Spotlight on... dairy-free
What does it mean to be allergic or intolerant to dairy? What are the health implications and where can you find answers? Nutritional therapist Jo Lewin is on hand to help...
Dairy-free diets
Discovering that you are intolerant or allergic to dairy products can seem difficult to start with. But as we found with our focus on gluten-free, with a little knowledge it can be a lot easier to shop and eat dairy-free than you might first imagine. Let us start by separating dairy allergy and intolerance as they are two distinctly different disorders.
Allergy - cow's milk
Cow's milk allergy is an immune response to one or more of the proteins (albumin, casein or whey) in cow's milk. This means that when you consume cow's milk, your immune system identifies the protein as dangerous and mobilises your body's defences. These responses can be triggered by a very small amount of the milk protein and it will usually be immediate. If you are allergic to dairy, you may experience a rapid reaction within the digestive tract (e.g. bloating, vomiting or diarrhoea/constipation), skin (e.g. eczema), respiratory system (e.g. asthma) or other inflammatory response such as headaches or joint pain.
Intolerance - lactose
An intolerance to dairy is less severe but may also bring about digestive, skin and inflammatory symptoms. Dairy intolerance may have various causes, the most common is an inability to digest lactose. All animal milks (cow's goat's and sheep's) contain a sugar called lactose. We make an enzyme in our guts, called lactase, which breaks down the lactose in the milk to be absorbed. Some people do not produce enough lactase to digest the sugar. Without lactase, the sugar ferments in the gut and causes unpleasant gastrointestinal symptoms.
The difference between intolerance and allergy...
Terms such as food allergy and food intolerance are often used interchangeably, yet they represent a disparate group of conditions. Modern classifications have divided adverse reactions to food into those that are immune mediated - food allergy and those that are NOT immune mediated - food intolerance..
Cow's milk allergy is an immune response to one or more of the proteins (albumin, casein or whey) in cow's milk. This means that when you consume cow's milk, your immune system identifies the protein as dangerous and mobilises your body's defences. If you are allergic to dairy, you will experience an immediate Type 1 hypersensitivity reaction. This response can be triggered by a very small amount of milk protein. Reactions range in severity from acute dermatological or digestive manifestations such as eczema, hives or diarrhoea to more severe potentially life threatening anaphylaxis or chronic malabsorption and inflammation. The only effective treatment for cow's milk allergy is to fully eliminate cow's milk and any products containing it.
Intolerance to lactose in cow's milk, is a non immunological condition. The age of onset, previous history of milk tolerance and dose related symptoms of bloating and diarrhoea make it relatively easy to distinguish intolerance from true allergy to cow's milk. Dairy intolerance may have various causes, the most common is an inability to digest lactose. All animal milks (cow's goat's and sheep's) contain a sugar called lactose. We make an enzyme in our guts, called lactase, which breaks down the lactose in the milk to be absorbed. Some people do not produce enough lactase to digest the sugar. Without lactase, the sugar ferments in the gut. An intolerance to dairy is less severe but may also bring about digestive, skin and inflammatory symptoms.
Everybody's different...It may be that dairy intolerance is not to do with lactose but as result of an inability to break down the protein component. Those with an intolerance may find they are less sensitive and are able to consume small amounts of dairy products with no ill-effects, particularly products which have been further processed such as live yoghurt or cottage cheese. Some find it easier to tolerate the milk of other animals such as goat, sheep or buffalo. Each individual is different and you will need to establish your own intolerance levels.
Individuals suffering from lactose intolerance might find it beneficial to supplement lactase enzymes to help digest dairy products. It is advised that you consult a doctor or accredited health practitioner before embarking on a supplement programme.
If you suspect you are intolerant or allergic to dairy products, you should go to your GP for diagnosis.
For more information on lactose intolerance see:
Information from The Dairy Council
NHS advice about lactose intolerance
Foods to include and exclude
The problem for those trying to avoid foods containing dairy products is that they include the most commonly used ingredients in food manufacture. It may become harder to buy ready-made foods and you will need to become an avid reader of labels and ingredients lists.
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