My love-hate relationship with dairy products

I have a bit of a love-hate relationship with dairy products. I love, generally speaking, how they taste. I also like the fact that dairy products (e.g. cream, cheese) are relatively rich in protein and fat, and (importantly) not so rich in carbohydrate. Their nutritional profile is, therefore, kinda in line with ‘primal’ foods such as meat and eggs that, on the whole, are ‘right’ for us from a nutritional perspective.

But on the other hand, I know from experience dairy products can sometimes trigger food sensitivity reactions that can manifest in a variety of ways. I found this out initially first hand. More-or-less lifelong eczema disappeared in my mid-20s when I took dairy products out of my diet. When I put dairy back in, the eczema came back. Out again, and away went the eczema once more.

Now, I know there will be some who will claim this is not a particularly scientific way of diagnosing dairy sensitivity. But then again, there’s nothing very scientific about stating “When someone punches me hard in the face it hurts” (but it’s true). Also, call me old-fashioned, but I do think there’s tremendous value in listening to one’s body, and (as a doctor) listening to what people tell me about their bodies. If we don’t, my experience is it’s not good for ourselves or those we might be attempting to help. For an example of this, see here.

When I started to use more nutritional therapy in my clinical practice, I became even more convinced of the role of dairy products in certain symptoms or conditions. I honestly have lost count of the number of people who have been cured of their eczema, asthma, sinus congestion, mucus/catarrh or whatever on elimination of dairy products.

In natural medicine, it is sometimes thought that individuals can get quite wedded to the foods that they are sensitive too. So, someone who is dairy sensitive might is often very keen on these foods, and might even crave, say, milk and cheese.

A couple of weeks ago I was giving a presentation and was talking about coffee (I’m a relative fan) when a gentleman in the audience asked about lattes (milky coffee). Look there’s nothing particularly scientific about this but I have noticed over the years that individuals who drink big milky coffees at least once a day usually have a dairy issue. I mentioned this association to him, and also mentioned how this may manifest (including sinus issues). This man responded “Actually, I do have persistent sinus problems.”

But the story does not end there. The event I was talking at was followed by a dinner, and I ended up sitting next to this man during the meal. After the main course and pudding, the cheese board came round. He took a selection and started eating it, while at the same time talking to me. As he progressed through his cheese course he became noticeably more congested and ended up having to blow his nose.

I remember a similar thing happening over a dinner which was attended, by chance, with an old tutor of mine from my medical school days. After he asked what I did, he enquired as to whether there was something he could recommend for his chronically bunged up sinuses. I suggested he might try a trial without dairy. He seemed keen to give it a go. However, he was even keener to try this approach after the pudding: half way through a bowl of ice cream he became noticeably congested, and repeatedly had to clear the phlegm from his throat.

Now, not everyone is dairy sensitive, but my time in practice has convinced me that it’s common enough for it to require more widespread recognition.

If someone is dairy sensitive, it’s really one or both of two dietary elements they are likely to be reacting to: lactose (a sugar) or dairy proteins such as casein. Lactose intolerance (an inability to digest lactose) tends to cause digestive symptoms such as bloating, wind and diarrhoea. It is probably protein-specific sensitivity that is responsible for all the other stuff including asthma, eczema and ENT symptoms.

Not all dairy products, in my experience, have the same capacity to generate problems from a food sensitivity perspective.

For example, raw (non-pasteurised) milk products generally seem to be very well tolerated, while pasteurised products are much more commonly an issue. Part of the explanation for this may lie in the fact that pasteurization can change the protein molecules in dairy products in a way that makes them harder to digest, and will therefore make them more likely to trigger problems.

Also, in practice I find that yoghurt is better tolerated than milk. Studies show that the bacteria deployed in the fermentation process that converts milk into yoghurt aid the digestion of milk proteins [1]. The pre-digestion of protein by bacteria helps to explain why, compared to milk, yoghurt is less likely to trigger unwanted reactions.

An added benefit to be had from yoghurt is that some strains of bacteria used in the making of yoghurt have lactose-digesting ability, and this is reflected in the fact that yoghurt contains less lactose than milk. As a result, those who struggle to digest lactose generally find they tolerate yoghurt better than the milk from which it is derived.

