Sorbet: Dairy-Free But Watch the Sugar

Though the northeast is suffering through a June that features far more rainy days than scorchers, the calendar and the astronomers proclaim that we've arrived in summer. And since editors are slaves to calendars, garnering material weeks or months early to appear on the proscribed date, frozen dessert articles are appearing like clockwork. If anybody under the age of 50 understands what that metaphor means.

Therefore we have Erin Lindholm on amNewYork, who provided a terrific reminder that most frozen desserts are sugar-filled candy confections. They taste great, they satisfy the craving for coolness in the heat, but they need to be occasional treats. You can't load up on the cool stuff and then eat your way through the rest of the day without taking these extras into account.

Sorbets are especially subject to this blindness. Because they're fruit-based and often dairy-free, even fat-free, most people will think of them as a light and less calorific alternative to ice cream. That might be true. Even so, you might be surprised at the sugar wallop they're packing.

While it’s true that sorbet’s a lower-calorie, lower-fat (often fat-free) alternative to ice cream, and it’s made of fruit and often dairy-free, that’s not a green light to eat the whole pint in one sitting.

“It should still be considered a treat or dessert unless it’s homemade, and you know what’s really going into it,” noted nutritionist Liz Stein.

The first step, said Stein, is to check the sugar. For all their appeal, “sorbets are still loaded with sugar.”

In the four market brands taste-tested for this article — Ciao Bella, Haagen Dazs, Sharon’s and Whole Fruit — sugar per serving ranged from 19g to a whopping 38g, which is a huge variable when we’re talking about a scoop of frozen delight.

Second, said Stein, is figure out where the sugar’s coming from. The fruit accounts for some of it, but "you want to choose a sorbet that has natural sugar, as opposed to high-fructose corn syrup." Case-in-point: In four samples, we found everything from cane sugar to plain old "sugar" to corn syrup.

I'm not as much a foe of high-fructose corn syrup as Stein. Sugar is mostly sugar, with four calories per gram no matter what the source. Cane sugar is the same thing as "plain old sugar." Corn syrup is the simple sugar glucose. Sugar is glucose plus fructose in equal parts, but converts to glucose inside the body. High fructose corn syrup (HFCS) is also glucose plus fructose, with a variety of blends from 42% fructose to 90% fructose depending on the needs of the final product. As a commercial syrup it also contains water, usually one-quarter of the total. This means that HFCS only has three calories per gram. It's made commercially starting from a corn syrup base.

I know that many people get hysterical over the tremendous amount of use of HFCS in consumer products, because it is much cheaper than sugar. (Remember that it's one-quarter really cheap water.) The science is not clear that HFCS promotes obesity or has any truly bad effects on the general population. My feeling is that any sugar consumed in large quantities is going to have an effect on obesity. It wasn't the switch to HFCS that made Americans obese, it was the change in habits, the lessening of physical activity, and the growth in portion size that made supersizing the new normal.

Back to the point. Go ahead, have a small sorbet as a summer treat. No reason at all to cut out treats entirely. Just remember that fruit or not, you're eating a cupful of sugar, with some cups having even more sugar than others. Moderation in all things, except moderation.

The Lactose Intolerance Clearinghouse Has Moved

I set up Steve Carper's Lactose Intolerance Clearinghouse way back in 1997. The site was as primitive as a site could be. The connection was primitive too, CompuServe's Ourworld Homepages.

The site grew a tiny bit more sophisticated as I learned better html. It's still basic, but I hope readable. I've had compliments on how clear and straightforward it is. No flash animation to navigate, no babbling videos, no tricky links.

In a sign of how the web has changed, CompuServe is dropping support of hosted webpages entirely. As of June 30, the http://ourworld.compuserve.com/homepages/stevecarper/ site will be gone forever.

The site will live on. I've moved it to my own domain. Every page on lactose intolerance can now be found at www.stevecarper.com/li.

The only change is that my science fiction pages now have their own section, www.stevecarper.com/sf.

The URLs of the individual pages have also changed in another way. CompuServe still limited file names to 8 characters, just as if the clock had never ticked over from 1997. I've put the full page name into each URL. For example, the Milk-Free Bookstore is now www.stevecarper.com/li/milk-free_bookstore.htm. The Product Clearinghouse is now www.stevecarper.com/li/The_Product_Clearinghouse.htm. And so forth.

Those of you who have bookmarked any pages in the past will have to change those bookmarks now. Because the CompuServe service is being discontinued I can't even redirect you from the old pages to the new.

However, I moved the Links section here on the blog to the top of the left hand column. Those have the new links in them. From them you can go to any part of the Clearinghouse that you want.

The new site is completely up and running. Well, I say completely, but there may be a bug or two in the links. With over 100 pages, way more than 1000 page links had to be changed. I'll be clicking on links to doublecheck for any errors, but if you find any please let me know.

