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Milk allergies or nondairy milk substitutes?

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If you're dealing with milk allergies and children's nutrition, you could also check out news such as "Drinking milk to ease milk allergy? " and "New treatment may desensitize kids with milk allergies, say researchers at Stanford and Boston." One study explains that giving children with milk allergies increasingly higher doses of milk over time may ease, and even help them completely overcome, their allergic reactions, according to the results of a study led by the Johns Hopkins Children's Center and conducted jointly with Duke University.

And in another study by different researchers, standard test may miss food ingredients that cause milk allergy, says a recent study. The standard test used to detect milk-protein residues in processed foods may not work as well as previously believed in all applications, sometimes missing ingredients that can cause milk allergy, the most common childhood food allergy, which affects millions of children under age 3, a scientist reported back on March 28, 2012 at the 243rd National Meeting & Exposition of the American Chemical Society's (ACS), the world's largest scientific society.

Joseph L. Baumert, Ph.D., who headed the study, explained that thermal and non-thermal processing of foods can change the proteins responsible for milk allergy in ways that make the proteins harder to detect using the standard test, termed the enzyme-linked immunosorbent assay (ELISA). Processing, however, may still leave the milk proteins capable of causing itchy skin, runny eyes, wheezing and other sometimes more-serious symptoms of milk allergy, despite the inability to detect the milk residue.

"The results of these studies could be utilized by commercial ELISA kit manufacturers to aid in improving ELISAs for detection of milk residue in processed food products. These improved tests can be adopted by the food industry, if necessary, to allow for reliable detection of milk residue regardless of the type of processing that is used," he says, according to the March 28, 2014 news release, Standard test may miss food ingredients that cause milk allergy. "These improvements should not result in commercial tests that are more expensive or difficult for food processors to use."

Food processors use the ELISA to assure that that processed foods that do not contain milk and processing equipment in facilities that process milk products are free of milk allergens, the substances that can trigger milk allergy

Milk allergy is not the same as lactose intolerance, a condition in which people lack adequate amounts of the enzyme needed to digest lactose, the main sugar in milk. Lactose intolerance involves the digestive system, with symptoms like bloating, stomach cramps and diarrhea, after consuming milk or milk products. Milk allergy affects the immune system and can cause swelling of the throat, which makes it difficult to breath, and other symptoms that require immediate medical help.

Baumert explained that manufacturers and food-safety agencies use ELISAs to ensure that food-processing equipment and finished products are free of allergens or labeled with appropriate warnings. ELISAs are one of the most widely used diagnostic tests in the world today, a mainstay in everything from diagnosing pregnancy and detecting the AIDS virus in human blood to diagnosing a range of other diseases in plants and animals.

The tests leverage the amazing ability of antibodies, proteins formed by the body's immune system, to attach to and mark for destruction bacteria, viruses and other foreign substances

An ELISA kit for milk proteins contains antibodies that bind to milk proteins that may be in a finished food product or on the surface of shared manufacturing equipment. If a sample taken from a finished product or from the surface of food-processing equipment contains milk residue, a color change will occur in the test, indicating a positive result for contamination with milk proteins.

Baumert, who is with the University of Nebraska-Lincoln, explains, according to the news release, that heating and other processing of foods can make milk proteins aggregate together so it is difficult to get the milk proteins into solution, which enables them to be detected by the antibodies in ELISAs. The clumping, however, does not necessarily destroy the protein's ability to trigger an allergic reaction in sensitive people.

Milk proteins and allergies

Clumped-together proteins also would be likely to maintain their potency once they reached the human body, he added. Heating and other processing can also alter the structure of the protein, which can affect the ability of the antibody to bind to the milk proteins. Alteration in the protein structure does not necessarily mean that the milk proteins become non-allergenic for the majority of milk-allergic individuals.

His team studied and documented how ELISAs perform on several measures of accuracy when milk proteins undergo changes in foods that are boiled, baked, fried or heated in other ways. The results could help the food-processing industry and ELISA manufacturers make changes that better protect consumers with milk allergies, he says, according to the news release, noting that other scientists are doing similar research on foods that contain eggs and peanuts — both common causes of food allergy.

