Did you know that the first adverse reaction to cow’s milk was actually detailed 2,000 years ago? Hippocrates described the first adverse reaction to cow’s milk as skin and gastrointestinal symptoms after consumption. Today, cow’s milk is among the first foods introduced into an infant’s diet, and accordingly, it’s one of the first and most common causes of food allergy in early childhood, leading many to seek out dairy-free diet options.
Cow’s milk protein allergy is a common food allergy in infants and children, and along with lactose intolerance, it requires a dairy-free diet at a time when adequate nutrition in critical. Researchers indicate that it’s important that parents receive reliable advice and ongoing support about appropriate dairy-free options and alternatives. Being aware of dairy-free food options or foods that contain less lactose helps you or your children adjust to a dairy-free diet. (1)
What Is a Dairy-Free Diet?
People follow a dairy-free diet for different reasons, but for most people, they’re searching for relief from digestive issues, bloating, skin problems and respiratory conditions that come from eating dairy products.
It’s reported that 0.6 percent to 2.5 percent of preschoolers, 0.3 percent of older children and teens, and less than 0.5 percent of adults suffer from cow’s milk allergy and are forced to follow a dairy-free diet. (2) In addition to this, between 30 million to 50 million Americans are lactose intolerant. Luckily, there are plenty of plant foods and dairy-free products that still give your body the nutrients you need to thrive.
A dairy-free diet includes foods that are free of milk and milk products. People who are lactose intolerant may choose to reduce or eliminate foods that contain lactose. Some may be able to have smaller portions of foods containing milk proteins, and they may find that fermented dairy is easier on their digestive systems. People with a cow’s milk food allergy, on the other hand, must completely eliminate milk proteins from their diets and find food allergy alternatives that provide calcium and other vital nutrients.
The primary sources of dairy that need to be avoided when eating a dairy-free diet include milk, cheese, butter, cream cheese, cottage cheese, sour cream, custards and puddings, ice cream, gelato and sherbet, whey, and casein.
7 Benefits of a Dairy-Free Diet
1. Less Bloating
Bloating due to dairy products is a common complaint among people with dairy sensitivities and allergies. (3) Bloating itself is usually a problem with digestion. For many people, the cause of excessive gas in the intestines, which causes bloating, is due to inadequate protein digestion, an inability to break down sugar and carbohydrates fully, and imbalances in gut bacteria.
All of these factors can be due to a dairy allergy or sensitization, so sticking to a dairy-free diet can help you get rid of that bloated stomach for good.
2. Better for Respiratory Health
Excessive milk consumption has a long association with increased respiratory tract mucus production and asthma. Research shows that A1 milk stimulates mucus production from gut glands and respiratory tract glands. (4) Although the research on whether or not milk consumption leads to mucus production is mixed, respiratory symptoms are often reported by people with dairy allergies or sensitivities, so avoiding dairy can be beneficial for these groups. (5)
3. Improved Digestion
Because an estimated 75 percent of the world’s population has some degree of lactose intolerance, sticking to a dairy-free diet guarantees that you avoid the digestive symptoms that millions of people suffer from every day. Ditching dairy can relieve cramps, stomach pain, bloating, gas, diarrhea and nausea. Dairy has also been labeled as a key trigger of IBS symptoms and other digestive conditions. (6)
4. Clearer Skin
There’s significant data supporting the role of dairy consumption in the development of acne. A 2010 study published in Clinics in Dermatology indicates that milk contains anabolic steroids as well as growth hormones that add to the potency of milk as a stimulant of acne. (7) Going dairy-free and taking probiotic supplements can help you treat acne naturally, without harsh over-the-counter medications and face washes.
5. May Reduce Risk of Cancer
Some research suggests that consuming milk products may increase your risk of developing cancer. A 2001 study conducted at Harvard School of Public Health found that a high calcium intake, mainly from dairy products, may increase prostate cancer risk by lowering concentrations of a hormone thought to protect against prostate cancer. (8) Milk products may also contain contaminants, such as pesticides, which have carcinogenic potential, and growth factors, such as insulin-like growth factor 1, which have been shown to promote breast cancer cell growth. (9)
Cancer’s link to your diet is very real, and given that dairy appears to increase the risk of some types of cancers in certain people, a dairy-free diet may help mitigate the risk of specific types of cancer.