You can leave a comment here. Or you can still do that at my old CompuServe email address, stevecarper@cs.com. That hasn't changed and it's not going anywhere. Yet. Who knows what changes the future will bring?

Goats Get Lactose Intolerance

Remember the old joke in which a teacher gives a class assignment to write about a pet peeve and some future delinquent writes about his pet, Peeve?

It's not very funny. I know.

Not funny. Just relevant. To me, at least. You can't imagine how many times I go on the Internet and find people dumb or oblivious or self-interested enough to proclaim that goat's milk is acceptable for people with lactose intolerance.

Here are some examples I pulled off of Google News, just this month.

FoodBizIntel: Meyenberg Goat Milk Products

Goat milk has a delicious, gourmet taste, is easily digested, and is a real milk alternative to lactose sensitivity.

Tabbouleh Chavrie Salad

Healthy tips about our all-natural cheese include goat cheese contains 30% less fat than sour cream and many cow’s milk cheese. It is gluten-free and is easily digestible for those who are lactose intolerant.

Editors' Picks: Automaker offers goat with purchase

Goat's milk, he added, "provides a nutritious alternative for the growing number of lactose-intolerant people ...

Milk, it was good for you as a kid, it is good for you as an adult

There is goat’s milk which has slightly different properties than cow’s milk. Those who are lactose intolerant may be able to drink goat’s milk.

Not just kidding around

Goat's milk contains a different protein base than cow's milk and so can often be tolerated by people who are lactose intolerant or have other digestive sensitivities, Heather said.

That would be no, no, no, no, and no.

Goat's milk has almost exactly as much lactose as cow's milk. Some people who are allergic to cow's milk can drink goat's milk because it contains a different set of proteins. But that is almost exactly opposite to what these nitwits claim.

How do I know that goat's milk will affect the lactose intolerant?

How about a lactose intolerant goat?

J Am Vet Med Assoc. 2000 Aug 1;217(3):372-5, 340.
Secondary lactose intolerance in a neonatal goat.

Weese JS, Kenney DG, O'Connor A.

Department of Clinical Studies, Veterinary Teaching Hospital, Ontario Veterinary College, University of Guelph, Canada.

A 2-week-old Toggenburg kid was evaluated for persistent diarrhea and poor body condition. The herd had high morbidity and mortality associated with diarrhea in neonatal kids. Lactose intolerance was diagnosed on the basis of results of a lactose tolerance test and glucose absorption test. Clinically normal herdmates were used as control animals. The kid responded to lactase supplementation. Cryptosporidium organisms were detected in feces of several affected kids during episodes of acute diarrhea. Lactose intolerance was presumed to have developed secondary to intestinal cryptosporidiosis.

In other words, this poor baby goat got an intestinal ailment, and developed secondary lactose intolerance, in exactly the same way that so many humans, especially infants and babies. do when their intestines are attacked by something like the "stomach flu," actually a gastrointestinal ailment. The cure was also exactly like that of a human: use lactase to digest the lactose and reduce the symptoms.

Everybody. Please stop saying that goat's milk is for people with lactose intolerance. That's not true. Even the goats know better.

Can You Travel Away From Your LI Symptoms?

Over the years I received a surprising number of emails like this one I received recently:

Something very interesting happened when I visited Italy last October. I was very cautious about eating their foods, especially all the cheese--which I love. One day I ate some over there---guess what--no problem. I ate more---no problem. I was elated! I got back to the States---ate some cheese---big problems!

Milk is milk all over the world so the symptoms of lactose intolerance should stay the same no matter where you go or what your eat. Most of the time I couldn't even hazard a guess why travel should make any difference at all.

But while milk is milk, cheese isn't always cheese. By that I mean that the more you age cheese the lower its lactose content. And the more you adulterate cheese - making it into cheese product of some sort - the more cheap stuff, like lactose (usually in the form of whey), manufacturers add to give artificial cheese a more milk-like taste. I hate to tell you, but not all that cheese you find on pizza is real cheese.

Now it's true that the Italians use some less aged, or mild, cheeses. But I imagine it's possible that a tourist might find herself in places that use better and more aged cheese.

As I say, it's just a guess. But it's the only answer I could come up with.

I'd like to hear your experiences while traveling. What happened when you ate cheese in Italy? Or anywhere else?

Galactosemia, the Most Serious Lactose Problem

Lactose is what's called a disaccharide, a complex sugar made out of two simpler sugars, in this case glucose and galactose. Lactose intolerance occurs when the body doesn't make sufficient lactase, the enzyme that splits lactose into the simpler, and therefore digestible, sugars.

Glucose is the primary energy source for the body. All carbohydrates digest down to glucose and we must maintain a supply of it to live even for a very short time. There's really no such thing as a glucose problem.

