Your bones may need calcium, but here's why it's time to moove on from milk

Because of a growing body of research, there is a dawning appreciation that allergy to the proteins in cow’s milk is behind a range of childhood illnesses.

Thanks in no small part to the efforts of the Milk Marketing Board from the 1950s onwards (do you remember “Full of natural goodness”, “Milk’s gotta lotta bottle”, or “Drinka pinta milka day”?) dairy produce enjoys an almost unassailable position in British dietary culture. Milk is seen as vital, an indispensable source of calcium and vitamin D, the foundation stone for healthy teeth and bones.

The health-care professions have been as taken in as anyone; not even evidence implicating dairy in the development of later-life problems such as heart disease has been able to undermine the belief that, for our children to get the best start, they need to be pumped full of cheese and yogurt, all washed down with a glass of nice-coldice- cold milk.

This cultural enthusiasm for dairy led the medical profession into a collective, decades-long blindness. Even today, parents who believe their child to be allergic to milk are likely to be dismissed as oddballs, clutching at improbable straws in an attempt to understand their offspring’s health problems. Dreadful eczema? That’s a skin disease. Intractable abdominal pain and digestive mayhem? There must be something wrong with the gut. Chronic cough and mucous? That’ll be the lungs.

Milk, after all, is what babies are made of. What could be wrong with such a natural, wholesome food? However, because of a growing body of research, there is a dawning appreciation that allergy to the proteins in cow’s milk is behind a range of childhood illnesses.

The journey towards this understanding has been made difficult by several confounding factors. First, there is more than one type of allergic reaction. Immediate hypersensitivity to milk, which is rarer, is easy to diagnose. Directly after exposure to cow’s milk protein, the affected individual displays a florid response, which includes swelling of the lips, face and eyes; a wheeze and breathing difficulty; and a rash called urticaria, which looks like widespread nettle stings.

Much more common in cow’s milk protein allergy (CMPA) is delayed hypersensitivity. This is tricky. There is no clear link in time between exposure and symptoms. These babies tend to have difficult-to-treat eczema, refractory respiratory problems and a range of digestive disorders such as reflux (where acid stomach contents come back into the gullet and mouth), diarrhoea or constipation, colicky pain and even bleeding into the bowel.

We still do not completely understand delayed hypersensitivity and it is likely to be more common than its currently estimated prevalence of around 5 per cent.

Even when delayed hypersensitivity is suspected, there are a number of factors that can frustrate the diagnosis. Unlike immediate hypersensitivity, there is no blood or skin-prick test that can be given. Confirmation can only come from strict exclusion diets, where one would expect symptoms to resolve over a period of between two and eight weeks.

Exclusion diets are hard to stick to. Doctors frequently advise parents to switch to soya-based products, but there is crossreactivity between cow’s milk and soya protein in around 60 per cent of cases. Failure to improve when on a soya-only diet is often mistakenly interpreted as ruling out CMPA.

Another common misconception is that breastfed babies can’t develop CMPA, yet the offending proteins in a dairy-consuming mother will cross into breast milk and provoke allergy in just the same way as with bottle-fed infants.

From an evolutionary perspective, consuming milk beyond babyhood is unnatural, yet all infants depend on milk in their first year or so. Breastfeeding mothers with allergic offspring can go dairyfree but bottle-fed babies are, figuratively speaking, up a gum tree.

Fortunately, there are now a number of formulas available to treat CMPA. In each, the protein components are hydrolysed – chemically “chopped up” into smaller units –which are less likely to provoke an allergic response. But these are very expensive and their growing use is a source of concern to those responsible for NHS prescribing budgets.

A better long-term solution is to encourage and support breastfeeding – currently fewer than a quarter of new mothers are still exclusively breastfeeding at six weeks.

This needs to be coupled with a thorough rethink of our relationship with dairy foods. Even experts in the field of CMPA remain spellbound by the belief that milk is essential for calcium and vitamin D, advising breastfeeding mothers to take artificial supplements if they are cutting out dairy.

But, in reality, milk is a relatively mediocre source of these nutrients. There are innumerable other foodstuffs that carry more calcium than milk – broccoli, figs, almonds, sesame seeds and leafy green vegetables, to name but a few.

As for vitamin D, getting ourselves and our children out into natural sunlight every day is nature’s time-honoured solution. Who knows, we might even inculcate a renewed enthusiasm for fresh air and exercise into the bargain.

Dairy might not be as good for you as you previously thought. Image: Getty

This article first appeared in the 06 November 2013 issue of the New Statesman, Are cities getting too big?

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Donald Trump is the Republican nominee. What now?

So a Clinton-Trump general election is assured – a historically unpopular match-up based on their current favourability ratings.

That’s it. Ted Cruz bowed out of the Republican presidential race last night, effectively handing the nomination to Donald Trump. “From the beginning I’ve said that I would continue on as long as there was a viable path to victory,” Cruz said. “Tonight, I’m sorry to say it appears that path has been foreclosed.”

What foreclosed his path was his sizeable loss to Trump in Indiana. Cruz had bet it all on the Hoosier State, hoping to repeat his previous Midwest victories in Iowa and Wisconsin. He formed a pact with John Kasich, whereby Kasich left the anti-Trump field clear for Cruz in Indiana in return for Cruz not campaigning in Oregon and New Mexico. He announced Carly Fiorina as his vice-presidential nominee last week, hoping the news would give him a late boost.

It didn’t work. Donald Trump won Indiana handily, with 53% of the vote to Cruz’s 37%. Trump won all of the state’s nine congressional districts, and so collected all 57 of the convention delegates on offer. He now has 1,014 delegates bound to him on the convention’s first ballot, plus 34 unbound delegates who’ve said they’ll vote for him (according to Daniel Nichanian’s count).

That leaves Trump needing just 189 more to hit the 1,237 required for the nomination – a number he was very likely to hit in the remaining contests before Cruz dropped out (it’s just 42% of the 445 available), and that he is now certain to achieve. No need to woo more unbound delegates. No contested convention. No scrambling for votes on the second ballot. 

Though Bernie Sanders narrowly won the Democratic primary in Indiana, he’s still 286 pledged delegates short of Hillary Clinton. He isn’t going to win the 65% of remaining delegates he’d need to catch up. Clinton now needs just 183 more delegates to reach the required 2,383. Like Trump, she is certain to reach that target on 7th June when a number of states vote, including the largest: California.

So a Clinton-Trump general election is assured – a historically unpopular match-up based on their current favourability ratings. But while Clinton is viewed favourably by 42% of voters and unfavourably by 55%, Trump is viewed favourably by just 35% and unfavourably by a whopping 61%. In head-to-head polling (which isn’t particularly predictive this far from election day), Clinton leads with 47% to Trump’s 40%. Betting markets make Clinton the heavy favourite, with a 70% chance of winning the presidency in November.

Still, a few questions that remain as we head into the final primaries and towards the party conventions in July: how many Republican officeholders will reluctantly endorse Trump, how many will actively distance themselves from him, and how many will try to remain silent? Will a conservative run as an independent candidate against Trump in the general election? Can Trump really “do presidential” for the next six months, as he boasted recently, and improve on his deep unpopularity?

And on the Democratic side: will Sanders concede gracefully and offer as full-throated an endorsement of Clinton as she did of Barack Obama eight years ago? It was on 7th June 2008 that she told her supporters: “The way to continue our fight now, to accomplish the goals for which we stand is to take our energy, our passion, our strength, and do all we can to help elect Barack Obama, the next president of the United States.” Will we hear something similar from Sanders next month? 

Jonathan Jones writes for the New Statesman on American politics.