In practice, foods such as cheese and ice cream seem to have roughly the same potential as milk to induce food sensitivity reactions. Butter, on the other hand, is generally very well tolerated indeed, and this may have something to do with the fact that it is exceedingly low in the protein and lactose elements that are usually at the root of food sensitivity reactions.

Another common finding is that individuals who react to cow’s milk-based products, do not react as badly, and may not react at all, to products made from dairy products from other animals such as goats and sheep. Why this may be is not known for sure. However, it has been suggested that milk from these animals is, compared to cow’s milk, more similar to human milk, thereby making it easier to digest and more appropriate for our consumption. Also, there is a school of thought which says that the earlier a food is introduced into the diet, and more of it that is eaten, the more likely we are to become sensitive to it. While cow’s products usually are consumed in quantity from early on in life, this is generally much less true for goat and sheep products.

I’ve seen many individuals shift from cow’s products to goat’s or sheep’s products and do much better for it. In children, for instance, just this shift is often enough to clear up persistent ENT problems including glue ear and recurrent sore throats/tonsillitis.

A bit of trial and error is sometimes required here, but it’s often worth it. I, for example, have worked out over time that I can consume butter and plain yoghurt (of any form) and goat’s products with no problems. However, cow’s milk and cheese is a problem for me, if consumed in significant quantities. Now I know that, I can adjust my diet accordingly. And if, for whatever reason, I decide to choose the cheese platter, then at least I know why I’m later full of mucus and have the beginnings of eczema back again the following day.

References:

1. Beshkova DM, et al. Production of amino acids by yoghurt bacteria. Biotechnol Prog 1998;14:963-965

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29 Responses to My love-hate relationship with dairy products

  1. Dennis 9 April 2010 at 4:24 pm #

    I cannot agree with you about modern cows milk being a primal food.
    Firstly milk has only been consumed by humans for a few thousand years, vis a vis animal flesh foods which have been consumed for tens or hundreds of thousands of years – I do not believe our genes have time to adapt properly.
    Secondly, modern milk is highly optimised for yield. In particular breeding has been performed (based on a mutation)to provide milk with type A1 casein rather than type A2 casein. The other common mammals provide milk with type A2 casein. Type A1 casein is particularly allergenic whereas type A2 casein if more benign.
    Thirdly, our predecessors consumed raw milk. It is now pasteurised which arguably makes it more difficult to digest and decreases nutritional value. Can you imagine taking mother’s milk, pasteurising it, then giving it to a baby and expecting baby to survive ?
    Fourthly homogenisation is not natural and has been implicated in health problems.
    If one must consume cows milk, unhomogenised whole milk from Guernsey and Jersey cows should be best because these cows still produce a good amount of type A2 casein whereas others provide only type A1 casein (the problem of pasteurisation still remains of course – raw milk would be better if available). Also consider goats milk.

  2. simona 9 April 2010 at 6:09 pm #

    The fact that milk is not a paleo food doesn’t mean that it is not healthy. However, I agree with Dennis that cow’s milk is not the food it was even 100 years ago and I would like to add that nowadays we get milk from cows that are pregnant so the hormonal load becomes an issue too.
    I am thinking of removing milk products, except butter, from my diet to see if my acne improves. I only started having serious acne in my early 30s after I moved to Ireland and started consuming homogenised milk. (I used to eat a lot of cottage cheese and yoghurt as a child.) It might have been something else, the fluoridated water for example influencing my hormones, who knows?
    It is near to impossible to find raw milk in Ireland as it is illegal to sell it and Jersey cows are hard to find too. I am trying to eat only sheep and goats cheese and rarely raw cow’s cheese but still wonder about the hormones.
    Dr. Briffa, can you comment on the link between milk and acne?
    Thank you.

  3. frances 9 April 2010 at 7:42 pm #

    Recently, after a mention in Dr Briffas posts, I went to the Weston A Price Foundation talk on nutrition in London. There was too much info to be able to precis here, but a look at their website http://www.westonaprice.org will give you an idea of the research and ideas they have, which has completely changed my way of thinking about food, especially dairy produce and meat. The point is that the dairy must be ‘raw’ (easier in France) and the meat pasture fed.
    I am not a scientist, but what they said made absolute sense and completely convinced me to alter my diet to include more saturated fats, and I am even thinking of trying to eat meat again after 22 years of being a vegetarian. Thank goodness I didn’t give up sustainable fish.
    I have struggled with IBS for a long time, to the point of not knowing what I could eat as I had ommitted so much from my diet, but I feel now that I have the tools to be able to do something about it. The biggest problem is finding the foods to eat, as unpasterised seems to be something you have to buy direct from the farm, but they are out there.