What about galactose? Well, galactose is a carbohydrate and the body will convert galactose to glucose shortly after it is absorbed into the intestines. If this doesn't happen, a variety of awful symptoms appear. These appear much more slowly than a glucose problem, however.

Occasionally, therefore, a baby is born with the inability to convert galactose and lives long enough for the doctors to figure out the problem. This is called galactosemia. It's pretty rare, which is why I talk about so seldom. I last did so in 2007, with the posts Galactosemia: the Other Lactose Problem and Sarah's Cure about a nonprofit organization to fund research for a cure.

I was reminded of my need to periodically mention galactosemia by a very good article on the subject by Dr Vandana Rao on DNA India.com.

Dr Rao said that:

Some of the common symptoms are jaundice, vomiting, poor feeding (baby refusing to drink milk-containing formula), poor weight gain, lethargy, irritability and convulsions.

Infants with Galactosemia will develop most of the above symptoms within days of drinking milk.

Milk includes both breastmilk and a milk-containing formula, which means that virtually every baby in the world with galactosemia will start showing symptoms within days of birth. Doctors today will recognize the problem and move the infant onto a nondairy formula immediately. Lactose must be avoided for life.

Now for a complaint. I keep mentioning that the people who write articles for newspapers or magazines, or just about any publication that they don't control, normally never also write the headline for that article. That is the job of an editor.

Now if you were an editor and you read that list of symptoms above, what title would you put onto this article? Could any of you be so thoroughly dense as to title it "Lethargic? It could be Galactosemia"?

Lethargic? Who among us not named Richard Simmons isn't lethargic at times? Wouldn't that word draw you to the article? Wouldn't you think that you yourself might be suffering from galactosemia?

You aren't. I guarantee that no adult suddenly stumbles upon the knowledge of being galactosemic. You know it from before you can talk or not at all, because you simply don't live long enough to talk if you don't find it out.

That is probably the most boneheaded headline I have ever come across, and you regular readers out there know that I complain about headlines with bile-spewing frequency.

My apologies to Dr Rao for having her excellent article spoiled by some ignorant clod. You deserved better.

For more information on galactosemia, go to Parents of Galactosemic Children Inc.

Follow-ups: Babycakes and Purely Decadent

I told you last month about the scorchingly hot New York Babycakes Bakery and the cookbook it released. The cookbook, let me remind you, is vegan and wheat-free, but uses spelt so it's not gluten-free.

Babycakes owner Erin McKenna talks about the difficulties of gluten-free baking and gives some tips on making vegan baked goods work in an interview on Express Night Out.com.

Earlier this year I also talked about Turtle Mountain's new line of coconut milk-based non-dairy frozen desserts from their Purely Decadent label. Carrie Forbes on Examiner.com gives her very positive reviews of three flavors.

Gluten-Free While Eating Out

Vanessa K. Bush wrote a long and interesting article about gluten-free foods at QSR Magazine.com. Eating gluten-free also often means eating dairy-free as well, since celiac disease can damage the lining of the intestine where lactase is made.

Bush noted that many restaurant chains now finally are beginning to cater to special diet needs.

Lone Star Steakhouse, for example, makes recommendations on its menus geared specifically to the gluten-sensitive. Suggestions include ordering mesquite grilled steaks and chicken without seasoning or lemon butter; ordering burgers and sandwiches without a bun, steak fries, or seasoning; choosing the baked sweet potato without butter or cinnamon; and ordering salads without dressing, croutons, tortilla strips, or bacon. The Macaroni Grill offers suggestions on its menus for a number of food sensitivities, ranging from egg and fish allergies to gluten-free, advising those with wheat sensitivities to avoid baked items like croutons and biscotti and certain seasonings.

She mentioned several desserts as well, but all appeared to have milk in them except for Chinese upscale chain PF Chang, which "has a Flourless Chocolate Dome served with fresh berries and raspberry sauce." That sounds dairy-free but I would doublecheck.

It's a good article, covering a lot of ground, so take a jump over to QSR, a specialty magazine for the restaurant industry that has a deeper take on food subjects than a lot of generalist sites.

Non-Dairy Sources of Calcium

While I'm thinking about non-dairy sources of calcium, I should take you to the source of sources, the USDA's Food Sources of Selected Nutrients page.

There's a plenitude of good information on that page and you may want to bookmark it for the future.

In the meantime, I've copied the table on non-dairy sources of calcium.



Blogger tends to reduce photos even at their largest size, so let me emphasize what appears in the fine print. Not all foods that have good amounts of calcium are good sources of calcium because other chemicals in those foods block its absorption. That's what I wrote about yesterday. Even so, that list will give you a head start on foods you should be including in your diet if you are avoiding dairy completely.