The scientists acknowledged funding from the United States Department of Agriculture AFRI Competitive Grant 2011-67017-20080 and the Food Allergy Research & Resource Program at the University of Nebraska-Lincoln.

The American Chemical Society is a non-profit organization chartered by the U.S. Congress. With more than 164,000 members, ACS is the world's largest scientific society and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

What the study researched

Commercial enzyme-linked immunosorbent assays (ELISAs) are commonly used by food industry for validating removal of allergenic residue from food contact surfaces and detection of allergenic residue in finished products. ELISAs are the method of choice due to their specificity, sensitivity, and ease of use in an industrial setting, however, limited validation of ELISA kits has been conducted on food matrices that have undergone thermal processing, the study's abstract notes.

This is important to note when selecting a commercial milk ELISA for monitoring allergenic residues as several variations in formats (qualitative and quantitative assays), specificity (detection of total milk protein, casein, or beta-lactoglobulin), sensitivity, and reporting units (NFDM, skim milk powder, casein, beta-lactoglobulin) exist. Milk proteins can be differentially affected by thermal processing thus limiting detection and affecting overall risk-assessment decisions. The effects of common processing techniques (boiling, baking, frying, retorting, and UHT) on detection of milk residue using commercial ELISAs were discussed at that 2012 meeting.

If you're allergic to dairy products and buy almond milk, are you getting mostly water by weight?

When you consider the price of almond milk, it’s actually mostly water by weight. You'd get more nutrition from almonds by eating a handful of whole almonds. But too many people are breaking their teeth on raw almonds, particularly if their teeth are brittle or they're aged. And young children could choke on nuts, so almond milk for older children is one possibility for some parents. But what can you do about the salt content?

At least if you want unsweetened almond milk, you can buy it without sugars or other sweeteners added. If you make your own almond milk, you don't have to add salt, and you don't have to add supplements and vitamins if you don't want to. You can get your dense nutrition and vitamins from all the other foods you eat.

If you look at how many almonds are in many commercial containers of almond milk, it might be one cup of almond milk containing the equivalent of only 4 to 5 almonds. But if you make your own almond milk, you can add water to a lot more almonds of your choice, such as a handful or a cup full. If you like the flavor, it really does taste better than some other types of milk substitutes.

Is commercial almond milk too high in salt content?

Although almond milk is healthy, the big problem for salt-sensitive people is that it's too high in salt. There is a problem finding local almond milk that's no-added sat or low salt versions in the unsweetened variety. There's no need to add all that salt. With most brands, you're getting 160 to 180 mg of salt per cup. Check out the article, "What the Heck Are You Eating: Almond Milk - Joy Bauer." In fact, here in Sacramento almond milk is so popular, it quickly gets sold out of the natural food aisle coolers, especially the unsweetened varieties.

You can make your own almond milk without adding sugar or salt or anything else other than almonds and water. The trick is to strain it through a cheesecloth so you get a milk-like consistency not full of little pieces of ground almonds that tickle your throat.

To make your own almond milk, soak it overnight in a covered jar of water in the refrigerator, then puree or emulsify it in a blender with liquid such as filtered water. Then you strain out all the tiny particles with a fine cheesecloth. Be sure to sterilize the cheesecloth by boiling it in water before you squeeze any food through it.

Too much salt added to some commercial almond milks?

An adequate amount of sodium for adults is between 250 and 500 mg/day. The Tolerable Upper Intake Level (UL) for healthy adults is 2300 mg/day. The 2005 Dietary Guidelines for Americans recommends an upper limit of 1500 mg/day for people over 50 and 1200 mg/day for those over 70. The average American adult consumes 4000 mg/day.

