The Milk-Free Bookstore's Top Ten Bestsellers

Back in the early 1980s, about the time I acquired my first computer, I would sometimes visit a friend who was hip deep in the computer world. Computers of all sorts littered his living room so that you had to step around them to get to other side. On the other side was yet another computer. This was the one he would use for something he called ARPANet. Apparently he typed messages and other people read them. Or maybe something more than that. I couldn't understand why he did it or why he talked so enthusiastically about it. I paid no attention anyway, since he was wildly enthusiastic concerning everything he talked about.

Some of you are ahead of me already. ARPANet was the forerunner of what he now called the Internet. By the 1990s I was typing messages on my own computer for others to read. By 1997 I put up the first primitive version of a website I called Steve Carper's Lactose Intolerance Clearinghouse.

Amazon.com started in 1995 and became big enough to notice in 1997, when it made the news with its IPO. I started buying books there early on.

Then, as now, Amazon's search engine was bizarre, quirky, and frustrating. For example, make a one-letter typo in a name and enter it into Google, and Google helpfully asks you if you meant the correct spelling. Amazon still tells you that it finds no matches and gives you no clue why. Put in lactose free and you find one set of books. Dairy free gives you a second set. Milk free a third set. This drove me crazy.

Having more time on my hands than most of you, I set out to track down every book listed on Amazon that those of us who wanted a milk-free life - lactose intolerant, milk allergic, kosher, vegan, multiple allergy, celiac, galactosemic, etc. - might possible be interested in. This became The Milk-Free Bookstore. At first I found maybe 50 books. Today I list well over 200.

One day, while reading the New York Times Book Review, their top ten bestsellers list caught my eye. I had to wonder what my bestselling books were. The numbers were available so I set up a spreadsheet, counted every sale, and ten books popped up that were clearly outselling the rest. I thought that this would be a great way of informing people what were probably the most useful books to solve the different problems the people who come here had. I added The Top Ten Bestsellers page to my bookstore. Eventually I managed to squeeze sixteen books into the top ten.

I took a look at the page recently and noticed that it hadn't been updated for a while. OK, it hasn't been updated since 2005. I have a good reason, or at least one I can use in public. It's no coincidence that I had my stroke in 2005. That doesn't explain why I didn't update the page at the end of 2006 or 2007, but I've found that saying "stroke" is a universal get-out-of-explaining card. I'd advise everybody to have a mild stroke. If you get anything done at all, people look at you like a hero instead of a lazy slob. It's terrific. For us lazy slobs, at any rate.

Most of you are well ahead of me again. Yes, I've just gone back and put all my sales from January 1, 2006 through today into my spreadsheet. That created a brand new top ten. I'll be putting each title up over the next ten days.

The ten books are a great eclectic list. There are lactose free books, allergy books, dessert cookbooks, gluten-free cookbooks, vegan cookbooks. Something for everybody. I'm astounded at how the field has grown over the years. Life is a million times easier than it was when I learned I was lactose intolerant in 1978 and one - count 'em - one cookbook was available. Not a very good one, either, I'm sorry to say. No, it didn't make the list. I've never sold a single copy. People have purchased over 275 different titles through my website, though, so being in the top ten means that certain titles are special.

Find out which starting tomorrow.

Your Guess Is As Good As Mine

I have absolutely no idea what is being said here, but congratulations to newly minted PhD, Jeremy Stewart MacLeod.

Jeremy Stewart McLeod - Doctor of Philosophy in Bioprocess Engineering

Dr McLeod focused on the nucleation and growth kinetics of alpha lactose monohydrate. Lactose represents about one-third of the solids in cows' milk, and is recovered using crystallisation.

A model has been produced that can predict the changing concentration profile as lactose crystallises from an industrial solution. The primary nucleation of alpha lactose monohydrate was investigated, including identifying the changing relationship as lactose nucleation moves from being dominated by the heterogeneous mechanism to homogenous mechanism.

The effect of mixing was studied using a Rushton turbine and a Venturi to agitate the system. Increasing agitation increased the frequency of activated molecular collisions, but the critical nucleus size remained constant. A strong correlation was found, for both mixing systems, between the nucleation rate and the frequency of vortex shredding.

Intolerable Food

This must be some of that dry British humor that Americans don't get. From CatererSearch.com.

Chef Sue Widdicombe has launched a range of allergy-friendly ready-meals to help caterers provide for customers with food intolerances.

As well as being gluten-, wheat- and dairy-free, the meals are also free from additives and preservatives. They also avoid MSG, eggs and shellfish and most are also sulphite- and sesame seed-free.

The name of her firm? The Intolerable Food Co.

Lactaid Promotes Calcium-Rich Milk to the African-American Market

Last year, Lactaid featured Hispanic actress Angelica Vale in ads targeted at the large lactose intolerant Hispanic market.

This year they've turned to celebrity chef and restaurateur Delilah Winder to target the African-American market."As a chef who is lactose intolerant testing all the food I prepared was somewhat of a challenge -- lactose intolerance can turn a perfect meal into a terrible memory," said Winder. "I found that I couldn't even enjoy my favorite dishes anymore. Discovering LACTAID® Milk and LACTAID® Fast Act Dietary Supplements helped me bring my award winning macaroni and cheese and all of my favorite dishes back to my table to enjoy with my friends and family."

The press release cites a new survey conducted by Yankelovich, Inc. on behalf of McNeil Nutritionals from February 28 - March 3, 2008 using online interviews among a sample of 200 African American adults 18 years of age or older that:

found that 63% of African Americans who experience stomach discomfort from eating dairy are likely to reduce or stop drinking milk or consuming dairy-rich products leaving them at risk for low calcium intake.

Frozen Kefir

Frozen yogurt's hot, hot, hot, if I say so myself.

So with a gourmet frogurt store coming to every corner near you, what niche will be next to open?

How about frozen kefir?

I've quoted kefir talk before, too.

Kefir, another fermented milk product, particular to Turkey and other Central Asian countries, is gaining popularity for the same gastrointestinal reasons. As with yoghurt, the Turkish language has provided the world with the name for this tart, sometimes effervescent and thick liquid. Keyif, the Turkish word for "good feeling" has lent itself to the ever-increasingly popular drink.

Commercially produced kefir can be found in specialty shops, as can the starter culture for home cooks. A small jar of what seems to be a slightly lumpy, milky liquid is all that is needed to start a continuous supply of friendly bacteria and yeasts. Kefir aficionados tell of the superior health benefits of this cultured milk over yoghurt. The variety of bugs work to actively colonize the gut; taking over the space in the mucosal wall that are usually crawling with destructive yeasts and bacteria.

But a frozen kefir store?

There's one coming to Chicago, according to the press release:

Lifeway Foods, Inc. (Nasdaq: LWAY), the country's leading manufacturer of kefir and a provider of other natural and organic dairy products, is opening its first "kefir boutique" café with the April launch of Starfruit in Chicago. The shop will offer several flavors of frozen kefir with over 20 toppings as well as customized kefir parfaits, and smoothie-style kefir drinks.

More about all things kefir at the Lifeway Foods website.

Russian Kosher Lactose-Free Sweets

Russian Kosher lactose-free sweets advertised on the Internet. Talk about words you'd thought you'd never see in the same sentence. Does this mean that the apocalypse is nigh or that the new millennium really has arrived?

It's for real, apparently. The website of that of the FJC, The Federation of Jewish Communities of the CIS. (The CIS, or The Commonwealth of Independent States, technically are eleven former Soviet Republics, including Russia, that are the remains of what used to be the USSR.)

The 'Kolomenskoye' confectionary factory, which is based in Moscow, has produced a line of sweets under the supervision of the Kashrut Department of the Chief Rabbinate of Russia headed by Rabbi Berel Lazar.

...

These delights, which include waffle cookies and two separate types of cakes, have certainly brought a smile to many faces this past weekend.

The Kashrut Department of the Chief Rabbinate of Russia guarantees the kosher element of those company products bearing the label indicating it kosherness. These products are considered to be 'parve', meaning that these treats may be eaten at any time and contain no lactose or meat products.

I've received emails from more than 30 countries since I started my website but this more than anything proves we are living on Planet Lactose.

FAAN'S Annual Food Allergy Conference

There's still time for people to hop a plane over to Baltimore, the site of the 15th annual Food Allergy Conference to be held by FAAN, The Food Allergy & Anaphylaxis Network.

Top topic of this year's conference is "Food Allergies: Living and Learning." Is that a press release I see before me?

The Baltimore conference will feature Robert A. Wood, M.D. He is a professor of pediatrics and international health and the director of pediatric allergy and immunology at Johns Hopkins University School of Medicine, as well as the author of Food Allergies for Dummies.

There are even special sessions for teens (ages 11 and up) and nurses at the conference. The teen lunch session will include discussion topics such as school, dating, traveling, and dining out. A concurrent session for parents of teens will enable them to share their experiences, challenges, and strategies for success. Clinical and school-based nurses will meet to discuss topics of professional interest such as schools, elimination diets, and food challenges with leading nurses in food allergy education and research.

The Baltimore conference will be held at the Sheraton Inner Harbor Hotel, 300 S. Charles Street, Baltimore, Md.

For more information, please visit FAAN at www.foodallergy.org, www.faankids.org, and www.faanteen.org.

A Taste of Home Cooking, Magazine Style

Eating Right Never Tasted So Good --


Healthy Cooking is a new magazine that offers recipe makeovers, healthy menu planning ideas, advice for special diet needs, and tips to lead a healthier lifestyle. Each issue includes recipe and non-recipe content provided by real home cooks and backed by nutritionists and health experts. Healthy Cooking is a bi-monthly publication from the editors of Taste of Home -- the largest cooking magazine in America.

Of course you recognize the sweet, tangy taste of public relations prose, that tender morsel provided to cooks everywhere by this press release.

Still, the magazine looks to provide help that may prove to be useful:

Every issue of Healthy Cooking will have five distinct sections:

• "Lighten Up" - ideas on how to still eat what you won't give up, and sensible hints, tips from Taste of Home's Test Kitchen experts

• "Eat Right" - Recipes from home cooks and healthy-living testimonials to help readers make better choices

• "You Win" - Eight prize-winning dishes from our readers

• "Live Well" - Recipes and advice for specific health needs such as
gluten, allergies or diabetes

• Seasonal Special Feature focusing on what's fresh and current, like "Power Foods"

Raw Milk Article Long but Flawed

David E. Gumpert's article Got Raw Milk? (single page version, from the Boston Globe Sunday Magazine, is a major treatment of the subject. Raw milk is milk that has not been pasteurized. Proponents claim that this improves the flavor of the milk, doesn't damage the nutrients, and is healthier overall. Many states ban raw milk entirely and almost all the rest have strict regulations concerning its sale. Unless extreme care is taken with the health of the cows and of the milk before it reaches the consumer, a variety of diseases can be passed through to those who drink it.

For background check out my own major article on the subject titled Raw Milk Not for Lactose Intolerants.

With that background, the section of Gumpert's article of greatest concern to us follows:

Results of a just-released study of 2,217 raw-milk drinkers in Michigan - conducted by a herd-share group there and by a professor at the University of Michigan and underwritten by the Weston A. Price Foundation - suggest that raw milk can be consumed by most sufferers of lactose intolerance, a condition the study's authors estimate affects about 10 percent of all Americans. This is a tiny sample, but of the 155 people in the study who said they had been "told by a healthcare professional they had lactose intolerance," more than 80 percent reported regularly drinking raw milk without symptoms. (An FDA spokesman counters that because of the study's methodologies, its authors do not consider the findings conclusive, nor do they call the consumption of raw milk a preventive measure.)

Since I've been saying loudly for a very long time that no evidence exists that people with lactose intolerance will be no more symptom-free from raw milk than from pasteurized milk, I need to point out a few facts that Gumpert doesn't include in his article.

First, David H. Gumpert. While newspaper reporters are usually supposed to be objective and report both sides of an issue, magazine writers are normally not under the same obligation. Partisans often write on subjects of concern to them. One of Gumpert's major concerns is raw milk. He's for it. Searching his The Complete Patient journal yields numerous articles over the last several years extolling the virtues of raw milk and attacking governmental interference with it.

Second, the Weston A. Price Foundation, the funder of the study. It is not an impartial observer in the controversy. Quite the opposite.

Specific goals include establishment of universal access to clean, certified raw milk and a ban on the use of soy formula for infants.

One of its major initiatives is the Campaign for Real Milk. Real = Raw.

Anti-milk groups always protest when they see studies on the benefits of milk funded by Dairy Associations and other interested parties. It will be interesting to see their position on this one. My take is that this study should be given the same level of credence, one based on the value of the science it produced tempered with the understanding that special interest-funded studies that hit print almost invariably are favorable to the product being studied.

What of the study itself? I wish I knew. I couldn't find the study mentioned on the Price foundation site. And Gumpert's journal entry says:

Hopefully, they'll get in published in a scholarly journal of some kind.

That appears to mean it is a non-peer-reviewed study that has not been looked at by the rest of the scientific community. The FDA has seen it, judging by the comment Gumpert put in his article, and they weren't impressed.

But what about the claim itself? Lactose intolerance individuals could drink raw milk without symptoms. Doesn't that prove something?

Not without a control group. Here's the fact that either the study doesn't bother to give or Gumpert left out. People with lactose intolerance can often drink any kind of milk, even pasteurized, without getting symptoms. That's a fact that's been showing up in peer-reviewed studies for decades.

If the Beals study did not do a blinded comparison of raw milk to pasteurized milk among its drinkers there is no possible way to know if they people who considered themselves lactose intolerant had symptoms from pasteurized milk. And without that comparison the numbers given by Gumpert are meaningless.

I hope more details emerge soon or the complete study is posted online. I'll keep an eye out for it.

In the meantime continue to view raw milk with the same suspicion you would view pasteurized milk. Don't let a group touting raw milk convince you otherwise.

Go GoDairyFree

Every few months I post something to remind people about or alert new readers to what I consider to be the only other really important lactose intolerance site other than mine, Alisa Fleming's GoDairyFree.org.

The focus there is similar to mine:

GoDairyFree.org is an informational website for dairy-free living. While the Go Dairy Free website and newsletter always have a milk-free focus, every effort is made to cater to additional special diet concerns, including vegan, multiple food allergies (eggs, nuts, soy), and the gluten-free / casein-free diet (GFCF).

They recently compiled their 750th dairy-free recipe, a database searchable and sortable in all sorts of ways.

And they do monthly prize drawings, like this one for April.

Check them out.

Arsenic Contamination in Rice Milk

Did you know that neither the U.S. nor the European Union (EU) closely regulates arsenic in foods?

Maybe you thought that nobody did so because it wasn't necessary. Apparently not so.

Andrew Meharg and colleagues at the University of Aberdeen, UK, have shown that people drinking rice milk are exposed to high levels of inorganic arsenic. ... Meharg found that all the commercial rice milks exceeded the EU limit for water and 12 out of 15 samples exceeded the US standard with the median total arsenic value being seven times greater than in soy and oat milk samples.

The report by Harriet Brewerton, on the Chemical Science magazine website, was based on an article in the Journal of Environmental Monitoring: "Inorganic arsenic levels in rice milk exceed EU and US drinking water standards"
Andrew A. Meharg, Claire Deacon, Robert C. J. Campbell, Anne-Marie Carey, Paul N. Williams, Joerg Feldmann and Andrea Raab, J. Environ. Monit., 2008, DOI: 10.1039/b800981c

Rice itself is well known to often contain high levels of inorganic arsenic. However, no one apparently ever thought to test rice "milk," a cow's milk substitute made by processing rice with water. The study team looked at all varieties, including commercially available and home-made milks, made from globally sourced white and brown rice grains.

Meharg's team recently received funding to see if they can breed rice plants that naturally take up less arsenic.

It's unclear what this study means for overall health. Vegans who drink rice milk exclusively may want to limit their consumption.

Tips on Epipens, Anapens, and Twinjects

Allergists Dr. Andrew Clark and Dr. Shuaib Nasser provided a valuable summary of information on injectable adrenaline devices (IADs) or epinephrine pens, known by the brand names EpiPen and Anapen in the UK and Canada, and EpiPen and Twinject in the US.

Since this is a blog dealing primarily with with milk allergies, the critical point should be made first.

It’s important to know who doesn’t need an IAD. Patients without asthma who have only ever had mild reactions to ingestion of substantial amounts of allergen do not require an IAD. Most children with egg and milk allergy therefore do not need one, as these allergies are usually mild and resolve within two to three years.

Most is not the same as all, obviously, and some children with milk allergies are seriously anaphylactic and need the safety net of such a device.

The rest of their ten points can be found at PulseToday.co.uk and is worth taking the time to go through thoroughly if you have any need to know about these invaluable lifesavers.

Lactagen Lauches New Website

Lactagen, that most controversial reliever of lactose intolerance symptoms, has announced that it has overhauled its website.

Lactagen^®, a dietary supplement and treatment program designed to help people suffering from lactose intolerance, is very excited to announce the launch of their new website. The website features extensive information about how Lactagen^® will help dramatically reduce symptoms of lactose intolerance long-term through its one-time 38-day program. People forced for years to limit their diet to dairy free foods can now enjoy dairy products without painful digestive discomfort.



On the new site, one can view hundreds of testimonials and can even watch videos of testimonials talking about their experience on the program. The website also includes; information on how the product was created, information on how it works, videos of press coverage and news stories, a link to purchase the product directly on the site and much more.

In addition, the website is geared towards educating and answering any customer questions. Not only can customers call an 800 number (800-DAIRY-OK) to speak with a digestive health consultant directly, but they can connect via LiveChat instantly, allowing customers immediate access to any questions they might have about Lactagen. Further, the new website offers free brochure on Lactagen, for those that prefer receiving additional information in the mail about the product.

The Lactagen website can be found at www.lactagen.com.

If you're curious about why I call Lactagen controversial, read this previous summary of opinion on them.

Lactagen continues to generate positive notices. In fact, I just received one yesterday.

It’s good to be skeptical about "treatments" you are unfamiliar with, but I tried it and it works beautifully! If my skepticism kept me from trying it, I would still be taking all those pricey Lactaid tablets. The hardest part is remembering to take it! The dosage increases daily. It mixes with water easily and has no bad taste. The “fix” lasts! And there is a money back guarantee! Not much risk there. Go for it!

Interesting coincidence.

More on the Use of Lactose in Medications

I've posted numerous times about the frequent presence of lactose as a filler, binder, or coating for pills, whether prescription or over-the-counter (OTC). The fullest discussion was probably in Lactose in Medications.

