Are you missing cheese? Or milk in your tea?

Dairy can be problematic for many people with IBS, BUT you may not need to be completely dairy free to manage your digestive symptoms. Here's all you need to know about dairy and irritable bowel syndrome.

In this episode:

• Lactose and Lactase: The role of lactase, the enzyme needed to break down lactose. Lactose intolerance can vary among individuals, including genetic factors and temporary intolerance after a stomach bug.
• Effects of Lactose: Excessive lactose can affect the gut, leading to symptoms like loose stools, gas, and diarrhoea. High-fat dairy foods can slow digestion and trigger symptoms.
• Lactose Content in Common Foods: Examples of lactose content in various dairy products, including cheese, ice cream, yogurt, and milk. Some people can tolerate limited amounts of lactose.
• A2 Milk: What's the difference between A1 and A2 milk, and the potential benefits of A2 milk for those who have issues with A1 milk. Responses to milk can vary among individuals.
• Nutrients for Dairy-Free Individuals: Essential nutrients like calcium and iodine for individuals who are dairy-free.
• Choosing Alternative Milks: Which milks are best if you're avoiding dairy?

Links

• Website - www. goodnessme-nutrition.com

Would you like to start eating

ice cream on holiday again?

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Maybe you're really missing a nice cheese

board at Christmas or that stringy long

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cheese as you pull apart a piece of pizza.

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I'm talking about dairy, lactose

and whether you need to remove it

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from your diet if you've got IBS.

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It could be that you're

just sensitive to lactose.

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Toes, and we'll talk about how

much you might manage and how

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to eat an appropriate amount.

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If you have I b s.

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or maybe you are vegan or you are allergic

to dairy, and I'll explain how to eat

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a well-rounded healthy dairy-free diet.

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In this episode of the Inside

Knowledge Podcast, you'll find out

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all you need to know about dairy

and irritable bowel syndrome.

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Let's get going.

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Hello!

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Welcome to episode 19 of The Inside

Knowledge with me, Anna Mapson.

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I work with people who have IBS and so

all the time I'm talking about diets

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that are good for the gut, what you

can do to avoid problems like bloating,

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constipation, diarrhea, excessive gas.

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These are the things that my

clients suffer with all the time.

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Dairy is a really common thing that

people will exclude, just like gluten

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which I covered in episode 16 about

should you go gluten free if you have

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IBS, today is should you go dairy free.

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When I'm talking about dairy,

I mean anything like cow's milk

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really, including cream, butter,

yoghurt, cheese and other foods.

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I'm just talking mostly about

cow's milk when I talk about these

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products, but obviously it does

include other animal milk products.

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Milk is mostly water, it's like 87 percent

water normally, and the solids that are

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in it are made up of lactose, that's

the sugar, some fats, and then also

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some minerals, and then there will also

be Protein, which is whey or casein.

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Lactose is the sugar in dairy

which most people react to.

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It requires us to have an enzyme

called lactase to break it down.

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And people have a tolerance limit

to lactose, depending on their

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ability to make this enzyme, lactase.

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So dairy intolerance might not mean you

need to be dairy free, but it could also

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mean that large portions of cheese and

milk all in the same meal might be more

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of a trigger than if you occasionally have

little bits of dairy containing foods.

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Our ability to process this sugar

is dependent on our ability to

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create this enzyme, lactose.

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Genetically, some people...

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have a harder time creating

this enzyme than others.

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People from Southeast Asia generally have

got high rates of lactose intolerance

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because they don't genetically have this

enzyme as freely as people from Northern

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Africa and Europe where people have grown

up farming cows and having dairy as part

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of their diet for many thousands of years.

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It's also might be interesting to note

that lactose intolerance is common and

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kind of temporary after a bout of food

poisoning or having a stomach virus.

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So you might find that you, after

recovering from a stomach bug,

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struggle to process dairy, but that

doesn't mean that it will last.

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It's often, you know, children and babies

particularly can really struggle with

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dairy containing foods after a stomach

bug for a couple of days, maybe a week,

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and then you should go back to normal.

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Lactose is a di saccharide.

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So if you remember the FODMAP episodes,

the previous two that I've just done on

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low FODMAP diet, that means it's a sugar.

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Um, it's made up of glucose and

lactose, and if you don't have

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enough lactose to break it down,

then your digestion will just be

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overwhelmed with this excess lactose.