  4. Lillea Woodlyns 9 April 2010 at 8:22 pm #

    I seem to react to dairy products from all of the common sources (cow, sheep, goat) in all forms including raw. Common symptoms for me are acne and congestion.

    I tested positive for casein intolerance via Enterolab in the US. Although the testing is a bit general – it only tests for ‘casein’ not each type of casein – it confirmed what I suspected about myself.

    I was put on cow’s milk formula when I was a baby and was allergic to it, and then for a while after that (perhaps 6 months) was allergic to almost all foods. I was then put on soy formula which I know is horrible stuff, but I wasn’t allergic to it so I understand why my mother did what she did back then. She didn’t know some of the information that we know now.

    After years of researching this, including the difference between a1 and a2 casein, and spending time on good forums like the free Yahoo group GFCFNN (gluten free casein free native nutrition) my conclusion is that some people for whatever reason cannot tolerate the proteins in dairy and probably never will. Avoiding dairy for a while may mean that they can eat a small amount from time to time and not react, but if they start to consume it regularly, the problems crop up again.

    There are many cultures in the world where little to no dairy products were consumed so it makes sense that some people might not be suited to it – that it isn’t just about food changing or too early exposure like I had. Consuming milk is definitely not a traditional thing, but consuming fermented dairy, in cultures that consumed it, is.

    Ghee (so milk protein is removed) is the safest for anyone who is casein intolerant, like me, but I find that I break out from it so it’s out. I don’t break out when consuming coconut oil, olive oil or macadamia nut oil or a number of animal fats so as much as I love the taste of butter, I do my best to avoid it.

  5. Angie 9 April 2010 at 10:26 pm #

    I am not sure that it is necessary for any of us to have a love-hate relationship with specific foods. There are clearly some populations who, in evolutionary terms, are less able to tolerate certain foods (e.g. lactose intolerance amongst people of Asian descent, as against, say, the Swiss and other Alpine populations – see Weston Price).

    My working assumption about all food intolerance/allergies is that it is not the food that is the source of the difficulty, but the way the body is responding, and it is therefore that which one should be trying to tackle. Avoiding the food deals with the symptoms pro tem, but doesn’t deal with the underlying cause.

    In my experience, allergies also come and go, appearing when – for whatever reason – one is up against it, and disappearing mysteriously when health and well being is restored. For example, a friend of mine, who is Jewish, and therefore more susceptible to lactose intolerance only became so following an ill-judged course of anitbiotics, which would implicate damage to intestinal flora.

    Some of the causes may be deficiency states (e.g. of B vitamins or unsaturated fatty acids for skin conditions), some may be things like a leaky gut, but I don’t think we should ever just accept that we are intolerant to this or that and move into a lifetime of avoidance. In short, even though we all talk as if ‘wheat’ or ‘dairy’ is at fault, it isn’t the food that is the problem!

  6. rox 9 April 2010 at 10:39 pm #

    Simona,
    my husband says his adult acne and sinus problems have stopped now that he’s cut out cows’ milk products (except butter). He can’t even tolerate yogurt or ice-cream. But goats’ milk products are ok. Dr Briffa recommends zinc for acne in Natural Health for Kids (page 31).

  7. Nancy LC 9 April 2010 at 10:41 pm #

    I am sensitive to dairy too, although my symptoms seem to change over the years. My last cheese-fest resulted in a prolonged arthritis attack in my foot, but I’ve had the mucus issues and sinus infections too. Another strange symptom was muscle spasms.

    I experimented with goats milk, yogurt and so on but it seems I can’t get away with any of it.

    I haven’t tried raw dairy products as they’re usually extremely expensive here.

  8. Jamie 9 April 2010 at 10:43 pm #

    John,

    It is interesting that you mention that individuals will often be drawn to or crave the very foods they react to. I see this in practice with gluten, particularly with bread as the main source. There is some good work about looking at gluten acting as an exorphin (an opioid-like substance) and its addictive potential. One of the effects of this exorphin exposure is the associated attachment behaviour.