Vinegar Helps Calcium Absorption

If you're going to drop dairy from your diet you need to make doubly sure you find ways to get the nutrients that dairy is famously has in abundance. Calcium is high on that list. Vegans are always quick to insist that you can get your calcium from green, leafy vegetables which are rich in calcium content. The latter high of that statement is true but the first half is more problematical.

Green, leafy vegetables contains chemicals called oxalates than bind the calcium in them, making the calcium unavailable for digestion. The calcium has low bioavailability, to put it another way.

About.com is a good source of information on oxalates.

Oxalates are naturally-occurring substances found in plants, animals, and in humans. In chemical terms, oxalates belong to a group of molecules called organic acids, and are routinely made by plants, animals, and humans. Our bodies always contain oxalates, and our cells routinely convert other substances into oxalates. For example, vitamin C is one of the substances that our cells routinely convert into oxalates. In addition to the oxalates that are made inside of our body, oxalates can arrive at our body from the outside, from certain foods that contain them.

Foods that contain oxalates

The following are some examples of the most common sources of oxalates, arranged by food group. It is important to note that the leaves of a plant almost always contain higher oxalate levels than the roots, stems, and stalks.

Vegetables
spinach, Swiss chard, beet greens, collards, okra, parsley, leeks and quinoa are among the most oxalate-dense vegetables
celery, green beans, rutabagas, and summer squash would be considered moderately dense in oxalates

So what is a dairy avoider to do?

Katie Alfieri, Rochester Wellness Examiner, blogged on Examiner.com that vinegar is the solution.

Dark, leafy greens are good sources of calcium, but some of these greens also contain compounds that inhibit calcium absorption. Adding a tablespoon of vinegar (either balsamic, apple cider or red wine) and 2 tablespoons of oil to your greens will allow you to absorb the calcium. This is especially beneficial for those who are lactose intolerant.

I always doublecheck information from Examiner.com, but in this case it's absolutely correct. The acetic acid in vinegar increases absorption of many important minerals. The oil is not strictly necessary but a vinaigrette is undoubtedly tastier for most folks. If taste is secondary you can even take a spoonful of vinegar with a glass of water before meals.

By the way, notice how many names of chemicals have littered this post. Beware anyone who talks about "chemicals" as some nasty, artificial creation to be avoided. Everything is a chemical and that means everything we eat is naturally no more than a huge mess o' chemicals. Without chemicals you would die instantly. Mostly because your body would simply disappear. Don't disparage chemicals. Celebrate them. It's our modern knowledge of chemicals that made the entire modern world of civilization possible. Every medication, natural, artificial, synthesized, or other is a chemical as well. Chemicals make you feel full, happy, and better. Understand them before you knock them.

Controversy Over "Vegan" Cookbook

Pat Crocker is the author of The Vegetarian Cook's Bible, which I mentioned in December in 2007 in my Cookbooks As Giving Gifts post. It didn't get a lot of attention but garnered fairly good reviews on Amazon.

This year she came out with The Vegan Cook's Bible. An interview with the people at the Chicago NBC station indicated that she has good advice to offer.

3. What are some principles of making vegan dishes flavorful?

I spent a lot of time developing a healthy (pardon the pun) 'Basics' section in order to do just that. This section includes vegan sauces, dips, spreads, glazes for perking up vegetable and fruit dishes, as well as providing many nut and fruit milk alternatives, along with egg, cream and butter plant alternatives. My promise in accepting the challenge of writing a vegan cookbook was that the recipes would be delicious and that even non-vegetarians and non-vegans would enjoy them because they simply tasted divine.

That all sounds great. There's also a bunch of solid vegan recipes on that page.

But when you go to Amazon you see a page full of angry reviews from vegans. They all complain that Crocker uses fish and honey in her recipes, both obviously not vegan dishes.

I don't understand why any author would do this in a supposed vegan "bible." It's clear that many of her recipes are completely vegan and I like the advice that I've seen. Yet I can't recommend the book. You'll have to make up your own minds whether to ignore the non-vegan recommendations to get to the useful recipes or just go on to another of the many vegan cookbooks published these days.

Young Adults Not Getting Enough Calcium

I hate to keep harping on the need for calcium, but I can't ignore the fact that a new study seems to come out about every other week saying that some segment of the public isn't getting their RDA of calcium.

This week the culprits are young adults sayeth an accusatory article on Forbes.com. A University of Minnesota study of 1500 young-uns found that they started reducing their calcium intake in high school or soon after.

More than half of the males and more than two-thirds of the females consumed less than the daily recommended level of calcium at the end of each of those time periods, the researchers found.

The study findings are published in the July issue of the Journal of Nutrition Education and Behavior.

The study also took the time to check what else was correlated with lower calcium levels. Lactose intolerance was, not surprisingly. People who drink less milk tend not to get enough calcium from other sources either.

Also connected was "excessive television watching." TV watchers. Order more pizza. Double cheese. Heck, you're already fat.

