Is Dairy Getting in the Whey of Your Success?

As I am closing out a super hectic week of work and school at the end of my second module in my final class for my Masters, I can't help but find the irony in not being able to finish Part III of my series on the 3 S's, which will be an in depth look into sleep. As you see, my sleep has unfortunately been somewhat erratic myself these last couple of days.

However, I want to be very clear on this, sleep is still incredibly important and essential to your health; however, in real life, there are times where something important comes up and you just have to make due with what you can. If you are short on one of the 3 S's, sleep in this case, make sure that you try to manage the stress and keep the sugar at bay, so you don't throw yourself off the rails.

But let's get into the topic at hand. In my capacity at Calton Nutrition, not only do I do work as a researcher and writer, but I also assist as a coach during their new Micronutrient Miracle VIP Inner Circle. If you are looking for access to some incredible minds that will help coach you through a 6-week health journey, I CANNOT recommend signing up for it enough!

That being said, a common question that keeps popping up is “what do I do if I have an issue with dairy?”

Now, I have talked about this before and if you really want an in depth look at the history of dairy, be sure to check out my 4-part series on Calton Nutrition, titled “A Brief History of Agriculture.”

However, when it comes to dairy, there are 4 main components that we are talking about. There are the proteins, e.g. whey and casein, the sugar, e.g. lactose, and the milk fat. When most people talk about having allergies or intolerances to milk, they are generally talking about the lactose and/or casein.

But let's start with the problems with lactose.

As I referenced in Part I of the 3 S's, lactose intolerance is a bit of a misnomer, as it is the historically “normal” thing. Today, ~75% of the world population cannot properly digest lactose [1]! However, with the advent of agriculture and the domestication of animals, particularly in Europe, a new trait became preferred for “lactase persistence,” whereby individuals still expressed the gene for the creation of the enzyme, lactase, which is essential for the proper metabolism of lactose sugar, even after weaning from their mother [2].

Common symptoms of lactose intolerance generally present as gastrointestinal issues including abdominal pain, bloating, diarrhea, flatulence and nausea [3]. While there is no official standard “threshold” for lactose as it is highly individual, people with lactose intolerance can generally consume upwards of 12g safely in a single serving, with particularly sensitive individuals experiencing issues with as little as 6g/serving [4].

As the lactase enzyme is deficient, people suffering from lactose intolerance are unable to digest the lactose sugar and it becomes fermented in the large intestine by the gut microflora, which leads to the production of gas [5]. Unfortunately, beyond outright deficiency, other causes of intolerance to lactose include small intestinal bacterial overgrowth and leaky gut [6, 7].

While most forms of dairy should be avoided in those with lactose intolerance, many can include some heavy cream, butter and hard cheeses, particularly Gouda, as they are virtually free of lactose [8]. Fermented dairy, such as traditional yogurt and kefir, is not only generally tolerated, but may actually assist in eliminating symptoms insomuch as the bacteria can predigest most of the lactose [9, 10]. Additionally, some quality whey proteins, such as IN.POWER Protein, also contain minimal lactose (1.07g/serving) and should not induce gastrointestinal symptoms.

However, individuals who are particularly sensitive might do well to also switch the butter to cultured butter, as it is fermented, or clarified butter, i.e. ghee, as all of the lactose has been removed.

On the other hand, there are allergies or intolerances to the milk proteins, with an affection rate of roughly 0.25-4.9% of children [11]. Now, as mentioned before, there are two primary classes of proteins in milk, casein and whey, and while some fractions of whey are potentially problematic, casein is typically more allergenic [12].

While lactose intolerance exhibits only gastrointestinal symptoms, milk protein intolerance has much wider variability in its presentation. Among the potential issues are the common allergic responses including respiratory problems, skin issues, gastrointestinal issues and potentially even anaphylaxis [12].

Interestingly, while they have different mechanisms, similar to lactose intolerance, the protein allergy is also associated with disturbances in the gut microbiome [13]. As such, consumption of fermented foods and probiotic supplementation has shown benefit in eliminating allergic reactions to milk proteins [14].

So as is often the case, heal the gut, heal the body.

As such, in cases of both lactose intolerance or milk protein allergy, it would be prudent to focus on eating bone broth, gelatin, fermented foods and supplementing with probiotics [15, 16]. In terms of working with gut dysbiosis and leaky gut, I have seen a lot of benefit with Great Lakes Grass-Fed Gelatin and MegaSporeBiotic.

Additionally, “Triple Threat” shakes will be of great benefit, as whey protein has shown benefit in repairing the gut lining [17], while a multivitamin will assist in combating intestinal permeability caused by micronutrient deficiency [18].

For some more information on healing the gut, check out my article on Breast Cancer & the Microbiome. Also, stay tuned for the rest of my series on the 3 S's, where we will also tackle things a little bit deeper.

References:

1) Mattar, R., de Campos Mazo, D.F. & Carrilho, F.J. (2012). Lactose intolerance: Diagnosis, genetic & clinical factors. Clin Exp Gastroenterol. Vol. 5:113-121.

