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Aquarian Online special feature
April 6, 2002
revised December 4
Daniel in the Middle
 
By Syd Baumel
 

Daniel Cramer thought he was being interviewed by CNN. Even I, in my pre-deadline haste, succumbed to the e-llusion that the sensational online article in which Cramer, a Harvard scientist, appeared to assault and batter the milk-bashing Physicians Committee for Responsible Medicine (PCRM) bore the imprimatur of one of the Big C news networks. And that’s probably just what the people at CNSNews.com – Cybercast News Service – would like you and I and Daniel Cramer to think.

Well, CNS ain’t exactly CNN.

Their website discloses that "CNSNews.com is a division of the Media Research Center and is its Internet News Wire Service."

The Media Research Center describes itself as "the [US] nation’s largest and most respected conservative media watchdog organization." According to Media Transparency (a liberal watchdog), MRC’s advisors include such ultra-right movers, shakers, and commentators as Elliot Abrams, Pete Du Pont (heir to the Du Pont fortune), and Rush Limbaugh.

According to CNS: "The Cybercast News Service was launched June 16, 1998 as a news source for individuals, news organizations and broadcasters who put a higher premium on balance than spin. . . .CNSNews.com endeavors to fairly present all legitimate sides of a story and debunk popular, albeit incorrect, myths about cultural and policy issues. . . .CNSNews.com is able to provide its services and information at no cost, thanks to the generous support of our thousands of donors and their tax-deductible contributions."

CNS doesn't name any of those donors, but Media Transparency lists a handful of major right-wing foundations (Olin, Sarah Scaife . . .) who between 1998 and 2000 funded CNS’s parent, MRC, to the tune of $950,000. The rest of MRC's generous budget – nearly $4 million in 1996 alone, according to an article in Columbia Journalism Review – is provided by unnamed corporate contributors and individual donors and subscribers, from conservative tycoons like textile king Roger Milliken and Texas oil-and-water man T. Boone Pickens on down.

L. Brent Bozell III, an outspoken ultra-conservative, is Founder and Director/President of both MRC and CNSNews. As Robert "Not Milk" Cohen was quick to observe, Bozell shares the same uncommon surname as BSMG Worldwide (formerly Bozell Sawyer Miller Group) and its sister advertising agency, Bozell. They’re the people who handle the PR and advertising needs of the U.S. dairy industry, including the "got milk?" and "milk mustache" campaigns. According to his bio at CNSNews: "Mr. Bozell also serves as Executive Director of the Conservative Victory Committee (CVC). An independent multi-candidate political action committee, the CVC has helped to elect dozens of conservative candidates over the past ten years. He has also served as National Finance Chairman for the Buchanan for President campaign, and Finance Director and later President of the National Conservative Political Action Committee."

Not that there's anything wrong with being a conservative media watchdog. They help keep liberals honest.

And vice versa.

Which brings us back to the January 23 article by CNS staff writer John Rossomando, provocatively titled "Harvard Prof Claims Misuse of Data To Push Anti-Milk Agenda."

But first some background. The Harvard prof, Daniel Cramer, M.D., Sc.D., is a professor of obstetrics, gynecology and reproductive biology at Harvard Medical School's Brigham and Women's Hospital. Cramer’s research specialty is ovarian cancer. In 1989, he and his associates published two papers that made an intriguing, but preliminary case that the uniquely large amounts of lactose and/or galactose in milk and other dairy products (except hard cheese, which has little or none) can be a cause of ovarian cancer in genetically or metabolically susceptible women. But subsequent studies by Cramer’s group and other researchers tended to be unsupportive, albeit inconclusively, for this may be a subtle effect that eludes easy replication. As Cramer said to me a month after the publication of the CNS article: "I think it still remains a viable opinion or hypothesis that it [milk] could account for some of the strong population differences between ovarian cancer, say between the Orientals and the Americans."

Unfortunately, PCRM has consistently cited only Cramer’s 1989 research to support its claim against milk, never letting on about the other studies. They usually present the case like this:

Several cancers, such as ovarian cancer, have been linked to the consumption of dairy products. The milk sugar lactose is broken down in the body into another sugar, galactose. In turn, galactose is broken down further by enzymes. According to a study by Daniel Cramer, M.D., and his colleagues at Harvard,12 when dairy product consumption exceeds the enzymes’ capacity to break down galactose, it can build up in the blood and may affect a woman’s ovaries. Some women have particularly low levels of these enzymes, and when they consume dairy products on a regular basis, their risk of ovarian cancer can be triple that of other women.
And then PCRM moves right along to the next anti-dairy polemic.

