I've been fielding questions recently about the relationship between milk or dairy consumption and respiratory mucous production (phlegm). Luckily, these conversations have not been over Holiday Dinners! If you know me well from my days working as a nurse in the Emergency Room, you'll know that respiratory secretions are perhaps my least favorite meal topic. The so called, "milk mucous effect" is a phenomenon that dates back to the 12th century, with people reporting increased phlegm, dry cough and a feeling of needing to clear the throat after drinking milk. What does the evidence say?
While the literature on this topic is mixed, and sparse, there does appear to be a subgroup of the population that reports significantly less mucous production on a dairy free diet (1). Indeed, randomly place patients presenting to a otolaryngology clinic (ENT) on a diet with our without dairy, and a significant amount of people report feeling better on the dairy-free diet with less respiratory mucous in about a week (2).
In an article written by researchers from the Swiss Federal Research Station for Animal Production and Dairy Products, they argue that "milk mucous believers" tend to report more symptoms after drinking milk, but that this hasn't been quantifiable in studies (3). For example, there was one study that evaluated the actual weight of nasal secretions (ie, boogers) in adults with head colds to see if drinking milk would make their boogers weigh more; it didn't (4). While there does appear to be a relationship between the reported symptoms of dry cough and the need to frequently clear the throat, there really isn't any good research showing an objective measure of this phenomenon or any measurable change in pulmonary function (4). This means that subjectively, this is something that some of us experience, but researchers haven't able to objectively measure it.
As always, what do I think? I think that our experience of the world matters and that it is important to validate what we are feeling. When it comes to the milk mucous phenomenon, it may be worth adopting a dairy free diet for 1-2 weeks if we think that dairy is playing a role in effecting our pulmonary symptoms. There are plenty of other sources of calcium and it would be prudent to make sure that we are getting enough (tip: fortified non-dairy milks tend to have similar amounts, make sure to check the label). While the research is not robust, it is clear that some of us may feel better without the dairy. The only way to know is to give it a try and see.
References
Does milk increase mucus production? Bartley et al. Journal of Medical Hypothesis. (2012) 10.1016/j.mehy.2009.10.044
Effect of a dairy diet on nasopharyngeal mucus secretion. Frosh et al. Journal of Allergy and Rhinology. (2018) https://doi.org/10.1002/lary.27287
Milk Consumption Does Not Lead to Mucus Production or Occurrence of Asthma. Wüthrich et al. American Journal of Nutrition. (2005) https://www.researchgate.net/profile/Brunello-Wuethrich/publication/7397206_Milk_Consumption_Does_Not_Lead_to_Mucus_Production_or_Occurrence_of_Asthma/links/0046352926073c4266000000/Milk-Consumption-Does-Not-Lead-to-Mucus-Production-or-Occurrence-of-Asthma.pdf\
Relationship between Milk Intake and Mucus Production in Adult Volunteers Challenged with Rhinovirus-2. Pinnock et al. American Review of Respiratory Diseases (1988) https://doi.org/10.1164/ajrccm/141.2.352
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