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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What type of Brexit did we vote for? 150,000 Conservative members will decide

As Michael Gove launches his leadership bid, what Leave looks like will be decided by Conservative activists.

Why did 17 million people vote to the leave the European Union, and what did they want? That’s the question that will shape the direction of British politics and economics for the next half-century, perhaps longer.

Vote Leave triumphed in part because they fought a campaign that combined ruthless precision about what the European Union would do – the illusory £350m a week that could be clawed back with a Brexit vote, the imagined 75 million Turks who would rock up to Britain in the days after a Remain vote – with calculated ambiguity about what exit would look like.

Now that ambiguity will be clarified – by just 150,000 people.

 That’s part of why the initial Brexit losses on the stock market have been clawed back – there is still some expectation that we may end up with a more diluted version of a Leave vote than the version offered by Vote Leave. Within the Treasury, the expectation is that the initial “Brexit shock” has been pushed back until the last quarter of the year, when the election of a new Conservative leader will give markets an idea of what to expect.  

Michael Gove, who kicked off his surprise bid today, is running as the “full-fat” version offered by Vote Leave: exit from not just the European Union but from the single market, a cash bounty for Britain’s public services, more investment in science and education. Make Britain great again!

Although my reading of the Conservative parliamentary party is that Gove’s chances of getting to the top two are receding, with Andrea Leadsom the likely beneficiary. She, too, will offer something close to the unadulterated version of exit that Gove is running on. That is the version that is making officials in Whitehall and the Bank of England most nervous, as they expect it means exit on World Trade Organisation terms, followed by lengthy and severe recession.

Elsewhere, both Stephen Crabb and Theresa May, who supported a Remain vote, have kicked off their campaigns with a promise that “Brexit means Brexit” in the words of May, while Crabb has conceded that, in his view, the Leave vote means that Britain will have to take more control of its borders as part of any exit deal. May has made retaining Britain’s single market access a priority, Crabb has not.

On the Labour side, John McDonnell has set out his red lines in a Brexit negotiation, and again remaining in the single market is a red line, alongside access to the European Investment Bank, and the maintenance of “social Europe”. But he, too, has stated that Brexit means the “end of free movement”.

My reading – and indeed the reading within McDonnell’s circle – is that it is the loyalists who are likely to emerge victorious in Labour’s power struggle, although it could yet be under a different leader. (Serious figures in that camp are thinking about whether Clive Lewis might be the solution to the party’s woes.) Even if they don’t, the rebels’ alternate is likely either to be drawn from the party’s Brownite tendency or to have that faction acting as its guarantors, making an end to free movement a near-certainty on the Labour side.

Why does that matter? Well, the emerging consensus on Whitehall is that, provided you were willing to sacrifice the bulk of Britain’s financial services to Frankfurt and Paris, there is a deal to be struck in which Britain remains subject to only three of the four freedoms – free movement of goods, services, capital and people – but retains access to the single market. 

That means that what Brexit actually looks like remains a matter of conjecture, a subject of considerable consternation for British officials. For staff at the Bank of England,  who have to make a judgement call in their August inflation report as to what the impact of an out vote will be. The Office of Budget Responsibility expects that it will be heavily led by the Bank. Britain's short-term economic future will be driven not by elected politicians but by polls of the Conservative membership. A tense few months await. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.