so… you think your lactose intolerant?
Lactose intolerance is a largely assumed issue within clinical nutrition and general medical practice settings. However, the evidence is not as straight cut as we are made to believe. Lactose intolerance is caused by a lowered prevalence of the Lactase enzyme in the small intestine which alters lactose digestibility and as a result can lead to gastrointestinal discomfort and symptoms (Mayo clinic). But, is it always lactose? Short answer... no. While lactose intolerance is prevalent in many ethnic groups, the prevalence is higher for people of Asian decent such as Chinese & Malay (Palacios, Badran, Drake, Reisner, & Moskowitz, 2009) (He, Sun, Jiang, & Yang, 2017).
It might not always be the problem and clinical tests should be done to ensure a proper diagnosis. A largely overlooked element of GI discomfort with dairy is Casein and whey protein intolerances (Milan. Shrestha,, Karlström, Martinsson, Nilsson, Perry, , ... & Cameron-Smith, 2020) (Pal, Woodford, Kukuljan, & Ho, 2015). To add to this; it may be that not all lactose in all dairy products is created equal with camel milk still containing lactose but preliminary studies (Cardoso, Santos, Cardoso & Carvalho, 2010) showing a much better tolerance to camel milk lactose vs bovine lactose, although the reasons why remain unclear. It is important here to note that camels are not true ruminant animals (cow, sheep, goat are ruminant) as many believe, they are often considered pseudo-ruminant that belong to the Tylopoda genera (Farah, 1993) and to understand that camel dairy is chemically and structurally quite different from Cow/Bovine dairy and is in fact the closet dairy in composition to human breast milk (Yadav, Kumar, Priyadarshini, & Singh, 2015). Sheep & Goats milk while generally better tolerated than cows milk so still contain many of the same casein proteins as cows milk, just in smaller amounts, which is why they may be better tolerated but people with true dairy allergies should avoid not just cow but sheep and goats milk too as they may still react to even these small protein amounts.
The evidence suggest the consumption of dairy is supported across many countries and from many differing milk producing species. However, the tendency now is towards Cow /bovine as the main form of dairy compared to a more diverse range (donkey, sheep, goat, camel) as previously consumed. When you couple this with the large-scale industrial framing for milk production that has had a large impact on the milk composition of the proteins found in cow's (Bovine) milk along with the proportionately higher consumption rates of cows dairy than every before in history it could be the answer as to the tolerance issues seen frequently in our population who claim lactose intolerance (Henchion, Moloney, Hyland, Zimmermann, & McCarthy, 2021).
With this in mind it may not be a true shift away from all dairy that is needed but a shift in the types of dairies we are consuming. The evidence for the use of Camel milk dairy as a bovine milk replacement for people with intolerances or allergies is strong along with the added bonuses of a mirid of reported nutraceutical* properties (Zibaee, Yousefi, Taghipour, Kiani, & Noras, 2015).
*The nutraceutical benefits of camel milk will be discussed in future blog posts.
References
He, M., Sun, J., Jiang, Z. Q., & Yang, Y. X. (2017). Effects of cow’s milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicentre, randomised controlled study. Nutrition journal, 16(1), 1-12.
Milan, A. M., Shrestha, A., Karlström, H. J., Martinsson, J. A., Nilsson, N. J., Perry, J. K., ... & Cameron-Smith, D. (2020). Comparison of the impact of bovine milk β-casein variants on digestive comfort in females self-reporting dairy intolerance: a randomized controlled trial. The American Journal of Clinical Nutrition, 111(1), 149-160.
Pal, S., Woodford, K., Kukuljan, S., & Ho, S. (2015). Milk intolerance, beta-casein and lactose. Nutrients, 7(9), 7285-7297.
Palacios, O. M., Badran, J., Drake, M. A., Reisner, M., & Moskowitz, H. R. (2009). Consumer acceptance of cow's milk versus soy beverages: Impact of ethnicity, lactose tolerance and sensory preference segmentation. Journal of sensory studies, 24(5), 731-748.
Cardoso, R. R., Santos, R. M. D. B., Cardoso, C. R. A., & Carvalho, M. O. (2010). Consumption of camel's milk by patients intolerant to lactose. A preliminary study. Revista Alergia de Mexico, 57(1).
Yadav, A. K., Kumar, R., Priyadarshini, L., & Singh, J. (2015). Composition and medicinal properties of camel milk: A Review. Asian Journal of Dairy and Food Research, 34(2), 83-91.
Zibaee, S., Yousefi, M., Taghipour, A., Kiani, M. A., & Noras, M. R. (2015). Nutritional and therapeutic characteristics of camel milk in children: a systematic review. Electronic physician, 7(7), 1523.
Zibaee, S., Yousefi, M., Taghipour, A., Kiani, M. A., & Noras, M. R. (2015). Nutritional and therapeutic characteristics of camel milk in children: a systematic review. Electronic physician, 7(7), 1523.
Lactose intolerance - Symptoms and causes - Mayo Clinic
Henchion, M., Moloney, A. P., Hyland, J., Zimmermann, J., & McCarthy, S. (2021). Trends for meat, milk and egg consumption for the next decades and the role played by livestock systems in the global production of proteins. Animal, 15, 100287.