Whether a pill's formulation uses lactose or not is just one of the possible variations that might affect your response to a drug, an issue that Melissa Healy, a staff writer for the Los Angeles Times, reports is not as well regulated by the Food and Drug Administration (FDA) as it should be.

In fact, a brand-name drug's generic counterpart is rarely an exact replica. Though the two share equal amounts of the same active ingredient, they generally look different. And those differences, say some pharmacologists, can result in small variations in how they work in patients.

A brand-name drug and its generic in most cases are formulated with different colorants, fillers and binding materials. Though all of those must come from an FDA-approved list of pharmaceutical ingredients, they are, in most cases, assembled differently in each manufacturer's product. One version of a drug might use lactose or sugar as an inactive ingredient; another might not. But incidental ingredients like these can affect the way patients dissolve and metabolize a drug's active ingredient -- faster or slower. And that, in turn, can result in variations in the two formulations' effects.

In almost all cases, the FDA permits a generic drug to release 80% to 125% of an active ingredient into the bloodstream, compared to that released in a single dose of the original medication. That range would make little practical difference in the effect that most drugs have. And the FDA and generics manufacturers defend the allowable range of variance as the same that is permitted among "batches" of brand-name drugs.

But medical and pharmacology specialists warn that the FDA's range may be too broad for some drugs, especially in cases where a drug has a "narrow therapeutic index" -- the fine line between an ineffective dose and a dangerous one.

Both doctors and pharmacists have guides that spell out the inactive ingredients for every prescription medication. As I mentioned in the linked post, they've been able to do a quick lookup of prescriptions drugs containing lactose for a long time.

But as I also mention there, a simple lookup of drug names that contain lactose fails to answer all the needed questions. The situation is much worse when generic drugs are involved and worse yet for over-the-counter medications. Discovering the use of lactose for a specific type, size, strength, and variety of pill is normally simple. Discovering whether any variation of the needed medication, in any guise from any manufacturer, contains lactose is sometimes next to impossible.

You need to start with your doctors and make sure they are aware of any concerns you have. You also need to be aware that you probably need to have few concerns. Few if any sufferers of lactose intolerance are so sensitive that they will react to the lactose in any one pill. I have found no medical journal articles that reported any allergic reaction caused by taking a pill containing lactose. (However, there are at least two known Allergic Reactions from Lactose in Dry Powder Asthma Inhalers.)

The use of lactose in so common that avoiding it may limit your choices - and your doctors' choices - unacceptably. If you feel you must do so, do so wisely and knowingly and be sure to thoroughly examine all the alternatives.

Research from AAAAI Annual Meeting

The annual meeting of the American Academy of Allergy, Asthma & Immunology just finished in Philadelphia, and they already have a press release out on the highlights. Here's highlights of the highlights.

Consumer attitudes and response to new food allergen labeling

Food allergic consumers (FAC) depend upon clear, accurate ingredient labels. Sam S. Ahn, MD and colleagues with Mt. Sinai School of Medicine in New York, NY examined FAC's opinions and responses subsequent to the Food Allergen Labeling and Consumer Protection Act (FALCPA).

Parents of children with food allergies completed a survey. The results of the survey indicated that FAC read labels "always" on purchase (90%) and upon preparing to use (85%) packaged foods. Participants with an opinion rated toll-free numbers (61% "very helpful") and package information (67% "very helpful") as more helpful for allergen information than corporate websites (40%), response to letters/email to the company (43%) and company sponsored brochures (30%).

FACs "agree-strongly agree" that since FALCPA it is easier to find allergens on labels (95%) and are more confident about label accuracy (74%). Only 28% of participants correctly knew that FALCPA exempts raw meat products. Increased use of advisory statements ("may contain") was noted by 63%.

The new labeling laws have resulted in strong consumer satisfaction and a modest increase in confidence, but FACs are noting an increase in advisory labels, increasingly ignoring them, and may not understand the full details of the law.

Analysis of 1016 commercial food ingredient labels to review Food Allergen Labeling and Consumer Protection Act (FALCPA) compliance, use of advisory statements, and possible pitfalls for food-allergic consumers

Labeling terminology has changed since FALCPA; however labeling practices impact food-allergic consumers but have not been extensively assessed. Danna Chung, MD and colleagues at Mt. Sinai School of Medicine in New York along with trained surveyors assessed 1016 commercial products.

At least one "major" allergen was listed for 73% of products. Allergen disclosure techniques included: separate warnings, using bold font, and parentheses. Regarding advisory labeling (not regulated by FALCPA), 19 different types of terminology were found; the most common terms were "Manufactured in a facility that also processes" and "May Contain" (each 27%).

When advisory labels listed tree nuts, the type(s) were typically undisclosed. "Allergen-free" terminology was found in less than 1% of products. Additional discrepancies and ambiguities included: non-disclosure of sources of gelatin and lecithin, and the simultaneous disclosure of "contains" and "may contain" for the same allergen.

The study concluded that general compliance with the FALCPA legislation appears high, though discrepancies and ambiguities resulting in non-compliant disclosure were identified. There are many circumstances where lack of full ingredient disclosure would present obstacles for persons with allergies to foods not considered "major allergens." Finally, consumers are exposed to an array of advisory labeling terms, not regulated by the FALCPA, presenting varying details and unclear risk disclosure.

Allergic status of schoolchildren with food allergy to egg, milk or wheat in infancy

Although children allergic to egg, milk or wheat in infancy tend to become tolerant by school age, allergic status after remission has not been well evaluated. T. Kusunoki MD, PhD and colleagues at Shiga Medical Center for Children, Moriyama, Shiga, JAPAN and the Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, JAPAN investigated allergic status of schoolchildren who avoided egg, milk or wheat due to immediate-type food allergy diagnosed at less than 1-year-old (early food avoiders), through analysis of a large-scale questionnaire-based survey of schoolchildren.

A questionnaire on allergic diseases was distributed to the parents of 14,669 schoolchildren aged 7-15 years in 30 schools in Kyoto, Japan. Of these, 13,215 questionnaires were recovered (return rate, 90.1%).

