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All About… Dairy

ALL ABOUT DAIRY

Dairy is actually a ‘grouping’ of foods which are talked about as one. However, within this category there are many different products, all of which require separate consideration because they each have different impacts when consumed by humans.

As you will know if you have looked at a few of our food lists, dairy is a confusing food in that in our Paleo templates, full fat butter and ghee are recommended as a great source of really healthy, nutritious fats . And yet, for those with impaired health: from digestive issues to immune conditions, butter – and sometimes even ghee – is completely eliminated. On strict initial stages of AIP all dairy – from ghee to milk – is avoided.

This food is so complex, despite it all being made from the milk of cows, because the nutritional profile, and hence how the fats, proteins and sugars are absorbed and assimilated by humans, changes in different dairy products. This seemingly single food source is actually contains all three macronutrients: fats, sugars and proteins – in varying amounts depending on the dairy product in question. Each of these macronutrients is dealt with slightly differently by the body – and the varying quantities of sugars, proteins and fats determines how inflammatory, insulinogenic and potentially ‘triggering’ the dairy substance is. As with everything in nutrition, how well these various products are tolerated relies heavily on the health of the individual consuming them.

 

But before we delve into what different dairy does:

 

The Hunter-Gatherer Diet Debate

 

Did cavemen eat dairy? No. Using animals for their milk is an innovation based on agricultural developments and farming herds of cows (as opposed to simply killing the animals that were opportunistically found in the process of the hunt). This ‘domestication’ of cattle is not part of hunter-gatherer tradition and so traditional Paleo diets (based on anthropological ideology as opposed to modern science) eliminate milk and every product that can be made from it.

But take a cursory glance at most Paleo websites or books and you will find that dairy has crept back into the diet of many individuals. However, you will always see this dairy listed with many caveats. This is because the nutrient profile of dairy products (and therefore the health benefits or detriments they confer) is heavily influenced by the quality of the milk used to make them. Milk quality is affected by two separate (though often linked) factors: the feed of the animals producing the milk AND the way in which the milk is processed prior to sale or manufacturing to make a dairy ‘product’ (such as cheese or yoghurt).

Milk in the UK is entirely different to milk in the US.  This is part of the reason why US websites and articles don’t translate effectively to the UK. The rules for processing both meat and milk in the US are slightly more lax than ours, allowing both more harsh farming practices (by this, read ‘feed-lot farming’) and also more ‘stuff’ into the food chain through the animal feed, such as hormones and antibiotics.

If you want to understand about the processing of modern milk and how the cows in factory farming are treated appallingly, our article on “Is All Milk Humane” covers this topic in depth.

 

Nutrient Profile – The Upsides of Dairy

 

Milk – the product that you would get if you milked a cow and drank it – contains a rich profile of the fat-soluble vitamins and also conjugated linoleic acid (CLA) which is known to be anti-inflammatory. It also contains proteins such as casein and whey – both of which have been linked to effective blood sugar regulation and positive health outcomes overall. A favourite of body builders, whey protein is used to build muscle and can form part of a healthy protein shake.

If you concentrate the fat from milk you get butter, from which you can make clarified butter or ghee. This ghee is almost 100% dairy fat – a rich source of a mix of saturated and unsaturated fatty acids, one of which is is CLA (mentioned above) the other is butyrate, increasingly believed to be beneficial for gut health and metabolic health. Whilst this fat profile doesn’t exactly make butter a ‘health food’, it certainly makes it a useful addition to the diet as a nutrient-dense fat source.

If you take the same milk product and ferment it you will make yoghurt. Unlike the fat-dense butter, milk, yoghurt and cream contain much more of the milk sugars and protein. Fermented foods such as yoghurts have been linked to improved microbiome health and to balanced yeast levels. Cheese too is a slightly aged dairy product, rich in creamy fatty acids and proteins. Whilst it (again) would never be touted as a health food, correctly prepared, aged cheeses can provide a great source of protein and fat.

 

It may be obvious by now, but the ‘heavier’, or ‘thicker’/’denser’ the dairy product, the lower the milk sugars and the higher the content of proteins and fats. This is why each dairy product is tolerated differently by people – because dairy sugars and proteins can prove problematic for some, meaning that the higher the fat content of the end product, the lower the potential for reactivity and inflammation as a result.

 

For decades government guidelines have maintained that drinking skimmed milk and eating low-fat yoghurts was preferable. This is milk with all of the fat taken out of it, leaving just the milk sugars and a small amount of protein. We have been advised that ‘low-fat dairy’ is ‘heart-healthy’, despite this leading to the commercial production of no fat yoghurts sweetened with sugar. We have been trained to think that ‘low-fat’ is better, though there is now a backlash to this ideology.

Strip the fat from milk and you’re basically left with milk sugar, known as lactose. This milk sugar can be well tolerated, and it is true that a lot of the European population have evolved with the genes which allow for the production of the enzyme ‘lactase’ which breaks down lactose.

For those who are lactose intolerant, milk and low-fat dairy can cause horrendous symptoms. This means that the lactose intolerance may actually be fine to consume butter and ghee, and even some full fat cheeses.