    Both in my nutrition practice and in my lecturing, I have seen very extreme & emotional reactions to the thought of removing bread from the diet. Now some of these people would seemingly give up air than give up bread. The reaction is quite fascinating to watch. These people will know how they feel when they eat bread – that they feel bloated, lethargic, cranky, sleepy, emotional, etc. Yet the promise of a resolution to these symptoms is not enough in itself to prise them away from that initial feeling of satisfaction of consuming that food.

    I’m not sure if dairy can have the same exorphin-type potential, but it might explain the attachment that people have to foods that they probably know causes them problems.

  9. simona 9 April 2010 at 11:49 pm #

    thanks Rox. I haven’t had any sinus or mucus problems, and I’m taking Zinc with copper in a multivitamin for a while now.
    I only started eating yoghurt again recently for the probiotics as I stopped all milk and yoghurt a while ago.
    I have been taking probiotics capsules too in an attempt to improve my gut flora. It’s not clear for me though when should the probiotics be taken. Udo Erasmus says after a meal, somebody else that in the morning it’s better on an empty stomach. Does anyone know which ones are entero coated so they don’t dissolve in the stomach? I’m worried that I’m paying for them and then they’re all killed by the acid in the stomach.

  10. Dennis 9 April 2010 at 11:51 pm #

    Simona and others – I accept that there is no point in having a love hate relationship with food and that just becuase a food is not paleo it should not be eaten. We cannot prove a particular food is good or bad but we can make a risk assessment and consume less of the more risky foods, more of the less risky food (just like a financial portfolio for instance !) My rule of thumb is the nearer to nature, the lower the risk and following his rule has helped my IBS immensely. Non paleo foods are therefore a bit riskier tha paleo foods but this does not mean they should be excluded, rather they should not be over-emphasised. My point about modern cows milk is that is hugely different from the raw milk the isolated Swiss consumed (see Weston A Price) ,for instance, hence I only consume very small amounts of gold top and some New Zeaand butter (yellow and most likely to be pasture fed). Also modern wheat is nothing like wheat that was consmned a few hundred years ago – I can tolerate some spelt (early wheat) but what plays havoc with my IBS. For IBS and general health the rule is to eat food in as near to their natural state as possible – therefore I minimise/avoid refined and processed foods and intensively farmed foods such as modern milk and wheat. Oats, brown rice and even rye are nearer nature than modern what and better tolerated.

  11. Jill H 10 April 2010 at 5:29 am #

    Hmm – well I think I would say that I have had a ‘love hate’ relationship with dairy all my life. As a child I was termed ‘sickly’ and failed to thrive and so, as a child of the early 1950′s when food rationing was still in operation, as well as my free quarter pint bottle of milk at school, my mother in a bid to get me to eat something used to feed me milky, malty drinks because that was the wisdom of the day. I always had bad breath and stomach upsets until I was old enough to make the connection and refuse the cow’s milk. I still never drink milk but a period in the 1980′s of living in The Netherlands exposed my family to a ‘real’ cheese shop where raw and artisan cheeses, mostly cow’s but also goats and sheeps could be purchased and my children’s favorite meal became ‘bits and pieces’ – a plate containing raw nuts, raisins, a small piece of cheese, apple and carrot. Both my husband and I continue to eat small portions of ‘artisan’ cheeses, mostly sheep or goats with apple, celery, carrot or grapes – never with bread or biscuits and this works for us. This started my reconnection with dairy – but as Dr Briffa has said – it isn’t scientific just listening to the body. I very rarely eat cows but have a small portion of sheeps (my favorite) or goats yoghurt in a smoothie in the morning or as a desert. I find I tolerate this very well, and the Balkans, Bulgaria in particular are very proud of their remarkable number of people who live to be over 100 and attribute it to their yoghurt. Interestingly, Maguelonne Toussaint-Samat in her amazing book ‘A History of Food’ seems to suggest that the earliest cheeses man consumed were probably made from goat’s or sheep’s milk because goats and sheep will adapt to any climate and browse on any kind of weeds.

  12. McHarris 10 April 2010 at 6:31 am #

    ANGIE: I am very interested in your hypothesis that it is NOT the food that is the problem????

