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because they are unable to digest the sugar in milk called lactose. This sugar only exists in mammals’ milk, including human breast milk. In order for lactose to be digested it must be broken down in the small intestine by the enzyme lactase. Most infants possess the enzyme lactase, and can therefore digest lactose, but this ability is naturally lost in most people after weaning (commonly after the age of two). Losing the ability to digest lactose at this age is a clear indication of how humans are not designed to drink milk as adults; it is not a natural food for us. The frequency of lactose intolerance varies from around 90-100

per cent of Asians, 65-70 per cent of Africans, to 10 per cent of Caucasians (Robbins, 2001). In the absence of the enzyme lactase, lactose is fermented by bacteria in the large intestine but not digested, which leads to a build-up of gas. Symptoms of lactose intolerance include nausea, cramps, bloating, wind and diarrhoea. The treatment is straightforward: avoid lactose. This means cutting out all dairy foods and checking labels for lactose in bread, chocolate and other processed foods. Many lactose intolerant people obtain their calcium from plant-based sources.

Allergies An allergic reaction to cows’ milk is very different to lactose intolerance and can, in extreme circumstances, be fatal. An allergic reaction to milk occurs when the body’s immune system perceives one of the proteins in milk (either whey or casein) as a foreign invader and launches an attack. Symptoms are generally more extreme than in lactose intolerance and include excessive mucus production resulting in a runny nose and blocked ears. More serious symptoms include eczema, colic, diarrhoea, asthma and vomiting. Casein is more difficult to avoid as it is often used in the production of bread, processed cereals, instant soups, margarine, salad dressings, sweets and cake mix.

Cows’ Milk and Diabetes Type I diabetes is an autoimmune disease where the immune system’s ‘soldiers’, known as T-cells, destroy the body’s own insulin-producing cells in the pancreas (insulin is the hormone necessary for correct sugar metabolism). Subsequently, the body can’t produce insulin and is therefore unable to use sugar (glucose), which then builds up in the blood. This reaction of the immune system is thought to involve a genetic

predisposition (diabetes in the family) and short duration of breastfeeding coupled to an environmental trigger such as cow insulin or casein – both from cows’ milk or cows’ milk based formula. In fact, there are three culprits in cows’ milk: bovine serum

albumin (BSA), casein and cow insulin. When diabetic and healthy children were tested for BSA antibodies

in their blood, all diabetics had levels as much as seven times higher than the healthy children. (Karjalainen et al., 1992). Following studies have confirmed this (Hammond-McKibben and Dosch, 1997). Another protein called casein is found in both human and cows’

milk but about 30 per cent of human casein is different from cow casein and it is thought to be the reason why the immune system reacts to it and destroys it (Cavallo et al., 1996; Becker et al., 1995). When these milk proteins reach the small intestine, they are not

fully digested and fragments are absorbed into the blood. The immune system recognises these fragments as foreign intruders and attacks them. Coincidentally, some fragments are identical in structure to the surface of the body’s own insulin-producing cells in the pancreas (Karjalainen et al., 1992; Martin et al., 1991) and the body cannot distinguish between the two. Both pancreas cells and invaders are destroyed by the immune system and eventually diabetes results. Finally, cow insulin presents a problem as well and is present even

in formula milk (Vaarala et al., 1999). The immune system of genetically susceptible babies given cows’ milk formula reacts strongly to it by forming anti-insulin antibodies (Paronen et al., 2000). A study revealed that genetically susceptible children weaned too

early and given cow’s milk formula had a 13.1 times greater risk of type 1 diabetes than non-susceptible children breast-fed for at least

Food (and serving size)

Cauldron Original Tofu (100g - a quarter of the pack)

Sesame seeds (25g - a small handful) Sunflower seeds (25g - a small handful)

Broccoli (80g portion boiled in unsalted water)

Calcium (milligrams)

318 168 28 32

Curly kale (80g portion boiled in unsalted water) 120 Watercress (80g portion raw) Almonds (30g - a small handful) Brazil nuts (30g - a small handful)

Alpro or Provamel Soya Milk, calcium enriched (200ml glass)

Dried Figs (100g - four to six pieces of fruit)

136 72 51

240 250

Tahini (10g - two teaspoonfuls generously spread on one piece of toast or stirred into a bowl of soup)68 Granary bread (1 slice)


three months (Perez-Bravo et al., 1996). A study in 40 different countries confirmed this and found that the more meat and milk in the diet, the higher the risk of diabetes - the more plant-based food in the diet, the lower the risk (Muntoni et al., 2000). The avoidance of cows’ milk during the first few months of life may

reduce the risk of type I diabetes. Infants who cannot breastfeed from their mothers would benefit more from taking a plant-based formula such as soya-based formula rather than one based on cows’ milk.

Plant-Based Sources of Calcium There are many plant-based sources of calcium. Good sources include non-oxalate (see next column) dark green leafy vegetables such as broccoli, kale, spring greens, cabbage, bok choy, parsley and watercress. Also rich in calcium are dried fruits, such as figs and dates, nuts (particularly almonds and Brazil nuts), and seeds including sesame seeds and tahini (sesame seed paste) which contains a massive 680 milligrams of calcium per 100 grams. Pulses, including soya beans, kidney beans, chick peas, baked

beans, broad beans, lentils, peas and calcium-set tofu (soya bean curd) provide a good source of calcium. Other fruit and vegetable sources include parsnips, swede, turnips, lemons, oranges, olives and molasses. A good additional source is calcium-enriched soya milk.

Calcium Uptake and Absorption The amount of calcium present in a particular food is not the only important factor to consider. The bioavailability of the calcium should be considered when deciding which foods are a good source. This means how much calcium is actually available for

absorption into the body from the food. The calcium in dairy products is not as well absorbed as that in

many dark green leafy vegetables (Lanou et al., 2005). For example, calcium absorbability from kale was demonstrated to be considerably higher than that from cows’ milk (Heaney and Weaver, 1990). While spinach contains a relatively high amount of calcium, it is bound to a substance called oxalate which hinders calcium absorption (Heaney et al., 1988) so it is important to obtain calcium from low-oxalate green vegetables. Grains, nuts and seeds contain a substance called phytic acid

which was also considered to hinder calcium absorption but it’s been shown that it only has a minor influence (Hurrell, 2003). Caffeine and smoking have been shown to reduce calcium absorption (Barger-Lux and Heaney, 1995).

Vitamin D The body requires vitamin D to absorb and retain calcium in the bones. Vitamin D is either obtained from the diet or it is synthesised in the skin following exposure to sunlight. But recent concerns about skin cancer have encouraged us to cover up and avoid the sun. Subsequently people in the UK could be at risk of vitamin D deficiency if they get too little sun exposure year round.

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