct new clinical studies to discard this myth, but to defend the scientific truth. In the same way as policies to avoid formula milk advertisements that may compromise breast-feeding were implanted, we need now policies to defend the harmlessness of dairy products regarding respiratory problems.1,3,4 It is important to transmit to the general population that avoiding dairy products is not useful to prevent respiratory illnesses, and that vegetables drinks are not “kinds of milk”, that they do not have the same nutritional or health benefits, and that they are not better substitutes of milk during childhood.
Health myths are remarkably persistent. But, if the myth that milk is related to mucus or respiratory pathology has been unfounded by scientific evidence, we believe our next step should be to transmit evidence-based information to the population and to combat false advertising and fake information spreading on social media.
1. Balfour-Lynn IM, Milk, mucus and myths. Arch Dis Child. 2019 Jan;104(1):91-93.
2. World Health Organization Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization; WHO nutrition publications. 2003. http://www.who.int/nutrition/publications/infantfeeding
3. Peñafiel Freire DM, Martín Calvo N, García Blanco L, et al. Association of dairy consumption with respiratory infections. Myth or reality?. Rev Pediatr Aten Primaria. 2018;20(1):45-52.
4. Lumia M, Takkinen HM, Luukkainen P, et al. Food consumption and risk of childhood asthma. Pediatr Allergy Immunol. 2015; 26(8): 789-96.
5. Agostoni C, Axelsson I, Goulet O, et al. Soy protein infant formulae and follow-on formulae: a commentary by the ESPGHAN Committee on Nutrition. JPediatr Gastroenterol Nutr. (2006) 42:352–61.
6. Nestle M.Corporate funding of food and nutrition research: science or marketing? JAMA Intern Med. 2016;176(1):13-14.
7. Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS. Relationship between funding source and conclusion among nutrition-related scientific articles. PLoS Med. 2007 Jan;4(1):e5.