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Allergies and intolerances

5 questions
Q: Everything I read says I should have dairy at least once a day. Well I am a little bit of lactose and tolerant. I have a hard time taking pills and Even having anything with dairy makes my stomach turn. What else should I do to get calcium in my body. I don't want weak bones when I'm older. - Jenn
A: Calcium is a very important nutrient but it isn’t the only thing you miss when excluding dairy from your diet. Research has shown that low intakes of milk often result in low dietary intakes of important milk nutrients: vitamins A, B 6 , B 12 and D; riboflavin, calcium, magnesium and protein.

I would encourage you to consider a couple of different options before giving up on dairy entirely. In order to be digested, lactose must first be broken down by an enzyme called lactase. If you are lactose intolerant, you can supplement your diet with a lactase enzyme to help with digestion. If you dislike pills, look for liquid drops which are available at most grocery stores and pharmacies. In addition, you could also try lactose-hydrolyzed milk (which has the lactose already broken down) or yogurt with active bacterial cultures and firm cheeses; both are very low in lactose.

It is also possible to rebuild your tolerance to lactose- containing foods and drinks. Start by taking lactase enzymes and try incorporating small amounts of milk (less than 125 ml), slowly increasing the amount over a few weeks. Drinking milk with a meal or with other foods, and keeping quantities small can also help.

If all else fails, some additional sources of calcium include: Calcium-enriched soy beverages or orange juice. Canned salmon with bones, almonds, sesame seeds, beans, broccoli, kale, bok choy, oranges, and figs. However, most of these are much lower in calcium per serving so you will need to include more servings to make up the difference.

Nicole Springle, RD


Q: I am lactose intolerant but can not stand the alternatives for real milk (rice milk, soya products etc.) I want to be as healthy as possible but have a really tough time finding recipes that are truly healthy without using cheeses and milk products. For example I love smoothies and pastas but most have milk in them. Is there a website or cook book out there that is specific for lactose intolerant eaters like me? I am 29 years old, female, 5'4, 129 lbs. - rlinnm
A: While lactose intolerance can make it difficult, it is not impossible to incorporate milk products into your diet. The good news is that most individuals with lactose intolerance can easily tolerate one cup of milk with a meal, or two cups consumed over a few meals. In fact, studies have shown that women with limited lactose digestion can still comfortably consume enough milk, yogurt and cheese to provide up to 1500 mg of calcium per day.

Many people who develop lactose intolerance are able to reintroduce lactose-containing foods into their digestive systems and adapt to consuming these foods without discomfort in little time. Smaller quantities of milk products, taken with meals or other foods and spread throughout the day, help to increases lactose tolerance.

I recommend starting with a half cup of milk at meals and adding milk products containing very little lactose such as yogurt and hard cheeses. By gradually introducing milk products back into your diet, chances are you should be able to recondition your system to tolerate these foods, which means you can enjoy them worry free!

If you are still having difficulties, you may want to try taking an oral lactase supplement before consuming milk products (this helps with digestion) or try lactose-free milk and cheese.

If you are looking for great recipes check out the “Healthy recipes" section on the website, where you are sure to find some tasty options that will fit your preferences. Enjoy!

- Nicole Springle


Q: My son is allergic to milk and all dairy related products so we do not have any dairy in our diet. What is the best way to companste for this? - Heather
A: I’m assuming that you’ve had this allergy diagnosed by your family doctor. Many people who think they have a milk allergy usually have something else. Less than 1% of adults and 3% of children have a clinically proven milk allergy, and children tend to outgrow a milk allergy by the age of three.

People who have a confirmed milk allergy and need to cut out milk products from their diets, need to make sure they get the 15 essential nutrients milk delivers from other sources. For your son, this would mean making sure he’s getting enough calcium and other bone-building nutrients, protein and vitamin B12.

Because I don’t have any more information, e.g. your son’s food likes and dislikes, I would ask your doctor for a referral to a registered dietitian who can personalize a plan for you.

- Zannat Reza


Q: Can you tell me if buttermilk has casein in it. My child is intolerant of casein and I know that if you clarify butter the casein goes to the top and the buttermilk sepaates to the bottom. Is commerical buttermilk the result of this same process? - mnobauer
A: For people with a milk allergy, a key protein in milk called casein is what causes a reaction. It would be wise to confirm with your physician that your child does, in fact, have an allergy to casein. If your physician has confirmed this allergy, then you will need to find alternatives to dairy products for your child. If your physician hasn’t already, please ask that he or she refers you to an allergy specialist and a dietitian so they can help you understand what food choices you will need to make to keep your child well nourished and healthy.

Buttermilk does contain casein.

Old fashioned buttermilk was the slightly sour liquid remaining when cream was churned to make butter. It was usually flecked with tiny spots of sweet, creamy butter that didn't quite make it to the top to be skimmed.
Today, most commercial buttermilk is made by adding a lactic acid bacteria culture to pasteurized milk. After the addition of the culture, the milk is left to ferment for 12 to 14 hours at a low temperature. It is usually labelled cultured buttermilk and may be salted or unsalted.
Lois Ferguson


Q: I have lactose intolerance, allergy towards milk and milk products since childhood. Im 50 years old. How can I compensate for that in my diet. Thank you for your kind assistance. - catherine
A: One point that is very important to establish is whether you have a lactose intolerance or a milk allergy. Lactose is the sugar in milk and lactose intolerance results from the lack of the enzyme that is necessary to digest lactose. However, an allergic reaction to milk involves a response of the immune system to the proteins in milk.
The good news if you are lactose intolerant is that you can still consume milk and milk products in small quantities or find products that contain less lactose. Mozzarella, blue, brie, swiss and cheddar cheeses contain minimal amounts of lactose. Yogurt contains bacteria that help to digest lactose, which also helps to reduce the load on your stomach. In addition, many people can tolerate small quantities of milk with meals. Another option is to use lactose reduced milk products or lactase pills or drops.
Milk products naturally contain 15 essential nutrients and provide one of the most reliable sources of calcium in the diet. If you truly suffer from a milk allergy you should consult a Registered Dietitian to help you replace the nutrients that may be lacking in your diet. You will likely need to carefully select foods that contain calcium; however, as very few foods come close to the amount naturally found in milk products, you may need some help with this. You can also check your intake of calcium and other nutrients on www.eattracker.ca. If this is a lactose intolerance you can still incorporate numerous milk products into your diet; however, food allergies really require more careful attention and assistance from a professional. Nicole


 
This site is brought to you by the Registered Dietitians at Dairy Farmers of Canada with a reminder that physical activity and healthy eating habits that include milk products is the perfect combination for staying in shape.
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