Is dairy the culprit?
By Dr Jaci Barrett
Co-Director Diet Solutions
Dairy has been blamed for a multitude of problems, particularly those affecting the gut (IBS symptoms), nose (rhinitis) and skin (eczema). Many people have restricted dairy from their diet, some with significant relief. But as dietitians, we don’t just want to make you feel better, we want to know how we make you feel better. To us, the specifics of how food affects you is just as important as how well we make you feel.
The most well understood component of dairy that can cause intolerance is lactose. Lactose is a disaccharide (double sugar) that requires the enzyme lactase to be digested and absorbed. Without enough lactase enzyme lactose is malabsorbed, leading to an osmotic response and fermentation of lactose, which moves water and gas through the bowel causing abdominal pain, bloating, lots of gas and sometimes diarrhoea.
If you are lactose intolerant, you will need to restrict dietary lactose, but that does not mean all dairy products. Some dairy foods have very little lactose such as butter and hard cheeses. Most people will produce some lactase enzyme so small amounts of lactose will be well tolerated, such as milk as an ingredient, or in a cup of tea. You need to work with your dietitian to determine your level of tolerance.
There is some evidence emerging that a protein component of dairy may contribute to some health problems including constipation and heart disease in susceptible individuals. Pleasingly, there are now products available on the market that, despite still being dairy foods, do not contain this A1-β-casein protein. A2 milk is now widely available in Australia and is produced by cows that only produce A2-β-casein rather than A1-β-casein. Again this means a dairy free diet is not required making it easier to make a switch to improve symptoms but maintain calcium intake.
Dietary amines are natural chemicals found in a range of foods including cheese and chocolate. Amine sensitivity has been linked to many conditions including eczema and migraines. There are no amines in milk and plain yoghurt so a reduced amine diet does not need to be dairy free. Restricting dietary amines may provide benefits to many people with a variety of conditions, but it is important to note that cheese and chocolate are not the only foods that need to be looked at. Your dietitian needs to consider other non-dairy amine rich sources as well as other naturally occurring and added chemicals that may triggering your symptoms.
In general, many people find benefit when restricting certain foods from their diet but understanding why you feel better will help to ensure:
- You are aware of the specific food component causing the problem
- You are not avoiding any foods unnecessarily
- You are aware of all sources of the potential culprit
- You can then determine your level of tolerance going forward.
Been avoiding dairy? Maybe you don’t need to avoid all dairy products and you can remain symptom free whilst enjoying some dairy foods and increasing your calcium intake. Chat to one of our dietitians about your dairy sensitivity to work out which component is the problem for you.