Although more than 80% became tolerant to these foods by school age, avoidance of other foods (buckwheat, shellfish, fruits and others) was seen at much higher frequencies than in non-early food avoiders at school age. Moreover, prevalence of asthma, atopic dermatitis and allergic rhinitis was higher in this group. These risks further increased in the subgroup of children who had not gained tolerance to egg, milk or wheat by 3 years old.

The rate of early food avoiders increased as age decreased, indicating a rising trend of food allergy in infancy. At school age, early food avoiders appear to have a higher risk of not only other allergic diseases but also allergy to other food allergens, indicating the need for continuous attention to food allergy.

Lactose-Free Infant Formulas

Dr. Peter Nieman writes for The Calgary Herald, found on Canada.com a useful reminder for mothers who may need to stop breastfeeding their baby, either temporarily or permanently.

For babies who have troubles digesting these standard starter formulas, a change can be made to a lactose-free formula -- which are usually identified by the letters LF (lactose free) on the label. Lactose is a form of sugar and it's important to know that the true incidence of lactose intolerance and colic is regularly overestimated.

The proteins in breast milk are 60 per cent whey and 40 per cent casein. Cow's milk-based formulas are predominantly casein-based.

Sometimes, a mother may switch from a starter formula to one which contains no lactose and soy protein. This "double switch" is frowned upon because it becomes harder to determine the cause of digestive upset. Also, some experts believe soy-based formulas carry potential dangers, a concern that has not been definitively established yet.

In the U.S. there are several major brand names that have milk-based but lactose free varieties.

Enfamil Lactofree LIPIL.



Similar Sensitive (formerly Similac Lactose Free).





Parent's Choice Lactose-Free Infant Formula.

Good Advice For Avoiding a Reaction

Mary Meehan-Strub gives good advice in her Coulee Consumer column, carried by a number of papers in Wisconsin, like the one in Onalaska. (Just hop on Interstate 90 and head west from Rochester, NY. Stop just before you get to Rochester, WI.)

Here's one on Food allergies are a growing concern.

For people who know they have food allergies, steps can be take prevent a reaction.

• Avoid combination foods like soups and casseroles (hard to trace all ingredients)

• Avoid buffet tables (potential cross contamination)

• Avoid desserts (nuts may be in unexpected places)

• Avoid inhaling vapors from cooking and baking of the allergen. For some peanut sensitive people, dust released from opening a peanut shell can cause a reaction.

• Avoid using the same serving utensil for several foods, or allowing other opportunities for cross-contamination. Store, prepare and serve potential food allergens away from other food

It also is a good idea to:

• Read ingredient labels. Identify ingredients that may cause a reaction. For example, people with a milk allergy must avoid foods that contain cheese, whey, rennet casein, artificial butter flavor, etc.

• Ask about ingredients and cooking methods used when eating away from home.

• Clean equipment/utensils that might have touched the allergen.

Green Vegan Pasta for St. Patrick's Day

Really. Does everything have to be green for St. Patrick's Day? Isn't the beer enough? And the stuff at the far back of the refrigerator?

Guess not. Jennie Gessler of the Erie Times-News found a recipe from Laura Matthias' vegan cookbook, ExtraVeganZa: Original Recipes from Phoenix Organic Farm, in which the spinach pesto makes the pasta dish a green one.

Don't add too much garlic to the pesto, she warns, among other helpful hints.

No More Rice & Veggie Cream-Cheese Alternative

Dairy-free foods are a niche market, always a precarious place for any company to find itself in. Over the years I can't begin to estimate how many dairy-free foods I've seen disappear from store shelves.

Another pair has bit the dust. They're Rice Cream Cheese Alternative and Veggie Cream Cheese Alternative. Both are brand names from the big name in cheese alternatives, Galaxy Nutritional Foods, Inc.. Other brands include Galaxy, Veggy, Vegan, Rice Vegan, and Wholesome Valley. They used to distribute under the name Soyco, but that's apparently been spun off or sold off to an Australian firm.



Products distributed under the Rice brand name are made from organic brown rice and are dairy-free. They contain casein, so they are not suited for those with dairy allergies. However, the Rice Vegan products are casein-free, as are the Vegan brand products.

Veggie products are soy-based and lactose-free but not casein-free.

You can search for the several cream cheese alternatives that remain on the Nondairy Milk Alternatives - Cheeses and Cream Cheeses page in my Product Clearinghouse.

Jelly Belly Dark Chocolate

Jelly Belly has 50 "official" flavors of jelly beans that they keep producing all year long.

Then there are the "rookie" flavors, special short-term prototypes made after the testers go wild and start sniffing the jelly fumes. Previous rookies include wildness like Honey Biscuit, TABASCO^® Cinnamon, and Baked Bean.

Just announced is the best rookie flavor of all time: the Dark Chocolate Jelly Belly.

Dark chocolate Jelly Bellys are dairy-free and kosher, although they are made in a plant that processes peanuts. They won't be around long, in all likelihood, so devour them today.

Yoghurt, Ayran, and Kefir: Traditionally Turkish

Last week I gave you a report on Lebneh and Lebanese Cuisine, with an emphasis on the traditional cultured milk drinks of Lebanon.

Here's a similar report from Turkey, care of Sharon Croxford of Today's Zaman.

Yoghurt, or yogurt as it is also spelled, results from the bacterial fermentation of milk. While its origins are unclear, it is likely that the first cultured milks appeared by accident after random fermentation from wild bacteria living on animal hides. The word itself derives from the Turkish "yoğurt" and traditional transliteration spells yoghurt. But not only did the Turks provide the world with the term for the sour, thickened milk, but they were probably also responsible for introducing it to European cuisines. Süleyman the Magnificent is said to have sent his doctor to cure the apparently incurable stomach ailment suffered by Francis I in France. The cure was, of course, yoghurt.

Ayran: the perfect beverage

Ayran is a mixture of yoghurt, water and salt. The thickness may vary across Turkey with those down south preferring something a little firmer. Most commercial manufacturers add approximately 1 percent salt -- about 1 gram for every 100 milliliters of liquid. Unsalted versions are available and can be easily prepared at home. Ayran is the perfect accompaniment to kebabs, döner, lahmacun (very thin, flat-style pizza), gözleme (savory flat, phyllo-style pastry) and some pide (thicker-crust-style pizzas) and börek (savory pastry).

