Milk Allergy and Intolerance

Jemma Morriss

Lactose Intolerance

Cows milk is one of the biggest problem foods in Western society. Around five and a half million of us in the UK have to avoid it due to a condition called lactose intolerance. Lactose Intolerance is an inability to properly digest the milk sugar lactose due to insufficient production of lactase enzyme. Lactase, which is secreted by cells in the small intestine breaks down lactose into the simple sugars glucose and galactose, which can be absorbed into the bloodstream. When undigested lactose is allowed to continue along the gut, it eventually ferments producing acid and gas, which in turn leads to bloating, wind, cramps, constipation and diarrhoea.

Lactose intolerance is a relative term because the amount of lactase required depends on the amount of lactose being consumed. Some people may have the ability to produce reasonable quantities of lactase, but still suffer uncomfortable symptoms because they consume a great deal of dairy produce. If lactase is produced in very small amounts or not at all, then dairy products are best avoided altogether.

It is primarily in Western society that lactose intolerance is seen as a disorder. In some cultures eg Japan and China, up to 90% of the population are what we would term lactose intolerant, but to them it is not seen as restrictive because dairy foods do not feature in their diet to the same degree that they do here.

Milk protein allergy

A much smaller number of people have to exclude dairy products because they have an allergy to one or more of the proteins contained in milk. The most common offender is casein. All true allergies are caused by an antibody in the blood called Immunoglobulin E or IgE. In an allergic individual, the immune system wrongly recognises an allergen, in this case milk protein, as a harmful substance and produces IgE to counteract it. The catalogue of symptoms that can manifest as a result include eczema, swelling of the face, mouth and throat, vomiting, diarrhoea, bloating, stomach cramps, runny nose, itchy eyes and wheezing.

Milk allergy affects around three percent of babies, but most tend to outgrow it within five or six years. In others, the allergy does not manifest itself until later in life. The tendency to develop allergies is an inherited trait and so children have an increased risk of suffering from milk allergy if one or both parents have allergies of any kind.

Hidden milk ingredients

Milk components crop up in all kinds of processed foods under various names. Watch out for the caseinates - sodium, calcium, potassium, magnesium, iron and zinc as well as ingredients such as lactic acid, lactaglobulin, lactalbumin, whey and curds. In addition lactose is often used as a filler in pharmaceutical tablets.

No more treats?

Once an intolerance of or allergy to cows milk has been established, the future may seem rather bleak - no more ice cream, yogurt, breakfast cereal etc. On the contrary though, following a dairy free diet is not as torturous as it might appear.

Other items of interest

Soya

The mainstay of the milk free diet has long been soya. This little white bean can be used to make versions of milk, yogurt and cheese. These soya alternatives taste an awful lot better than they used to and in fact many people who have no immediate problem with cows milk are turning to soya simply because it is healthier. Soya milk is a good source of protein, fibre and essential fatty acids and contains no cholesterol. Extensive research has shown that 25g of soya protein each day, as part of a balanced diet, can significantly reduce total and LDL or "bad" cholesterol. Soya has the added advantage of providing isoflavones, plant compounds that are associated with reducing the risk of certain cancers, heart disease and menopausal symptoms.

Other alternatives

Another possible replacement for cows milk is goats milk. This still contains lactose but many people find it easier to digest. Goats milk is quite similar to cows milk in taste but isn't quite as smooth, and it can be purchased spray dried Allergycare Spray Dried Goats Milk 200g. Nanny by Vitacare is an infant formula of goats milk that has proved a very popular alternative for bottle-fed babies that have difficulty digesting cows milk.

Sheeps' milk provides twice as much calcium as cows milk as well as vitamins B2, B12 and zinc. However, it has to be said that it is an acquired taste! This is available as a frozen product, pasteurised Ark Farm Pasteurised Sheep Milk or unpasteurised Ark Farm Unpasteurised Sheep Milk, or in the form of a powder Woodlands Park Sheeps Milk Powder Skimmed.

Rice and oat milks are palatable alternatives containing neither cholesterol nor lactose. Oat milk is particularly suitable for pouring over breakfast cereals as the cereal masks its oaty taste. Fruit juice is another option for accompanying muesli and other breakfast cereals.

Those who don't drink milk needn't miss out on ice cream either as there are some delicious non-dairy frozen desserts available. Examples are First Glace, which is made from oats and the Swedish Glace and Tofutti ranges, including Rock n Roll Cones, which are soya based.

What about calcium and other nutrients?

Removing cows milk from the diet will not necessarily lead to a deficiency in nutrients but there are one or two areas to be extra vigilant in. Cows milk is the primary source of calcium in most people's diet, but there are plenty of other foods that provide this important mineral. Other excellent sources include green vegetables like broccoli and kale, sea vegetables, nuts, molasses and sunflower seeds. Some soya milks are fortified with calcium so that they provide just the same amount as cows milk.

Perhaps even more important than ensuring a plentiful intake of calcium is maximising its absorption in the body. Factors that can help to reduce calcium loss include reducing caffeine and alcohol consumption, getting plenty of exposure to sunlight, regular exercise and an adequate intake of magnesium, which works with calcium to promote bone growth.

An adequate supply of vitamin A is easily obtainable in a dairy free diet. Precursors to vitamin A, carotenoids are found in abundance in fruit and vegetables, especially carrots. If there is any concern over dietary intake though, there is always the option to take a daily supplement eg MicrOrganics Hawaiian Pacifica Spirulina Powder.