When it comes to allergies, we love to hate milk, but is ignorance making us easy prey for quacks?

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1 A gut reaction 'The field of food intolerence is full of hot air and not science' Foodcollection/Getty Images Simon Crompton Last updated September :00PM When it comes to allergies, we love to hate milk, but is ignorance making us easy prey for quacks? There are some extreme tales about milk, such as that of Sharon Hoskins, 46, from Rugby, who was reported in July to have had a hysterectomy to cure abdominal pains, only to find out later that her symptoms were a reaction to dairy products. Or Jackie Croasdale, 45, from Chorley, Lancashire, whose discovery that she had a milk intolerance put an end to two years of unexplained welts all over her body, tiredness, bloating and stomach cramps. But there are everyday tales, too. Gemma Groves, 30, from London, had no unpleasant symptoms at all but found that cutting out milk products on the advice of a complementary practitioner made her feel more energetic and less bloated. Even my eyesight seems Page 1 of 5

2 clearer, she says. These three are part of a growing band of people who are cutting out dairy products as public interest in food allergies and intolerances rises. Fed by the messages of diet gurus who claim that huge numbers of us have hidden food allergies, more and more of us are cutting out foods from our diet. The market in free from foods is booming, with business analysts predicting that the world market in food allergy and intolerance products will be worth more than $26 billion ( 16 billion) annually within five years. Dairy has become one of the most commonly blamed culprits for everything from bad bowels to wheeziness, with international studies now indicating that milk is the most frequently reported food intolerance. But are we all being drawn into anti-milk hysteria? Some diet and digestion experts are worried that, in a field that is desperately under-researched and poorly understood, there is public confusion, professional defensiveness and the risk of people being exploited by charlatans and big business. Professor Peter Whorwell is a gastroenterologist who runs a clinic at the Wythenshawe Hospital, Manchester, for people with unexplained bowel problems. Most of his patients ask whether they should exclude milk from their diet, but their problem, he has found, is more likely to be a poor diet or too much high-fibre food. Gut and diet specialists believe that public confusion about the difference between allergies and intolerances make it more likely that people mistakenly cut dairy from their diet. How many people know that a milk allergy is completely different from a milk intolerance and that a lactose intolerance is, in turn, different again? A genuine cows milk allergy, where the immune system goes into overdrive against the proteins in milk, is extremely rare in adults. It affects 2-7 per cent of babies under one year old, causing rashes, diarrhoea, vomiting, stomach cramps and difficulty in breathing. But most will outgrow it by the age of 6, and 90 per cent will have outgrown it by adulthood. In other words, unless you were allergic to milk as a baby, you re very unlikely to be actually allergic to milk. Milk allergy is a true allergy, involving the antibodies in your blood, so it can be easily tested for with a blood test. Milk intolerance, which is a difficulty in digesting milk, causes symptoms that come on more slowly than an allergic response. It doesn t involve the immune system at all, so can t be tested for in the same way. One type of milk intolerance is well researched and well understood by doctors. This is lactose intolerance, where the gut doesn t produce enough of the enzyme lactase to be able to process the lactose (sugar) in milk. This causes cramps, bloating, diarrhoea, flatulence and nausea within an hour of eating the product. Lactose intolerance can begin at any time of life, and can be brought on by conditions such as gastroenteritis. It is common in people of African or Asian background, where per cent of people have at least some lactase Page 2 of 5