Then there are those who are reactive to dairy proteins. Dairy ranks as one of the most common allergenic foods globally, meaning that a sizeable proportion of people actually have immune reactions to the proteins found in dairy produce: either casein or whey, and occasionally both. For these individuals, consuming ghee might be possible, though the proteins left in butter are highly likely still to cause milk reactivity. Milk, cream, yoghurt and cheese would be off the table.

 

So what is it about Dairy that can be damaging? What is the lactose and protein doing to those who are sensitive to it? Why does a Modern Paleo template still recommend eliminating Dairy, at least for a short time? And why does AIP completely eliminate all Dairy – including ghee – at least initially?

 

The Downsides of Dairy

 

Grains, Hormones… a Diet of Convenience

 

When you consume Dairy you are drinking/eating the product of a cow – and this will be heavily influenced by the feed it receives during its life. (For more on how feed type can affect Dairy and meat in terms of quality and nutrient profile, our Deeper Science article on Grass-fed Meat goes into great depth here).

If the animals’ feed is all grains and cereals the milk produced is dramatically lower in the essential vitamins and minerals of grass-fed cows’ milk. Consuming grains will influence the fatty acid profile of the end product – exactly the same way consuming grains can affect us as humans. More than this, conventionally reared cows are normally given antibiotics against infection and often hormones in order to accelerate growth (not always common in the UK, but still possible). Animal husbandry has become the business of intensive farming and, in the eyes of the businessman farmer, needs must.

Cow’s milk, much like breast milk, will contain the traces of everything consumed by the cow – including drugs and hormones – and you wouldn’t give a lactating mother hormones, drugs and antibiotics that are a risk to her baby. Whilst a Modern Paleo approach is never going to be completely anti-drugs and pharmaceuticals, to take these in with everyday foods is absolutely not healthy for the human body.

 

Insulin

 

Whilst the vitamin profile of dairy products does contain some useful nutrients, most of these can be found in higher amounts from alternative sources (more on this will be coming in our Deeper Science section soon). Much of the ‘good’ or ‘unique’ features of milk are found in the fat. Removing all fat leaves simple proteins (quite inflammatory for some – see below) and simple milk sugar.

 

When it comes to ‘nutrients vs. anti-nutrients’ for our criteria of inclusion in a Paleo template, whilst the sources of Dairy which are richer in fat can be quite nourishing, low-fat Diary is a pointless, non-nutritious food with potentially damaging side effects and is therefore definitely eliminated.

 

And no, we are not absolutely anti-all-sugar here at Paleo in the UK, but it is worth mentioning the insulinogenic impact of dairy in the body.

Whilst dairy sugar (lactose) is not regarded as having anywhere near the equivalent effect of actual sugar in the body, it will stimulate a small release of insulin as it is ingested.

However, the proteins within dairy – whey in particular – are metabolised by the body in an highly insulinogenic way, meaning they prompt the body to release insulin. Normally associated with the consumption of sugars and carbohydrates, the release of insulin is essential to many bodily functions. Unchecked, permanently high levels of insulin can lead to insulin resistance which has metabolic consequences such as weight gain, increased adiposity and inflammation.

Insulin promotes the shuttling of energy (from the food consumed) into the cells of the body. This is not a problem, it is by design. This is how our muscles have energy to do their job. As with everything in the body, however, this becomes problematic when the insulin levels (and therefore energy storage levels) remain in excess. The insulin-raising effects of whey is precisely why bodybuilders LOVE this as a protein source. Its insulinogenic nature means that when they have depleted stores of glycogen in their muscles after a workout, whey will naturally raise insulin which, in turn, shuttles glucose back INTO the muscles in order for them to repair (and ultimately grow).

The issue comes because not everybody needs to have insulin levels rising and shuttling calories into storage. Whilst a discussion of the insulin-obesity hypothesis is beyond the scope of this article, suffice to say there is a Goldilocks zone for insulin (not too little, not too much) and the free consumption of milk proteins can easily contribute to higher insulin levels overall.

 

Digestion

 

Beyond metabolism (i.e. insulin regulation and cellular energy), dairy directly affects digestive processes.

Whilst ‘lactose intolerance’ as it is diagnosed revolves around whether an individual possesses the ability to make the lactase enzyme, lactose can create further digestive symptoms beyond indigestibility. Those with disrupted gut microflora might wish to be careful with lactose as it is a fermentable carbohydrate. Fermentable carbohydrates feed all gut flora, and therefore anyone with dysbiosis (imbalanced gut bugs) may wish to avoid consuming dairy products until their gut flora is balanced and feeding their microbiome does not result in symptoms of distention, bloating and gastrointestinal distress. Beyond the lactose, dairy proteins have been shown to be both difficult to digest and to preferentially feed a specific strain of E. Coli in the gut. Whilst this is a bacteria that is supposed to be within the human digestive tract, an overgrowth (due to overfeeding) can also cause dysbiosis and symptoms.

