ASK THE NUTRITIONIST: What do I need to know about dairy and its alternatives?

This week’s column features the fourth of the top 10 nutrition questions I get asked. Tune in over the following weeks for the remainder. If you missed it, the first week, I covered soy products and those that are most beneficial for your health. Then I covered nutritional supplements and organic foods. Are they actually healthier? If you missed that one, you can read it here.

Today we’re going to discuss dairy, and dairy alternatives. We’ll discuss why some people eschew dairy, common signs you may be dairy intolerant, and which dairy alternatives are superior if you want to try one.

Why give up dairy?

Some people give up dairy because they are concerned with consuming any products from animals as an ethical issue. Others give up dairy products because they are concerned with the treatment of dairy cattle and the respective quality of the milk. Many people feel the quality of the dairy is substandard when taken from cattle raised this way.

It’s estimated there are currently more than 10,000 dairy farms across Canada, housing more than 1.4 million dairy cattle. About 94 per cent of our dairy cattle are Holstein (white with black markings). Commercial dairy cattle are repeatedly impregnated and separated from their offspring to continue lactation. They have cramped and unhygienic and/or cruel living conditions, routine exposure to antibiotics because they develop infections in this environment, and are fed suboptimal food. They are slaughtered for beef usually between five and six years of age. The natural life expectancy for cattle is 15 to 20 years.

For more information on the concerns people have with the welfare of dairy cattle in Canada, you can go here. There is certainly room for improvement in the commercial production of dairy.

So, some people eschew dairy products because they don’t want their purchasing power to support this type of farming. Others still consume dairy but purchase only from organic and sustainable farms with more humane practices. These products cost more because of the time and care to produce them.

Organic and humanely farmed dairy can be purchased through health food stores and healthy food co-ops, but this is an added expense when we are already in an extreme situation with pricing. In this case, consuming less, watching the health food store for discounted products (then freezing them to prolong the shelf life), or purchasing through a healthy food co-op to get a discount can help cut the cost. Some people just replace dairy with other foods to avoid the whole scenario.

Isn’t dairy healthy?

Not everyone believes dairy is healthy to begin with. It’s an old debate in nutrition circles and you will no doubt have come across someone at some time who has said something to this effect. The thinking seems to be that since it’s not our milk, we shouldn’t be drinking it. But neither are chicken’s eggs or seeds on plants or fruit on our trees. We still enjoy them very much. That’s the nature of our place in the food chain.

I’ve also noticed nutritionists tend to advise others depending on their own personal preferences. If they are a vegan, all others should be, too. If they are sensitive to dairy, all dairy is toxic, etc. This is neither scientific nor best practice. We must know when and why some people can’t enjoy a particular food and how to guide them around that without any unnecessary limitations.

Dairy is a very nutrient-dense food. It contains all the essential amino acids, calcium, phosphorus, selenium, potassium, zinc, choline, magnesium, riboflavin, B12, and vitamins A and D. Because our dairy is heat treated (pasteurized), the A and D are damaged during that process and thus added back in after.

Dairy is also a versatile food and is easy to use in recipes, so it makes its way into many products on our shelves, not just those in our fridge. You may not realize just how ubiquitous it is. However, there are some people for whom dairy can be very unhealthy.

Some people lack the enzyme to break down dairy (lactase). They are lactose intolerant. These people typically suffer digestive complaints after exposure to dairy and can get relief by switching to lactose-free dairy or by consuming digestive enzymes that contain lactase when they eat a meal containing dairy.

There are also people who are triggered by the proteins in dairy — typically, the casein. They are truly dairy intolerant. In such people, the reaction is harder to discern. It can involve inflammation in the body and brain and can even trigger behaviors. It can happen as a sudden reaction or slowly, over time.

This type of reaction is common in those with autism spectrum disorder (ASD) and children with learning disabilities. It’s also common in those who have celiac or non-celiac wheat sensitivity and in those who have leaky gut syndrome and those with autoimmune diseases. In all of these cases dairy can become a triggering food even in small quantities.

If you suspect you have this type of intolerance, I advise professional assistance. The first issue is to identify what you’re reacting to by doing a strict elimination diet and getting thorough testing. Hair and blood testing can be helpful. Eliminating all dairy is restrictive, so knowing exactly what needs to be eliminated and for how long is important. With ASD the elimination is usually (but not always) permanent. With celiac and leaky gut it’s often temporary. With autoimmune disease it can go either way. It’s essential in these cases not only to remove the dairy but to find safe alternatives and to repair the gut damage that triggers the reaction.