6. Decrease Oxidative Stress
Although a diet rich in milk products is promoted to reduce the likelihood of osteoporotic fractures and reduce the cost of healthvcare, research published in the BMJ found that high milk intake was associated with higher mortality in one cohort of women and in another cohort in men, and with higher fracture incidence in women. Researchers suggest that a high intake of milk might have undesirable effects because milk is the main dietary source of D-galactose, which influences the process of oxidative stress and inflammation.
Experimental evidence in several animal species indicates that chronic exposure to D-galactose is damaging to health. Even a low dose of D-galactose induces changes that resemble natural aging in animals, including shortened life span caused by oxidative stress damage, chronic inflammation, neurodegeneration and decreased immune system. (10)
7. Prevent Milk Allergy and Sensitivity Reactions
The only true cure for a milk allergy is to avoid milk and dairy products completely. Probiotics and digestive enzymes may help people better digest milk proteins if the allergy isn’t severe, but for a majority of people, ditching the culprit food is the only answer. For people who are lactose intolerant, a reduction in or lack of lactase can cause unabsorbed lactose to pass into the colon, leading to bacterial fermentation that causes symptoms like flatulence, diarrhea, bloating and nausea. Studies suggest that these gastrointestinal symptoms improve when milk is removed from the diet. (11)
Milk protein allergy is also a recognized problem in infancy and might affect up to 15 percent of infants. It’s speculated that milk protein consumed by a mother passes to her infant while breastfeeding. For this reason, pediatricians often recommend that moms give up dairy if their infants experience adverse reactions to their breast milk. (12)
There’s still no suitable therapy available against cow’s milk allergy except avoidance, so dairy alternatives may be necessary. It’s important for anyone going dairy-free to be aware of the nutrients that they were getting from dairy and to consume them in other foods. The nutrients most at risk if dairy products are excluded are calcium, potassium and magnesium.
According to a recent study, for women 19 to 50 years of age who are on a dairy-free diet, only 44 percent of calcium and 57 percent of magnesium and potassium recommendations are met. (13) Naturally, this increases the risk for low potassium, magnesium deficiency and calcium deficiency.
Here are some dairy alternatives that help you to get the nutrients you need when following a dairy-free diet:
1. Goat Milk
While goat milk is still dairy, it’s high in fatty acids and more easily absorbed and assimilated in the body than cow’s milk. The actual fat particles in goat milk are smaller and contain lower concentrations of lactose. Goat milk also has reduced casein levels, making it a better choice for people with a casein protein sensitivity.
A1 casein can actually lead to inflammation and contribute to gastrointestinal issues like irritable bowel syndrome, Crohn’s, leaky gut and colitis, as well as skin issues like eczema and acne, along with autoimmune diseases. While most cows produce A1 casein, goat milk contains only A2 casein, making it the closest milk to human breast milk in terms of protein.
A 2004 study published in the Journal of Pediatric Gastroenterology and Nutrition found that goat milk, when used as the first source of protein after a breastfeeding period, is less allergenic than cow milk in mice. The number of mice with diarrhea was significantly higher in the cow milk-sensitized group than in the goat milk-sensitized group. Serum cow milk-specific immunoglobulin G1 and histamine levels were also significantly higher in cow milk-sensitized mice. (14)
Goat milk nutrition also may surprise you — it’s high in calcium (supplying 33 percent of your daily value), phosphorus, vitamin B2, potassium, vitamin A and magnesium.
2. Coconut Milk
One of the best dairy-free options available is coconut milk, a liquid that’s naturally found inside mature coconuts, stored within coconut “meat.” When you blend and then strain coconut meat, it becomes a thicker, coconut milk-like liquid. Coconut milk is completely free from dairy, lactose and soy. Although cow’s milk contains more protein and calcium than coconut milk, you can make up for that with calcium-rich foods like kale, broccoli, watercress and bok choy.
Coconut milk is a good source of important nutrients like manganese, copper, phosphorus, magnesium, iron and potassium. A 2000 study published in the West Indian Medical Journal found that the medium-chain triglycerides in coconut milk provide a ready source of energy and may be useful in baby foods or in diet therapy. (15) Coconut milk is, however, high in calories and fat. While the fat is definitely a healthy type, portion control is important, especially if you’re working toward reducing your weight.
