In the September issue of healthy food guide, Laura Day investigated the growing trend in avoiding dairy, plus giving you the pros and cons of milk alternatives.
“If you asked someone five years ago what type of milk they preferred, you’d have got a pretty straightforward answer: skimmed, semi or full fat maybe soya at a push. Fast-forward to the present day though, and the answer is likely to be very different” said Day.
Cows are no longer the only providers of this staple. These days we’re buying alternatives to dairy made from many different sources: oats, rice, hemp, nuts – even peas. These ‘milks’ in various guises and varying shades of white/cream/beige are no longer a limited choice for the few.
In fact every year more and more of us are saying no to cow’s milk as trendy premium nut ‘mylks’ crop up in the nation’s health-crazed capital. So what’s changed ?
“It’s thought around 1 in 5 UK households have swapped regular milk for dairy-free alternatives. between 2011 and 2013, our yearly consumption of free-from milks soared from 36 million to 92 million litres, while last year Waitrose reported its sales of almond milk had overtaken soya milk for the first time” Day said.
This growing appetite for alternative milks goes hand in hand with our dietary awareness (a good thing), better allergy labelling (a great thing) and the current vogue for celebrity and online food blogger endorsement (more dubious). The feeling is, if the glowing elite is saying that cow’s milk is bad for them, the same may be true for us too, right?
A full-blown allergy to the protein in milk (which sets up an immune response) is rare. That doesn’t stop more of us than ever identifying with the symptoms of lactose intolerance, and the broad-brush solution is increasingly to self-diagnose and cut out an entire food group. So what’s really going on?
WHAT IS LACTOSE INTOLERANCE?
From birth we produce an enzyme called lactase. This breaks down the lactose (natural dairy sugar) in milk so that it can be absorbed into the blood. Intolerance occurs when we don’t produce enough lactase, so lactose remains undigested and ends up in the gut, where it ferments. This causes unpleasant side effects, including:
“Lactose intolerance is a difficult one, as even people who are intolerant can actually tolerate some lactose in their diet,” says Dr. Miranda Lomer MBE, senior consultant dietitian in gastroenterology at Guy’s and St. Thomas’ NHS Foundation Trust. “People who say they can’t tolerate milk find they can spread a small amount throughout the day – a dash in tea, say, as opposed to a latte.”
From birth, milk is vital to our development, either in the form of breast milk or infant formula. Once we hit our first birthday, we’re steered on to a trajectory of drinking cow’s milk for strong teeth and healthy bones. It’s a great energy source, full of protein, and packed with vitamins and minerals – the big one being calcium. It’s recommended that by the time we’re adults we get around 800mg calcium a day.
“The reason we look to milk for calcium is that it’s very easily absorbed due to the way it’s contained within dairy,” say Dr. Lomer. “Alternative milks, while fortified, don’t contain the same structures that allow calcium to be so easily absorbed in the gut. Dairy-free milks can be consumed as part of a healthy, balanced diet but we should be careful not to give regular milk a bad name – if you’re cutting it out, you need to make sure you’re getting nutritional diversity to make up for it.”
IS DAIRY REALLY SCARY?
SO IS LACTOSE INTOLERANCE increasing, or are more of us simply following a trend?
Ethnicity plays a part. Around 90% of the population in Asian countries are lactose intolerant because milk doesn’t form a huge part of the diet after weaning, but in the UK, outside of the Asian community, it’s rare for us to stop producing lactase. In fact, only about 5% of the UK population are lactose intolerant.
What’s perhaps more common, explains Dr. Lomer, is secondary lactose intolerance. ‘This is related to a temporary problem, such as gastroenteritis, when the gut has become sensitised,’ she says. ‘But we can usually recover from these incidences quickly.’ Her advice ? To add dairy gradually back into your diet after the problem has been resolved.
THE CASE OF A2
Lactose isn’t the only troublemaker.
In recent years, we’ve heard about the digestive struggles some people seem to have with a particular protein found in milk. Naturally, the food industry has come to the rescue with a dairy-based milk that’s free from this protein.
Cow’s milk contains two types of casein (milk proteins): A1 and A2. The A1 protein is the dominant in the milk produced in Europe. But according to some, many of us may be struggling to digest A1. Indeed, although research is scant, Australian-founded company A2 Milk insists those who struggle to digest ordinary milk may find solace in the alternative, naturally occurring A2 protein. Some UK farmers are now rearing cows that produce milk containing A2 only.
Interestingly, although A2-containing milk still contains lactose, research published earlier this year by Professor Sun Jianquin from Huadong Hospital in Shanghai found improved gastrointestinal symptoms in self-reporting lactose-intolerant subjects when they drank A2 milk – indicating, perhaps, that it’s not lactose that’s causing the problem but the A1 protein.
This area needs considerably more research, especially in light of a review from the European Food Safety Authority in 2009, which looked at all the available studies into the two proteins and concluded there was insufficient evidence to support the benefits of A2.
‘There’s a lot of misinformation out there and I think it goes along with current diet crazes such as gluten-free eating,’ says Dr. Lomer. ‘More of us can tolerate milk than we think, and, for the majority, it should be included in a healthy, balanced diet.’
Cow’s milk (semi-skimmed and skimmed)
Pros: It’s an easily available staple. A source of protein, calcium, iodine and vitamin B2 and particularly high in vitamin B12. Skimmed milk contains slightly higher levels of calcium than semi-skimmed (which in turn has more than whole milk) due to the processing. Skimmed milk has had most of the fat removed and is a great choice if you’re watching your calories and fat levels.
Cons: Small numbers of people have a full-blown allergy to the proteins in cow’s milk and some are intolerant to lactose – although lactose-free versions of cow’s milk are now readily available.
Almond milk (unsweetened)
Pros: It’s dairy free, low in fat and calories, and, unless you buy an organic version, usually fortified with calcium and vitamins D, E, B2 and B12.
Cons: It’s lower in protein and can’t be used as a substitute milk for toddlers due to low calorie levels. Although some contain vitamins D and E, these are fat soluble, so may not be absorbed unless you’re having the milk with a higher-fat food.
Pros: It’s dairy free and hemp seeds are rich in short-chain omega-3s (the ones found naturally in plant foods) and omega-6. Often fortified with calcium and vitamin D, so make sure you read the label.
Cons: It’s relatively low in protein compared with other milks and it it’s so readily available, although as it becomes more popular it’s entering the mainstream.
Pros: It’s a dairy free and has a pleasing taste, making it one of the most poplar alternatives. It’s fortified with vitamins B12 and vitamin D.
Cons: Although low in natural sugars and calories, it contains more saturated fat than other milk, including semi-skimmed. Plus it’s not all that comparable to cow’s milk form a nutrition point of view.
Pros: It’s a dairy free. Many are fortified with calcium and vitamin B12.
Cons: It contains low levels of arsenic, and for this reason the Food Standards Agency advises against children under 4 and half having it at all (although the amounts of arsenic are too small to be a problem for adults). It’s higher in sugars than other milk alternatives.
Pros: It’s dairy free and can be used as a milk replacement from the age of 2 if you choose the higher-fat varieties (such as Oatly Foamable). Oat milks are often a source of fibre, in particular beta-glucan, a type of soluble fibre linked to improved blood sugar and cholesterol levels. Some brands have added calcium and sometimes vitamins D, B2 and B12.
Cons: It’s relatively low in protein.
Soya milk (sweetened and unsweetened)
Pros: It’s dairy free but almost comparable to cow’s milk in its high protein content. Plus it’s low in fat, and a source of calcium if fortified.
Cons: People who are intolerant to the protein in cow’s milk are often intolerant to the protein in soya milk, too. In fact, there may be up to a 50% crossover, so it may not work as an alternative for everyone.
Pros: It has the same nutrition profile as regular cow’s milk – it’s just free from the A1 protein. It may be easier for some people to digest, although this isn’t proven.
Cons: It’s a lot more expensive than standard milk.
Pros: Nutritionally, it’s the most similar to full-fat cow’s milk. Some people who can’t tolerate cow’s find goat’s milk easier to digest.
Cons: Around 90% of people with a true allergy to cow’s milk protein (as opposed to lactose intolerance) will also have an allergy to goat’s milk protein.
Chart on the left shows the difference between milk (semi-skimmed and skimmed) vs non-dairy alternatives in calories, saturate fat, sugar, protein and calcium per 100ml serving.
PS: Do check out point 3 in this blog on: is dairy really scary ? Also, if you liked this blog then do check out this nutrition podcast. Furthermore, if you found this blog helpful, I have created a resources page where I have put all the useful things that have helped both myself and my clients a like.
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