The potential health benefits attributed to the bacteria of yoghurt are related to the traditional, spontaneously fermented milks, not those soured with standard bacteria used in industrial production. Ayran purchased in sealed plastic and foil cups are unlikely to provide the sought-after gastrointestinal assistance; any bacteria present will not survive the harsh internal environment of the human body.

Kefir, another fermented milk product, particular to Turkey and other Central Asian countries, is gaining popularity for the same gastrointestinal reasons. As with yoghurt, the Turkish language has provided the world with the name for this tart, sometimes effervescent and thick liquid. Keyif, the Turkish word for "good feeling" has lent itself to the ever-increasingly popular drink.

Commercially produced kefir can be found in specialty shops, as can the starter culture for home cooks. A small jar of what seems to be a slightly lumpy, milky liquid is all that is needed to start a continuous supply of friendly bacteria and yeasts. Kefir aficionados tell of the superior health benefits of this cultured milk over yoghurt. The variety of bugs work to actively colonize the gut; taking over the space in the mucosal wall that are usually crawling with destructive yeasts and bacteria.

One of the benefits of both ayran and kefir is that the process of fermentation sees milk's natural sugar, lactose, broken down, used as food by the bacteria. This makes digestion of both drinks easier than their predecessor, milk. Their other nutritional benefits come from their abundant minerals; calcium, potassium, phosphorus, magnesium and vitamins riboflavin, B12, A, K and D.

Pioneering Gluten-Free Lactose-Free Cookbook Updated

Way back in the early 1970s, Carole Smollan had a problem. Her two daughters had celiac disease at a time when virtually no one had ever even heard the term. She also lived in South Africa, a long way from the small communities that were also trying to deal with the disease and the necessary diet.

Determined to help, she developed a gluten-free flour for the South African market and wrote Gluten-Free Guide for Southern Africa, published in 1975 and revised and updated in 1985.

The 1980s were ages ago in special diet and "free from" food years. Smollan has finally put out an entirely new edition, according to a book review by Hilary Biller in The Times of South Africa.

In her latest guide Smollan has put her 30 years of experience of advising people on this kind of diet and her updated knowledge into a newly-published guide. It’s aimed at those on a gluten-free diet but also the hostess, careers, partners, wives, husbands, girlfriends etc. of those who need to provide a gluten-free diet on a regular basis.

The guide is far more than a cookbook and jam packed with useful information. She tackles issues like lactose intolerance, food labelling and there are even travel tips for those suffering from food allergies.

Smollan has her own website at www.glutenfreeguide.info. Click here for the contact page for ordering the current book, now titled Gluten Free Guide: Making It Simple.

Lactose Intolerance Doesn't Cause Bad Breath

I received a question today asking me if there's a connection between lactose intolerance (LI) and bad breath.

No. There isn't. Simple and straightforward.

As always, I forgot the internet and the legions of pseudoscience. Not to mention the anti-milk crowd which wants to demonize dairy in all its forms.

A Google search on "lactose intolerance" and "bad breath" brings up a breathtaking 75,000+ hits. Many of them are copies of (or variations of: hey, if you're peddling pseudoscience why would a little plagiarism stop you?) two basic articles.

One is by Dr. Harold Katz, founder of The California Breath Clinics.

High Protein Foods
These bacteria love those proteins, and certain foods are packed with them:

Milk and Cheese and most other dairy products. (The fat content does not matter.) If you are lactose intolerant, do not eat or drink these products! Since your system cannot digest them properly, they are available to the bacteria for an extended period of time. A recent research article from the Los Angeles Times (November 1996) on lactose intolerance showed that nearly 67% of all Americans can be classified as "Lactose Intolerant". This is due to the fact that in a diverse population such as we have here, there is a predilection for Asians, Hispanics, and African-Americans to be lactose intolerant.

Fish are high in proteins. As many people eat a high fish diet, logically they make the problem worse.

The pseudoscience here is of very high quality. Lactose intolerance is the inability to digest the lactose sugar in dairy products. Dairy proteins are digested perfectly well. No dairy proteins are available for an extended time. They are absorbed by the small intestine and don't reach the colon where the bacteria are.

Other questions should be springing to mind as you read this. Meat is high is protein as well. Shouldn't meat be a prime cause of bad breath? What about plant protein? Vegetarians always say that high protein plant products can be eaten in lieu of meat. Wouldn't they cause bad breath?

While Dr. Katz's notions about diet are bizarre and obviously wrong to anyone who knows anything about nutrition and digestion, you'd have to be more aware to catch the subtlety wrong in the other theory, which can be found in articles similar to this one by Sue Spataro.

[The bad breath] is powerfully strong and people can sense it from feet away. Others may think the person has poor oral hygiene when in reality they are lactose intolerant. The oral hygiene has nothing to do with their bad breath. The bad breath is caused by the lactose rich foods sitting in the person's intestines and fermenting. The body tries to get rid of the gases that are produced as the result of fermentation by having them reabsorbed by the bloodstream and exhaled out.

The hydrogen breath test is a common way doctors make the diagnosis of lactose intolerance. This tests measures the amount of hydrogen in the breath. Normally, very little hydrogen is in the breath. But undigested lactose in the colon (large intestine) is fermented by bacteria, and various gases including hydrogen is produced. The hydrogen is absorbed by the intestines, carried through the bloodstream to the lungs, and exhaled. In the test, the patient drinks a lactose-loaded beverage, and the breath is analyzed at regular intervals. Raised levels of hydrogen in the breath indicate improper digestion of lactose. Certain foods, medications, and cigarettes can affect the test's accuracy and should be avoided before taking the test. This test is available for children and adults.

Yes, fermenting bacteria do create reactions that end in the production of extremely vile-smelling gases, mostly from volatile sulfur compounds. And it is quite true that this is the only reaction which creates hydrogen that percolates through the body and is emitted in the breath, the reason why the hydrogen breath test has become the most common test for LI.

What's not true is that the sulfur compounds do the same thing. The gases that are produced leave the body via a different exit, the process known as farting (or flatulence). Doctors would surely have noticed by now, after millions of hydrogen breath tests, if the lactose load that we drink to make the test work also caused sulfur to pour out along with the hydrogen. So would we patients. We don't, because it doesn't happen.