3. Almond Milk
There are many vital health benefits of almonds nutrition. They’re low in saturated fatty acids, rich in unsaturated fatty acids, and contain filling fiber, unique and protective phytosterol antioxidants, as well as plant protein. In addition to this, almond milk contains probiotic components that help with digestion, detoxification and healthy bacterial growth within the gut flora, which is key to utilizing nutrients from food and preventing nutrient deficiencies.
A 2005 study conducted in Italy found that almond milk is an effective substitute of cow’s milk in infants with cow milk allergy or intolerance. For the study, 52 infants with cow milk allergy or intolerance were separated into three groups: almond milk, soy-based formula and protein hydrolysate-based formula. For all three groups, there was no difference in growth rate, including the increment of weight, length and head circumference. Supplementation with the soy-based and protein hydrolysate-based formulas caused the development, in some infants, of a secondary sensitization (23 percent to soy-based and 15 percent to protein hydrolysate-based formula), whereas supplementation with almond milk did not. (16)
Although kefir is technically a dairy product, it’s fermented, and fermented milk products can actually help people with milk-related lactose intolerance. Keep in mind that fermentation changes the chemical makeup of foods, and as in the case of fermented milk, kefir is relatively low in lactose.
A 2003 study published in the Journal of the American Dietetic Association found that kefir improved lactose digestion and tolerance, and its use may be another potential strategy for overcoming lactose intolerance. (17)
There are also a number of kefir benefits, including its ability to significantly suppress inflammatory markers of IgE immunoglobulins, heal digestive conditions like IBS and build bone density. For people with a cow’s milk allergy who need to be on a strict dairy-free diet, I recommend that you use goat milk kefir.
Amasai is a traditional, fermented milk beverage that’s very similar to kefir. The process of fermenting foods, including dairy products like yogurt, amasai and kefir, produces beneficial bacteria called probiotics. Amasai is also a good source of vital nutrients, including calcium, B vitamins, vitamins A, iron, magnesium, potassium, omega-3 fatty acids and CLA.
Because amasai contains probiotics, it works to heal and repair the gut lining, which can help to diminish allergies and sensitivities. You will probably find that you (or your child) are able to digest amasai that comes from A2 casein cows more easily than dairy that comes from A1 cows and is ultra-pasteurized.
A 2016 study published in Nutrition Journal found that compared with milk containing only A2 casein, the consumption of milk containing A1 casein was associated with increased gastrointestinal inflammation, worsening of post-dairy digestive discomfort, and decreased cognitive processing speed and accuracy. (18)
Ghee is clarified butter, but it’s simmered longer to bring out butter’s inherent nutty flavor. Traditionally, ghee is made from buffalo or cow’s milk, but the process of making ghee removes the water and milk fats, leaving a high smoke point and a unique nutrition profile without any lactose or casein. People who are sensitive to lactose or casein can use ghee as part of a dairy-free diet because it has these allergens removed.
It can even be argued that ghee benefits are even better than butter’s. Butter contains 12 percent to 15 percent medium- and short-chain fatty acids, while ghee contains 25 percent or greater. Ghee is also rich in fat-soluble vitamins A, C and E, in addition to vitamin K. (19)
NOTE: Kefir, amasai and ghee contain dairy proteins, and although they can be made with A2 casein cows or goat milk, I recommend that you seek advice from your health practitioner if you have had an allergic reaction to dairy.
Lactose Intolerance vs. Milk Allergy
Although cow’s milk allergy and cow’s milk intolerance are two different terms, they’re often used interchangeably, which can be confusing. Lactose intolerance is a condition in which people have digestive symptoms, like gas, bloating and diarrhea, after eating or drinking milk or milk products.
Lactose is a sugar that’s found in dairy products and milk. In order to digest lactose properly, the small intestine produces the enzyme called lactase. Lactase is responsible for breaking down lactose into glucose and galactose so the body can absorb it. However, when the body’s ability to make lactase diminishes, the result is lactose intolerance. The truth is that once a child is weaned off breast milk, the digestive system gradually adapts to other foods and produces considerably less lactase. (20)
The symptoms of lactose intolerance arise when the body is unable to digest the lactose and it’s not properly absorbed, and the amount of lactase an adult can digest varies. Symptoms can range from mild to severe based on the amount of lactose the person ate or drink.