3 deficiency (not all will have symptoms). But it s rare in Caucasians, where the figure is 7-20 per cent. Doctors can easily test for lactose intolerance using blood, breath and stool tests. However, most people in the UK who say they have a milk intolerance or allergy have neither. Dr Isabel Skypala, who runs the food allergy clinic at the Royal Brompton Hospital, in London, says that in 30 years as a specialist allergy dietitian she has diagnosed only two cases of milk allergy in adults. About 25 to 35 per cent of her patients say they have a problem with milk, but only 5 to 10 per cent will be lactose intolerant. That leaves the majority with a more mysterious problem. There s been lots of research on food allergies but very little on non-allergic bad reactions to food, especially in adults, and especially on milk, she says. And since the mechanisms of these adverse reactions are not understood, there is also no reliable way to test for them. She is sceptical about food sensitivity testing by complementary practitioners using devices such as Vega machines which purportedly measure the body s electrical conductivity when subjected to various substances and foods. I told one patient this week that, in my view, you can t diagnose a milk intolerance using that test. In fact, you can t diagnose anything using that test. Other food sensitivity tests of dubious merit include kinesiology (muscle testing), hair analysis and stool tests. And though she acknowledges the very real problems that some people have with milk intolerance, she believes that for many the root of the problem is simply the creaminess or fattiness of milk. Many of the people I see will be avoiding milk, and some will say they are allergic, though they aren t. Sometimes I suggest they try low-fat products, and things improve. Generally, people have more cheese and dairy products in their diet than they used to. We have more luxuries such as cream and yoghurt, and that s bound to have an effect on the digestive system. The improvements that some people experience when they cut out milk from their diet may be simply the result of changed routines, she believes. Going on any diet can in itself improve the way you feel it s partly the placebo effect. You feel that you re doing something to help yourself, feel better about yourself. You will probably eat more regularly and be stricter about what you eat not having the croissant you normally would because of the butter, for example. Whorwell agrees that there are many people who have real, but scientifically undefined, problems with milk. There are some people who just can t drink it, in the same way that some people can t eat wheat or nectarines. We all have foods that we don t feel comfortable with if I have onions, I feel gassy and my tummy feels peculiar. But too many people have been persuaded that milk is a problem food. Unfortunately the whole area of food intolerance is full of hot air and not much science, which makes it a very good area for charlatans, who come up with some crazy new diets and techniques for testing. Page 3 of 5

4 Given that the main priority is that patients get better, Whorwell believes in keeping an open mind until research comes up with some definitive answers. So, despite his concerns about alternative approaches, he recently conducted a study on a controversial test for food intolerance called the YorkTest, which has been criticised by many doctors as being unscientific. Against all his expectations, Whorwell found that adapting people s diet according to the test s findings did seem to make them feel better. But he was surprised at the hostility his result provoked from other professionals. When someone comes up with a study that indicates that a diet or test works, they just start shouting from the rafters, rather than doing the legitimate studies on food intolerance that would prove or disprove it, Whorwell says. The whole area is a can of worms. In the middle of this scientific minefield stands the public. The simplest message for those who believe they have a milk allergy is to be systematic about working out what s wrong with them (see details, left), and not to make radical changes to their diet until they have pretty good evidence that milk really is the problem. If you think dairy is upsetting you, cut it out for a while that s fine, Skypala says. But make sure you re getting enough calcium in your diet. There could be any number of things upsetting your gut, so we always advise people to exclude a food from their diet for only four to six weeks, and then reintroduce it to see if it really does make a difference. If you think you have a problem with milk... Go to your doctor, who can rule out milk allergy and lactose intolerance by referring you to an allergy specialist or a gastroenterologist for a blood test (lactose intolerance). Keep a food diary to see if you can link certain foods to certain symptoms. Record whether you consistently have flatulence or diarrhoea 20 minutes after milk and dairy: if so, you may have lactose intolerance. Note whether you have flatulence or diarrhoea 20 minutes after eating soft cheese but rarely after eating hard cheese (which contains less lactose): if so, it is further evidence of lactose intolerance. Try to avoid high-fat milk. If that doesn t help, try to avoid lactose. If that doesn t help, you may have a generalised milk intolerance. Times Newspapers Limited 2011 Version (31208) Registered in England No Registered office: 3 Thomas More Square, London, E98 1XY My Account RSS Site Map FAQ Classified advertising Display advertising Privacy Policy Syndication Terms & Conditions Contact us Page 4 of 5

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