Sugar-free, gluten-free, dairy-free... It would seem nowadays that this is the holy (or unholy?) trilogy of hashtags accompanying Instagram posts of many foodies and the health-conscious the world over. Food bloggers and websites seem to be full to the brim of recipes calling for almond milk, oat milk or rice milk – what was once the domain of vegans and the lactose intolerant is now being brought to the masses.

Many mainstream alternatives to cow’s milk are now coming to the fore and there are many more options than the original substitute, soy. If you thought the 'wonder seed' quinoa couldn’t get any more super, you can now buy quinoa milk, or make your own! Yoghurts and ice creams made from coconut milk are now making their way from dedicated health food shops into large supermarkets. In short, those looking for dairy alternatives no longer have to trawl the internet to find them because living a dairy-free diet has never been easier.

As there seems to be an increase in the number of people going dairy-free, is it safe to presume that intolerance is on the rise, or are people cutting dairy out unnecessarily because they think it is healthier?

Let's take it way back. Milk is produced for nourishing infant mammals – it has all the nutrients they need to survive and grow with optimum nutrition. Early stage milk contains colostrum which are antibodies that can pass from mother to baby to help protect against diseases. Therefore, it makes sense that it would be good for us. Interestingly, we humans are probably the only animals to deliberately drink milk as adults, and in fact the only species to drink the milk of other mammals on purpose. 

Cow’s milk has been the subject of numerous advertising campaigns espousing its benefits throughout the last 50 years. And it’s true, milk is a great source of nutrients. One glass contains a host of essential vitamins and minerals as well as a good amount of protein and healthy fats: 

• Calcium – 28% RDA.

• Vitamin B2 (Riboflavin) – 26% RDA

• Vitamin B12 – 18%

• Vitamin D – 24% RDA

• Phosphorous – 22% RDA

• Potassium – 10% RDA

Two main causes of dairy intolerance

1. Allergy to cow’s milk:

This is when your immune system reacts to the actual proteins within the milk, producing antibodies against them. So now, whenever you drink milk, your body goes on the defence and produces the chemical, histamine. Histamine is the cause of the familiar signs of allergies like itching, swelling, hives and vomiting.

This type of allergy is most common during early infancy, but children usually grow out of it by age 5. 

2. Lactose intolerance:

Lactose intolerance is when you do not produce enough of the enzyme lactase that breaks down the milk sugar lactose into more easily digestible components to be absorbed by the small intestine. If lactose is not broken down, it travels to the large intestine where it is metabolised by intestinal bacteria, and the subsequent fermentation reaction causes all kinds of uncomfortable side effects like gas, bloating and diarrhoea.

As babies, we have the ability to produce lactase to break down the lactose in our mother’s milk. For most humans, lactase activity declines once we stop being breast-fed, leaving them unable digest lactose into adulthood. However, some humans have inherited a trait call lactase persistence, meaning that levels of lactase they produce stay high, so they have no problem with dairy products. Roughly 75% of the world’s population lose the ability to fully digest lactose on the transition into adulthood. 

There are some really interesting geographical differences however. Lactose intolerance is lowest around northern Europe (under 5%), whereas in Southeast Asia, nearly 100% are lactose intolerant. It can be fair to say that over time, since farming began to replace hunting and gathering, we evolved to be able to tolerate and digest lactose. Gaining this ability opened up a rich source of nutrients, so was therefore evolutionarily advantageous.

So, is dairy good or bad for me?

We have all been told that dairy is good for bone health because of the calcium content, and there is a great deal of evidence that supports this. However there is a school of thought that this is not the case, as countries that have a high consumption of dairy, like the US, often have high rates of osteoporosis, whereas other countries with low dairy consumption often have low rates of osteoporosis. However, it is important to remember that correlation does not equal causation – this does not mean that consuming dairy causes osteoporosis. There are a great many other factors to consider. 

One enduring anecdote from those who end up going dairy-free is that their skin clears up. There have been some studies that link acne and dairy consumption, but that isn’t to say that consuming diary causes acne. Overall, as with many things, there is no concrete answer, no ‘one-size fits all’. Some people can consume dairy and be fine, others may have adverse reactions to drinking a glass of milk, but be fine with yoghurt and cheese. 

There is no real reason to avoid dairy unless you have an allergy or are lactose intolerant, but it really depends on the individual and it's best to understand the different tolerances and what applies to you, if at all. We are all different! If you choose to eat dairy, go for the high quality stuff, ideally grass-fed and full fat. A lot of the benefits of dairy are due to its healthy fatty acid content, and these are wiped out in fat-free and low-fat alternatives, as low-fat dairy products are usually supplemented with extra sugar, which is never good! But it may be worth doing a little personal study to find out whether you function better by testing the wide spectrum of forms in which dairy comes.

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