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There are also proteins in

dairy which can trigger.

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issues, particularly allergic

reactions, and this is mostly casein.

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Dairy allergy is quite rare, though,

and it's most often identified when

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you're in childhood, but It might be

more difficult to diagnose a dairy

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allergy if you have a milder reaction,

especially one that is delayed.

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When we talk about allergic reactions,

people who have this can either get an

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instant reaction, like if you think people

who get anaphylactic reaction to peanuts,

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for example, or it can be delayed with

dairy, so sometimes people can get a

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massive flare up of their eczema and other

atopic conditions like asthma attacks,

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that kind of thing, that can be anywhere

from three hours to three days later

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after having a large amount of dairy.

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So, going back to lactose,

let's have a think about what

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dairy does for people with IBS.

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There are a number of ways that lactose

or high dairy meals can affect you.

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One of them is, like I said, if you

don't have lots of lactase, then

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you've got excessive lactose in the gut

and it can pull water into the small

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intestine, causing loose stools and

gas, and that can trigger diarrhea.

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Or the undigested lactose molecules can

pass through to your large intestine,

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which can ferment and cause gas

and then also can trigger diarrhea.

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So that's the way it can affect our

digestion, but also, if you think about

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high fat meals, we know that they can

slow down your digestion, causing slower

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transit of gas coming through the gut,

and that can really increase your pain

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and just, you know, having a flare up

of excessive gas can also really trigger

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your gut brain connection, really making

you worry so sometimes it's high fat and

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that's if you're eating a lot of cheese.

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So if it's lactose that is your trigger,

there are some things you can do to

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try and include dairy in your diet that

avoid you getting those kind of symptoms.

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People who have a lactase deficiency

can normally tolerate around 12

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grams of lactose per meal without

getting any symptoms or the

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symptoms will be relatively mild.

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So you might be surprised to know how much

lactose is actually in common foods such

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as cheese and ice cream, yogurt and milk.

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Around 40 grams of a hard

cheese like cheddar or parmesan.

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That's only one gram of lactose for 40

grams So you can actually have quite a

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lot if lactose is your issue Then you

probably could have quite a lot of cheese

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But as I mentioned you may be tripped up

by the high fat content in cheese and that

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can also trigger either slow digestion

gas or diarrhea, so It might be the fat

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content of cheese rather than the lactose.

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Butter, which some people also try

to avoid, has traces of lactose.

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Obviously, if you're allergic to

dairy, you wouldn't ever include

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these kind of foods, but if you

have a lactose intolerance, you're

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probably going to be okay with butter.

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There's very little lactose in butter.

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The next food that sometimes

people avoid is ice cream.

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And actually for around 88

grams of ice cream, there's

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only three grams of lactose.

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So if you were to have like a big

bowl of ice cream, you're probably

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somewhere still in the region of

six to seven grams of lactose.

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So as long as the rest of the meal doesn't

have any lactose like cheese, or you're

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not having a really milky drink with

it, you're probably okay with a bit of

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ice cream on a one off occasion as well.

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If you move on to the higher lactose

containing foods like yoghurt and milk,

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around 200 grams of yoghurt, like a plain

whole yoghurt, will have somewhere in

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the region of 10 to 12 grams of lactose.

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So that is a good portion of yoghurt,

, which would be around the sort of

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limit that you can manage for lactose.

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The main biggest jump comes if

you're drinking cow's milk, and

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this is where a glass of milk,

like a big glass, 275 millilitres,

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would include 16 grams of lactose.

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So that would easily tip you into the

region of getting a lactose intolerance.

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All these kind of results are

going to be very individual.

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So some people will be fine with

cheese and will be able to manage

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a little bit of milk in their tea,

but couldn't tolerate like a latte

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or a hot chocolate made of milk.

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Whereas other people just wouldn't

be able to manage any of that.

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So you do have to experiment a bit

to try and find your best level.

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But if you enjoy eating dairy

containing foods, there probably

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is a way that you can work it out.

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So you just need to work out

what your limit is for lactose.

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What about lactose free milk?

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Well, this is a good alternative

for you if you enjoy dairy foods,

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but you have a problem with lactose,

you can switch to lactose free milk.

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It's just milk that's added, added

an enzyme to remove the lactose.