CVS Accused of Selling Expired Lactaid

A Houston television station has reported that the CVS pharmacy chain, the largest retail drug store chain in the country with almost 7000 stores, was selling products as much as three years past their expiration date.

An organization created by a coalition of labor unions, Change to Win, did a survey of 34 Houston area CVS stores that:

revealed that 90 percent of the stores visited were selling everything from expired dairy products and infant formula to over the counter meds for adults and children.

"That's the highest rate we've seen out of anywhere in the country," said [Garrett O’Connor of Change to Win].

He says the products expired anywhere from a few months ago to a few years. He cited a particular drug called Lactaid.

"They don’t even make this box any more. It expired November of 2005 and it was purchased in April of 2009," said O’Connor.

The television station revisited three of the stores and found that expired products were still on the shelves.

Expired Lactaid would not be dangerous but would likely lose its potency and effectiveness.

This is a reminder to always check the expiration date of any over-the-counter medication before you buy it.

Planet Lactose Otherworldly News

Reports continue to pour in from the far corners of the world. Some, like those I blogged about yesterday, in Planet Lactose World News, make for good sense and good reading.

Others just drop my jaw and raise my blood pressure.

What can I possibly say after reading the following from IranSlogger.com?

Meanwhile, the headlines of the local edition of Az-Zaman said that "unconfirmed reports" claim that 'Izzat al-Duri - Saddam's second in command and the highest-ranking Ba'thi still at large - has died 10 months ago. The paper quoted a source "close to the Ba'th party" who claimed to have met al-Duri several times in 2003 and 2004; the source said that al-Duri was extremely sick and was unable to walk more than a few dozen meters in 2004, and that his health condition deteriorated thereafter until he died and was buried in a desolate area in the Hamreen hills - according to his will.

Since the US invasion, rumors said that al-Duri was sick with cancer and claims of his death have been made periodically. However, an Algerian paper published an interview with al-Duri two weeks ago, in which he allegedly denied that he had cancer (the interview, however, was made remotely and through written questions, which does not provide concrete evidence.) Sources in the Ba'th party had also stated that al-Duri's apparent sickness (which was visible in his public appearances before 2003) was not due to blood cancer as was widely believed, but to an undiagnosed case of lactose intolerance.

No. No, no, a thousand times no. Lactose intolerance cannot be confused with blood cancer. They have no symptoms in common. None at all. This can only be the most pitiful attempt at a cover-up of a real illness ever made.

I apologize to lactose intolerance sufferers all over the world for this. We have a true ailment that makes some of us truly sick. It shouldn't be used for comic relief and it shouldn't be used for lies and obfuscation. We deserve better.

Planet Lactose World News

I try to remind everyone here on a somewhat regular basis that lactose intolerance is a worldwide problem. Every known culture has a percentage of people who are lactose intolerant.

I found an article by Julia Ranniko on Monsters and Critics.com that discusses lactose intolerance in Germany.

"For some people, just a few drops of milk in their cafe au lait can overflow the barrel. But a lot of other people can handle minimal levels of lactose pretty well," says Isabelle Keller of the German Society for Nutrition.

The food industry has taken note of the problem and is regularly offering products with reduced lactose levels - milk, yoghurt, cream, cheese or pudding. But hidden lactose can be tricky, warns Keller, since lactose can be included in unexpected products, such as pre-prepared soups, rolls or sausage.

That's the same problem that people in the U.S. face. And according to the article, as many as 15% of Germans are LI, a high figure considered that most estimates only put the percentage in the U.S, at around 20%.

And now for the news from China. How many of you knew that China's two biggest dairy giants were based in Inner Mongolia? Put your hand down, you're not being serious. No, this is really true says an article by Ding Qingfen in China Daily.com.

China, with no history of consuming dairy in major amounts, still drinks only one-quarter as much milk per capita as the world average. The dairy giants are trying to increase that consumption. And one of the ways they're doing so is to emphasize the availability of low-lactose milk, a must in a nation where most people are lactose intolerant.

Yili launched a nationwide promotion for its high-end categories after the Spring Festival in late January and "it proved to be big success", [Zhang Jianqiu, executive president and spokesperson of Yili] said.

"Our top dairy products such as Satine and Low Lactose Milk generated the biggest profits in the first quarter," he noted.

Dogs and Milk Revisited

Dogs are mammals. That means they lose the ability to digest milk as they grow older, just like virtually every other mammals, including humans. Like lactose intolerant humans, dogs can have a small amount of milk without it creating symptoms. It's still a good idea not to take chances. If you want to give your dog dairy, find a lactose-reduced treat, like the Frosty Paws I mention in Ice Cream Sandwiches for Dogs or the Pup Ice I recently blogged about in Puppermint Lactose-Free Ice cream.

