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?

Getty
Show Hide image

Absolutely Fashion showed what fashion week is really like: nasty, brutish and short

With fake meetings about fake covers, the documentary gave a glimpse into the abyss at the heart of the fashion world.

London Fashion Week is the sad little sister of the one in Paris, where I once attended a Valentino couture show dressed by Gap, watched what looked like live-action anorexia nervosa at Armani and got into a fight at Chanel. Did a man wearing a lion’s head on his real head look stupid? Yes, said I. No, said the fashion ­journalist, with fury.

Fashion Week had a small elegy this year – a BBC2 documentary called Absolutely Fashion: Inside British Vogue, which was fantastically misnamed. There is nothing inside Vogue, except a vague groping for novelty, which is technically an abyss. But that did not stop the programme’s director, Richard Macer, from sitting in Vogue House for nine months, watching women smell each other’s mascara. In the way of a certain type of media, he seems to have emerged more ignorant than when he began. This is the central principle of fashion: stupefy the buyer and she will pay to be reborn as something uglier.

“He doesn’t understand fashion,” said one critic, which I think meant: “He should have licked Karl Lagerfeld’s shoes while crying about belts.” To this critic, that is understanding fashion. It is a religious hierarchy. (That no one has asked Lagerfeld what he has done to his face, and why, proves this. When I met Lagerfeld in Paris, he was behind a velvet rope. I wondered if he sleeps with it.) Macer is a sexist, suggested another critic, who seemed to think that any industry that employs women in large numbers – human surrogacy farms, for instance, or Bangladeshi textile factories, or German super-brothels – is feminist. This is the stupidest definition of feminism I have yet heard and I have fashion to thank for it.

Macer was too frightened to ask questions about exploitation, pollution or the haunting spectacle of malnourished adolescents inciting self-hatred in older females in pursuit of profit, and he is not alone. I read no insights about London Fashion Week, but I do not care about clothes. He was so cowed by his access as to be undeserving of it, and Absolutely Fashion was as much about the laziness and commercial imperatives of modern journalism as it was about fashion, from which we should expect nothing.

Macer had a tiny scoop: British Vogue learned that American Vogue was running a cover of the singer Rihanna in the same calendar month. It decided to run early and people stayed up all night anxiously repaginating. He had the opportunity to ask Anna Wintour, the editor-in-chief of the US magazine, about it, but a staffer begged him not to. So he didn’t. He segued from journalist to PR. He drank the opiate – and I understand this, because if you don’t, you won’t survive. “Come again,” Jean Paul Gaultier once told me in Paris. His meaning was: “. . . but only if you love my clothes”.

In one scene, the actor Hugh Jackman was photographed in a bathtub at Claridge’s Hotel in London. He was fully clothed and looked marginally more stupid than he does dressed as the genetically mutated wolf man Wolverine, but that is not the point. “Come and see how handsome you are, Hugh,” cooed a Vogue woman. I wouldn’t have minded Jackman preening over an image of himself in private, but this exposed a truth: some journalism is celebrity PR.

Elsewhere, Kate Moss did a shoot wearing clothes that belonged to the Rolling Stones. It was based, she said, on a well-known shoot that they once did “in exile”. She meant tax exile, which was funny.

That Vogue, which is still, at least nominally, a magazine, should devote itself to this junk is not excused by an intellectual curiosity so dulled that one executive said that New York Fashion Week had “a sort of Lego element to it”.

British Vogue is edited by Alexandra Shulman, and in the manner of print media with long-standing editors – she has been there for 24 years – it is, in essence, a cult. In this case, a passive-aggressive-ocracy. (People are always surprised to learn that magazines are tyrannies, but there it is.)

I do not know whether Shulman wanted Macer there or not, or whether she didn’t have the clout to stop it, but once he was in, she treated him with the bored derision of a woman contemplating a ball gown chewed by moths. Shulman has the face of a woman who should get out while she can. In her only revealing scene, she had to choose between two front covers. One was “artistic” because it showed Kate Moss’s knickers; the other was unthreatening because it showed only Kate Moss’s face. “My heart is never allowed to rule,” she said, and she laughed. But I think she meant it.

She lied to Macer, too, holding fake meetings about fake covers so the world would not learn that Vogue had, by its cracked standards, a huge scoop: the Duchess of Cambridge would appear on the cover of the 100th-anniversary issue in a hat.

Absolutely Fashion also taught us, had we not known, that fashion is peopled by privileged creatures who are impervious to the extent of their privilege and who are, therefore, bad journalists, because they cannot even effectively interview themselves. For instance, the photographer Mary McCartney, one of Paul’s daughters, told Macer that she had never got work because her father was a member of the Beatles.

To be oblivious to reality is essential in fashion. Everyone is equal under the skirt. Yet McCartney flourishes because of the doctrine of the age: the already prosperous are more worthy of prosperity.

Not everyone seemed so disingenuous. One woman described the search for the non-existent novelty as “exhausting”. She no longer believed in the cult.

Absolutely Fashion, if you watch it critically, is more interesting than Macer perhaps allowed himself to dream. In its way, it embodied any fashion week anywhere: nasty, brutish and short. 

This article first appeared in the 22 September 2016 issue of the New Statesman, The New Times