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26 June 2020

A2 milk – health or hype?

We check out the evidence for its claims.

“Feel the difference”. That’s the tagline for the a2 Milk brand, targeted at people who don’t get on with regular milk. It’s pricier than the standard stuff but is there any evidence you’ll feel any difference after drinking it?

The A2 debate has been around since the early 1990s. Back then, much of the debate centred on whether the A1 protein in milk was a risk factor for diseases such as heart disease, type-1 diabetes and autism. But in 2009, the European Food Safety Authority published a report stating these claims weren’t backed by available evidence.

Today, the focus has largely shifted to digestive problems.

The a2 Milk website states “for some of those people who have trouble drinking regular cow’s milk, it might be because of the A1 protein” – hence “feel the difference”.

A 2019 systematic review published in Nutrition Reviews assessed 25 studies involving A2 milk. It couldn’t say for sure there were benefits from drinking A2 milk, concluding the evidence only provided “moderate certainty” for digestive symptoms and low to very low certainty for all other outcomes.

Dr Daniela Kuellenberg de Gaudry, lead author of the review, said most trials had a follow-up time of 12 weeks or less and included a small number of participants, leading to imprecise results.

Twelve of the 25 studies in the review were sponsored by The a2 Milk Company. The company said more studies have been published since the review, including research by AgResearch and the Auckland-based Liggins Institute. This study was co-funded by a2 Milk and the Ministry of Business, Innovation and Employment.

The study investigated the effect of regular milk (containing both A1 and A2 proteins) and a2 Milk on digestive comfort in women with self-reported dairy intolerance. The small double-blind study of 40 women, published in the American Journal of Clinical Nutrition, concluded some aspects of short-term gut discomfort were improved with a2 Milk compared with regular milk. Longer-term studies are underway.

University of Otago human nutrition and medicine Professor Jim Mann has followed the A2 debate since the milk was launched and has seen no convincing evidence of benefits.

“A2 milk is an example of brilliant marketing. Until more large-scale human trials are conducted, you’re better off buying your milk on taste, price and sustainable packaging,” Professor Mann said.

Based on the state of current evidence, Dr Kuellenberg de Gaudry wouldn’t recommend A2 milk for people in the general population with gastrointestinal complaints. “But it cannot be ruled out that the evidence could change in the near future when more studies performed with high-quality standards are published,” she said.

Despite the lack of definitive evidence, The a2 Milk Company is creaming it. For the half year ending 31 December 2019, it posted a $185 million profit after tax – an increase of 21 percent.

In 2018, Fonterra entered into a partnership with The a2 Milk Company. Fonterra sells a2 Milk under the Anchor brand. This milk isn’t cheap. Two litres costs $6.45 while two litres of Anchor’s regular blue top milk is $4.63. You can also buy A2 protein milk from smaller companies such as Fresha Valley for a cheaper $4.90 for two litres.

What is A2 milk?

Nutritionally, A2 milk is similar to regular milk in terms of how much protein, fat and calcium it contains. The difference is in their types of beta-casein protein. Beta-casein makes up 30% of the protein in milk and comes in two main forms – A1 and A2. Most cows produce a mix of A1 and A2 beta-casein but some cows produce only A2 beta-casein, which is where A2 milk comes from.

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