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So you can also get some yogurts

where this enzyme has been added and

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it just helps to improve digestion

for those who struggle with it.

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So it's a definite advantage which

means you can still enjoy some

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of those foods like yogurts and

milk without the digestive issues.

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Another question I've been asked about

dairy is what about that A2 milk?

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So you might have seen this in the

shops, you may, may not have, it's

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not very common and it's quite hard to

find but sometimes it's talked about

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online as an alternative to dairy.

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Basically, it's to do with the

protein casein that is in milk.

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So it's about 30 percent

of the protein content.

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Whey is another type of

protein that's in milk.

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There are three different types of casein.

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There's alpha, beta and kappa

and that beta casein has got

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two types, there's A1 and A2.

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In northern Europe, when farmers were

farming dairy, somewhere between five

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and ten thousand years ago, there was

just a genetic mutation in the cows.

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that increased the ratio

of A1 to A2 beta casein.

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There are very small molecule

differences in the chemical

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structure of this protein component.

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A1 milk produces something called beta

casomorphine 7, which has morphine like

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effects, as in It slows down the transit

time, and this has been shown in animal

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studies, but not actually in humans.

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One study has shown that some people

who drank more A1 milk, had looser

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stools, and Had more IBS type issues.

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So there are some evidence base that

a 2 milk may improve your ability

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to digest it and that is because

everybody's so different But the majority

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of cases it's probably not going to

make a difference if you don't have

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a problem digesting dairy There is

no point in trying this type of milk.

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So that opioid like effect though It has

been shown in some people to decrease this

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stool mass so like have less bulk in your

stool ready to go and it may also affect

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the bacterial mass and the motility and I

think that is really interesting thinking

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about whether it's worth a try for you.

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So I hope that has given you some

confidence that you can include

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some aspects of dairy, particularly

the lower lactose foods, in

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your diet if you so enjoy it.

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But if you're vegan or maybe you do have a

dairy allergy and you don't have any dairy

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at all, then what nutrients must you think

about in order to stay really healthy?

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Well, obviously calcium, that is the

main thing that we often think about.

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The key ways to include calcium in your

diet include green leafy vegetables,

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sesame seeds, almonds, and tofu

that is in a water based solution.

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So any tofu that has been sloshing around

in its calcium solution will retain

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some of that calcium when you eat it.

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And it's a really great way to

include calcium in your diet,

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particularly because it has also

good protein sources for vegans.

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Other ways to maximize your calcium

intake is to make sure that you

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have sufficient vitamin D and that

will help you to use the calcium

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that you do get out of your diet.

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Normally people are recommended to eat

two to three portions of dairy per day.

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So I really want to stress that you

should get two to three portions of

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vegan, calcium rich foods per day as well.

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Especially because the calcium that is in

plant based sources isn't as bioavailable,

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which means it's harder for your body

to use them from plant based sources.

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It's not impossible, and it's

completely possible to have

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a great, healthy vegan diet.

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It's just something you

need to think about.

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Another nutrient to think about is iodine.

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This.

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is not naturally really high in dairy

based foods, but it is found in dairy

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that we consume because of the way that

they clean out the dairy machinery.

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So they slosh it on to make sure that

it is sterile and that can then lead

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to some iodine getting into our milk.

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This is why organic milk tends

to have slightly lower levels of

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iodine than non organic dairy milk.

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Iodine can be found in other

things that are from the sea.

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So for vegans, seaweed is a great

option and I would sprinkle that

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on your food and add it a couple of

times a week to make sure that you're

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getting some sources of iodine.

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If you're dairy free, but not vegan,

you could also eat some white fish,

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so things like cod, haddock, or

include Prawns and other seafood,

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they will have levels of iodine in

them that would add to your diet.

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And iodine is one of the nutrients

that is routinely missed when people

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completely give up dairy and are

following a vegan diet with no seafood.

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This is because it's not something

you automatically think about,

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but people can get very low in it.

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And some of the issues with not having

enough iodine may be to reduce your

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ability of your thyroid to work properly,

and that maintains your metabolism.

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and controls your weight

and all kinds of things.

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The thyroid is really

essential for keeping us going.

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Like our little clock inside our body.

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So iodine is helpful for that, but

also for a range of other things.

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But it's such a micronutrient,

like we don't need a lot of it.