2) Itan, Y., Powell, A., Beaumont. M.A., Burger, J. & Thomas, M.G. (2009). The origins of lactase persistence in Europe. PLoS Comput Biol. Vol. 5(8):e1000491.

3) Di Rienzo, T., D'Angelo, G., D'Aversa, F., Campanale, M.C., Cesario, V., Montalto, M., Gasbarrini, A. & Ojetti, V. (2013). Lactose intolerance: From diagnosis to correct management. Eur Rev Med Pharmacol Sci. Vol. 17(Suppl 2):18-25.

4) EFSA Panel on Dietetic Products, Nutrition & Allergies [NDA] (2010). Scientific opinion on lactose thresholds in lactose intolerance & galactosaemia. EFSA Journal. Vol. 8(9):1777.

5) Misselwitz, B., Pohl, D., Frühauf, H., Fried, M., Vavricka, S.R. & Fox, M. (2013). Lactose malabsorption & intolerance: Pathogenesis, diagnosis & treatment. United European Gastroenterol J. Vol. 1(3):151-159.

6) Zhao, J., Fox, M., Cong, Y., Chu, H., Shang, Y., Fried, M. & Dai, N. (2010). Lactose intolerance in patients with chronic functional diarrhoea: The role of small intestinal bacterial overgrowth. Aliment Pharmacol Ther. Vol. 31(8):892-900.

7) Wilder-Smith, C.H., Materna, A., Wermelinger, C. & Schuler, J. (2013). Fructose & lactose intolerance and malabsorption testing: The relationship with symptoms in functional gastrointestinal disorders. Aliment Pharmacol Ther. Vol. 37(11):1074-1083.

8) Heaney, R.P. (2013). Dairy intake, dietary adequacy & lactose intolerance. Adv Nutr. Vol. 4(2):151-156.

9) de Oliveira Leite, A.M., Miguel, M.A., Peixoto, R.S., Rosado, A.S., Silva, J.T. & Paschoalin, V.M. (2013). Microbiological, technological & therapeutic properties of kefir: A natural probiotic beverage. Braz J Microbiol. Vol. 44(2):341–349.

10) Kechagia, M., Basoulis, D., Konstantopoulou, S., Dimitriadi, D., Gyftopoulou, K., Skarmoutsou, N. & Fakiri, E.M. (2013). Health benefits of probiotics: A review. ISRN Nutr. Vol. 2013:481651.

11) Fiocchi, A., Brozek, J., Schünemann, H., Bahna, S.L., von Berg, A., Beyer, K., Bozzola, M., Bradsher, J., Compalati, E., Ebisawa, M., Guzmán, M.A., Li, H., Heine, R.G., Keith, P., Lack, G., Landi, M., Martelli, A., Rancé, F., Sampson, H., Stein, A., Terracciano, L. & Vieths, S. (2010). World Allergy Organization (WAO) diagnosis & rationale for action against cow’s milk allergy (DRACMA) guidelines. Pediatr Allergy Immunol. Vol. 21(Suppl 21):1-125.

12) Hochwallner, H., Schulmeister, U., Swoboda, I., Spitzauer, S. & Valenta, R. (2014). Cow’s milk allergy: From allergens to new forms of diagnosis, therapy & prevention. Methods. Vol. 66(1):22–33.

13) Molloy, J., Allen, K., Collier, F., Tang, M.L., Ward, A.C. & Vuillermin, P. (2013). The potential link between gut microbiota & IgE-mediated food allergy in early life. Int J Environ Res Public Health. Vol. 10(12):7235-7256.

14) Vandenplas, Y., de Greef, E. & Devreker, T. (2014). Treatment of cow’s milk protein allergy. Pediatr Gastroenterol Hepatol Nutr. Vol. 17(1):1-5.

15) Ulluwishewa, D., Anderson, R.C., McNabb, W.C., Moughan, P.J., Wells, J.M. & Roy, N.C. (2011). Regulation of tight junction permeability by intestinal bacteria & dietary components. J Nutr. Vol. 141(5):769-776.

16) Lamprecht, M., Bogner, S., Schippinger, G., Steinbauer, K., Fankhauser, F., Hallstroem, S., Schuetz, B. & Greilberger, J.F. (2012). Probiotic supplementation affects markers of intestinal barrier, oxidation, & inflammation in trained men: A randomized, double-blinded, placebo-controlled trial. J Int Soc Sports Nutr. Vol. 9(1):45.

17) Benjamin, J., Makharia, G., Ahuja, V., Anand Rajan, K.D., Kalaivani, M., Gupta, S.D. & Joshi, Y.K. (2012). Glutamine & whey protein improve intestinal permeability & morphology in patients with Crohn's disease: A randomized controlled trial. Dig Dis Sci. Vol. 57(4):1000-1012.

18) Rapin, J.R. & Wiernsperger, N. (2010). Possible links between intestinal permeability & food processing: A potential therapeutic niche for glutamine. Clinics. Vol. 65(6):635-643.

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