Episode 80 - Are You Avoiding Dairy For The Wrong Reasons?

Are You Avoiding Dairy For The Wrong Reasons?

Put your hand up if you avoid dairy!

Do you have a clinical reason to avoid it? You may not tolerate it or follow a vegan diet and choose to avoid all animal products. That is A OK. But unless you fall into those categories, it’s actually a really nutritious food that is useful as an endurance athlete.

In this episode I discuss:

• Some of the reasons you might need to avoid dairy
• How do we digest lactose or milk sugar
• Why milk sugar is not bad for us
• Why I dislike a lot of milk alternatives on the market
• What is lactose intolerance?
• What are the signs and symptoms of lactose intolerance?
• How do you diagnose lactose intolerance
• What treatment is there if you are lactose intolerant
• Some cool research in probiotics in lactose intolerance

Links:

To get your nerd on, dive deeper into this Systematic Review paper: The effects of probiotics in lactose intolerance: https://pubmed.ncbi.nlm.nih.gov/29425071/

Check how well you’re doing when it comes to your nutrition: Triathlon Nutrition Checklist

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Episode Transcription

Episode 80: Are You Avoiding Dairy For The Wrong Reasons?

Taryn Richardson  00:00

Welcome to the Triathlon Nutrition Academy podcast. The show designed to serve you up evidence-based sports nutrition advice from the experts. Hi, I'm your host Taryn, Accredited Practicing Dietitian, Advanced Sports Dietitian and founder of Dietitian Approved. Listen as I break down the latest evidence to give you practical, easy-to-digest strategies to train hard, recover faster and perform at your best. You have so much potential, and I want to help you unlock that with the power of nutrition. Let's get into it.

Taryn Richardson  00:42

Welcome to this episode of the Triathlon Nutrition Academy podcast. Happy Friday, or if you're in the northern hemisphere, happy Thursday. Today, we're going to dive deep into dairy, because dairy has got such a bad rep. Now put your hand up if you're somebody that avoids dairy. There might be a clinical reason that you don't consume it. Maybe you have a milk protein intolerance, which means that you just don't digest it at all. Or maybe you follow a vegan diet where you don't have any animal products whatsoever. And that's totally fine. But it's really common for me to hear and talk to athletes who avoid dairy for no real reason. Maybe somebody has told them they should do it. Maybe they've read it on the internet, or maybe they don't think they tolerate it. We've been having this discussion inside the Triathlon Nutrition Academy this week. And I thought that you would benefit from hearing about it too, because there's a lot of people that avoid dairy for all the wrong reasons.

Taryn Richardson  01:41

Did you know that we are the only mammals to drink milk from another species? And we're also the only ones that continue to do so into adulthood? And we've evolved or adapted ourselves to be able to do that. Right in the beginning when farmers started to domesticate cattle, some humans develop this mutation that gave them the ability to still digest the lactose in milk. Now that trait turned out to be an advantage and that gene spread across populations. And now people can digest milk into adulthood, which is pretty cool.

Taryn Richardson  02:17

So in this episode, I want you to start to think about you and what you do. Unless you're somebody that has a severe intolerance to dairy or chooses to avoid it for ethical reasons. It's actually a really nutritious food. It's a great source of protein and some carbohydrate. It's a great source of calcium as well, and other micronutrients. And there's no added sugar to milk, despite what some people think - unless you're drinking chocolate milk and that's a totally different story. But milk doesn't have sugar added to it. And we'll talk a little bit about that in a second.

Taryn Richardson  02:50

But the biggest problem I see with dairy avoiders is that they substitute it with milk alternatives. And these things are really heavily processed. They're not meant to be milk - they don't really have all of the nutrients of milk, but they're trying to fake it till they make it and not doing a very good job of that. They often don't have any protein or a little bit but not enough. They often have heaps of added sugar and thickeners and gums and stabilisers and other crap to make it appear and behave a bit more like milk. You think about almond milk. Have you ever got an almond milk from a café and it still behaves like milk - it's all smooth? But if you try to do that yourself at home with not a barista blend, the almond milk splits when you heat it? And that's because those barista blends have a whole heap of crap added to them to get them to maintain their consistency through heat treatment.

Taryn Richardson  03:44

Milk alternatives also don't contain any or much calcium. And so they have to fortify it with calcium to get it to, again, appear and behave and have the same nutrients as milk. But not all milk alternatives are calcium fortified. And that's something you need to look at. I like to call them expensive water because they basically are that. Have a look at the ingredients of an almond milk carton next time you're in the supermarket. The first ingredient is water. And then there's a little bit of almonds, and then there's a whole heap of other crap in it to make it behave and look more like milk.

