Tuesday, June 19, 2018

Once, not so long ago, the answer to the question “do you drink milk?” would have been a simple one, because everyone drank milk. And although the majority of people still do drink milk, the picture today is a little more complicated, with milk alternatives on the rise as dairy-free diets grow in popularity.

If you’re someone who has given up milk for any reason, be it lactose intolerance, veganism or just not liking the stuff, it’s important to make sure you’re getting enough of the nutrients found in milk (especially calcium) from other sources. For an expert view on the benefits of milk and the problems associated with lactose intolerance, plus advice on the best foods and drinks to replace the nutrients commonly found in milk in your diet, we spoke to dietitian Junee Sangani of the British Dietetic Association.

What are the nutritional benefits of milk?

Milk is a great source of protein and calcium and plays an important role in bone health. Milk actually contributes 19% of the calcium intake in the diets of UK adults. For our body to get the same amount of calcium as that obtained from a glass of milk, we would have to eat 63 brussels sprouts, 11 servings of spinach or four servings of broccoli.

The protein found in dairy can also make us feel fuller for longer and delay our desire to eat , while the calcium may help to reduce the amount of fat that is absorbed in our gut.

In addition to protein and calcium, milk also provides nutrients such as iodine, phosphorus, potassium and vitamins B2, B1 and B12, which are beneficial after a workout in particular. Research suggests that milk provides benefits in muscle recovery and hydration after training – it’s a natural, tasty and affordable way to help your body get all the nutrients it needs following intense exercise.

Recent studies have also found that despite its saturated fat content, milk and dairy foods have shown no significant association in increasing the risk of developing heart disease or type 2 diabetes.

Are there any downsides to milk?

Although milk is a great source of protein, for certain individuals – for example, those with chronic kidney disease – excessive consumption of milk can be dangerous thanks to its phosphate levels. Also, some flavoured milks contain large quantities of sugar, as much as double the amount of sugar of regular cow’s milk, so it’s a good idea to check their nutritional information before consuming.

What is lactose intolerance and how prevalent is it?

Lactose intolerance is a type of enzymatic food intolerance which occurs when people have little or no lactase, so they can’t digest lactose. Lactase is an enzyme that aids digestion of lactose, which is a milk sugar. This breaks down lactose into two sugars called glucose and galactose, which can be easily absorbed into the bloodstream. People with lactose intolerance don’t produce enough lactase, so lactose stays in the digestive system where it’s fermented by bacteria. This leads to the production of various gases, which cause the symptoms associated with lactose intolerance.

Depending on the underlying reason why the body isn’t producing enough lactase, lactose intolerance may be temporary or permanent. Most cases that develop in adults are inherited and tend to be lifelong, but cases in young children are often caused by an infection in the digestive system and may only last for a few weeks. Many people who have this condition can tolerate small amounts of lactose so there may be no need to avoid dairy completely.

In the UK and Ireland only 5% of the population are thought to suffer from lactose intolerance. It’s thought that this is because the climate in northern Europe is more conducive to dairy farming, and consequently milk and dairy products have been part of the adult diet for centuries. In other European countries, and in areas where dairy is not traditionally consumed, the prevalence increases.

If you think you might be lactose intolerant, should you get a diagnosis before changing your diet?

Yes, the symptoms caused by lactose intolerance can be similar to several other conditions like irritable bowel syndrome, or milk protein allergy or intolerance, so it’s important to seek medical advice from your GP before cutting out dairy from your diet completely.

Symptoms of lactose intolerance usually develop within a few hours of consuming food or drink that contain lactose and they may include wind, diarrhoea, a bloated stomach, stomach cramps and feeling sick.

The severity of your symptoms and when they appear depends on the amount of lactose you’ve consumed. Some people may still be able to drink a small glass of milk without triggering any symptoms, while others may not even be able to have milk in their tea or coffee.

If you do stop drinking milk for any reason, what nutrients do you need to replace and what are the best foods and drinks for that?

Milk is a good source of protein, calcium, potassium, phosphorus, iodine and vitamins B2, B1 and B12 which are all important vitamins and minerals for health. To replace them, try the following foods and drinks.

Protein – meat, fish, eggs, cheese, yogurt, soy milk, lentils, quinoa and tofu

Calcium – Cheese, yogurt, bony fish like sardines and whitebait, calcium-enriched milk alternatives like soya, nut and rice milk, and vegetables (kale, greens, broccoli)

Potassium – Fruit (bananas, avocado and blackcurrants), vegetables (sprouts, mushrooms, spinach and parsnips) and nuts, lentils and kidney beans

Phosphate – eggs, cheese, yogurt, nuts (walnuts, peanuts, hazelnuts) and bony fish (sardines, whitebait, pilchards)

Iodine – Cheese, yogurt, and fish (cod, haddock, shellfish,scampi), potatoes, bananas, prunes

Vitamin B2 – Oily fish, eggs, nuts, meat, cheese, fruit (grapes, passion fruit) and vegetables (spinach, mushrooms, broccoli)

Vitamin B1 – Fish, nuts, seeds, fruit (pineapple, orange, melon) and vegetables (asparagus, peas, sprouts, spinach)

Vitamin B12 – Yogurt, cheese, eggs, meat, fish, fortified breakfast cereals

Do milk alternatives like nut or soy milk match up to cow milk, or do they contain different nutrients?

Soy (aka soya) milk is the most common cow’s milk alternative, and its fat and protein content is similar to cow’s milk. Rice and almond milks are lower in both protein and fat. Most milks are also now fortified with calcium, although coconut milk is not usually (and it has a high fat content), while plant-based milk alternatives may not contain the same amount of vitamins and minerals that occur naturally in cow’s milk. It’s important to check nutrition labels to compare the products.

What are the risk and potential benefits, if any, of drinking unpasteurised milk?

When milk is pasteurised it is heated up very quickly and cooled down again. This process ensures that harmful bacteria and potentially dangerous organisms are reduced, decreasing the health risk. Unpasteurised milk has not been heat-treated. Unpasteurised milk may contain pathogens that could be harmful to health – sales of unpasteurised milk are limited in England, Wales and Northern Ireland because of their links with food poisoning. It probably isn’t worth taking the risk, because studies have not found significant nutritional differences between unpasteurised and pasteurised milk, or different effects on health.