Notice how each theory makes use of a bit of real science to give the work a sheen of verisimilitude before venturing off into parts unknown. Katz talks about bacteria in the intestines, but ascribes to them a role unknown to other doctors. Spataro uses the hydrogen pathway to try to make a point about unnamed other gases that are not as odorless as hydrogen.

Standard medical science has nothing to say about lactose intolerance causing bad breath. A search of PubMed, the medical journal database, turns up no articles making the connection. It's a "truth" known only to the internet.

If you want real facts about bad breath - facts that nowhere mention "lactose" or "dairy" or "protein" - I recommend that American Dental Association's FAQ page on bad breath or the Mayo Clinic's Causes of Bad Breath page.

Don't get suckered by pseudoscience.

Egg Allergens Scrambled

In a breakthrough for allergy sufferers, European researchers have manipulated eggs to reduce - almost, but not quite, remove - their allergenic properties.

The press release says:

People who suffer from egg allergies may soon be able to have their quiche and eat it too. Chemists in Germany and Switzerland report development of a new process that greatly reduces allergens in eggs and may lead to safer, more specialized food products for individuals with egg allergies.

...

In the new study, Angelika Paschke and colleagues describe their process, which exposes raw eggs to a combination of high heat and enzymes to break down their main allergens. The researchers then tested their reduced-allergen egg against blood serum collected from people with egg allergies. The modified egg product was 100 times less allergenic than raw egg, the scientists say. It does not significantly affect flavor and texture when used in various products, they add.

The study "In Vitro Determination of the Allergenic Potential of Technologically Altered Hen's Egg" is scheduled for the March 12 issue of ACS' Journal of Agricultural and Food Chemistry.

Being able to do this in eggs doesn't imply that a similar technique will work against the allergens in milk, but all fundamental breakthroughs in the field are good news.

Checking the Science in the Science Fair

Mark Anderson in the St. James Plaindealer writes about a Middle School Science Fair.

Jonathan Peterson already knew about lactose intolerance because he has to watch his own diet for lactose. But his science fair project gave him a chance to go more into depth and teach others about the dietary condition.

Peterson posted a list of foods on his display, then covered up the answer key telling whether they contained lactose.

Good going, Jonathan. Simple, interactive, informative, and entertaining. High marks.

But content is as important as presentation.

Foods included chicken noodle soup, potato chips, fruit loops, crackers, roast beef, life savers, bread, jelly, processed hamburger, marshmallows and french fries.

Of those, visitors were surprised to learn only the roast beef, life savers, jelly and marshmallows are lactose free.

I'm surprised too, I'm sad to say. Let's go over these answers.

Chicken noodle soup. There must be 50 million chicken noodle soup recipes in the world. With all that variation, it would be no surprise to discover that somebody, somewhere must add a dairy product. Normally, however, there's no good reason to expect to find any lactose in chicken noodle soup. And you wouldn't expect to find any in normal commercial chicken noodle soups. Here's the ingredients list for Campbell's Condensed Chicken Noodle Soup. No lactose containing ingredients. Some restaurants may include dairy, though. The fast food chain Chick-fil-A's
Hearty Breast of Chicken Soup contains nonfat milk, whey, and butter. Chicken noodle soup is something to ask about when eating out, but can easily be found lactose-free commercially or made at home.

Potato chips. Similar situation. Your plain, standard, everyday potato chips will almost certainly be lactose-free. Plain potato chips aren't hip and cool, which is to say that brand extension ensures that potato chips comes in a huge variety of flavored varieties. You'd expect that sour cream and onion or cheddar or ranch flavored chips would have dairy in them and you'd be right.

Fruit loops. I have to assume that either Jonathan got it wrong or the reporter transcribed it weirdly. I can't find a product called "fruit loops." What any kid will be familiar with is Kellogg's Froot Loops. Slight problem. Kellogg's Froot Loops has no dairy products.

Crackers. Of the ten million different cracker products in the world, some will be lactose-free and some won't. No way of knowing unless you can read the ingredients list.

Life savers. Believe it or not, butter rum flavor Life Savers hard candy actually contains real butter. Unless you knew this, you could go through a dozen or more flavors and think they were all lactose-free, as Jonathan apparently did. I've read so many ingredients lists in my life that I happen to know of this exception.

Bread. Lots of different breads. Some, like real French or Italian breads or Jewish ryes, are bound to be lactose-free. Most commercial varieties will contain some lactose.

Jelly. Most commercial jellies will be lactose-free. I don't know of any exceptions, but I could be surprised by one tomorrow.

Processed hamburger. I honestly don't know why this is listed as having lactose. Cheeseburgers, sure. Hamburger buns, possibly. But the hamburger itself? And what does "processed" mean? I suppose some grills might use a butter-based product for frying, but oil is cheaper and more likely. Pure hamburg should be lactose free.

Marshmallows. Should be lactose-free.

French fries. Many years ago, the warning lists giving foods with lactose in them would often include french fries. I found out they did this because commercial french fries are sprayed with sugar that browns when cooked to give them that good golden appearance. That sugar is uniformly dextrose, however, a different sugar than lactose. I've never come across a real world example of lactose being used as a browning agent for french fries. That's true for all true cut-from-the-potato fries. Supermarkets and fast food restaurants are not necessarily that simple. Some flavored fries may, as with potato chips, have a dairy-based flavor added or be made of chopped, formed, processed potatoes that use some dairy as a flavoring or cooking ingredient.

Life is unfortunately not as simple as Middle School. Being aware that lactose may lurk in all sorts of products is a lesson that's a terrific one to drill into all kids with lactose intolerance or milk allergies. The complications of food processing science may take a bit longer to fully understand. Either way, reading the ingredients lists or asking waiters or serving staff are musts.

And thanks to Jonathan Peterson for coming up with such a useful teaching opportunity. Sorry to be such a tough grader.

Lebneh and Lebanese Cuisine

Low-lactose products were first made in the Middle East, where, no coincidence, herding and milking of animals began. To keep the dairy products from spoiling in the heat, they were often "soured" or acidified, by using bacterial cultures to turn the lactose into lactic acid.

Rami Zurayk of SlowFood.com tells us more about these products in the course of a fascinating article about Lebanese cuisine.

The processing of milk first started in the Middle East for the purposes of preserving it for long periods of time. Milk yields different products with increasing shelf lives: fresh milk yields yoghurt (laban) then labneh, then cheese. Milk can also be further processed into drier cheeses such as shankleesh. Labneh, since it contains less water, represents a later stage of processing than yoghurt.