Taryn Richardson  04:18

So my question to you is, are you actually intolerant to dairy? Or are you avoiding it for all the wrong reasons? You might actually be lactose intolerant. And that's undiagnosed in a lot of people. I, myself am a lactard - I'm lactose intolerant and have been for a long time. And I don't tolerate normal milk, but I still consume dairy. So that's what I want to talk to you about today. And there's around 60 to 70% of the world's population is lactose intolerant to some degree in adulthood. When we're little, we drink our mother's milk. If you choose to breastfeed or you are fortunate enough to breastfeed and then little people grow into adults. And we either have that gene that helps us to produce the lactase enzyme, or it gets switched off as we grow into adults. So it's actually a mutation where we have this persistence of lactase enzyme that stays with us through adulthood.

Taryn Richardson  05:15

So what on earth am I talking about? What is lactose intolerance? What is this lactase enzyme? So lactose intolerance is where you have an inability to digest lactose. Lactose is our milk sugar. So when you look at the label on a milk, you'll see sugar in the nutrition information panel. That's referring to lactose - the milk sugar. It's not referring to added sugar. A skim milk will look like it has more sugar compared to a full cream milk if you're looking at the nutrition information panel, but it doesn't have added sugar compared to full cream. It just has a higher concentration of lactose in it because all other fats been skimmed off. For us to digest and absorb lactose, we need the enzyme lactase. Lactase pulls the disaccharide of lactose. Lactose is two sugar units - one glucose, one galactose. Lactase's role is to split those into two molecules in the small intestine so that we can actually absorb it. When you're lactarded, you don't produce enough of that enzyme, or any, to help that process happen. And so, that lactose molecule instead of being pulled apart, and digested and absorbed properly, it keeps going further along the gastrointestinal tract.

Taryn Richardson  06:33

And that's where you get those symptoms of what people call dairy intolerance. And the severity varies, but it might be things like, lots of gas production, and stuff that doesn't smell great, let's be honest. Bloating, because of that gas production and tummy rumbling. And that's caused because of the bacteria that sit further along our gastrointestinal tract. They then have a field day with that lactose molecule and digest it and ferment it and produce that disgusting gas that gives us all of these symptoms. You might also experience pain and nausea. And a big one is diarrhea, and a particular urgency to go to the toilet as well, which on a day to day basis, people might have a coffee with normal milk and go "yep, it's the coffee", but it could actually be the lactose. Or it could also rear its ugly head when you're on the run course and you have this urgency to go. That's one reason, but there are many for that.

Taryn Richardson  07:29

So how do we actually diagnose if we're lactose intolerant, or there's something else going on? The easiest way to do this is to have a Lactose Breath Test. You can generally do that online, through your GP is probably the first point of call. But there are places that send you out a Lactose Breath Test that you can breathe into a bag, send it back, and they can analyse it for you. And you can also just try and figure it out yourself a little bit. If you've been avoiding dairy because you think all dairy is bad, maybe try reintroducing a little bit of lactose free milk and see how you go.

Taryn Richardson  08:04

A couple of other things to consider if you feel like you don't tolerate dairy, so it could be a complete milk protein intolerance, let's not muck around with that. If you have Celiac disease, or even undiagnosed Celiac disease, then there's potentially some damage to the little microvilli that sit in your small intestines. That can give Celiacs or undiagnosed Celiacs, some short term lactose intolerance. And that resolves itself in the majority of cases, as long as you're not underlyingly lactose intolerant, once your gut heals. And you go on a strict gluten free diet and those little microvilli grow back and you have the ability again to produce that lactase enzyme. You can also get some transient or short term lactose intolerance if you've had a parasite or a gut bug or something like that, or H. Pylori, that often leads to lactose intolerance. And again, if you treat the underlying thing that's going on, that can often resolve itself as well. So it's a transient intolerance to lactose, not a lifelong thing, as long as you are a persistent lactase enzyme person into adulthood.

Taryn Richardson  09:12

Now, what do you do if you are lactarded? A couple of tips and tricks from somebody that is personally lactose challenged - you can take lactase enzyme. It's a little tablet. You can get a liquid form as well that you consume with your first mouthful of dairy foods - of foods that contain lactose. Just get it from the chemist. Sometimes you can get them from the supermarket. There's a few brands around. You could also check on Amazon for some. But you're looking for lactase enzyme. There's different concentrations - the more units the better, honestly. But you know, firsthand experience, it covers it but I don't find it covers it completely. So if I really want ice cream, I will eat it. I don't do it often because it's not worth it. But I would have a couple of lactase enzyme pills with that if I wanted to give my body a little bit of a chance to digest that lactose itself.

