A1 protein free milk benefits mood and subjective cognition in free-living Australian adults: a pragmatic, exploratory, open label randomised controlled trial

TL;DR

Switching to A1 β-casein free milk may improve mood and cognition in healthy adults, especially women, without needing to eliminate all A1 milk.

Contribution

First study to examine the health effects of A1 β-casein free milk in healthy individuals without milk intolerance symptoms.

Findings

Switching to A1PF milk reduced anxiety, depression, stress, and fatigue, particularly in females.

Females reported improved subjective cognition and fewer gastrointestinal symptoms after switching milk types.

No significant changes in gut microbiome or immune response markers were observed.

Abstract

Adverse effects of milk containing A1-type β-casein on digestion, immune response, and cognition have been identified in milk-intolerant individuals, but health effects in healthy individuals without symptoms of milk intolerance are yet to be examined.

The objective was to explore the impact of reducing A1 type β-casein intake via switching milk type from conventional A1/A2-type β-casein milk (A1/A2 milk) to A1-type β-casein protein free milk (A1PF) on brain, immune response, gastrointestinal, and skin (BIGS) outcomes in a real-world setting.

An open-label, pragmatic, exploratory randomised controlled trial was conducted in 997 healthy, free-living Australian older adolescents and adults (16–65 years) who regularly consume A1/A2 protein-containing milk and milk products. Participants were randomised into two groups, to consume ≥250 mL/day of A1/A2 milk (control) or to switch to ≥250 mL/day of A1PF milk (intervention) for 28 days, while continuing to follow their usual diet (including up to 1 serve a day of A1/A2 dairy products). A sub-group of 265 participants conducted stool, saliva and cognitive testing on days 0 and 28. All participants completed subjective questionnaires on days 0, 14, and 28.

No differences in gut microbiome composition, alpha-diversity, or function were found by switching milk type. After switching to A1PF milk, a small increase in stool consistency was reported (−0.16, p = 0.007), and females experienced a marginal reduction in gastrointestinal symptoms (p = 0.015) and improved subjective cognition (p = 0.03). Switching to A1PF milk reduced anxiety (−0.61; p = 0.002), depression (−0.56; p = 0.023), stress (−0.70, p = 0.012) and fatigue (p = 0.001; females only), compared to drinking A1/A2 milk, with stronger effects in females. No consistent effects on markers of immune response or skin health were identified.

Switching from conventional A1/A2 milk to A1PF milk may benefit mood and subjective cognition, particularly in females, without the need for complete elimination of A1 β-casein from the diet. Further investigations are warranted.

https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385966, identifier ACTRN12623000628640.

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