When you're consuming 180 mg of salt each time you enjoy a cup of unsweetened almond milk, it builds up too much salt in your system all day, since some people finish a quart of almond milk daily with cereal, smoothies, or frozen as desserts. Or they use it in baking. The salt adds up. Almonds don't grow on trees full of salt. It's added in commercial almond milk unless you find a brand that says no added salt and no added sugar, or you can make your own.

Too much added sugar or other sweeteners in sweetened almond milk

The next issue is with sweetened almond milk. It's so sweet to those on a no-added sugar regimen that it can surprise a person on a diet of unsweetened beverages with too much sweetness. Most sweetened brands of almond milk contain about 16 grams of sugar per cup. See, "Sugar Shockers: Foods Surprisingly High in Sugar - WebMD " Also you can see, "How many teaspoons in 16 grams of sugar."

There are 4 teaspoons of sugar in one cup of sweetened almond milk, enough to send your blood glucose levels soaring. All that sugar is not good for people with health conditions aggravated by eating sugar-sweetened foods. Most brands add cane sugar to sweeten the almond milk labeled plain or sweetened or flavored such as 'vanilla.' Unless the label says unsweetened, it has sweeteners, either syrups or cane sugar, or some other form of sugar or sweetener.

You can learn how to convert grams of sugars into teaspoons to get a more realistic picture in your mind of how much sugar you're consuming in one cup or one serving. See, " How to convert grams of sugars into teaspoons | MSU Extension."

You don't see many brands that add a pinch of stevia. You don't need added salt or sugar in your almond milk. You can sweeten it yourself if you want sweet, using fruit. And the salt doesn't really make the almond milk taste better, only saltier. If you're on a low-salt diet for high blood pressure, are salt-sensitive, or don't want the salt for medical reasons, you can buy any brand that doesn't add salt or sugar or make your own.

If a product says 16 grams of sugar per cup, there are 4 teaspoons of sugar in it for each 8-ounce cup

Plain almond milk is sweetened, not plain as in unsweetened. In the industry, the difference between plain and unsweetened is that plain means no flavoring added, but sweetener is added. Unsweetened means no added sweeteners. So how much exactly is a gram of sugar? One teaspoon of granulated sugar equals 4 grams of sugar. If you see people sweetening their tea of coffee with one teaspoon of sugar, why would you flow four teaspoons of sugar into a cup of almond milk you're going to pour over already sweet fruit or cereal or use in baking where you're adding other ingredients?

Or simply drinking because you're thirsty? If you're thirsty, try clean, filtered water instead of a cup of liquid with four teaspoons of sugar. That's 16 teaspoons of sugar per quart in your blood stream to hike up the surges in your blood glucose levels. You don't need that much sugar to quench your thirst or moisten your cereal or cream your berries. For thirst, there's always water. For a snack or meal, choose the unsweetened variety or make your own almond milk.

If you are feeding children, don't get their brains addicted to sweet liquids. They'll crave it later on on sodas, candy, and cake or take a step in the direction of diabetes or obesity, if they're predisposed to those conditions. Or at best, they'll use sweet foods to comfort themselves instead of exercise, relaxing music, or meditation.

You can find almond milk in varieties such as chocolate and unsweetened, vanilla and unsweetened, just unsweetened, or sweetened in similar flavors. See, "Is vanilla almond milk healthy? | NutritionFacts.org."

Plain often means sweetened but without vanilla or chocolate flavorings. See, "Chocolate Unsweetened - Almond Breeze." If you're buying unsweetened, check the added salt levels. Then check the various brands to see whether vitamin D2 is added, which is in most brands, or the better quality vitamin D3, more expensive, but what most people are taking when they take quality vitamin D3 supplements.

Some brands add a medley of vitamins to the almond milk, and some add the cheap calcium carbonate rather than the higher quality and more absorbable calcium citrate. If you take supplements, do you still want them in your almond milk? Some people buy expensive supplements but find the cheaper vitamins and minerals end up in their almond milk or other type and brands of various nut milk substitutes.

So get unsweetened if that's what you want. That way at least you can sweeten it yourself, if desired, with fruit or cereal or bake with it savory or sweet foods.