 

All of the above-mentioned health implications of consuming dairy sugars and proteins can be inflammatory. The entire purpose of the Paleo and/or AIP dietary approach is to remove inflammation from the body. Depending on the digestive environment, the adiposity and insulin resistance of the individual and also the genetic ability to break down lactose, Dairy has a different inflammatory potential in each person. This is why Dairy is difficult to pin down – and why initial elimination may result in gradual reintroduction.

 

 

Immune Health

 

Then there is the element of Dairy that truly eliminates it from any Autoimmune Protocol. As we have mentioned, Dairy is on the Top 10 list of allergenic foods according to international databases. However, this is describing ‘true allergy’, percentages of which are really quite low in terms of overall populations.

And yet any common allergen is an indicator of the potential inflammatory nature of that substance: in the case of Dairy, it is the dairy protein known as ‘casein’ which is thought to be most aggravating and can cause the production of antibodies. In anyone with autoimmune concerns, any protein or substance which is a known irritant or immune trigger is eliminated due to the potential for creating inflammation which will exacerbate the health condition.

Interestingly for anyone following an Autoimmune (or even a Paleo) diet, Dairy proteins are one of the most common cross-reactives with gluten. ‘Cross-reactives’ are when the immune system has identified an enemy (for example, gluten) and yet cannot distinguish the new food (Dairy) from the known enemy because of the similarity in the proteins’ structures. In those who have cross-reactive issues between gluten and Dairy, consuming Dairy is like consuming gluten for the immune system and will cause all the same symptoms: inflammation, Intestinal Permeability, digestive distress and associated systemic conditions.

Again, this does not happen in everyone – not even everyone with known gluten sensitivities. It is all a potential, and something to consider when personalising your Paleo protocol. For those following AIP, the elimination of all Dairy proteins is essential (which is why ghee is also eliminated) and there can also be no risk of hormones or antibiotics entering the system when you are trying to thoroughly ‘reset’ the immune tolerance and the regulation of the body.

 

So Why Is It So Complex?

 

From the arguments presented above you may grasp that Dairy isn’t one of the foods we can make strict rules about, long term. Whilst initially it is always wise to identify how your system functions without the influence of Dairy, for many reasons (not all of them nutritional – it can also make cooking, socialising and caloric sufficiency easier) Dairy can be a healthy and productive addition to the diet.

But if you want to eat Dairy, there are ways to do this that will be more beneficial than others.

Yes, realistically, the best milk and dairy produce you can get will be from organic, grass-fed cattle. But you also need to pay attention to the processing which happens to the Dairy you purchase.

In the Dairy world ‘processing’ means pasteurising and homogenising: an ordeal of heating and cooling the milk itself, eliminating any ‘bugs’ but in so doing stripping all of the decent nutrients and balanced profile out of the dairy, actually leaving it relatively nutritionally dead. All of the positives for including Dairy are eliminated when you consume products made from milk that has been treated in this way. Much like fat-free Dairy, whilst homogenised Dairy from organic, grass-fed cows may contain no anti-nutrients, it certainly does not contain the nutritional profile and nutrient-density that it could.

 

The solution is to buy ‘raw’ milk. Whilst this freaks some people out, because we are so used to our food supply being utterly sterile, finding trusted farmers is a large part of any journey with Paleo.

 

Finding a farmer you trust and a supply that you know is treated well will be the key to obtaining raw milk that is super-healthy, ultra-nutritious and, as far as is possible, completely safe to consume.

 

Once you’ve identified a great farm and can get good Dairy then you are consuming one of nature’s most nurturing foods, literally produced for growing calves and therefore rich in many essential building blocks for life. Whilst some would argue that humans are not calves, there are a certain amount of similarities between the needs of growing (and repairing) humans as there is with young animals. The nutrients in cows milk (especially the butyrate and CLA) are specially targeted to create healthy gut tissue and allow for protein synthesis and growth.

If you find raw milk, you can then do an enormous amount with it. Making homemade yoghurt will result in a fantastic probiotic-filled, nutritious food. If you clarify the raw milk butter you will make the best ghee you can find.

 

So, as with everything when you decide to follow a Paleo regimen, the quality is key.

 

HOWEVER… whether you’re Paleo or AIP – this is a RE-INTRODUCTION. You can only know your sensitivity to Dairy by removing it for a while prior to trying again.

And just a word of warning: Dairy, in our experience, can be highly addictive – from a texture and comfort perspective (as well as neurologically, potentially). Even if some ‘advanced Paleo’ people have brought dairy back into their lives with success – you have to be your own experiment. Remove, reintroduce (SLOWLY) and remember that wanting something to work really can influence how many symptoms you’ll ignore! Our complete guide to Reintroductions on Paleo is here, and Reintroductions on AIP is here.

References:

Agostoni, C. and Turck, D., Is cow’s milk harmful to a Chile’s health?, J Pediatr Gastroenterol Nutr. 2011;53(6):594-600

Bonthuis, M., et al., Dairy consumption and patterns of mortality of Australian adults, Our J Clan Nutr. 2010;64:569-577

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Functional Medicine Consultant, Health Coach & Genetics Specialist - working holistically to treat chronic health conditions including mental health issues, complex digestive disorders, hormonal dysregulation & autoimmunity.

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