I'm mentioning this again because of a post on examiner.com, Is it safe to give Milk to your Dog?, by Michelle Tarkeshian. If you search for lactose or milk allergies or similar subjects, as I do, you'll see lots of posts that fall under the examiner.com rubric. They're not experts, though. They're volunteer bloggers, just as I am. You need to judge their experience and expertise for yourselves, but I consider most of what they write on subjects of concern to us to be amateur level at best. They may do some research, but that doesn't necessarily mean they understand what they're researching.

Take Tarkeshian's post.

Is it safe to give milk to a dog? A few weeks ago I was trying to think of a new treat I could give my dog. I started thinking about cats and how they drink milk, so I decided I could give it to her. As a dog owner I am always trying to think of new treats that will mix it up a little, and milk seemed like a good idea. Then I started thinking about if it was safe for her.

Some dogs lack the enzyme beta lactamase. This enzyme helps the digestive system break down "lactose" the sugar that is in milk. Because some dogs lack this enzyme they are lactose intolerant, but some dogs are not.

First, cats are just as lactose intolerant as dogs. Veterinarians do not recommend giving milk to cats. At best cats can drink a small amount. Some cats will have more symptoms than others, just as dogs do. Still, care is the watchword. I don't understand how any pet owner who posts on a public blog pretending to be expert can not know this.

Many of you who have read my book or my science posts might also wonder about the use of beta lactamase. I did. I had to look it up. Beta lactamase has no connection to breaking down lactose. The enzyme is beta galactosidase. Unfortunately, a few seemingly authoritative sites online do give this information. Some are British, so it might be a case of alternative labeling.

Whatever the enzyme may be called, the reality is that almost all adult dogs lack it and so are lactose intolerant. Please don't give your dogs (or cats) milk. Find a lactose-free alternative.

Premature Babies and LI

Here's a question I wish I could have been more help with.

my baby was born at 28wks 5 wks ago and is not tolerating his breastmilk via tube feeds - this is why i am following up the LI lead

This was my reply:

The research I have says that premature babies develop the ability the manufacture lactase very rapidly and so normally do not have LI.

Here's one mention of the problem that may be of some relevance.

"Early initiation of half-strength lactose-containing formula or breast milk results in rapid induction of lactase activity in the brush border and less feeding intolerance. A recent study suggests that full-strength lactose formula resulted in more feeding intolerance than low-lactose formula in premature infants; thus, the precise lactose concentration of lactose for inducing lactase activity is still undetermined."

A little-known fact is that lactase-production does not reach full strength in the intestines until almost the last week before birth. Foodreactions.org gives this chart:

> 23rd week ------------------------- 10% of full term
> between 25th and 34th is ------ 30% of full term
> between 34th and 35th week -- 70% of full term

Therefore all premature babies are born lactose intolerant. Although some sites suggest that the lactase-making ability is still lacking until the baby achieves what would have been a full term, this is not supported by most experts. Babies may need non-dairy liquids or lactose-free milks for the first feedings, but should regain their ability to drink breastmilk of a proper formula shortly thereafter.

Non-Allergenic Weaning Product Announced

Nutricia, the big pharmaceutical house, announced a new product of great interest to parents of children with milk allergies.

Nutricia, the European market leader in advanced medical nutrition, announces the launch of Neocate Nutra, the first and only weaning product made from 100% non-allergenic amino acids. Neocate Nutra has been specifically developed for weaning infants and older children with cows' milk protein allergy (CMPA) and multiple food protein intolerance (MFPI). Unlike many weaning products, Neocate Nutra contains no hidden allergens and is designed to provide children with the key essential nutrients they need for development. With its unique format, Neocate Nutra is suitable for taking infants through the various stages of weaning and also for older children on very restricted diets who are looking for convenient and varied food options.

Neocate Nutra represents a groundbreaking advance in the management of CMPA, a condition which affects between 2 to 7.5% of infants worldwide.(1) With the launch of Neocate Nutra, parents of CMPA infants of a weaning age and above can, for the first time, choose with confidence a weaning product that is made from 100% non-allergenic amino acids, ruling out any possible allergic reactions caused by an exposure to any trace of cows' milk. Neocate Nutra contains key essential nutrients potentially missing from a dairy-free diet and contains a child's full dietary requirements of calcium and two thirds of their daily requirements for iron and vitamin D*. This helps to ensure valuable nutrition for healthy bones, growth and development throughout the weaning stage and beyond. ...

Neocate Nutra is a versatile and convenient product. When water is added to this powder-based product, a smooth, spoonable "yoghurt style" consistency is formed which can be adjusted by adding more or less water as desired. With its neutral taste, Neocate Nutra is perfect on its own or can be combined with a variety of sweet or savoury "safe" foods. Neocate is manufactured in a cows' milk protein-free plant. Neocate Nutra is suitable for infants from 6 months and young children.

National launches of Neocate Nutra will be taking place across the world during the course of 2009 and 2010.