Very few people will add 4 teaspoons of sugar in a cup of tea or coffee, so why does the industry add it to almond milk? The answer may vary with the company, but the effects are very addicting to children and adults who get a dopamine release in their brain when they consumer table sugar, which brings them back to buy more or crave more sweet taste.

What's good about unsweetened almond milk is that it's vegan, has no saturated fats, no cholesterol, is high in calcium and dietary fiber, and is high in riboflavin, vitamin B2. Riboflavin helps your body get energy from carbs and helps in red blood cell production. It also helps to convert the amino acid, tryptophan to another B vitamin called niacin.

Almond milk also is high in magnesium. It's also high in vitamin A, vitamin B12, vitamin E, and zinc. The problem with commercial almond milk is that most brands add too much salt, which makers it very high in sodium. You may wish to check out the article, 6 Health Benefits of Almond Milk.

If you're interested in the calories in almond milk, for most brands, it's only 30, but there usually are 23 calories coming from fat, even though the total fat of a cup of almond milk is only 2.5 g. There's no saturated fat, but you get 0.5 g of polyunsaturated fat and 1.5g of monounsaturated fat in a cup of almond milk.

Another advantage is there's no cholesterol in this vegan beverage. With various brands, the sodium levels tend to vary betwen 160 mg and 180 mg of salt per cup. That's not a low-sodium drink. Low sodium drinks or soups are 140 mg per cup or less, and 115 mg per cup would be ideal, if industries would lower the salt levels in the unsweetened almond milk brands.

You're only getting 2.4 mg of carbohydrates per cup of almond milk. But there's 1 g of protein per cup. And in the unsweetened variety, there' s no added sugars. Check out one of the brands that has approximately these amounts per cup with 160 mg of salt per cup added, "Calories in Silk - Pure Almond Almondmilk, Unsweetened, Vanilla." After all, you're only getting 30 calories per cup of almond milk. One cup is one serving. An issue for some people is who can drink only one cup a day because it tastes so good?

Studies on vanilla flavorings

You can check out two of the in vitro studies that suggest vanillin, one of the many aromatic compounds in vanilla, may be protective against colorectal and cervical cancer. There was also a study showing that vanilla extract may interfere with bacterial communication, concluding vanilla “might promote human health by…preventing bacterial pathogenesis.” Or see an unusual vanilla study published out of Germany in 1999.

Never give a baby sugar in water to calm a crying baby or toddler. It only addicts the baby to sugar and sweet cravings by affecting the dopamine in the kid's brain. Children may remember tastes and smells from infancy, long before the child can put sweet cravings to calm emotions into words.

Whatever a child eats in infancy and as a toddler, the child probably remembers years into the future as a familiar food, particularly if it's reinforced by seeing family members eating similar foods. Also check out the video, The Best Baby Formula.

Almond milk salers are on the rise locally and nationally. A few years ago, almond milk manufacturers posted the biggest dollar sales gains among all nondiary milk substitute-alternative beverages in 2011. Soon sales of almond milk increased by 79 percent. So that as of last year almond milk accounts for 21 percent of the retail market for dairy alternative beverages.

In some natural food stores, you'll also find almond milk yogurt, but not the unsweetened variety. So you can make your own almond milk yogurt. See the recipes, "Almond Milk Yogurt (Homemade In Crockpot) Recipe - Calorie Count" or "How to Make Almond Milk Yogurt: 6 Steps." Or check out, "Almond Milk Yogurt (Homemade In Crockpot) Recipe - Calorie Count."

You may want to try all the varieties of milk substitutes to find out which you like. You can choose from hazel nut, hemp, rice, oat, flax, or soy milk or make your own milk from different types of nuts and seeds.

Some people don't want too much protein in their diets

Almond milk is significantly lower in protein than cow's milk. One cup has just 1 gram of protein compared to dairy milk, which serves up 8 grams per cup, and soy milk, which delivers 6 to 7 grams of protein per cup. Of course, that’s not an issue as long as you’re getting your protein from other sources. Then again, you can add a scoop or less of your favorite protein powder to almond milk to increase the protein content.