Taryn Richardson  10:07

The next big thing is you would avoid lactose in dairy. Now there are loads of lactose free products on the market now. There's a lot of lactose free milks. And that is just normal milk with the lactase enzyme added to it. It's not a chemical shitstorm, it's not heavily processed, it's more natural than milk alternatives despite what many baristas try and argue with me about. I've given up these days. But it is normal milk with lactase enzyme added to it to break down that lactose. It does taste a little bit sweeter as a result because the lactose molecules have been pulled apart. But that is a great option to still have normal dairy, have the benefits of protein, carbohydrate, calcium, all those nutrients without giving you tummy upset. A lot of yoghurts you'll tolerate as well, as long as there's some bacteria in there that they eat - lactose is their food source. And you can tolerate hard cheese because there's really not a lot of lactose in hard cheese. You just want to watch your portions of things like cottage cheese and cream cheese and any of those sorts of things. But you shouldn't be avoiding those things. And switching to non dairy alternative if it's purely just lactose intolerance.

Taryn Richardson  11:20

If you legit don't tolerate dairy, or you follow a vegan diet, then your best alternative is soy milk - and one ideally that is unsweetened and is fortified with calcium. That's something that we dive into deeply in Phase 1 of the Triathlon Nutrition Academy program, because I'm so passionate about making sure you get everything that you need to set you up for long term health forevermore, as well as your performance as an athlete now. If you can avoid it, I would save your hard earned dollars on expensive water and those really insuperior milk alternatives and go for something else. Unless you love the taste of, like, a macadamia milk or an almond milk. There's so many these days. There's hemp, there's oat milk, which honestly oat milk is basically just sugar. They will start to bring out some unsweetened varieties. But a lot of these alternatives are just random ingredients to make it look and behave more like milk. I don't mind if you have those things as long as you're getting enough calcium in your day.

Taryn Richardson  12:23

The other really exciting treatment option is the use of probiotics. There is a particular strain, B animalis, that has the best evidence for reducing symptoms of lactose intolerance. I'll link the paper in the show notes if you do want to dive deep into the research and nerd up. But this is a really good systematic review based on 15 randomised double blind study. So if you're not across research, this is excellent quality of research. So that might be something that you want to explore as well and see if that can help resolve some of your symptoms. Now, you may want to look at supplementing with that, or finding some food products that have that already in it.

Taryn Richardson  13:02

I would encourage you, as always, to question all of the BS that you see and read online. If you've been avoiding dairy unnecessarily because somebody told you it was bad for you, or it causes inflammation, or it's going to make you fat or whatever it is that you've read, maybe look at introducing it back into your life. It ticks a lot of nutrient boxes for us, even if we're the only mammals that drink it into adulthood. But word of warning, if you've been avoiding dairy for a long time, you've had no lactose in your diet, whatsoever, then you will have naturally reduced your lactase enzyme production because it's a use it or lose it type scenario. If you're not putting that stimulus in, we don't need to be producing lactase because there's not any hitting our gut.

Taryn Richardson  13:50

So, slowly introduce small volumes and see how you go. Like 100ml of milk. And I would probably, like if you're really worried, if you're going, "Taryn you're freaking me out here", try lactose free milk. Try a 100ml of lactose free milk and see how you go. If you don't tolerate that, then you may have something else going on. Maybe it's more like a milk protein intolerance issue rather than lactose. But regardless, small steady increments so that you can actually see what's going on. And don't change too much if you're going to start reintroducing something like that. You want to be able to see really clearly if what you're doing has any ill effect or no effect. By doing those small little volumes, it gives your body time to reproduce lactase enzyme again before you start going smashing gallons of the stuff and not having the ability to deal with it and then going, "Oh, there's something else wrong with me." Slow and steady wins the race.

Taryn Richardson  14:50

So hopefully that's cleared up a little bit of confusion when it comes to dairy. I honestly bang my head against the wall with busting myths constantly. I feel like I waste so much time to re-educating people in an evidence based way because there is so much crap on the internet. But if you are somebody that has milk alternatives as your dairy source, then let's think a little bit differently and a little bit more strategically about why we're doing these things, rather than blindly doing something. Now, I'm not saying throw dairy into your diet if you're a vegan athlete. I'm also not saying throw dairy into your diet if you have a milk protein intolerance. Please don't take that advice from this session. It's more for somebody that would be avoiding dairy because you don't really know why or you think you're intolerant, but really, you're lactose intolerant. So let's dive a little bit deeper into what you're doing and see if there's a way that we can move forwards to still give you the best bang for your buck out of all the foods that you're putting into your high performance engine on a day to day basis.

Taryn Richardson  15:54

Thanks for joining me for this episode of the Triathlon Nutrition Academy podcast. I would love to hear from you. If you have any questions or want to share with me what you've learned, email me at [email protected]. You can also spread the word by leaving me a review and taking a screenshot of you listening to the show. Don't forget to tag me on social media, @dietitian.approved, so I can give you a shout out, too. If you want to learn more about what we do, head to dietitianapproved.com. And if you want to learn more about the Triathlon Nutrition Academy program, head to dietitianapproved.com/academy. Thanks for joining me and I look forward to helping you smashed in the fourth leg - nutrition!