Milk – a four-letter word?

Whichever way you look at it, cow’s milk is consistently the most common food allergen.

Classic IgE-based milk allergy is the most common food allergy, and so too is hidden or delayed-onset IgG milk allergy. A myriad studies have shown that milk sensitive people have much higher levels of IgG antibodies that target milk proteins.(1)(2)(3)(4)(5)(6)(7)(8)(9)

Most cheeses, cream, yoghurt and butter contain milk protein, and it’s hidden in all sorts of food. If you check labels, you’ll find it’s sometimes called simply milk protein, sometimes whey (which is milk protein with the casein removed) and sometimes casein, which is the predominant type of protein – and the most allergenic – in dairy products. You’ll be amazed at how many foods contain milk – from bread and cereals to packaged food and crisps. So if you’re tested and find you’re allergic to milk, you will have to be vigilant with processed foods.

Milk’s status as an allergen isn’t surprising. This is a highly specific food, containing all sorts of hormones designed for the first few months of a calf’s life. It’s also a relatively recent addition to the human diet. Approximately 75 per cent of people (25 per cent of people of Caucasian origin and 80 per cent of Asian, Native American or African origin) stop producing lactase, the enzyme that’s needed to digest the milk sugar lactose, once they’ve been weaned – one of many clues that human beings aren’t meant to drink cow’s milk, at least beyond early childhood.(10) Lactase deficiency or lactose intolerance leads to diarrhoea, bloating, cramping and excess gas.

However, it’s not the lactose that causes the allergic reaction. It’s the protein. In other words, you can be either lactose intolerant, or milk protein allergic, or both; and in fact, lactose intolerance and milk allergy often occur together.

Of course, most of us have been brainwashed by milk marketers since childhood into believing that milk is practically a wonder food. This can only leave you speculating how half the world, for example most of China and Africa, can survive, let alone thrive, without it. Milk is a reasonably good source of calcium, among other nutrients, but drinking milk certainly isn’t the only way, or necessarily the best way, to achieve optimum nutrition . On top of that, it contributes to a wide range of common diseases.

Cow’s milk is a major contributing factor to middle-ear infections, an allergic disease that affects over a million of our babies and children each year. Milk allergy also contributes to iron deficiency, the most common nutritional deficiency in the world, by impeding the absorption of iron, and damaging the inside lining of the intestines, which causes slow blood leakage and a further loss of iron in red blood cells. In a quarter of people with iron deficiency, anaemia can set in – seen in about 10 per cent of children overall, 30 per cent of children in inner cities, and as many as half of all children in poor countries.

Cow’s milk is also one of the top two or three food allergens found in children and adults with poor sleep, asthma, eczema, migraines, rheumatoid arthritis, hyperactivity, bronchitis, more frequent infections and longer hospital stays for premature infants, non-seasonal allergic rhinitis, bed-wetting, so-called growing pains, colic, heartburn, indigestion, chronic diarrhoea, chronic fatigue, hyperactivity, depression, autism, epilepsy (although only in those with concomitant migraines and/or hyperactivity), and perhaps, as we saw above, even type 1 diabetes. If you have ever suffered from any of these conditions, milk should be high on your suspect list for a hidden food allergy.

Getting enough calcium without milk

If you’re allergic to cow’s milk then goat’s or sheep’s milk are not a viable alternative as they all contain casein, and your immune system is unlikely to be able to distinguish one milk from another. If you’re allergic to milk, getting the right amount of calcium becomes an issue of particular concern. After all, it is a fact that milk is a good source of both calcium and vitamin D, both of which are needed by the body to build healthy bones. No one who has seen elderly women severely bent over from osteoporosis of the spine can take the issue of calcium loss in the bones lightly. Yet a 1997 study found no connection between teenage consumption of calcium from cow’s milk and the risk of bone fractures later on as an adult.(11) Other studies have concluded that the more dairy products a woman consumes, the more likely she will suffer from osteoporotic bone fractures! (12)(13)(14)(15)

Not all studies have revealed such findings, but the evidence for milk helping to build strong bones is far from clear-cut. The linear idea that bones contain calcium, and milk contains calcium, so milk must be good for the bones, crumbles in the light of recent research published in the British Medical Journal. This study shows that supplementing calcium makes no real difference to the risk of osteoporosis.(16) The study gave over 3,000 woman aged 70 and over, all of whom were deemed to be at high risk for osteoporosis, supplements of 1,000mg of calcium and 800ius of vitamin D, or nothing. After two years there was no difference in fracture rate between those supplementing calcium and vitamin D and those who weren’t. Despite all this, both the US and UK governments help fund dairy industry campaigns to get kids and teenagers drinking more milk!

The simple truth is that we’ve become overly obsessed by the role of calcium deficiency in osteoporosis – an attitude that has driven an obsession with drinking that highly allergenic substance, milk. There are plenty of other factors that contribute to poor bone formation, reduced bone density and osteoporosis: high blood pressure; undetected coeliac disease; a diet excessively high in animal protein, including dairy; high caffeine consumption; excessive alcohol; excessive salt and refined sugar; lack of weight-bearing exercise; advancing age; and diets low in nutrients such as vitamins C, D, and K, and/or minerals such as magnesium, manganese, copper, boron and silicon, as well as calcium. Even a lack of onions in your diet may accelerate bone loss!

