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| What is
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Lactose
intolerance
Lactose is a
sugar found naturally in milk. It’s important to distinguish
between lactose intolerance and milk allergy, because milk
allergy can cause severe reactions.
Lactose intolerance is caused by a shortage of the enzyme
lactase, which is needed to break down lactose so it can be
absorbed into the bloodstream. When someone doesn’t have enough
of this enzyme, lactose isn’t absorbed properly from the gut,
which can cause symptoms such as bloating and diarrhoea.
Lactose intolerance can be caused by a number of things. In
humans, the body produces less lactase after the age of two.
However, in white Western Europeans, lactase can be produced
into adult life, which allows lactose to be broken down
properly.
Because of this, lactose intolerance is more common in certain
ethnic and racial populations than in others. In the UK, we
think about 5% of the general population have lactose
intolerance. In communities where milk is not traditionally part
of the typical adult diet, a much bigger proportion of people
are affected. For example, up to 75% of the black African
community and more than 90% of the Asian community are
intolerant to lactose.
Digestive diseases, or injuries to the small intestine can
sometimes cause lactose intolerance, because they reduce the
amount of lactase produced. In rare cases, the condition can be
inherited.
Milk from mammals including cows, goats, sheep and humans
contain lactose. This means that goats’ milk and sheep milk
aren’t suitable alternatives to cows’ milk for people who are
intolerant to lactose. There is no medical treatment for lactose
intolerance, but symptoms can be avoided by controlling the
amount of lactose in the diet. Adults with lactose intolerance
can often have a small amount of milk without getting any
symptoms.
(See last table for info on
egg products). Intolerance should not be confused with allergy.
See Symptoms of below.
Milk Allergy
Allergy to
cows’ milk is the most common food allergy in childhood, and
affects 2-7% of babies under one year old. It’s more common in
babies with atopic dermatitis. A reaction can be triggered by
small amounts of milk, either passed to the baby through the
mother’s breast milk from dairy products she has eaten, or from
feeding cows’ milk to the baby.
Children usually grow out of milk allergy by the age of three,
but about a fifth of children who have an allergy to cows’ milk
will still be allergic to it as adults. The symptoms of milk
allergy are often mild and can affect any part of the body. They
can include rashes, diarrhoea, vomiting, stomach cramps and
difficulty in breathing. In a very few cases, milk allergy can
cause anaphylaxis.
Cows’ milk allergy is caused by a reaction to a number of
allergens in cows’ milk, such as casein and whey. Casein is the
curd that forms when milk sours, and whey is the watery part
that is left when the curd is removed.
People can be allergic to either whey or casein, or both, and an
allergic reaction can be triggered by very small amounts of
these allergens in people who are sensitive. Heat treatment,
such as pasteurisation, changes whey, so people who are
sensitive to whey might not react to pasteurised milk. But heat
treatment doesn’t affect casein, so someone who is allergic to
casein will probably react to all types of milk and milk
products.
Milk from other mammals (such as goats and sheep), and
hydrolysed milk and soya formulas, are sometimes used as a
substitute for babies who are at risk of developing cows’ milk
allergy. However, the allergens in milk from goats and sheep are
very similar to those in cows’ milk. This means that someone
with a cows’ milk allergy might react to these other types of
milk as well, so goat’s and sheep milk aren’t suitable
alternatives for people who are sensitive to cows’ milk.
Some highly hydrolysed milk formulas are suitable for babies
with cows’ milk allergy, but other types of formula, such as
partially hydrolysed milk and soya formulas, aren’t suitable,
because many babies with cows’ milk allergy might react to them
as well.
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Symptoms of |
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Unlike a food allergy (which is triggered by
small amounts of food and causes immediate symptoms), food
intolerance symptoms appear hours, or even days, after consuming
your problem food.
Common symptoms include:
Irritable bowel syndrome
Joint problems
Migraines
Muscle and joint pain
Depression and anxiety
Fatigue
Nausea and vomiting
Ulcers and hyperactivity in children
Most people are intolerant to more than one food. The commonest
culprits are wheat, dairy products and yeast, eggs, beans, nuts,
tea and coffee.
Food intolerance can be caused by enzyme deficiencies, viral
infections, allergic reactions and disturbances of the body's
normal gut bacteria.
Eating large amounts of a certain food, spicy or processed
foods, drinking too much alcohol and exposure to toxic chemicals
may increase the risk of developing food intolerance.
The standard way of diagnosing food intolerance is eliminating
suspect foods from the diet for several weeks. If the symptoms
ease, foods are reintroduced individually and the effects
assessed - a qualified dietician should supervise this. This
process is called an elimination diet and can be hard going, but
the results are well worth it.