The Nutricia North America website already has an order page for the product for the U.S. and also one for Canada.

Non-Dairy Protein Drinks

Last month I talked about lactose-free whey protein drinks. The lactose in those drinks is removed by a filtration process. The underlying protein is still dairy whey, however, so I can only recommend them for those with lactose intolerance, not for others who are trying to avoid dairy.

Patricia Biesen on examiner.com does a review of Dairy-free protein shakes, including some made with hemp and pea proteins.

Her short article is labeled "part 1" and she wrote that "In my next post I will post some tips and tricks to disguise the taste [of the protein drinks]", so I'm going to assume you'll be able to see some follow-up pages by the time you click over there.

Candidiasis Not From Lactose Intolerance

Here's another of the more unusual questions I've received over the years.

Does Lactose Intolerance set up the stage for systemic Candidiasis to develop? My 13 year old daughter has been recently diagnosed with Lactose Intolerance, although our recollections support the notion that she's probably been suffering with it for years. She is currently being treated for oral thrush (Candidiasis) and had a similar epsisode last year. For all of the normal reasons someone gets Candidiasis, she is negative, and I wondered if Lactose Intolerance could be the culprit?

I responded:

I know of no good medical evidence that this is true. There are some people who believe that in LI undigested lactose reaches the colon (true) and gets fermented by the bacteria that normally live there (true) and that undigested lactose can preferentially change the composition of the bacteria that live there (true). They then make the leap that this sets up favorable conditions for the candida yeast to grow. I don't know if this is true and I have certainly never seen a single medical journal article that says this.

Even if there is any truth to this, it would seem a simple matter to use lactase pills to digest any lactose that might be part of your daughter's diet and so remove the undigested lactose that is the basis for this theory. In fact, whether there is any truth to this or not, my first advice to anyone who is LI is to take lactase with every and any bite of food that contains any dairy product. Doing so greatly relieves symptoms and is an inexpensive and sensible thing to do.

Can LI Hurt You?

Lactose Intolerance (LI) isn't a disease, yet it can cause symptoms that vary from annoying to sheer misery. It's not surprising that every once in a while I get questions asking whether LI can cause actual damage.

I replied:

It depends (you knew that was coming, right?). If your symptoms are minor, then really nothing of concern is occurring. If you have serious diarrhea, you can wind up with several things that are bad to have, although certainly not life threatening. You may become dehydrated; may lose important nutrients; may develop anal fissures or hemorrhoids from the continue strain on the tissues. If you start bleeding while on the toilet, you need to see a doctor. It's most likely hemorrhoids, but you need to make sure.

The same advice holds for those who wonder whether going off lactase pills is a bad thing. The symptoms may become a problem if you don't take lactase, but whether you take it or not has no effect on your intestines or any other part of your system.

Milk Fat Intolerance?

Yesterday I answered the question of whether butter has lactose. Answer: not very much.

Today I'm going to look into the logical consequence, sparked by a question emailed to me.

Over the years I have not been able to get a good answer as to why I must avoid butter or subject myself to having to tolerate abdominal bloating, etc.

That's a good question. If somebody is bothered by butter and it's not the lactose, then what it is?

Assuming there is a direct connection, then the only other component to butter is the milk fat. Butter is probably 80% milk fat and 1% lactose. That would make the fat a logical culprit.

Is there such a thing as milk fat intolerance?

I don't know. The research on the subject is practically non-existent. And contradictory.

My searches have come up with a grand total of two studies in the medical literature.

The first was "Do Lipids Play a Role in Milk Intolerance?" J. P. Costet, et al., pp. 156-61 in Milk Intolerances and Rejections, J. Delmont, ed. Basel: Karger, 1983. In this limited study the authors did find that 9% of their test subjects could not tolerate milk fats. From this they concluded that the "role of lipids in milk rejection this appears moderate and of little importance."

The second study is from the European Journal of Clinical Nutrition. 1997 Sep;51(9):633-6, "Milk fat does not affect the symptoms of lactose intolerance," Vesa TH, Lember M, Korpela R.

OBJECTIVE: This study investigated the role of the fat content of milk on symptoms of lactose intolerance. DESIGN: Subjects recorded intolerance symptoms using a visual analogue scale (VAS) following ingestion of three test milks for varying fat content for a two-day period. SUBJECTS/SETTING: The subjects were thirty adult volunteers, patients of two Estonian out-patient clinics with diagnosed lactose intolerance. The study milks were drunk at home or at work. All thirty subjects completed the study protocol. INTERVENTION: Each subject drank, in random order, fat-free milk (4.9% lactose), high-fat milk (8% fat, 4.9% lactose), and a lactose-free and fat-free control milk. They drank 200 ml of the milk twice a day for two days, one milk type per session, with five days between sessions. The subjects noted their gastrointestinal symptoms during the test periods and during a 5 d milk-free period at the beginning of the study. The occurrence and severity of symptoms were compared. A global measure of the severity of symptoms was defined by computing the sum of the symptoms scores. RESULTS: The sum of symptoms was higher during all milk periods than during the milk-free period (P < 0.01). There were no statistically significant differences in the occurrence or severity of symptoms during the fat-free milk period compared with the high-fat milk period. CONCLUSIONS: Even a marked difference in the fat content of milk did not affect the symptoms of lactose intolerance. Consequently, there seems to be no case for recommending full-fat milk products in the treatment of lactose intolerance.