You don't need to buy the sweetened variety because if you're making a smoothie, just add fruit such as bananas, apples, or berries, if you want to sweeten your way. Or bake with the almond milk. Most brands of almond milk are fortified with calcium and Vitamin D. Taste it and decide whether almond milk is for you.

Or try a cup or two of almond milk in a raw vegan smoothie of equal amounts of peeled cucumbers, sliced frozen peaches, spinach and green cabbage pureed in your blender. Another way of sweetening the unsweetened variety to the level of sweetness you prefer is to add coconut water. The goal is to have the choice

Lactose intolerance and raw milk

The claim that raw milk reduces lactose intolerance doesn't pass the smell test, a new Stanford University study, "Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study" finds. The research findings are published today, March 10, 2014 in the Annals of Family Medicine.

This new pilot study aimed to determine whether raw milk reduces lactose malabsorption and/or lactose intolerance symptoms relative to pasteurized milk. Some sour news for lactose-intolerant people who hoped that raw milk might prove easier to stomach than pasteurized milk: A pilot study from the Stanford University School of Medicine shows little difference in digestibility between the two.

The study was small — it involved 16 participants — but the lead investigator says the results were highly consistent among all the participants and deflate some of the claims surrounding raw, or unpasteurized, milk. "It's not that there was a trend toward a benefit from raw milk and our study wasn't big enough to capture it; it's that there was no hint of any benefit," explains nutrition expert Christopher Gardner, PhD, according to the March 10, 2014 news release, "Claim that raw milk reduces lactose intolerance doesn't pass smell test, study finds." Gardner is a professor of medicine at the Stanford Prevention Research Center and senior author of the study.

Although relatively few people drink raw milk — it's thought to comprise less than 1 percent of milk consumed nationwide — Gardner says he believes in making sure that the claims regarding foods or supplements are based on sound science

"When claims about 'all-natural' foods are merely anecdotal, it works against the food movement and undermines nutrition science," Gardner explains in the March 10, 2014 news release, "Claim that raw milk reduces lactose intolerance doesn't pass smell test, study finds. "Let's get to the part that's real and do away with myths and anecdotes."

For people who are lactose-intolerant, eating dairy products can be painful. Their bodies lack enough lactase, which is the enzyme that breaks down lactose, the sugar in milk and milk products.

This digestion difficulty can cause stomach cramps and diarrhea, among other symptoms

Many people who report discomfort after consuming dairy products haven't been formally tested for the condition, making it difficult to know how many meet the clinical standards for lactose-intolerance, Gardner says, according to the news release. Although many strategies for coping with the condition exist — taking lactase enzyme tablets, choosing lactose-free foods — none of them fully eliminates the problem.

In recent years, proponents of raw milk have cited examples of lactose-intolerant people who were able to drink raw milk without consequences. Some raw-milk producers claim that because the product isn't pasteurized, it contains "good" bacteria that can increase lactose absorption.

"When I heard that claim it didn't make sense to me because, regardless of the bacteria, raw milk and pasteurized milk have the same amount of lactose in them," Gardner says, according to the news release. "But I liked the idea of taking this on since it seemed like a relatively straightforward and answerable question because the symptoms of lactose-intolerance are immediate. If drinking milk makes you uncomfortable, you will know within two hours. You either have cramps and diarrhea or you don't."

Do you get cramps and diarrhea from dairy products--within two hours of consuming that food?

For the pilot study, Gardner's team recruited 16 participants who were tested to confirm their lactose-intolerant status. The test measures the amount of hydrogen in a person's breath after drinking a beverage that contains lactose.

Higher levels of hydrogen, as set by a National Institutes of Health panel, are present when undigested lactose ferments in the colon, which occurs for "malabsorbers." (Of the 63 potential study participants who reported having mild to moderate symptoms and who were screened, only 43 percent actually met the malabsorption standard, Gardner noted.)

Participants consumed three different types of milk

The trial had a "crossover" design, meaning the participants each consumed three different types of milk during the course of the study: pasteurized milk, raw milk and soy milk, which doesn't have lactose and served as a control. "The crossover design is really compelling because it means each participant can evaluate their symptoms in the same way as they drink the different kinds of milk," Gardner says in the news release.

The participants were randomly assigned the order in which to consume the different milks, which were provided in unlabeled containers. Additionally, small amounts of sugar-free vanilla syrup were added to all three milks to make it more difficult for the participants to know which one they were drinking.

For eight days, the participants consumed one type of milk, with the quantities increasing between days two (4 ounces of milk) and seven (24 ounces)

On the first and eighth days, they consumed 16 ounces of milk and underwent breath tests days to gauge the amount of hydrogen they were exhaling. They had the option of consuming none or a smaller portion of the milk on any of the days if their symptoms became too severe.

After a one-week clearing-out period in which they consumed no milk products, the participants repeated the process for the two other types of milk. The participants were also given a log in which to record the severity of four symptoms — gas, diarrhea, audible bowel sounds and abdominal cramping — on a scale of 0 to 10, with 10 being the most severe.

When the team compared the hydrogen breath test results, they found little difference between the consumption of raw milk and pasteurized milk

In fact, the hydrogen levels on the first day of the eight-day period were higher for raw milk than for pasteurized milk, but those differences were no longer present on the eighth day, Gardner says, according to the news release. The participants also didn't notice a difference in the severity of their symptoms when drinking raw versus pasteurized milk.

Unsurprisingly, they reported the most discomfort on the seventh day of two portions of the trial when they consumed the largest amount — 24 ounces in one sitting — of either raw or pasteurized milk. In rating their symptoms on the 0-to-10 scale, the participants put their discomfort levels at an average of 4 when drinking the most of both types of dairy milk.

In the final tally, Gardner noted that 13 of the 16 participants were willing to drink the full 24 ounces of both raw milk and pasteurized milk

"I was stunned that so many of them tolerated that much milk because these were people who are clinically lactose-intolerant," he says, according to the news release. Irene Gabashvili of Sunnyvale, California says she happily volunteered for the trial, according to the news release. She remembers drinking raw milk as a young girl at her grandmother's farm, but said that in her 30s she began developing discomfort when she drank milk.

"By participating in this trial, I realized that milk is everywhere — it's in salad dressing, it's even in bread," Gabashvili explains in the news release. She used to purchase lactose-free products, but has since stopped because she found she liked soy milk after drinking it during the trial and she also discovered she could tolerate small amounts of pasteurized milk.

Although the number of participants was small, Gardner says the pilot study is a solid first step and provides meaningful evidence that could be pursued in a larger trial

He explains that future studies should note that the participants were willing to tolerate the discomforts of drinking milk for eight days, which he believed was long enough to determine whether their digestive systems adapted to the additional bacteria in raw milk. "We brought in focus groups of lactose-intolerant people to get feedback before we started the study, and they said they would be willing to put up with the symptoms for about a week, so I doubt if other researchers could find people who would be willing to do it for a year, but they might be able to get them to try it for two weeks," Gardner observes, according to the news release.

The lead author of the study is former undergraduate student Sarah Mummah. Other co-authors are study coordinator Beibei Oelrich, MD, PhD; research nurse Jessica Hope; and former undergraduate student Quyen Vu. The study was funded by the Weston A. Price Foundation and by Stanford's Program in Human Biology.

For more information, you can check out the website of Stanford's Department of Medicine, in which the work was conducted. Or see the site, Stanford University Medical Center. The Stanford University School of Medicine consistently ranks among the nation's top medical schools, integrating research, medical education, patient care and community service.

For more news about the school, please visit the Stanford medical news site. The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children's Hospital Stanford. For information about all three, please visit Stanford Medicine.org.

Other studies (or their abstracts) that you may wish to see by different researchers at different universities include, "Cinnamon Use in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis" and "In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices."

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