Dairy-Free Diet

Author: Heather Pratt

Many people feel best following a dairy-free diet. Some people’s digestive systems don’t produce an adequate amount of the enzyme lactase and are therefore unable to breakdown the lactose (milk sugar) in milk and dairy products. These people are considered to be lactose intolerant. Others may be allergic to the proteins (such as casein and whey) in milk and dairy products. These people have a milk allergy in which the immune system responds to the presence of milk proteins. The most common food allergy in infants and young children is to cow’s milk. Many children will outgrow a milk allergy.

What are the symptoms?

The symptoms of lactose intolerance occur within a few hours of ingestion of milk or dairy products and can include bloating, abdominal pain, gas, and diarrhea. The severity of lactose intolerance varies among individuals. Milk allergy symptoms may present as any of the common symptoms of food allergies, including skin rashes, eczema or hives; gastrointestinal distress; asthma; recurrent ear infections; runny or stuffy nose; breathing problems; or many other possible symptoms.¹

What do I need to avoid?

When eating out at restaurants and at others’ homes, always ask about ingredients. When choosing foods in packages always refer to the ingredient list rather than trusting label claims that may appear on the front of the package. The FDA requires that the top 8 allergens (milk, tree nuts, eggs, peanuts, fish, wheat, shellfish, and soybeans) be declared on the label. Milk and products that contain it will be identified either in the ingredient list, sometimes in parenthesis after an ingredient (e.g., “whey (milk)”) or immediately after the list in a “contains statement” (e.g., “Contains: milk”).

The following foods contain milk and should be avoided on a dairy free diet:

Butter
Buttermilk
Casein (aka caseinate, calcium caseinate, ammonia caseinate, magnesium caseinate, potassium caseinate, and sodium caseinate.)
Cheese (in all forms)
Cream

Curds
Ghee
Half-and-half
Ice cream
Milk (in all forms)

Read ALL labels and watch out for dairy in unexpected places like:

Baked goods
Butter flavor
Candy
Caramel
Cereals
Chocolate
Creamers
Flavors (natural and artificial)
Lunch meat, hot dogs, sausages

Margarine
Medications
Nougat
Sauces
Sherbet
Soups
Snack foods
Specialty beverages (like lattes and smoothies)
Supplements

What to Eat Instead of Cow’s Milk Products

Luckily there are numerous real foods that are naturally dairy free such as fruits and vegetables, meats, fish, eggs, nuts and seeds, legumes, grains, and oils (olive and coconut, for example). There is also a wide range of dairy-free substitute products on the market, including, cheese, cream cheese, sour cream, milk (from oat, almond, rice, coconut, etc.), ice cream, chocolate, and yogurt. Be sure to read labels to ensure you are getting a truly dairy free product.

Many people find that they can tolerate some types of dairy but not others. Dairy products made through different techniques contain differing amounts of lactose and protein. What you personally need to avoid will depend on what compounds in milk you are intolerant of or allergic to and the severity of that intolerance or allergy. If you do not have a life-threatening or severe allergy to dairy, you may want to experiment a bit to find which dairy products work for you and which don’t.

For those who are lactose intolerant, hard cheeses, butter, and heavy cream may be better tolerated since they contain only traces of lactose. Many lactose-intolerant people can also eat probiotic-rich yogurt without side effects. This is due to the bacteria in most yogurts (except frozen yogurt), which often break down the lactose. There are also brands producing products using an enzyme that removes the lactose, making these lactose-free versions a good choice for anyone wanting to avoid lactose.

Those with an allergy to milk protein will generally need to avoid all dairy products, although some may be able to tolerate ghee (clarified butter) since it has had the milk solids (which contain the lactose and proteins) removed.

In milk and products made from milk, there are different types of the protein beta-casein. Cows can produce milk with either beta-casein A1, A2 or a blend of A1 and A2 depending on their breed. In most milk and dairy products found in America, beta-casein A1 is the predominant protein, owing to the breed of cows favored here. But different breeds of cows can produce milk with A2 as the dominant type of beta casein. Some people find A2 easier to digest than A1 and therefore can enjoy milk and dairy products in which it is the dominant casein protein. Similarly, the beta-caseins expressed in goat, sheep and buffalo milk are often better tolerated because, while not technically A2, they are more A2-like.³

With so many options for people who don’t tolerate traditional cows’ milk and products made from it, a dairy-free diet can be flavorful and satisfying. Just remember that many Americans receive most of their calcium intake from dairy products. It is important to be sure to eat other calcium-rich foods (leafy green vegetables, almonds, sardines, etc.) or take supplements when avoiding dairy.

References

Krohn, Jacqueline, MD. Allergy Relive and Prevention. Hartley and Marks. 2000.
Healthwell.com. Dairy Fee Diet. Found at http://www.healthwell.com/healthnotes.cfm?contentid=1063000&org=newhopeon March 4, 2004.
Jainquin, S., Leiming, X., Lu, X., Yelland, G.W., Clarke, A.J. (2015). Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms and discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutr J, 15, 35. https://doi.org/10.1186/s12937-016-0147-z