The cow and the coronary: epidemiology, biochemistry and immunology.

Background: Certified death rates from coronary heart disease (CHD) are positively correlated country-by-country with milk consumption, particularly with that of the non-fat portion of milk. CHD death is also associated with circulating antibodies against milk fat-globule membrane (MFGM), raising the possibility that milk intake might be a specific risk factor for CHD. We studied the epidemiology and immunology of milk to see if the association is causal.

Methods: We plotted the intake of various foods country-by-country against CHD death rates to see if they were correlated in space and/or in time. We prepared fluorescein-tagged human antibodies against bovine MFGM to see if they showed any auto-reactivity against human tissue.

Results: Milk showed a positive correlation with CHD death rates in both space and time (r>0.9 in some cases). Beef was not correlated and cheese was negatively correlated, though not strongly. Wine was strongly negatively correlated. Human anti-bovine MFGM antibodies bind to human large granular lymphocytes and also to human platelets, causing aggregation.

Conclusions: We suggest that non-fat aspects of milk, particularly the Ca/Mg ratio, lactose and MFGM antigens, have specific coronary atherogenic effects, both biochemical and immunological, and the simultaneous attack from these three directions may explain why this foodstuff has such a strong effect. Wine appears to be an antidote for the harmful effects of milk.