A "conservative media watchdog" has every right to tear a strip out of PCRM for such selective citation of the research. And Cramer is annoyed. But not as annoyed as CNS made him out to be. In fact, Cramer is annoyed with CNS. Their article stated:

The group Physicians Committee for Responsible Medicine (PCRM) is using the research of Dr. Daniel Cramer, M.D. to support a recent ad campaign that claims milk and dairy products contribute to "obesity, ear infections, constipation, respiratory problems, heart disease, and some cancers."

But Cramer said those conclusions are false and that his research never supported such claims.

"We don't have the scientific proof to say that it has definitely been linked to cancer," said Cramer, a professor of obstetrics and gynecology at Brigham Women's Hospital at Harvard Medical School.

Feeling certain that Cramer's objections had been grossly exaggerated, I emailed him:

Am I right in inferring that your comment was specifically regarding ovarian cancer and not (as the article implies) the entire laundry list of ‘obesity, ear infections, constipation, respiratory problems, heart disease, and some cancers’?

Cramer replied:

You are absolutely correct that my comments applied to the milk and ovarian cancer association and not broader issues of the role of dairy products in health and illness.
 

In a subsequent telephone call, Cramer elaborated:

 
I don't think I said ‘I mind them [PCRM and other anti-milk organizations] citing [my research].’ I said ‘well this is getting to be an old story as far as I'm concerned, because I am a little bit tired of seeing it come up and up and again without citing the other studies that seem to be contradictory.
 
The CNS article next quoted Cramer suggesting PCRM has a vegan "agenda":

I think that particular group has their own sort of agenda, of not wanting milk production around, and cows to be utilized. Their agenda is that [they] don't want ... cows exploited or they want everybody to be vegetarians.

Cramer doesn’t deny it:
 

I guess I was perturbed that day about a lot of other things going on and tried to brush this off as quickly as I could. . . .And then I think I launched into my tirade about how I don't like the way they do their ads and things.


Cramer recalls that he had been venting about the anti-milk campaign in general, including PETA's infamous "got prostate cancer?" ads featuring a milk-mustachioed New York Mayor Rudolph Giuliani, recently diagnosed with the dread disease.

Although CNS had made Cramer – who sounds genial and good-humoured on the phone – sound like an irascible redneck, they had legitimately scored points against an organization that persistently allows its humanitarian values to bias its presentation of medical research.

Sadly, PCRM’s spin on ovarian cancer is typical. For example:

  • PCRM’s website contains volumes of its current and archived literature. Yet a site search in March, 2002 failed to turn up a single mention of milk and colon or rectal cancer. It’s not hard to imagine why. This is one cancer for which there is no evidence of an adverse effect for milk. Quite the opposite: studies tend to suggest milk is protective, probably because of its calcium and vitamin D.
  • In its fact sheet for consumers, "What’s Wrong with Dairy Products?" PCRM’s citation of the research on osteoporosis is confined to just four studies – all of them negative:
    • Milk is touted for preventing osteoporosis, yet clinical research shows otherwise. The Harvard Nurses’ Health Study,1 which followed more than 75,000 women for 12 years, showed no protective effect of increased milk consumption on fracture risk. In fact, increased intake of calcium from dairy products was associated with a higher fracture risk. An Australian study2 showed the same results. Additionally, other studies3,4 have also found no protective effect of dairy calcium on bone.
    Even Roland Weinsier and Carlos Krumdieck, in their glum review on "Dairy Foods and Bone Health" in the American Journal of Clinical Nutrition found that of 57 distinct outcomes in 46 studies, 24 were significantly positive compared to just three that found a significantly negative effect of dairy on bone health. Even among the 18 studies that looked at fracture rates, four were positive: PCRM only mentioned the three that were significantly negative. Ironically, PCRM would lose no points were it to forthrightly cite the entire range of results. The 18 most crucial studies that looked at fractures, with their predominance of "nonsignificant effect" results and only a few significantly supportive of dairy roughly equalled by significantly negative studies (and of better  scientific quality, according to Weinsier and Krumdieck's classification criteria),  adds up to a strong vote of scientific and statistical nonconfidence in the ability of dairy foods to do what they're cracked up to do: prevent fractures. But given the likelihood that some dairy foods - unlike milk - reduce the body's calcium stores or do little or nothing to increase them, a finer-tuned analysis of this research (or a meta-analysis in which the studies are combined to yield greater statistical power) might indeed find a more credible trend for milk to have a protective effect, but probably not a strong one. For example, one of the highest quality studies found that among Japanese women, low milk intake was associated with subsequent hip fractures, but only "marginally" in terms of statistical significance. Weinsier and Krumdieck therefore classified this as a "nonsignificant effect" study.