The avoidance of dairy products in people with lactose intolerance is an area of controversy. According to research conducted in Belgium, most individuals with lactose intolerance can tolerate up to 12 grams of lactose (250 milliliters of milk) without suffering from gastrointestinal symptoms, although symptoms become more prominent at doses above 12 grams.
A National Institutes of Health Consensus and State-of-the-Science Statement confirms that even in persons with lactose maldigestion, small amounts of milk, yogurt and hard cheese, particularly if ingested with other foods and distributed throughout the day, and reduced-lactose food may be effective management approaches, though the amount of lactose people with lactose intolerance can take is based on low-quality evidence. (21) It may also be helpful to know that fermented dairy products like cheese and yogurt contain less lactose than fresh milk and can be well-tolerated by people who are lactose intolerant.
A cow’s milk protein allergy results from an immunological reaction to one or more milk proteins. Studies show that the immediate and IgE-associated mechanisms of a cow’s milk allergy are responsible for approximately 60 percent of cow’s milk-induced adverse reactions. Typical IgE-associated symptoms appear immediately or within one to two hours after cow’s milk ingestion, with food allergy symptoms typically affecting the skin, respiratory system and gastrointestinal tract.
The prevalence of cow’s milk allergy in the general population is about 1 percent to 3 percent and is highest in infants and lowest in adults. (22) Research shows that the prevalence of cow’s milk allergy is increasing, which may be explained by a decrease in breastfeeding and an increased feeding with cow’s milk-based formulas. Symptoms of cow’s milk protein occur often, but not always, within the first weeks after the introduction of dairy.
Many children with a dairy allergy develop symptoms in at least two of the following organ systems: gastrointestinal (50 percent to 60 percent), skin (50 percent to 60 percent) and respiratory tract (20 percent 30 percent). Symptoms of the gastrointestinal system include frequent regurgitation, vomiting, diarrhea, constipation, blood in stool and iron deficiency anaemia. Skin symptoms include atopic dermatitis and swelling of the lips and eye lids, and respiratory symptoms include runny nose, wheezing and chronic cough. (23)
Calcium Supplementation Precautions
Calcium is an important nutrient that’s needed to support strong bones, teeth and nails. We all require a relatively high amount of calcium in comparison to many other trace minerals, especially young people, pregnant women and older people. Calcium is also needed to control levels of magnesium, phosphorus and potassium in the blood, since these minerals all work together to balance one another.
Aside from dairy products like milk, calcium can be found in certain plant foods as well. Leafy green vegetables, like collard greens and kale, are great sources of calcium, as are other plant foods like okra and a variety of beans. Consuming calcium-rich foods is the best way to make sure you get the nutrients you need.
There has been a lot of controversy surrounding the negative effects of calcium supplements. Some research suggests that calcium can form fatty plaque buildup in the arteries and potentially lead to heart attacks or strokes. Other controversies surrounding calcium are related to potential risk for cancer, including breast and prostate cancer. (24)
Calcium supplements can also interact with several medications, including antibiotics, thiazide diuretics, digoxin and phenytoin. Calcium can increase the risk for kidney stones as well when taken in high amounts and interfere with the absorption of other minerals, like iron, magnesium and zinc.
Aim to get the recommended daily amount of calcium you need from foods first, and supplement only if needed to make up for any serious shortfall, like a calcium deficiency. Real food sources of calcium contain the enzymes, minerals, vitamins and other nutrients that your body needs for proper digestion and nutrient absorption.
Final Thoughts on Dairy-Free Diet
- People follow a dairy-free diet for different reasons, but for most people, they’re searching for relief from digestive issues, bloating, skin problems and respiratory conditions that come from eating dairy products.
- The primary sources of dairy that need to be avoided when eating a dairy-free diet include milk, cheese, butter, cream cheese, cottage cheese, sour cream, custards and puddings, ice cream, gelato and sherbet, whey and casein.
- Some benefits of going dairy-free include less bloating, clearer skin, less oxidative stress, improved digestion, and relief from dairy allergies or sensitivities.
- Completely cow milk-free alternatives include goat, coconut and almond milk. Fermented dairy options include kefir and amasai, which are often more easily digested, even by people with lactose intolerance. Ghee is another option that’s clarified and easily digested by people with a lactose and casein sensitivity.