What foods are considered “dairy”?
The short answer is: anything made from animal’s milk – be it from a cow, sheep, goat or camel. This includes butter, all cheeses and cultured milk products such as yogurt, sour cream and kefir and also products such as evaporated and condensed milks. It can also be referred to by terms such as curds, whey, ghee, casein, rennet, lactose, lactulose, whey and casein hydrolysates, lactalbumin and lactoglobulin. Contrary to common usage, it does not include eggs.
What are common "hidden" sources of dairy?
While it may be obvious that you shouldn't sit down to a grilled cheese sandwich, many other foods containing dairy are less obvious. Thus it's always important to read the label carefully for any pre-packaged goods and to ask the 'chef' for any foods that are prepared for you.
Some common, though not necessarily obvious, sources of dairy are hamburger buns, soft pretzels, barbeque-flavored potato chips and most baked goods such as cookies, crackers and cakes.
What is a dairy allergy?
It is estimated that 4% of the American adults and 8% of children are allergic to dairy products, making it one of the most common allergens. People who have dairy allergies are typically allergic to the proteins in dairy (called "casein" and "whey") rather than to the sugar ("lactose").
These proteins are present in all products made from the milk of an animal. However, these proteins are broken down to some extent in cultured milk products such as cheese, yogurt and kefir. Also, while all animals’ milk have these proteins in them, the protein molecules differ slightly from species to species. Thus, some people who are unable to tolerate cow’s milk are able to have goat’s milk or sheep's milk, while others are allergic to all products made from animal milk.
Dairy allergies can cause severe allergic reactions, including anaphylaxis, which is a life-threatening reaction. It is therefore important to work with your medical practitioner to identify what levels of dairy exposure are safe for you. Also, many people with dairy allergies also have 'cross-allergies' to soy, so it is important to make a careful trial before switching to soy as a dairy substitute.
What is lactose intolerance?
Lactose intolerane is one of the most common digestive intolerances, affecting an estimated 30 million American adults. Lactose intolerance can set in at any time, beginning as young as 2 years old.
Lactose is a sugar present in milk products. Lactose intolerance occurs when the body does not produce enough of the enzyme, called “lactase,” that the body needs to break down lactose coming in through your diet. This can happen as a natural aging process or as a result of illness such as celiac disease.
The good news is that lactose intolerance is relatively easy to manage, by switching to lactose-free milk, yogurt and ice cream, and by selecting only hard cheeses, in which the aging and fermenting processes has broken down the lactose. Also, there are over-the-counter lactase pills or chewable tablets you can take together with your first bite of dairy. These pills provide the lactase enzyme the body will need to digest the food.
Are there any other kinds of dairy intolerances?
Yes - while dairy allergy and lactose intolerance are the two most common reasons why your doctor may tell you to modify or eliminate the dairy in your diet, it is also possible to have an ‘intolerance’ to even lactose-free dairy that is not a ‘true’ allergic reaction. This means that they are caused by a digestive or even auto-immune mechanism but one that is not regulated in the way the body regulates allergies.
What type of dairy you need to avoid will depend on what causes your intolerance to it. For instance, people who have "histamine intolerance" have difficulty breaking down the histamine (a naturally-occurring chemical) that builds up over time in, among other things, foods that have been cultured, fermented or aged. Thus, they may have no problem drinking a glass of milk but have a variety of reactions to eating dairy products such as yogurt, kefir and cheese.
Similarly, although the causal link is not yet well understood, research suggests a connection between dairy (and gluten) and symptoms of ADHD/ADD in some children. For these children, it is important to avoid all dairy sources, not just those containing lactose.
How do I get started?
Glad you asked – for more information, you can check out our guide to Common Dairy Substitutes, download our Dairy-Free Shopping List for your next trip to the grocery store and then check out our New Diets Toolkit for meal planning resources, Food Challenge FAQs, a downloadable food journal and our exclusive Survival Guide to New Diets.
Where can I find out more?
Here are a few links to other resources on the web for people with dairy allergies, lactose intolerance and other dairy restrictions: