Diet for Lactose and Casein Intolerance
by Sue Kira, Naturopath & Clinical Nutritionist
– Alternatives to dairy products
– How do I get calcium if I don’t eat dairy?
– Specific calcium rich foods to enjoy
Lactose and casein are two different components of milk. Lactose is the sugar found in milk and casein is one of the major proteins found in milk. Intolerances to both lactose and casein are prevalent these days and can cause a number of unpleasant symptoms such as nausea, diarrhoea, abdominal bloating, cramps and gas as well as itching, hives, facial flushing, wheezing and even anaphylaxis in severe reactions.
Human milk, cow’s milk and other animal species’ milk contain proteins, fats, carbohydrates, vitamins and minerals. Depending on the type of milk, there are different levels of fats, carbohydrates and proteins present.
Lactose, the main milk carbohydrate or sugar that is digested by an enzyme known as lactase, is produced in the bodies of babies so that they can digest breast and other milks. Some children and adults don’t produce enough lactase, which can lead to a condition known as lactose intolerance, where the milk sugar is not properly digested. This especially happens after weaning as the body stops or slows down the production of lactase naturally.
Many people are intolerant to casein, one of the main proteins in milk. While milk and milk products do have nutrients, the lactose and casein in them can cause problems for many people, especially for those with a health condition.
This is why a diet for lactose and casein intolerance completely avoids all dairy products, while still providing you and your family with safe, healthy alternatives rich in calcium, healthy carbohydrates, good fats and proteins.
While a diet for lactose & casein intolerance is not considered a cure, the idea is to eliminate foods considered detrimental, and include foods that support your body to give it the best chance to heal naturally and regain balance and vitality. That’s why it is so important to exclude antagonistic foods and drinks such as gluten, dairy, additives, and sugar.
And that’s good news for those with a lactose or casein intolerance because there can often be a cross-reactivity between dairy intolerance and gluten intolerance due to the protein structures being very similar.
Also recommended in this diet are foods and recipes for gut healing like bone broths and soups, because many people with intolerances of any kind usually have a degree of leaky-gut (also known as intestinal permeability).
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Alternatives to dairy products
These days there are many different available options to replace dairy products in your diet. These include ‘mylks’ from a variety of nuts and seeds, and legumes like cashews and soy beans, that can all make a creamy smooth milky tasting drink. Many of these are now made into various products like ice-creams, yoghurts and even cheeses.
How do I get calcium if I don’t eat dairy?
This is a common question I get asked when discussing the option of going off dairy products. Calcium is in many other foods such as leafy greens, seafood, legumes, nuts and seeds and some fruit. Many foods and drinks are also fortified with calcium.
The calcium found in dairy foods is in the wrong form for easy absorption by the body. That’s why we are told that we need to eat so many serves of dairy a day to get the calcium needed. But there are so many other sources of calcium from foods which are more bio-available (absorbable) than dairy calcium.
Specific calcium rich foods to enjoy
The following foods include the amount of calcium in milligrams to provide an indication of calcium levels. For comparative purposes, a cup of cow’s milk contains about 300mg of calcium.
White Beans: 191 mg in 1 cup of canned beans
Creamy and light, these legumes are a great source of calcium and also iron.
Canned Salmon: 232 mg in ½ large can with bones – the bones have the most calcium! Canned salmon that has been wild caught provides an economical way to get this great food, rich not only in calcium but also good essential fatty acids called Omega 3’s. My favourite is the Alaskan wild caught red salmon. (I get mine from Aldi)
Sardines: 321 mg in about 7 sardines’ fillets (small tin)
Even higher in calcium and good fats than salmon, sardines also contain vitamin D needed for calcium absorption.
Dried Figs: 107 mg in 8 whole dried figs
Great as a snack or rolled into a fruit and nut ball, figs are a source of calcium along with antioxidants and fibre.
Bok Choy: 74 mg in 1 cup
This versatile Chinese cabbage provides a hefty dose of vitamins A and C, along with calcium and fibre. Other green vegetables also provide you with calcium options.
Kale: 188 mg in 2 cups raw (chopped), which is about ½ cup cooked.
Kale is filled with calcium and antioxidants and makes great green smoothies.
Turnip Greens: 197 mg in 1 cup cooked (chopped)
The calcium in this leafy green comes from turnip bulbs that are great roasted. But the greens, often thrown away, are also a great source of additional calcium, antioxidants and folate.
Black-eyed Peas: 185 mg in 1/2 cup canned
I ‘m not talking about the famous band, but beans in a tin that are filled with calcium, potassium, folate and fibre.
Almonds: 72 mg in ¼ cup dry roasted (about 20 nuts)
Aside from calcium, almonds also contain potassium, vitamin E and iron – and make a great snack.
Oranges: 65 mg in 1 medium orange or orange Juice contains 500 mg in 1 cup (only if fresh). Full of vitamin C and calcium, this fruit is a great mid-morning snack or its juice is a great additive to salad dressings
Sesame Seeds: 88 mg per 1 tablespoon
Sesame seeds are probably my favourite source of calcium as well as good fats. They make a great Tahini dressing that can be spread onto slices of apple for a snack, or used in salad dressings and over steamed vegetables to add more flavour and of course calcium. Sesame seeds are great in crackers and also nut and seed bars and balls. An easy way to add more calcium to your diet.
Seaweed: 126 mg in about 1 cup raw
Not everyone’s cup of tea, but seaweed is a great source of calcium, fibre and iodine, which helps with proper thyroid function. Seaweed can be sprinkled dried onto salads and with veggies or can be part of a dip or casserole for added saltiness and nutrition.
Soymilk: 300 mg in 1 cup
Soymilk is a great option for people who are lactose intolerant and it contains more protein than regular milk. Soymilk made into a solid is called tofu. Only buy organic soymilk!
Tofu: 861 mg in ½ cup
This meaty textured vegetarian protein is made of dried soybeans that have been ground and boiled and then set like a jelly with magnesium. Tofu is a great low fat source of protein and calcium that can be cubed and used in stir-fry meals.
Client name and identifying information changed
Jamie is a runner. He loves to run everywhere, the beach, the park, on the roads and on the treadmill at the gym if the weather is not good. But for a while, the only place Jamie was running to was to the toilet. It seemed that every time he drank a cup of tea or coffee or ate a meal, he was off, running with diarrhea to the loo.
He said he had to ‘put his life on hold’ as he couldn’t run anywhere because of the fear of not being close enough to a toilet. He was terrified to even leave his house and worked from home as much as possible.
On the day he visited me, he didn’t eat or drink prior to seeing me for fear of having to ‘run’ off. Because he already had parasites ruled out by his doctor I was certain that he was reacting to dairy products. I was surprised that he hadn’t been tested previously for allergies or intolerances (maybe that would have been checked next). I suggested that he stopped consuming all dairy products, as well as gluten foods, to allow his gut to heal.
Sometimes a person who has an intolerance may not show symptoms for many years, but an incident may trigger the symptoms such as flu, a gastro bug, or even stress. It’s like a cascade of events that eventuates in a food reaction.
Within a couple of days on the new diet, Jamie’s stools were almost perfect and although he still needed some probiotics (dairy-free of course) to re-balance his gut flora, he was back out there, running around freely again.