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So I'm not suggesting anyone should rush

out and start taking loads of supplements.

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But what you can do is just think about

where else to get it from your food.

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It's not routinely added to alternative

milks in the same way that calcium is.

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So you'll often find calcium

carbonate added to almond milk,

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soya milk, those kind of things.

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But iodine just isn't added as much.

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So if we move on to choosing alternative

milks, there are There are obviously

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tons out there nowadays of almond milk,

soya milk, oat milk, all different

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brands, different tastes and different

types of nut milks that you can get.

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They're actually not really allowed

to be called milks, I think they're

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called almond drink most of the

time because milk is a protected

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characteristic of the dairy trade.

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And I get it, it's not an actual

milk, but, you know, it's a milk

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drink, so it's semantics, isn't it?

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Um, anyway, a question I get

sometimes is, What should I

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actually drink if I am dairy free?

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What is the best alternative?

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My main advice for you is

to think about what you like

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drinking and just choose that.

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There is no way you're going to

replace the nutritional content of

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dairy with a plant based alternative.

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There just isn't anything that is a good

match in terms of the protein content,

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the calcium content, vitamin D, iodine.

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But you don't have to get

those nutrients from a milk.

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So you can have all of those

nutrients in your very healthy diet.

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It doesn't need to come from milk.

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So the best thing to do when looking

for an alternative to dairy, if you're

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switching out to a different source, is

to think about something that you like.

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If you want to have coconut milk on your

cereal and then soya milk in your tea,

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as an example, that is completely fine.

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It's just whatever you

will enjoy the most.

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For smaller children who are in a dairy

free household, or kids who can't drink

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a lot of milk, I would try to make an

exception to that, and there is certain

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milks which are aimed at children.

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I don't want to like, brand drop or

anything, but there's Alpro milk,

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soya one, that's called Growing Up, or

something that's made for children, and

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it does try to match, um, some of the

nutrients, and try to like, be a bit

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more of a overall good nutritious milk

rather than something like oat milk,

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which is just basically oats and water,

which is not going to give you the amount

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of nutrients that a dairy milk would.

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So that's one of the reasons where,

especially when we've got children.

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With growing bones, teeth,

everything like that.

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They're really energetic.

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You want to make sure that they're

hitting all of those key nutrients, but

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once you stop worrying about what is

the best milk for you on a nutrition

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basis, and you just think about how to

get those nutrients in another way, Then

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it just comes down to taste and personal

preference and there's no real drama.

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The only thing I would say is

that some milks may contain

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things that can set off your IBS.

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So if you're someone who's very

sensitive, be aware of ingredients.

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Like carrageenan or other

thickeners and gums that try to

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emulate some of the fatty content.

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So where you're using plant based

milks, they're often very thin

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and they try to add thickeners to

make them a bit more palatable.

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These in some people with IBS can make

your stomach a little bit sensitive.

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The same goes for things like

natural flavors or sweeteners.

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Just check that it is suitable for

you and if other products containing

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those things also have the same effect

before you rule them out completely.

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I hope with this episode that you've

been able to see there are some nuances

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in dairy consumption that need to be

tailored to you and your experience of

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eating and drinking these kind of foods.

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In my experience of working with lots

of people with IBS, there is a very big

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difference to somebody who has cereal

in the morning with loads of cow's

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milk on it, maybe two or three lattes

throughout the day, and then something

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like a cheesy pasta sauce with loads

of, you know, a sauce made of milk and

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loads of cheese for their main meal.

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Compared to somebody who might have

a A little bit of feta in a salad,

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maybe you have a tiny bit of milk

in a tea a couple of times a day.

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That consumption of dairy is very,

very different, but can still give

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you some of the benefits of getting

your correct calcium intake and

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making sure you're getting some

of that iodine that I mentioned.

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And also just a good source of protein,

so we mustn't forget that dairy is

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also a good source of protein as well.

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And if you found all of this helpful,

but you still don't know how to apply

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it to your own life, then get in touch,

because I take on one to one clients

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in my gut to reset, where I work with

people individually over three months.

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If you want to work with me, just come

to my website and sign up for a free

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discovery call where we can talk about

the issues that you're experiencing

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and how I may be able to help.

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That's it for this week.

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I'm going to be back next

week, so bye for now.