In the context of the prevailing trend toward more natural products, there seems to be an increasing
preference for raw milk consumption as raw milk is associated with several perceived health benefits
that are believed to be destroyed upon heating. However, many human pathogens can be isolated from
raw cow milk. The prevalence of foodborne pathogens in raw cow milk varies, but their presence has
been demonstrated in many surveys and foodborne infections have been repeatedly reported for
Campylobacter, Salmonella spp. and human pathogenic verocytotoxin-producing Escherichia coli. In
industrialized countries, milk-borne and milk product-borne outbreaks represent 2e6% of the bacterial
foodborne outbreaks.
The aim of this review is to present scientifically sound data regarding the risks and benefits related to
the consumption of raw and heated cow milk. Both microbiological aspects (e.g., the prevalence of
milk-borne pathogens, pathogen growth inhibition by antimicrobial systems and by lactic acid producing
bacteria, probiotic bacteria, etc.) and nutritional or health aspects (nutritional value, immunity, allergies,
lactose intolerance, diabetes, milk digestibility, etc.) are considered.
As such, it is demonstrated that consumption of raw milk poses a realistic health threat due to
a possible contamination with human pathogens. It is therefore strongly recommended that milk should
be heated before consumption. With the exception of an altered organoleptic profile, heating
(in particularly ultra high temperature and similar treatments) will not substantially change the
nutritional value of raw milk or other benefits associated with raw milk consumption.