For those on the spectrum it’s not only the gut that reacts, but the brain, so it is wise to have professional guidance to know which approach you need. These clients will crave cheese and wheat but react horribly to them with all sorts of behaviours. This is because these foods also trigger dopamine, which sets them off, and which has a lot to do with regulating addictive behavior in the brain. Food rages are not uncommon in such cases when the food is limited.

My son is on the spectrum and it took decades for him to be able to consume dairy without an inflammatory cascade. With dedicated exposure and enzymes and work on his gut, he is now able to eat poutine with the best of them without suffering. I, on the other hand, will never be able to consume dairy without some inflammation. I simply have to limit my exposure and pick my battles. Coffee cream, for example, is tolerable. Cheese on pizza can take me down.

Intolerances can also run in families, as in ours. It may not even be clear until you get older and realize those allergies you thought you had gone away when you realized you couldn’t have lactose and stopped drinking milk. I see this sort of thing a lot. Dairy intolerances are often hidden and take time to uncover.

But this does not mean dairy is not a nutritious food. This is one area where there just isn’t a one-size-fits-all approach. If you are unclear if you suffer from dairy intolerance, here is a little quiz that can help.

dairy intolerance quiz

Do you:

  • Have a history of tonsillitis, or had your tonsils removed?
  • Have a history of ear infections?
  • Have a history of repeated strep or throat infections?
  • Have an autoimmune disorder?
  • Have an intolerance to wheat or gluten?
  • Have gut biome issues (yeast infections, leaky gut, regular digestive woes)?
  • Have seasonal allergies?
  • Have bouts of rhinitis or regular post-nasal drip?
  • Have eczema?
  • Have acne?
  • Have other unexplained hives/rashes?
  • Have dairy cravings (we often crave what we’re intolerant to)?
  • Have a history of migraines or joint pain?

If you answered yes to two or more, it’s possible you have an intolerance to dairy. If you answered yes to three or more, it’s almost certain. It’s best to get professional help to see if you can increase your tolerance or should just remove it altogether.

The substitutes

Sheep or goat’s milk:

The best substitute to bovine dairy is sheep and goat dairy. This is because they are at least equally nutrient dense. Sheep milk has double the protein, more healthy fats, and more vitamins and minerals, including calcium, iron, magnesium, phosphorus and zinc. However, it’s also fattier and has a stronger flavour. The casein of sheep and goat’s milk are different from bovine dairy, and can often be tolerated by those with an intolerance to cow’s milk. Both the protein and fat in sheep’s milk are easier to digest. This is, in part, because the casein in it is known to be easier to digest. Sheep milk contains A2 beta casein, which makes it a natural A2 type of milk without A1 protein, unlike cow or goat milk.

A2 milk:

Those who are sensitive to A1 casein can also try A2 cow’s milk. You can find it at health food stores, although it’s often scooped up quickly. This is dairy made from cattle that only produces the A2 protein. Most milk you buy contains both, but some people are sensitive not to the lactose but the A1 protein. This dairy works better for them. Learn more about it here.

Nutmilk:

Failing these I recommend nut milk like almond or cashew or coconut because they contain some protein and many nutrients. My preference is homemade because it does not contain all the additives and preservatives, but not everyone has the time or energy for this. When we want a milk alternative at home, we use a can of full-fat coconut cream, diluted with water and stirred with some powdered cinnamon and nutmeg. It’s easy and refreshing. You just stir it before you use it.

If you’re selecting store-bought nut milk, try to find one with as few additives as you can and ensure you’re getting your complete proteins with your meal despite removing the dairy.

I don’t recommend processed cheese products as a substitute for cheese. However, there is a fermented cashew pate that is incredibly cheesy in flavour. You can find the recipe for that here. In our home we use nutritional yeast as a super-healthy parmesan alternative on popping corn or dishes where we want that cheesy flavour.

I hope this is helpful. Tune in next week for a deep dive on eggs. Do you eat the whites, the yolks, or both? How many a day is safe? What about cholesterol? And I’ll share a decadent new egg recipe you have to try. As always, if you have a question for the column, you can write to me at nonienutritionista@gmail.com. If you want clinical care or to know more about what I do, you can find me online at hopenotdope.ca.

Namaste!

Nonie Nutritionist

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