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?

Photo: Bulent Kilic/Getty Images
Show Hide image

We need to talk about the origins of the refugee crisis

Climate change, as much as Isis, is driving Europe's migrant crisis, says Barry Gardiner. 

Leaders get things wrong. Of course they do. They have imperfect information. They face competing political pressures. Ultimately they are human. The mark of a bad leader is not to make the wrong decision. It is to make no decision at all.

David Cameron’s paralysis over the unfolding human tragedy of Syrian refugees should haunt him for the rest of his natural life. At a time when political and moral leadership was most called for he has maintained the most cowardly silence. 

All summer, as Italy, Greece, Hungary and Macedonia have been trying to cope with the largest migration of people this continent has seen in 70 years, Downing Street has kept putting out spokespeople to claim the government is working harder than any other country “to solve the causes of the crisis” and that this justifies the UK’s refusal to take more than the 216 refugees it has so far admitted directly from Syria. The truth is it hasn’t and it doesn’t.

Anyone who truly wants to solve the causes of the nightmare that is Syria today must look beyond the vicious and repressive regime of Assad or the opportunistic barbarism of ISIL. They need to understand why it was that hundreds of thousands of ruined farmers from Al-Hasakeh, Deir Ezzor and AL-Raqqa in the northeast of that country flocked to the cities in search of government assistance in the first place - only to find it did not exist.

Back in 2010 just after David Cameron became Prime Minister, the UN Food and Agriculture Organisation warned that, after the longest and most severe drought in Syria, since records began in 1900, 3 million Syrians were facing extreme poverty. In 2011 the International Institute for Strategic Studies published a report claiming that climate change “will increase the risks of resource shortages, mass migration and civil conflict”. These were some of the deep causes of the Syrian civil war just as they are the deep causes of the conflicts in Tunisia, South Sudan, Somalia, Libya and Egypt. So what about Cameron’s claim that his government has been working to solve them?

Two years after that Institute for Strategic Studies report pointed out that conflict as a result of  drought in countries like Ethiopia, Eritrea and Somalia had already claimed 600,000 lives,  the parliamentary Committee on Arms Export Controls found the UK Government had issued more than 3,000 export licenses for military and intelligence equipment worth a total of £12.3bn to countries which were on its own official list for human rights abuses; including to Libya, Tunisia, Somalia, Sudan, Egypt and Syria. That was the same year that UK aid to Africa was cut by 7.4% to just £3.4billion. Working to solve the root causes? Or working to fuel the ongoing conflict?

A year later in 2014 home office minister, James Brokenshire told the House of Commons that the government would no longer provide support to the Mare Nostrum operation that was estimated to have saved the lives of more than 150,000 refugees in the Mediterranean, because it was providing what the government called a “pull factor”. He said: “The government believes the most effective way to prevent refugees and migrants attempting this dangerous crossing, is to focus our attention on countries of origin and transit, as well as taking steps to fight the people smugglers who wilfully put lives at risk by packing migrants into unseaworthy boats.”

In fact the ending of the rescue operation did not reduce the number of refugees. It was not after all a “pull factor” but the push factor – what was happening in Syria - that proved most important. Earlier this summer, David Cameron indicated that he believed the UK should consider joining the United States in the bombing campaign against Isis in Syria, yet we know that for every refugee fleeing persecution under Assad, or the murderous thuggery of ISIS, there is another fleeing the bombing of their city by the United States in its attempt to degrade ISIS.  The bombing of one’s home is a powerful push factor.

The UK has not even fulfilled Brokenshire’s promise to fight the people smugglers. The Financial Action Task Force has reported that human trafficking generates proportionately fewer Suspicious Activity Reports (SARs) annually than other comparable crimes because the level of awareness is lower. Prosecuting the heads of the trafficking networks has not been a focus of government activity. Scarcely a dozen minor operatives pushing boats on the shores of Turkey have actually been arrested. But it is not the minnows that the UK government should be concentrating on. It is their bosses with a bank account in London where a series of remittances are coming in from money transfer businesses in Turkey or North Africa. Ministers should be putting real pressure on UK banks who should be registering SARs so the authorities can investigate and begin to prosecute the ultimate beneficiaries who are driving and orchestrating this human misery. They are not.

That image, which few of us will ever completely erase from our mind, will no doubt prompt David Cameron to make a renewed gesture. An extra million for refugee camps in Jordan, or perhaps a voluntary commitment to take a couple of thousand more refugees under a new European Quota scheme. But if the UK had been serious about tackling the causes of this crisis it had the opportunity in Addis Ababa in July this year at the Funding for Sustainable Development Conference. In fact it failed to bring forward new money for the very climate adaptation that could stem the flow of refugees. In Paris this December the world will try to reach agreement on combating the dangerous climate change that Syria and North Africa are already experiencing. Without agreement there, we in the rich world will have to get used to our trains being disrupted, our borders controls being breached and many more bodies being washed up on our beaches.