Navigating the Dairy Dilemma for Health (Part 1)

Reasons to ditch dairy will vary. For some, Cow’s Milk Protein Allergy could be the primary issue requiring total avoidance of dairy. For others, the issue may only be Lactose Intolerance and removal of the lactose sugar molecule means lactose-free dairy products are still an option. From a naturopathic point of view, there can be other reasons to avoid dairy, even if it is only temporarily. Gut issues such as parasite infection, Coeliac Disease and IBS often respond well to a dairy-free diet.

In Part One of our two part blog series, we separate the curds from the whey to break down the issues surrounding why dairy can be a dilemma.

Cow’s Milk Protein Allergy can be IgE mediated (rapid onset) or non-IgE mediated (slow onset). Symptoms will vary depending on which type of reaction and can be alarming to witness in young children. The good news is that the condition is generally seen to resolve in childhood.(1) The statistics in Australia and New Zealand show that around 2% (1 in 50) of babies are allergic to cow’s milk, with around 80% of children outgrowing cow’s milk allergy by 3-5 years old.(2)

There are more than 20 protein components to cow’s milk, the most commonly recognised being whey protein and A2 casein protein. The latter has been promoted as better tolerated in recent years which may be the case for some sufferers however, most individuals with cow’s milk allergy have a sensitivity to both caseins and whey proteins.(3)

Rapid onset IgE mediated symptoms can include:(3)

• urticaria/hives
• wheezing
• itching or a tingling feeling around the mouth or lips
• angioedema: swelling of the lips, tongue or throat
• coughing or shortness of breath
• vomiting
• anaphylaxis

Slow onset non-IgE mediated symptoms can include:

• diarrhoea
• hematochezia (blood in stools)
• abdominal cramps
• colic

While many patients present at the clinic to discuss potential food intolerances, our practitioners will always ensure there is education and awareness about the difference between food intolerances and food allergies with the potential for anaphylaxis and can arrange the right type of testing and referral on a case by case basis.

Lactose Intolerance occurs when the small intestine does not produce enough of the lactase enzyme to digest lactose, the sugar found in milk.(4)  There are 2 causes: genetically determined lactase non-persistence or the presence of another gastrointestinal disorder, known as Secondary Lactose Intolerance. Symptoms vary depending especially on the amount of ingested lactose, the residual lactase activity and the small bowel transit time.(5) A Hydrogen Breath Test can be arranged via a GP to confirm the diagnosis.

Gastrointestinal symptoms include:(4)

• abdominal pain
• bloating
• nausea
• diarrhoea
• constipation

Other symptoms may involve

• headache
• severe fatigue
• cognitive dysfunction
• muscle and/or joint pain
• skin lesions
• mouth ulcers
• heart palpitations
• eczema
• increased micturition (urination)

Secondary lactose intolerance occurs when the gut lining (where lactase is produced) is damaged for different reasons including (6)(7)(8)

1. gastroenteritis strips the intestines of lactase for a few weeks
2. parasitic infection temporarily reduces lactase levels
3. Coeliac Disease damages the gut lining causing brush border lactase deficiency
4. chronic irritation due to food allergy or food intolerance
5. Irritable Bowel Syndrome (IBS) patients are at increased risk of the condition

In these types of instances, temporary avoidance of milk and dairy products is highly recommended. People are often deterred when gut symptoms don’t resolve immediately after removing dairy or lactose from their diet but as we can clearly see in the above examples, there can be other factors that need resolving in order for effective change and a dairy-free diet can be part of the healing process.

Discuss your Dairy Dilemma with us

In some cases, choosing between a lactose-free or dairy-free diet may need some guidance. Our Naturopaths and Nutritionists are experts in all things dairy related and can assist with the decision. Next week we take a look at adjusting to dairy-free and how to get adequate calcium in the diet and also explore the lactose threshold where allowances can be made.

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