Many alternative therapists offer treatment for food
intolerance. Although they may be helpful, none of these methods
have been clinically validated - if in doubt ask for evidence of
clinical trials.
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Risk Indicator |
An intolerance to a foodstuff, such as dairy, is not life threatening.
NB It is important to distinguish between an intolerance
and an allergy, the latter will cause an almost immediate
reaction and can be dangerous or life threatening. |
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Triggers |
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Unless the sufferer of milk allergies/intolerances is aware of all the names
that milk (or milk derivatives) can be disguised as on a label then it is
difficult to totally avoid.
Please note that
product ingredients with a * do not necessarily contain milk products. This
depends on the manufacturer or type of product.
- ammonium caseinate
- artificial butter flavour
- butter solids/fat
- calcium caseinate
- caramel colour*
- caramel flavouring*
- casein
- caseinate
- delactosed whey
- demineralised whey
- dried milk
- dry milk solids
- flavouring*
- high protein flour*
- hydrolysed casein
- hydrolysed milk protein
- lactalbumin
- lactalbumin phosphate
- lactate
- lactoferrin
- lactoglobulin
- lactose
- magnesium caseinate
- milk derivative
- milk fat
- milk protein
- milk solids
- natural flavouring*
- Opta (fat replacement)
- potassium caseinate
- rennet casein
- Simplesse (fat replacement)
- sodium caseinate
- solids
- sour cream solids
- sour milk solids
- whey
- whey protein concentrate
Flavourings with Lactic Acid may sometimes contain derivatives of milk. So if
someone is severely allergic to milk, what happens if it touches their skin?
If a certain product touches a sufferers skin, the reaction caused is likely
to be an itchy rash, urticaria (nettle rash), sneezing, wheezing or shortness of
breath. Occasionally, anaphylaxis has been reported as a result of skin contact
with an allergen.
So what happens if the milk or it's derivatives are an ingredient of a
cosmetic, toiletry or perfume that comes into contact with the skin? Depending
on how allergic the sufferer is, they may get any of the reactions described
above. This is true for all food allergens, not just milk.
Milk derivatives may be found in hair conditioners, body creams, soaps and
face foundation creams. Casein, one of the main proteins in milk, is often
present in the lubricant coating of condoms. Casein-Free "Condomi" condoms are
available from the Vegan Society. |
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What foods can I substitute? |
Milk is rich in protein, calcium
and Vitamins A and B and it is important to insure an adequate
intake of these elements when on an dairy-free diet.
Soya is rich in protein, and other foods of importance in a
dairy-free diet are potatoes, vegetable oil and fish. Cod liver
oil or fish oils are rich in vitamin A. Calcium is found in
sardines, watercress, figs, rhubarb, almonds and other nuts.
Fresh fruit and vegetables are a good source and vitamins and
minerals (especially important for children for the formation of
strong, healthy teeth and bones).
There are a number of other milks that are available that may be
substituted for cow's milk when baking or cooking. The type of
substitute used will depend on the type of food it is used for.
Rice milk is good for drinking and putting on cereal. It can
also be used when baking or as a thickening agent. In some
recipes water, broth, or juice can be substituted for the cow's
milk.
Sometimes, a milk allergic person can use goat's milk or soy
milk. Both of these milks, however, are also very allergenic. In
fact, most people allergic to cow's milk are also allergic to
goat's milk.
Persons with lactose intolerance should never use goat’s milk.
Lactose is present in all animal's milk.
Try
Meals.com for a great range of calcium rich, dairy free
recipes
Milk
Soya,
Rice,
Oat,
Nut,
Coconut,
Sheep's Milk*,
Goats Milk*,
Ewes Milk*,
Butter/Margarine
Soya Spread (some pure oil margarines)
Yoghurt
Soya Yoghurt,
Oat Yoghurt
Cheese
Rice Cheese,
Soya Cheese (Hard/flavoured/slices/spreads)
Cream
Soya Cream,
Whip Topping,
Coconut Cream
Ice-cream
Soya Ice-cream,
Rice Ice-cream
Chocolate
Carob And Vegan Chocolates
Whole Egg
Whole Egg Replacer
Egg White
Egg White Replacer
Egg In Recipes - To Replace One Egg
As Recommended By The Vegan Society: 1
Tablespoon Gram Flour Plus 1 Tablespoon Of Water Or 50ml White
Sauce Or 1/2 Banana Mashed
* PLEASE NOTE:
Sheep's,
Goats And Ewes Milk Are Technically Not Dairy Products, However
They Have A Similar Composition To Cows Milk And May Cause
Similar Reactions/Intolerances |
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