Labneh is characterized by its white/cream color and its soft and smooth paste. It is easily spreadable and has a clean and slightly acidic flavor. In households throughout Lebanon, labneh is consumed on a daily basis. It is most commonly eaten fresh drizzled with olive oil and scooped with pieces of pita bread. It is also used as a filling for sandwiches.

Labneh can be made from cow, goat or sheep milk. It contains around 10% fat, 10 % protein, 5 % lactose, 15 % milk solids, and 25-35 % total solids. It has a pH ranging from 3.5-4 (Bodyfelt, 1988).Good quality labneh requires a starter culture consisting of strains of Streptococcus thermophilus and Lactobacillus bulgaricus. These bacteria are crucial to a fermentation process that transforms lactose to lactic acid and thus makes labneh more tolerable to lactose-intolerant consumers.

Shankleesh is the only mold-ripened cheese native to the Middle East. It is believed to be of Kurdish origin. Shankleesh is essentially concentrated, skimmed milk yoghurt which is hand-molded and given a smooth outer surface, then ripened and coated with thyme and other herbs. It can be consumed after ripening for a couple of days or it can be stored in containers (traditionally clay jars) at ambient temperature. It will then be colonized by yeasts including Debaryomyces hanseni and Penicillum. It is this development of this micro-flora that gives shankleesh its distinctive taste and increases its shelf life while decreasing the risk of contamination by pathogenic organisms. High salt and low moisture content also contribute to the preservative effect. This was especially important under conditions where refrigeration was not available.

Shankleesh can be made from cow, sheep or goat milk. The type of milk will affect the taste of the final product. Milk is fermented into yoghurt, which is then shaken to extract the ghee. The remaining protein rich liquid is heated until it solidifies. The coagulum is then salted and hand-molded into fist-sized balls. It is sun-dried and then fermented in a clay pot for a month. The resulting product has a moderately pungent and somewhat musty flavor with a perceptible bitter note. It is also naturally very low in fats (around 5%) and constitutes a very healthy source of proteins and calcium. Shankleesh is usually eaten as an appetizer (mezzeh) broken into small pieces, mixed with finely cut onions, tomatoes and green peppers and drenched in olive oil.

Passover By Design Cookbook Also for Gluten Intolerants

The Internet is a pleasure palace for the world's lovers of irony. How else to describe the odd thrill of finding the press release for Passover by Design, the new cookbook in the Kosher By Design series, on ChristianNewsWire.com?

Acclaimed kosher diva Susie Fishbein, author of the Kosher by Design cookbook series is releasing her fifth project – Passover by Design (ArtScroll Shaar Press, February 2008; $29.99/Hardcover, 276pp; ISBN: 1578190738). With over a quarter of a million books sold, Kosher by Design has become the most popular kosher cookbook series in print today. Passover by Design follows suit with Fishbein's signature style of combining gorgeous food and décor photos together with 172 chic recipes that shimmer with simple elegance.

...

Because 130 of the recipes are gluten-free, About.com's Guide for Celiac Disease, Nancy Lapid, has endorsed the book as a welcome year-round resource for anyone who is gluten-intolerant.

Fishbein has her own website as KosherByDesign.com, with details of the five books now in the series, the other three being Kosher By Design Entertains, Kosher By Design Short on Time, and Kosher By Design Kids in the Kitchen.

Lactose Intolerant Quadruplets

In the So You Think You Have Troubles Category...

Jill and Kyle Williams are the parents of quadruplets. They did it naturally, too, with no fertility drugs.

When Jacque Hillman of The Jackson Sun called, all four of the almost one-year-olds had a stomach virus. Jill was sick, too.

The next day a tornado hit and the Williams' power went out.

Just daily life with Ace, Hensley, Hudson and Avery is a trial. All four are teething. They have developmental problems, a consequence of all being premature. It's not clear from the article whether their lactose intolerance is also from being premature. Premature babies are often born LI because the lactase enzyme is one of the last bits to develop in the ninth month of pregnancy. Usually premature babies get their lactase very quickly after birth, however.

In the Williams' case:

Avery takes two or three bottles a night, and although she doesn't stay awake long, it means that Kyle and Jill are often up during the night. Sometimes the couple has to shop for Enfamil for lactose-intolerant babies through every Wal-Mart, Walgreens and Kroger store in Jackson to find enough.

The quads go through 24 bottles a day. And 48 diapers.

Immune System Not in Your Gut

"Probably 50% of our direct immune system resides in or around the gut."

"Fully 60 percent of your adaptive immune system resides in your small intestine."

"70% of our immune system is located around the digestive system."

"About eighty percent of the full force of your defensive immune system resides in your intestines or gut."

With these "facts" floating around the internet, it was inevitable that someone concerned about milk allergy would get the idea that "the immune system resides in the gut." Sure enough, I saw this statement earlier today.

It's not true. At best, it's a misunderstanding of the role that the digestive system plays, but even that overstates the truth. In reality, it's sheer pseudoscience perpetrated by new age quacks who want to sell you their digestive enzymes or supplements or herbs or even weirder stuff. (Yes, of course our old friend NAET peddles this nonsense. Just one of many.)

The excuse that is given on these sites is often something they call "leaky gut syndrome." The mainstream medical community doesn't recognize this syndrome, and it's tough to find any medical journal articles that even address it. That doesn't matter to the alternative medicine gurus. Leaky gut appears to be yet another of the quackeries that started in the UK, that haven of ignorance about food, nutrition, and digestion, and was snapped up here in America by those looking to make a quick buck out of other peoples' ills.

It's as perfect a scam as can be imagined. Because it has no recognized existence alternative practitioners are free to invent any set of symptoms and cures they want to sell. Since all cures will be anecdotal, and many will simply involve taking an offending food out of the diet anyway, the cures might lead to an alleviation of symptoms for some. If they do, fine, that's a testimonial. If not, the sufferer will go on to another "cure." Heads they win, tails you lose.

For information that sticks to the real world of medicine, How Stuff Works has a good, plain-language explanation of the immune system. (Seventeen pages and no mention of leaky gut!)

Another straightforward set of pages are those on Allergic Reaction at eMedicinehealth.com.