All these areas are worth looking at in your life. In the meantime, how can you get that calcium? The chart below shows you sources other than dairy products. See how milk products compare to these foods. If you start your day with cereal and soya or rice milk or any other milk fortified with calcium, and a heaped tablespoon of ground seeds, you’ve already achieved 404mg of calcium. Have a few almonds and a bean dish during the day, with some broccoli, and you’re up to 800mg of calcium. That’s the equivalent of two and a half glasses of milk. The RDA of calcium for an adult is 800mg, and most decent multivitamins will provide a further 200mg. So, there’s no need to go short if you eat a healthy diet free from dairy products, but you do need to know what to eat.

Common sources of calcium: how they compare

Milk 250ml = 315mg calcium
Firm cheese 50g = 350mg calcium
Yoghurt 175ml = 275mg calcium
Food Serving Calcium (mg) Rating
Almonds 125g (1/2 cup) (200) **
Baked beans 250g (1 cup) (163) **
Beet greens, cooked 125g (1/2 cup) (87) *
Bok choi, cooked 125g (1/2 cup) 84 *
Brazil nuts 125g (1/2 cup) 130 *
Bread, wholewheat or White 1 slice 25
Broccoli, cooked 125g (1/2 cup) 38
Cauliflower, cooked 125g (1/2 cup) 18
Chickpeas, cooked 250g ( 1 cup) 84 *
Dates 60g (1/4 cup) 12
Figs, dried 4 medium 61 *
Kale, cooked 125g (1/2 cup) 103 *
Lentils, cooked 250g (1 cup) 40
Nuts, mixed 125g (1/2 cup) 48
Orange 1 medium 52 *
Prunes, dried, uncooked 60g (1/4 cup) 18
Raisins 60g (1/4 cup) 21
Red kidney beans, cooked 250g (1 cup) (52) *
Rhubarb, cooked 125g (1/2 cup) (184) **
Rice, white or brown 125g (1/2 cup) 12
Rice drink (fortified) 250g (1 cup) 300 ***
Salmon, canned with bones 213g (1/2 can) 225 **
Sardines, canned with bones 213g (1/2 can) 210 **
Sesame seeds 125g (1/2 cup) (104) *
Sesame paste (tahini) 30g (2 tbsp) (40)
Shrimps, cooked/canned 70g (12 large) 41
Soybeans, cooked 125g (1/2 cup) (93) *
Soya drink 250g (1 cup) 28
Soya drink (fortified) 250g (1 cup) 300
Spinach, cooked 125g (1/2 cup) (129) *
Tofu, regular processed* 100g (1/3 cup) (150) *
White beans, cooked 250g (1 cup) (170) **

( ) – Calcium from these foods is known to be absorbed less efficiently by the body.
* The calcium content shown for tofu is an approximation based on products available on the market. Calcium content varies greatly from one brand to the other and can be quite low. Tofu processed with magnesium chloride also contains less calcium. Rating as established according to Canadian Food and Drugs Regulations
* Source of calcium
** Good source of calcium
*** Excellent source of calcium
Source: Health Canada, Canadian Nutrient File, 1993


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2. Fallstrom, S P et al., Serum antibodies against native, processed and digested cow’s milk proteins in children with cow’s milk protein intolerance, Clin Allergy, vol 16, pp 417-23 (1986)
3. Shakib, F et al., Study of IgG sub-class antibodies in patients with milk intolerance, Clin Allergy, vol 16, pp 451-8 (1986)
4. Host, A et al., Prospective estimation of IgG, IgG subclass and IgE antibodies to dietary proteins in infants with cow’s milk allergy. Levels of antibodies to whole milk protein, BLG and ovalbumin in relation to repeated milk challenge and clinical course of cow’s milk allergy, Allergy, vol 47, pp 218-29 (1992)
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8. Cavataio, F et al., Gastroesophageal reflux associated with cow’s milk allergy in infants: Which diagnostic examinations are useful?, Am J Gastroenterol, vol 91, pp 1215-20 (1996)
9. Duchateau, J et al., Anti-betalactoglobulin IgG antibodies bind to a specific profile of epitopes when patients are allergic to cow’s milk proteins, Clin Exp Allergy, vol 28, pp 824-33 (1998)
10. US National Institutes of Health ( 11. Feskanich, D et al., Milk, dietary calcium, and bone fractures in women: A 12-year prospective study, Am J Public Health, vol 87, pp 992 (1997)
12. Paspati, I. et al., Hip fracture epidemiology in Greece during 1977-1992, Calcif Tissue Int, vol 62, pp 542-547 (1998)
13. Lau, E M and Cooper, C, Epidemiology and prevention of osteoporosis in urbanized Asian populations, Osteoporosis, vol 3, pp. 23-26 (1993)
14. Fujita, T and Fukase, M, Comparison of osteoporosis and calcium intake between Japan and the United States, Proc Soc Exp Biol Med, vol 200, pp 149-152 (1992)
15. Xu, L et al., Very low rates of hip fracture in Beijing, People’s Republic of China: The Beijing Osteoprosis Project, Am J Epedemiol, vol 144, pp 901-907 (1996)
16. Torgerson, J et al., Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care, BMJ, vol 330, pp 1003 (2005)