Lactose intolerance is a really common digestive problem that can leave you feeling bloated, nauseous and crampy whenever you consume lactose.
Lactose is a type of sugar that’s mainly found in milk and dairy products, but there’s often confusion when it comes to dairy intolerance – and that’s because there are two main ways you can be intolerant to milk.
You can be lactose intolerant, where you struggle to digest a sugar found in milk.
Or, you can be milk protein intolerant and have issues with a specific protein found in the white stuff.
Dr Gill Hart, a food intolerance expert with YorkTest Laboratories, says: ‘There’s a great deal of confusion about milk intolerances. It’s important that people have the right information to help them manage their symptoms.
‘Someone might recognise that they get a reaction after drinking milk, and assume they have a lactose intolerance.
‘But it’s actually just as likely you’ve got a milk protein intolerance, which manifests in different ways – and the action that you need to take to make a difference to your lives is different too.’
What are the symptoms of lactose intolerance?
Common symptoms associated with an overall dairy intolerance are similar to IBS symptoms.
These include abdominal pain, bloating and excess wind – as well as skin complaints like eczema, psoriasis, urticaria, rashes, itchy skin, and headaches, migraines, weight gain, tiredness and fatigue.
Symptoms can begin between 30 minutes and two hours after consuming lactose. These symptoms are not nice, but they are not life threatening.
Dr Hart adds: ‘Both lactose intolerance and milk protein intolerance can cause digestive issues.
‘With a milk protein intolerance, it is highly likely that four or five different other foods are also contributing to the problem as well, and so you need to find out what those foods are.
‘As well as digestive problems, milk protein intolerance causes other symptoms – such as migraines, headaches, fatigue, and skin issues.
‘With lactose intolerance the symptoms are usually digestive problems, as the body can’t digest the sugar.
‘But unless you get properly tested, you won’t know if you’re dealing with a lactose or a milk protein intolerance issue. To complicate matters further, some people have both lactose and milk protein intolerances.’
There are also ramifications when it comes to long term care.
‘With a milk protein intolerance, you may be able to tolerate milk in the future after an initial elimination diet,’ says Dr Hart.
‘You can’t do that with a lactose intolerance – you’ll have that for the rest of your life, and you may benefit from taking lactose enzyme supplements if you want to try and continue to eat food containing dairy’.
What are the differences between lactose intolerance, milk intolerance and a milk allergy?
To add to the confusion, milk and lactose intolerances are also extremely different to a milk allergy.
Milk allergies manifest with things like a swollen tongue or lips, difficulty breathing and vomiting – and it can be potentially deadly, too.
If you suspect you’ve got a milk allergy, or a lactose intolerance, you need to consult your GP.
Lactose intolerance affects around 5% of the population, milk intolerance affects around 45% of the population, and only approximately 2% of the adult UK population have a milk allergy.
Lactose intolerance is caused by a reaction to the sugar in milk, and it’s triggered by a deficiency in the enzyme lactase in the body.
Milk intolerance is caused by a reaction to the protein in milk, and it’s triggered by a response of your body’s immune system.
A milk allergy is also caused by a reaction to the protein in milk – but the more severe symptoms is due to the response from a different antibody in your immune system.
Can lactose intolerance be cured?
The bad news is that a lactose intolerance is a lifelong condition, but it can be treated by avoiding products that contain lactose and by taking lactose enzyme supplements.
If you have a milk intolerance, it isn’t necessarily for life. You could potentially tolerate milk after trying an elimination diet.
If you have a milk allergy then it is possible to outgrow this condition. But until that happens, the only thing to do is avoid all milk products.
But that’s not always as simple as you might think it is.
Dr Hart says it can be tricky to remove dairy products from your diet because milk goes by many other names in food ingredients lists.
She advises: ‘If you’re cutting dairy from your diet, you’ll typically ditch milk along with things like yoghurt, cheese, ice cream, and butter.
‘But milk products in foods can also be listed as Lactoglobulin, Lactalbumin, Casein, Caseinate.’
If you think you might have a milk protein intolerance, a blood test can pinpoint the precise nature of your sensitivity.
Explaining the principles behind the practice, Dr Hart says: ‘A food intolerance is essentially someone experiencing reactions to certain foods.
‘When food particles enter the bloodstream, the immune system can sometimes identify these food protein particles as “foreign” and produces what’s known as “IgG antibodies” to “attack” the food in question.
‘This response is your immune system’s natural defence mechanism to ward off harmful invaders in the body which can create inflammation.
‘So, essentially, these IgG reactions go hand in hand with gut imbalances and inflammation and are released in the presence of certain trigger foods.
‘A good food intolerance test works by measuring which foods cause food-specific IgG reactions, so that people can then be advised on which foods they might wish to cut from their diet.’
Debates about the benefits of milk continue to rage in the UK.
A study released in September last year, conducted by McMaster University, Canada, found that eating three small portions of dairy a day may actually protect against heart disease and stroke.
Others, however, question the merits of milk when it’s a product humans have had to evolve to be able to digest.
What are the best dairy-free milk alternatives?
Alternative milk sources – such as coconut, rice, oat, almond, hazelnut or soya milks – are booming in popularity in the UK.
Soya milk has been the most popular non-dairy substitute for decades because its nutrition profile closely resembles that of cow’s milk.
In place of butter you can use coconut oil, or mashed avocado.
There are now plenty of non-dairy vegan ‘cheese’ products now available in mainstream shops – including frozen pizzas and vegan mozzarella bites.
Dr Hart says that when it comes to making a good old-fashioned cup of tea, soya milk has the trump card.
The YorkTest Laboratories team recently put a range of alternative milks through their paces to make the perfect dairy-free brew.
‘We tested a range of alternative milks to find how well they made tea. And after rating them on colour, aroma and taste the results were interesting to say the least,’ explains Dr Hart.
‘The variation was huge – some decided to split and curdle, giving a grainy and unappealing appearance, whilst others blended perfectly, creating a much more convincing cuppa.
‘The differences in aroma and taste also varied wildly, too.
‘But all our testers found that soya milk gave the best all round tea experience!’
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