What is a dairy-free diet?

What is a dairy allergy?

This occurs when your immune system reacts to one or more of the proteins (albumin, casein or whey) present in milk. If you are allergic, you will experience an immediate Type 1 hypersensitivity reaction. This response can be triggered by a very small amount of milk protein.

Reactions range in severity from acute symptoms like eczema, hives or diarrhoea to potentially life-threatening anaphylaxis or chronic malabsorption and inflammation. The only effective treatment is to fully eliminate milk and any products containing it.

What is an intolerance?

Most often this refers to an intolerance to lactose, the sugar naturally found in milk (cow, goat and sheep). We make an enzyme in our intestine called lactase, which breaks down the lactose in milk allowing it to be absorbed. As we age, some of us fail to produce sufficient amounts of lactase and without it, the sugar ferments in the gut. An intolerance to dairy is less severe than an allergy but it may still lead to digestive, skin and inflammatory symptoms. However, if your intolerance isn't due to lactose, it's likely to be caused by the protein component of milk.

Those with an intolerance may find they're able to consume small amounts of milk with no ill-effects, particularly the products which have been processed such as live yogurt or cottage cheese. Some people find it easier to tolerate the milk of goat, sheep or buffalo, rather than cow’s milk. We're all different and you'll need to establish your personal tolerance levels.

Who else might follow a dairy-free diet?

Some people prefer to avoid dairy for other reasons – perhaps they dislike the taste, they have a cultural preference or because they feel better without it.

What are the health implications of a dairy-free diet?

Milk is nutrient dense and makes a useful contribution towards our nutrient intake – from providing a protein source to supplying minerals like calcium and iodine as well as vitamins such as the B group and vitamin A.

We typically value dairy foods for their calcium content but, fortunately, there are plenty of alternative food sources such as green leafy vegetables and nuts and fish with bones, such as tinned sardines. Speak to your GP if you suspect you may be at risk of a nutritional deficiency, including a calcium deficiency.

In the UK, milk and dairy products are also one of the main sources of iodine. This little-talked-about nutrient is important for thyroid function. Those most at risk are young girls and pregnant women.

How will I know which foods to omit on a dairy-free diet?

Eating dairy-free involves omitting any product containing milk – these include the obvious ones like butter, yogurt, cream and cheese but you will also need to check labels for the following:

• Casein/caseinates
• Whey
• Ghee (though vegetable ghee is fine)
• Buttermilk
• Hydrolysed casein/whey
• Lactalbumin
• Lactose

Don’t forget milk and milk derivatives are likely to be found in:

• Batter (for pancakes, waffles, fish fingers etc.)
• Bread – many enriched breads will include butter and/or milk
• Low-fat and vegetable spreads
• Synthetic cream
• Crème pâtissière and custard
• Sweeteners

How should I go about a dairy-free diet?

• Audit your cupboards and food stores, and replace products containing dairy or dairy derivatives with suitable alternatives
• Get into the habit of reading labels
• Create a 'safe' list of the foods you enjoy and eat most often
• Be dairy savvy if a product is labelled 'dairy-free' – this only applies to cow's milk, not to other animal milks.

What are the alternatives to cow's milk?

Some people are able to tolerate goat, sheep or buffalo milk – these are readily available as both fresh and UHT products including milk, cream, yogurt and cheese.

Plant-based alternatives such as rice, oat, almond, coconut and soya are now widely available. Look for fortified versions which have nutrients like calcium and, in some cases, iodine added to them. If you're looking for a butter alternative, coconut oil works well – otherwise check labels carefully because some margarines contain whey or casein, and they also may not perform well when used for high temperature cooking such as frying.

Learn how to make dairy-free milk at home.

Is a dairy-free diet safe for everyone?

Dairy makes a valuable contribution to a healthy, balanced diet – this means if you have to replace dairy foods you need to ensure you get enough calcium, iodine and other key nutrients from the substitutes you choose. Failing to do so may result in nutrient deficiencies.

If you or your child have been advised to follow a dairy-free diet, request a referral to a registered dietician for specialist help and guidance.

If you suspect you are intolerant or allergic to dairy, refer to your GP for a diagnosis.

For more information on lactose intolerance see:

Information from The Dairy Council

NHS advice about lactose intolerance

NHS advice about childhood dairy allergy or intolerance

Do you follow a dairy-free diet? Share your experiences in the comments below.

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Kerry Torrens BSc. (Hons) PgCert MBANT is a Registered Nutritionist with a post graduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food. Find her on Instagram at @kerry_torrens_nutrition_

Jo Lewin is a registered nutritionist (RNutr) with the Association for Nutrition with a specialism in public health. Follow her on Twitter @nutri_jo.

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