     

     

    PCRM continues:

    You can decrease your risk of osteoporosis by reducing sodium and animal protein intake in the diet,5-7 increasing intake of fruits and vegetables,8 exercising,9 and ensuring adequate calcium intake from plant foods such as leafy green vegetables and beans, as well as calcium-fortified products such as breakfast cereals and juices.

    This is excellent advice. But ironically, the study PCRM cites for the benefits of exercise is also one of the positive milk studies. It found milk powder to be superior to placebo, but not as effective as calcium tablets or calcium tablets and exercise combined, in slowing bone loss in postmenopausal women.

    I raised these issues in an email to PCRM's Nutrition Director, Amy Lanou, Ph.D.

    "Does PCRM purport to present research to the public in an evenhanded and - to use its own rhetoric - 'responsible' manner," I concluded, "or does it see itself as a biased advocacy group - a tit for tat answer to the dairy industry's massive spin and influence?" Dr. Lanou's reply and my follow-ups are reprinted here.


    Ironically, in seeking to expose PCRM for spinning medical research, CNS did PCRM one better. It seriously misrepresented Cramer's study:

    Cramer concedes there is some circumstantial evidence linking lactose, a primary component of milk, to ovarian cancer in mice. But he also said the facts do not support PCRM's claims that a definite link exists between milk and cancer.

    In fact, that evidence – Cramer et al.’s 1989 study – is a case-control study of 235 women with ovarian cancer. But don't tell that to Brian Carnell, one of many PCRM foes and dairy loyalists who have been exhibiting the CNS story like a stuffed trophy. On his website AnimalRights.Net – a decoy website actually dedicated to "Debunking the Animal Rights Movement" – Carnell gloated:

    Of course, PCRM's position is that research with animals is inherently invalid, so they would certainly dismiss even this thread of evidence.

    If they’d ever cited it in the first place.

    CNS also brought forward a second witness for the prosecution, providing more fodder for Carnell:

    CNSNews also notes that a researcher that PCRM cited back in October as providing evidence against milk also disputes PCRM's use of her research.

     
    In that case, Dr. June Chan published a study in the American Journal of Clinical Nutrition that hypothesized a causal connection between milk and prostate cancer. PCRM issued a press release with Neal Barnard chiming in that "there is every reason for men to avoid cow's milk altogether."
     
    But when contacted by CNSNews, Chan had a different take on her research. "We do not recommend that people change their diets or stop drinking milk," Chan told te [sic] news organization.
     
    Kudos to CNSNews.Com for pursuing this story and getting the real story rather than just the smoke and mirrors that PCRM would like people to see.

    Kudos are not exactly what Carnell deserves for leaving out the second half of the quote attributed by CNS to Chan: "It is up to people to decide what they will do following this study."

    Being well acquainted with "the real story" about milk and prostate cancer, I had reason to suspect it was CNS that was doing the smoke and mirrors act. But when I emailed Chan to ask if she had been fairly represented, she never replied. Perhaps like Cramer ("You are definitely correct that I am fed up with the subject"), she had grown wary of reporters bearing possible agendas.

    My suspicions were based, in part, on what Chan and Edward Giovannucci, a scientist at the Harvard School of Public Health, had written in another paper published last year. It was a review of nearly two dozen human studies supporting what CNSNews and all those who have reprinted and parroted their article would have us believe was an isolated study "which theorized that a link exists between milk and prostate cancer" (emphasis mine). In fact, that study was not a theoretical paper. It was the contribution of Harvard's mammoth Physicians' Health Study to the ongoing question of whether dairy foods promote prostate cancer. The answer, as Chan and Giovannucci pointed out in their review, would seem to be yes.