    Some of the causes may be deficiency states (e.g. of B vitamins or unsaturated fatty acids for skin conditions), some may be things like a leaky gut, but I don’t think we should ever just accept that we are intolerant to this or that and move into a lifetime of avoidance. In short, even though we all talk as if ‘wheat’ or ‘dairy’ is at fault, it isn’t the food that is the problem!

    I am diagnosed with MULTIPLE food chemical intolerances – gluten, dairy, MSG, SOY, Salicylates, AMines, Lectins, Glutimates….. IF I consume them I AM ILL….. I have been off them a considerable time, and rechallenged them as (it was hopes) my body might be healing – and I can assure you I am still frightengly intolerant of the,. EG I rechallenged dairy again this week by taking obe spoon full of top quality pure King Island Yoghurt each day.

    Day one – gut pain and trotskies
    Day two – gut pain and trotskies
    Day three – above plus leg pain, arm pain, back pain
    Day four – above plus entire body pain
    Stopped yoghurt
    Day eight – gut has settled down and body pain is slowly dispersing

    The same happens with salicylates etc … so how long exactly if it is GIT related, does it take for the gut to heal before a person is supposedly cured?

    By removing the offending items – all as stated above, I can live a moderately (not entirely) pain free existence, by reintroducing them I am crippled again.

    I question your hypothesis.

    I also have attempted goats milk and such products – they do not work for me. Menu planning is very difficuly when many (so called essential items) are not allowed as part of your diet, but the option is to tie oneself to the parmaceutical industry for the remainder of my life – sorry folks that is not my idea of living!

  13. Mike Slavin 10 April 2010 at 9:43 am #

    I have trouble with mucus – chronic catarrh, and have tried to give up dairy products for a period, going on to soya milk, etc., for up to 6 weeks – with little discernible effect. From this discussion I’m sure I should go further, perhaps eliminating other foods, but my question is for how long one has to eliminate them to get a positive reaction. 6 weeks seems to be a long time given the metabolic process times in the gut.

  14. robin dowswell 10 April 2010 at 7:47 pm #

    Jamie,

    If you come back to this post then check out the wiki entry for casein. It points to studies that confirm the opioid potential of dairy products.

    ^ Kurek M, Przybilla B, Hermann K, Ring J (1992). “A naturally occurring opioid peptide from cow’s milk, beta-casomorphine-7, is a direct histamine releaser in man”. Int Arch Allergy Immunol. 97 (2): 115”20. doi:10.1159/000063326. PMID 1374738.

  15. Chris 11 April 2010 at 4:27 am #

    Just out of curiosity is there reason (evidence or anecdote) to think or explore the notion that including more fibre in the diet, soluble fibre in particular, may mediate (give some relief by degree) some of the reactions and intolerances described above?

  16. simona 11 April 2010 at 4:46 pm #

    Chris,

    Have a look at dr. Art Ayers’ blog Cooling Inflammation and his recommendations regarding fibers like pectin and inulin for beneficial gut flora.

    http://coolinginflammation.blogspot.com/

    Eat your onions, leeks, tomatoes and an apple a day seems to be the conclusion. Probiotics and live yoghurt.

    Yes, milk products have an addictive quality (through opioid like peptides and probably the fat content too) However, I can see that that could be explained from an evolutionary point of view (for the offspring). Wheat and sugar cause addictions too, and unfortunately some people are in denial about that, as you say Jamie.

  17. Jill H 11 April 2010 at 9:01 pm #

    Interesting Chris. I don’t know scientifically, but it got me thinking. There is no doubt that eating a little sheeps cheese say with an apple (soluble fibre?) works for me whereas eating the same cheese with bread or biscuits – of whatever variety, rye, oats, spelt instead of whole wheat (?insoluble fibre) usually ends up in discomfort – pain. I have wondered whether the enzymes in the fruits or vegetables have helped but never thought about the type of fibre and certainly the fibre contained in grains seems not to help. The other success story for me in my love hate relationship with dairy is the occasional use of a probiotic.

