Health Matters | A1 or A2, It’s Just Milk. Don’t Fall For The 'Marketing Gimmick' Unless Your Doctor Recommends

Health experts and nutritionists cheered the move, seeing it as a step towards clearer labelling and better health. But just five days later, on August 26, the FSSAI made a surprising U-turn and withdrew the advisory.

As per reports, the Indian Council for Agricultural Research’s governing body member Venugopal Badaravada, has opposed the FSSAI’s directive. In a letter directed to Prime Minister Narendra Modi, he has urged the food authority to retract its directive and set up a high-level committee to further review the issue.

The initial move didn’t generate as much discussion as the subsequent reversal did. The move sparked discussions on social media platforms, drawing attention from the medical community. Several health experts discarded the idea of A2 milk as nothing more than a marketing ploy.

Sample this: A popular hepatologist, Cyriac Abby Philips, posted on the social media platform X, “…Some of my patients were spending close to Rs 4,000 for a litre of A2 milk. It’s milk. Not A1, not A2, not single origin.”

“It’s just goddamn milk. Every A2 milk fraudster seller out there is going crazy that their swindling business is going bust. You can fool people for a limited time only,” he added.

The premise of this being a marketing gimmick is strong, though. The price of A2 milk – which is claimed to be superior with more health benefits – hovers around Rs 90 to Rs 99 per litre in the market. Regular toned and full cream milk, which includes both A1 and A2 proteins, costs around Rs 56 and Rs 68.

At News18, we tried to understand the difference between these two varieties of milk from almost a dozen doctors with varied specialisations such as endocrinologists, gastroenterologists, general physicians, paediatricians, hepatologists and nutritionists.

The replies from several doctors were too honest and brutal. A doctor with more than two decades of experience in paediatric critical care medicine in a top private hospital in NCR replied to a text message saying “Never heard of A1 or A2. I only knew them as bogies in an AC train so far.”

None of the experts we spoke to agreed that buying A2 has any significant health benefits over regular milk unless the person is lactose intolerant or has been clinically advised to choose special milk. They also highlighted a crucial issue that there’s no reliable way to verify if milk labelled as A2 is genuine and different from regular milk – because it can simply be sold at a higher price to deceive consumers.

Let’s understand the basic science between the A1 and A2 varieties of milk

The story starts with “beta casein” – it is the main protein in milk that accounts for almost 80 per cent of milk protein.

Now, there are several types of casein in milk and beta-casein is the second most prevalent that prevails in more than ten different forms out of which the two most popular are A1 beta-casein and A2 beta-casein.

While the regular milk contains both A1 and A2 beta-casein, A2 milk contains only A2 beta-casein.

Now, there is a hypothesis that a high consumption of A1 beta casein increases the risk of diabetes mellitus type 1, ischemic heart disease, sudden infant death syndrome, schizophrenia, and autism spectrum disorder. Weak and small studies, mostly anecdotal, suggest that A1 beta-casein may be associated with digestive discomfort in certain individuals.

Sample this: A study published in 2014 in the European Journal of Clinical Nutrition. The results of the study suggested differences in gastrointestinal responses in some adults consuming A1 or the A2 type.

“There was also a significant positive association between abdominal pain and stool consistency on the A1 diet but not the A2 diet.”

The findings were culled out from just forty-one females and males in the randomised 8-week cross-over study. The study concluded that its results “require confirmation in a larger study of participants with perceived intolerance to ordinary A1 beta-casein-containing milk.”

This, so far, has not been validated in subsequent, strong studies. No big study has yet proven that the peptide released by A1 milk during digestion leads to various health issues.

Experts’ verdict

Popular endocrinologist Dr Anoop Misra explained that “except abdominal tolerance, there is no difference (in both varieties of milk), otherwise”.

He shared a presentation slide which clarified almost all doubts. It said, “A2 and A1 are different by chemical composition difference of a single nucleotide.”

It added, “A2 is similar to A1 in nutrient composition” and “A2 shows beneficial effects when compared with A1 milk regarding gastrointestinal adverse effects. No positive effects were found for cardiovascular markers with A2 milk.”

Similarly, every other doctor I reached out to, rejected the concept of better or worse milk.

Dr Rajeev Jayadevan, a gastroenterologist and former president of the Indian Medical Association Cochin decluttered the entire issue while sharing his personal experience with both variety of milks.

“I have used both types of milk for well over a decade each and found absolutely no difference.”

He recalled that this is a longstanding debate about the type of protein in milk produced by different cow breeds, and people have gone ahead and called them A1 and A2 milk.

“Despite assertions about one being superior to the other, there is no good scientific evidence to support these claims,” he said while adding the difference is only one amino acid in an entire protein – and it is unlikely to cause any difference after digestion.

“Remember, it is easy to find correlations between two variables in any study, for example, you might find people who wore a blue T-shirt got higher scores in a test than those who wore white. That does not mean the scores are really because of the shirt colour.

“Likewise in healthcare, there are so many claims and false beliefs based on correlation. At this time, there is no need to change from one milk to the other based on A1 and A2 alone.”

Not just for adults but for children also, A1 or A2 milk does not make any significant difference.

Dr Dinesh Raj, paediatrician at Delhi’s Holy Family Hospital told News18 that while studies have proven that A2 milk may be slightly better tolerated (digestible) by those who have difficulty tolerating milk, data on long-term adverse outcomes is very sparse.

Raj also echoed the observations similar to other experts. “Interestingly, most of the studies comparing these two forms of milk have very few subjects, often less than 50 subjects. Moreover, there are no studies from India to corroborate its claimed health benefits,” he said.

Another interesting finding, he said, is that despite so much buzz in the marketing world, there are hardly any new scientific papers published in quality journals in recent years.

He raised an important question while adding that the debate has been picked up by manufacturers to promote one form of milk over the other with unjustifiable prices – making it simply a marketing gimmick.

“Also, testing of these milks is not easy and the types of equipment used are only available in big settings. Hence, who knows what milk you are drinking?”

Since we were born, we have known that milk is a wholesome food, rich in many nutrients including protein, carbs, minerals, lipids and vitamins. While A2 milk may be slightly easier to digest in sensitive individuals, most of the other claimed benefits are not supported by any robust evidence.

In short, if you aren’t lactose-intolerant or allergic to dairy, it’s okay to enjoy a regular glass of milk each day!