New York Eats
Breakfast
Skim latte + Bagel with scallion schmear
Lunch
Yogurt + Fruit
Post-Gym
Whey protein shake
Dinner
Greek salad with all of the feta
Super-healthy, protein-packed vegetarian eating, right? Then why do your insides churn as if you were birthing a tyrannosaurus rex? Perhaps you've attributed this gastrointestinal wrangling to your Ashkenazi Irritable Bowel Syndrome [IBS] destiny, but perhaps you're wrong. Perhaps, there's a very simple explanation for your distress: dairy.
Dairy lurks everywhere. In that latte. On your bagel. In your yogurt. In your protein shake. In your salad.
You're getting loaded up with dairy, and you may not realize just how much you're consuming.
Mammals Make Milk
Mammals have a unique relationship with dairy. From kittens and pigs to baboons and humans, milk is the first source of nourishment for a newborn mammal. Provided from mother to child, this milk contains more than calories; this milk contains essential antibodies to protect the newborn from bacteria and viruses. Once the young has been sufficiently nourished, the mother will wean her child. Without demand for milk, the mother will stop lactating.
Yet, one mammalian species had developed a taste for milk beyond infancy: humans. Or so it would seem.
Do humans have an ongoing need for milk or is it simply a preference? Does this thirst for dairy flow from a Freudian regression to mother's bosom? Or, has this belief been implanted by the US Food and Drug Administration through lobbying by the dairy industry?
Regardless of the reason, it's important to ensure you don't have a medical reason to avoid dairy.
3 Medical Reasons To Avoid Dairy
Epinephine is an injection given directly into the muscle in the event of anaphylactic reaction.
1. MILK ALLERGY
Do you get short of breath and break out in hives when you encounter dairy? Do you need to carry an EpiPen, just in case?
This is the most obvious of the medical reasons to avoid dairy. By now you should know whether or not you have an allergy to milk. Milk allergy is uncommon: only 1-2% of children under the age of five and 0.2-0.4% of the general adult population (foodallergy.org).
Milk allergy is a potentially life-threatening condition caused by an immune response to milk protein. An allergic reaction occurs within minutes of ingesting dairy and can lead to anaphylaxis and death.
2. Lactase Deficiency
Lactase is the enzyme that splits lactose into two smaller sugar molecules: galactose and glucose. Without lactase, lactose cannot be digested and will pass from the small intestine to the colon. Image from Sciencebuddies.org
Lactase is an enzyme produced along the walls of the small intestine. This enzyme is required to digest lactose, the primary carbohydrate contained within mother's milk.
Infants produce lactase in large quantities. Yet, as weaning occurs, production of this enzyme wanes. In essence, the human body isn't designed to digest milk beyond infancy.
70% of the world's adult population can't digest lactose due to a lactase deficiency (de Vrese, et. al.). Lactase deficiency is especially prominent among descendants of Asian, African and Middle Eastern descent. Yet, central and northern Europeans tend to produce lactase into adulthood.
Why?
These particular Europeans domesticated cows, goats and other milk-producing animals. This symbiotic relationship drove an evolutionary selection to retain production of lactase beyond infancy, known as lactase persistence. The ability to digest dairy products from farm animals conferred a caloric advantage.
Would you know if you have a lactase deficiency?
Although certainly less overt than milk allergy, lactase deficiency may not be so obvious because lactase production exists on a spectrum. Certain people may retain a degree of lactase production whereas others may cease production altogether. Furthermore, dairy products do not contain a uniform amount of lactose; in general cheese contains far less lactose than whey or half and half.
Lactaid contains the enzyme lactase. A person deficient in lactase can use this over-the-counter medication to avoid bloating, gas and diarrhea when consuming dairy.
What happens without lactase?
Without lactase, lactose cannot be broken into glucose and galactose. The lactose molecule is simply too large to be absorbed directly across the intestinal membrane.
So, lactose continues on the journey to the colon, which is teeming with voracious bacteria eager for a sugary treat. The byproduct of this bacterial feast? Gas and bloating!
Lactose also attracts nearby water, thereby reducing water reabsorption by the colon. The result? Dairy diarrhea aka the runs.
Symptoms of lactose maldigestion typically appear within 30 minutes of ingesting dairy.
Lactase deficiency of americans, by ancestry
EAST ASIAN: 90-100%
Native American: 80-100%
African: 75%
Ashkenazi Jew: 70%
Latino: 50%
European: 20%
(de Vrese et. al.)
World map showing lactase persistence versus lactase deficiency
At the completion of weening, the majority of humans lose the ability to produce lactase and digest lactose. However, groups of humans who domesticated milk-producing animals demonstrate lactase persistence (a genetic mutation conferring the ability to produce lactase beyond infancy) as the ability to digest milk from farm animals conferred an advantage. Northern Europeans demonstrate the highest rates of lactase persistence.
The low lactose intolerance of the United States is an average and doesn't represent vast differences in lactase persistence, based on ethnic origin.
Lactaid is a lactose-free milk. Although this is a solution for anyone lacking the enzyme lactase, it doesn't address an overreactive immune system that may be attacking the protein in milk, known as dairy intolerance.
3. Milk Sensitivity
Milk sensitivity is the least obvious of the three medical reasons to avoid dairy.
Okay, so you don't have an anaphylactic reaction when encountering dairy and you don't have the runs characteristic of an overt lactase deficiency. But, something just doesn't feel right. Maybe you feel bloated and gassy all the time. Or maybe you feel exhausted after consuming certain dairy products.
After years of mysterious gastrointestinal distress, you finally schedule food sensitivity testing. And the results are in:
What does all of this mean?
Simply, your immune system perceives dairy as an invading organism. To protect itself, the body produces antibodies against these dairy proteins. From your skim late to your whey protein shake, dairy is mistakenly activating your immune system.
The result of releasing this barrage of antibodies? A range of symptoms from bloating and diarrhea to headache and fatigue.
You aren't alone. Dairy is a common culprit among food sensitivity triggers.
The solution? Reduce dairy consumption or cut it out altogether.
Curious if your immune system is attacking dairy or other foods in your diet? Schedule food sensitivity testing at services@DoctorK.nyc to find out.
Have additional questions about milk allergy, lactase deficiency or milk sensitivity? Post below!
Resources
Swallow DM. "Genetics of lactase persistence and lactose intolerance," Annual Review of Genetics. 2003. 37: 197-219.
de Vrese, Michael, et. al. "Probiotics: Compensation for Lactase Insufficiency," American Journal of Clinical Nutrition. Feb., 2001.
https://www.foodallergy.org/file/facts-stats.pdf
http://www.sciencebuddies.org/science-fair-projects/project_ideas/BioChem_p031.shtml