    "Dairy intake has been consistently associated with increased risk of prostate cancer," they wrote, citing 19 out of 23 studies to date significantly supporting such an association. "This is one of the most consistent dietary predictors for prostate cancer in the published literature," they remarked. "In these studies, men with the highest dairy intakes had approximately double the risk of total prostate cancer, and up to a fourfold increase in risk of metastatic or fatal prostate cancer relative to low consumers."

    Nine out of thirteen of these studies had significantly implicated milk, Chan and Giovannucci wrote.

    "In summary," they concluded, "there is reasonable evidence that both vitamin D metabolites and calcium, and specifically calcium from dairy sources, play important roles in the development of prostate cancer." (Emphasis mine. The reference to vitamin D was for a protective role.)

    Chan and Giovannucci are not mavericks.

    In response to a complaint against the dairy industry by PCRM, a USDA-convened panel of experts recently acknowledged that "The World Cancer Research Fund in association with the American Institute for Cancer Research states that diets high in milk and dairy products possibly increase the risk of prostate cancer." After reviewing the evidence themselves, the panel recommended that "Advertisements related to high-risk groups for prostate cancer or cardiovascular disease (i.e. adult males) should clearly indicate that low-fat milk is preferred or indicate that risks may be associated with whole milk consumption." (Actually, the research suggests that low-fat milk poses at least as much of a threat to the prostate as whole.)

    Daniel Cramer had gotten caught in the middle, between vegan polemicists on the one side and a conservative dog pack on the other. According to CNS, PCRM’s Communications Director Simon Chaitowitz had no comment on Cramer’s criticisms: "We have nothing to say about this." But, privately, Cramer says he did take some heat from PCRM President, Neal Barnard, M.D.:

    Neal Barnard was quite upset with the CNS article. I didn’t know what to tell him. I said, "Well, I'm not too happy with the way you've tried to sell your anti-milk campaign either."

    Cramer had once almost become part of that campaign himself:

    You know one time they invited me to go to what they said was "a meeting about dairy products." Fortunately I said no. But the next few weeks I heard they were parading doctors in front of posters with black milk cartons with poison signs on them [laughing]. I just said "My God, I'm glad I didn’t do that."

    Cramer just isn’t comfortable with any kind of dairy extremism:

    Certainly the [CNS] fellow trying to portray me as very pro-milk and anti- any sort of activity which would suggest that milk is not helpful – you know that was clearly wrong as well.

    Indeed when an inflamed Robert Cohen, an anti-dairy zealot who makes Neal Barnard look like a Good Humor Man, called Cramer, spoiling for a public debate, Cramer quickly tamed Cohen’s savage breast. But not, perhaps, exactly as Cohen tells it.

    Cohen, who has fallen on bad times lately within the vegan community for allegedly deceitful and vindictive behaviour, described his call with Cramer in an email to his "notmilk" mailing list:

    Dr. Cramer shocked me. Here is what he said:

    "I was mis-quoted [sic]. I hate milk. I never drink it. Milk should not be consumed by any woman over the age of one."

    Cramer's "quote" sounded more like Cohen than a Harvard academic. "Does this sound like you?" I asked Cramer, and then I read the quote. Cramer gasped out a laugh:

    I don't think I said that! But you know he'll probably pull up a tape recording of me saying that. I don't remember saying that; I don't think I would have said that. What I think I said was women do not need milk after weaning; there's far too much emphasis on dairy products in a woman's diet. We didn't even get into the subject of other dairy products. I certainly would never have said they can’t consume cheese: that's a reasonably good product; it doesn’t have the galactose in it.

    I mentioned that cheese cuts a rather unflattering figure as a calcium source in the opinion of experts like Weinsier and Krumdieck, notably because of its high load of sodium and protein. Cramer took it in and added: "The whole dairy thing and the bones is a little confusing." He cited the paradox of the Chinese shunning dairy yet having far fewer fractures than Americans and other populations who bone up on it every day. "How do we explain that?" Cramer asked. (I wasn't aware of it at the time, but studies tend to suggest that a shorter hip axis in Asians could have a lot to do with it.)

    Earlier, Cramer had written that he said one other thing to Robert Cohen:

    I expressed my concern that the scientific debate about dairy products was being muddled by exaggerations on both sides.

    Amen.

    Syd Baumel
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