FINDING NO-ALLERGY DIET: MILK ALLERGY OR LACTASE DEFICIENCY?
Still others cannot digest lactose, the main carbohydrate (or sugar) in milk. Normally, fingerlike projections along the intestinal wall, called villi, secrete lactase, an enzyme specifically designed to digest lactose. But lactose-intolerant people produce little or no lactase. So the milk passes through undigested, producing one heck of a belly-ache: abdominal discomfort, bloating, gas pains and often diarrhoea.
Lactase activity is generally highest at birth and slows down as we grow into adults. Many of the world’s peoples – including blacks, Mexicans, Indians, Asians and those of Mediterranean descent – lose lactase in childhood. Others, particularly whites from northern or western Europe and their descendants, lose lactase later. Also, a bout with the flu or another virus can shut down anyone’s lactase activity for several days. When the intestines are inflamed the tips of the villi are broken off and produce little or no lactase. That’s why a milk-loving child may spurn the drink – or get a tummyache from it – after a stomach virus.
Many lactase-deficient people find they can tolerate milk if they simply cut down on milk and milk products, or consume small amounts throughout the day. Others can drink milk that’s been treated with Lactobacillus acidophilus, special (and perfectly safe) bacteria that breaks down the lactose, doing the work their intestines can’t.
Lactobacillus, incidentally, is the same bacteria that turns milk into yoghurt. In Mediterranean, Asian and African countries, where people are frequently lactase deficient, yoghurt is the most widely used milk product.
Some cheeses, such as Cheddar and Cheshire, are very low in lactose, while aged Gouda and Edam are lactose-free. Cottage cheese has 86 per cent less lactose than milk.
You can also try adding Lact-Aid powder, a lactose-digesting enzyme product, to milk. (All these products, incidentally, are available in most health food stores and many supermarkets.)
Until recently, milk allergy and lactose intolerance were regarded as totally separate problems. If you had both, it was considered a coincidence. Now, some doctors are convinced that, in many people, lactase deficiency actually develops as the result of an allergic reaction to either milk or some other food. That’s because food allergy usually causes intestinal inflammation, which mows down the villi and creates lactose intolerance. Doctors who advance this theory believe that 95 per cent of the people who experience stomach distress after drinking milk have lactose intolerance secondary to an allergy of some kind. Of course, you can be allergic to milk without developing lactose intolerance.
In any case, many people with food allergies – children and adults alike – will have to eliminate milk in all forms if they’re ever going to feel better. ‘If a child comes in with a stomach ache, leg aches and a stuffy or runny nose, and they’re also drinking a lot of milk, we take them off milk,’ Dr Stigler told us.
For parents who are concerned that growing children will miss out on much-needed calcium without milk in their diet, Dr Stigler has some reassuring words. ‘Many of us working in the field of allergy feel that allergic people don’t absorb a lot of the calcium in milk. If you’re sensitive to milk, the intestines reject it. So allergic kids aren’t necessarily using the calcium in milk anyway.’ Take away the milk, says Dr Stigler, and as with most people who give up a food to which they are allergic, a child will probably feel worse for the first couple of days.
‘But their symptoms will start to clear up after the first three or four days,’ Dr Stigler predicts. ‘In a week’s time, if milk was the cause of the stomach aches and the leg aches and the runny nose or whatever, it will all go away.’
Dr Stigler also told us that, when milk is eliminated, children may eat ravenously for three or four days, whereas before they were just picking at their food. ‘Take away the quart and a half or two quarts of milk a day – the average amount an allergic kid will drink – and they’ll then make up for milk calories with other food. They’ll eat extra of something else to make up the difference.’
Milk allergy, like simple lactose intolerance, may be dose related, Dr Stigler adds, especially when it causes digestive or respiratory upset. ‘It may take half a pint or more to cause the stomach ache. But if you have a child who has eczema – a skin rash often caused by milk allergy – very often as little as a teaspoon of milk will cause the reaction.’
Avoiding milk may sound easy at first, but you have to stay on your guard against hidden sources.
‘You think you’re staying away from milk. But if you eat a hot dog or spaghetti, they may contain milk,’ pointed out Constantine J. Falliers, an allergist and asthma specialist in Denver, Colorado.
So you’ll need to read labels carefully – advice that applies to any allergy elimination plan. Look for the code words ‘caseinate’, ‘lactose’ or ‘whey’ – all are milk additives. As we mentioned before, most ‘non-dairy’ creamers contain just such milk additives. (Non-dairy creamers also contain ingredients from other foods – corn, soya, animal and vegetable fats; flavour additives; and petroleum-based chemicals – which may trigger allergy on their own.)
You can confidently buy bread, margarine and other foods marked pareve or parve – those are made without a trace of milk to conform to kosher food laws. And if you’re anywhere in the neighborhood of an ethnic bakery, drop in and stock up. Kosher bread (challah) is free of milk, as are some French, Italian and Syrian breads.
If you’re allergic to penicillin, check to find out if your dairy supplier uses penicillin before you reintroduce milk to your diet.
To cook without milk, experiment by substituting water, soya milk or fruit juice in your family’s favourite recipes.
By the way, a small number of people with milk allergy are also allergic to soya, so switching to soya milk may not clear up their symptoms. Some people can tolerate goat’s milk as a substitute; others cannot. Only trial and error will tell.
*16/65/5*
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