  18. jo 11 April 2010 at 10:21 pm #

    i have also had problems with dairy…i cut it out about 15 years ago on your advice… and after that was diagnosed with lactose intolerence by the dr’s too. i couldnt even eat a yoghurt without getting an upset stomach, although could tolerate a small amount of goats butter, cheese and even milk in some foods

    however i started to try raw cows milk a couple of months ago… and was able to add a glass full to my museli in the morning without any reaction, i even drank a glass of hot chocolate with warmed raw milk and raw chocolate powder and no side effects!!

    after not having any dairy for so long (and not particularly missing the taste) i am not sure if i should stay dairy free, or that it will beneficial to me to continue with this raw milk daily? i do think there are some advantages of raw milk… just not sure if they are better than having no dairy products?

    i guess i will continue with it a while longer and see if my health changes…

  19. Alannah 12 April 2010 at 9:30 pm #

    Is raw milk really safe? It’s freely available here in France, but I’ve been warned off it by scientist friends because of the “high fecal content” – I quote. I eat plenty of unpasteurized cheese, though, with no ill effects – why should milk be seen as more risky?

  20. Chris 13 April 2010 at 11:56 am #

    Recently I saw (or heard) reference to a feature that discussed gut flora in the context of how changes to dietary inputs determine changes to the balance of gut flora. The striking content of the piece (if my recollection is correct) was reference to the possibility of cross generational ‘carry over’ of diet induced changes in the balance of gut flora.That’s to say that if a parent (mother in the main, I should think) eats a poor diet and suffers denuded gut ecology accordingly then such a trait may be passed to offspring. I’ll try to recall the source.

  21. frances 15 April 2010 at 1:46 am #

    Hi Alannah,
    Where do you find the raw milk in France? I’m trying out the Weston A Price way of eating, live in Normandy, and have no probs finding creme fraiche, butter and cheese that is unpasterised…..but not milk

  22. Alannah 16 April 2010 at 9:53 pm #

    Hi Frances,
    I live in Paris surrounded by “bio” shops and fantastic fromageries, & can get it in many of these. But I always hesitate because of the bacterial risk, which no-one seems to have broached. Wasn’t pasteurization originally crreated to reduce the chance of disease?
    Oh, and Monoprix has filtered milk, but I’m not quite sure what that is…

  23. frances 17 April 2010 at 1:37 am #

    Hi Alannah,
    Ah Paris……here in rural normandy, where it is probably produced, you can’t find it! Luckily I can get everything else. So I am going to try making my own Keffir which sounds even better than raw milk.
    Apparently, if your gut is healthy, you can deal with any bacteria in raw milk…
    There is loads about all this on the Weston A Price website.

  24. Daisy 17 April 2010 at 11:40 am #

    Hi Frances, I would be interested to hear how you get on with the kéfir – I mean, what does it taste like?! Thanks

  25. ST 11 June 2010 at 11:55 am #

    Interesting article and one I can relate to.

    I spent over 2 years going to the doctors with a chronic sinus problem that came on suddenly. Prescribed with decongestants/ nasal sprays which didn’t fix the problem at the root at all. As a trial I eliminated milk from my diet and reduced dairy in general. The results were incredible. Despite being told by my doctor that milk was unlikely to be the causing factor it was. I spent years with the familiar morning congestion and mucus, thinking there was nothing I could do about it. I’ve now seen a few other people get similar results on cuttin out or reducing their milk intake.

    I think your point about listening to your body is vital. Too often when advice is given based on general theories, we forget we all have unique chemistries which are telling us all the time when something is wrong. I am a firm believer now in using dietary changes to try to eliminate the root of problems than taking pills to address the symptoms.

  26. drora kemp 19 September 2010 at 5:57 pm #

    I have hated dairy products ever since I remember myself. I can taste a trace of butter in baked products, the smell of croissants makes me gag, I can’t eat cakes with whipped cream toppings and had my first cheese cake when I baked a Toffuti one. I am Caucasian and my parents were normal dairy consumers.
    When I visited Paris, the Mecca of food, I lived on baguettes with turkey and olives.
    My cholesterol levels are great, but can’t help, when looking at mountains of gourmet cheeses or baked goods, wishing to be reborn a normal, dairy-ambivalent person. Moreover, I have never met anyone with my affliction. Has anyone done so?

  27. Jeremy 24 August 2011 at 2:25 am #

    Well i eliminated dairy from my diet – and along with it went chronic sinusitus (had an operation for this), chronic dandruff and eczema. Frankly – it works.

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