This is again an extremely limited study, both in number and duration. Nor is it obvious that a fatty milk would produce the same results as butter.

Fats in general don't tend to produce gas in the intestines. Carbohydrates - sugars, starches, fibers - are the main gas producers. That makes it hard to blame the fat in butter just as fat.

If we're back to using logic - a slippery course whenever food is concerned - we're not left with many answers. Here are the possibilities.

1. My questioner is wrong about butter being the problem.

2. Milk fat intolerance is real but not properly identified as a problem.

It would be convenient to jump to the conclusion that the medical community has fallen down on this. On the other hand, I also just heard from somebody who wrote me that her LI symptoms went away when she changed toothpaste. That's why I never trust anecdotal information. Anecdotes make my head hurt.

Hey, Bill Gates. Have I got a study for you to fund.

Butter and Lactose

I got a good two-part question recently. I just have a minute today so I'll answer the quick and easy part now and tackle the other tomorrow.

I have read that there is little to no lactose left in butter, which I don't understand, since churning it creates cream, which I really must avoid.

This one's easy because it's a simple mistake of getting things backward, not hard to do when you're trying to remember something you've "read."

Churning butter does not create cream. Churning cream creates butter. The churning process pumps air into the fat, with the other solids and much of the water falling away. This remainder was the original buttermilk. (The modern buttermilk product is not very similar.)

Butter is about 20% water and 80% fat, with a slight amount of lactose left in the rounding. It really is low lactose and since you don't use very much butter in any particular serving of food can probably be eaten by most people even with lactose intolerance.

Could there be another problem with butter, though? That's what I'll talk about tomorrow.

June Is Dairy Alternative Month - Or Is It?

June is National Dairy Month. So naturally, June is also Dairy Alternative Month. Says who? The Vegan Awareness Network or VEGANET.

And who are VEGANET? You got me. They must be the only organization outside of the Unified Network of Unabombers who don't maintain a website. Apparently all they do is send out press release announcing months.

Like this one from 2004:

Vegan Month (November 1-30)
This outreach event encourages everyone to GO VEGAN! Vegans choose to neither eat nor use any animal products (e.g., meat, poultry, seafood, dairy products, eggs, gelatin, leather, fur, etc). A growing number of caring, compassionate people are adopting this conscientious lifestyle. Primarily ethical reasons, but also health and envrionmental [sic] concerns, motivate them to GO VEGAN. For information: VEGANET, P.O. Box 3545, Washington, DC 20007-0045. Phone: (877) GO-VEGAN.

Last year they called the antimatter Dairy Month the No Dairy Month. That didn't seem to catch on. Dairy Alternative Month is a much better name.

It hasn't picked up much traction, although a few blogs are using it as springboards for vegan proselytizing or the more sensible, um, dairy alternatives.

Just so you know, I list dozens of dairy alternative products in my Product Clearinghouse.

And if anyone can give me more information on the mysterious VEGANET (or the similarly-named organization based in Knoxville) I'd like to know.

How to Make Yogurt at Home

Mother Earth News has a long (five pages), detailed article about home-made yogurt written by V.B. Ramig.

She gives recommendations about yogurt makers and has a yogurtmaking troubleshooting guide that's sure to be helpful to those who like me are twelve thumbs in the kitchen.

Hooray for Newsweek!

Newsweek decided a couple of weeks ago to drop the "news" part of the week. Apparently conceding that it could no longer compete with Internet swiftness, the editors rejiggered the magazine to contain mostly opinion and interpretation of issues in the news rather than breaking news stories. It's, at best, a work in progress still. Magazine columnists work best as spice in the meal, not the main dish.

Each week also features a major cover story that they intend to function part as think piece, part as background for the educated reader. These have also been uneven, both in length and depth. They've interviewed Obama (yawn) and examined the "real" Iran (worthy yawn). In need of something to stop the yawning they pulled out the newsmagazine equivalent of a bunker buster. They dissed Oprah.

Specifically, Live Your Best Life Ever! by Weston Kosova and Pat Wingert smashes into tiny smithereens the lack of science and sense in the crackpots and quacks that dispense fraudulent medical advice on her show. Yes, that means you Jenny McCarthy and your anecdotes about autism that substitute for research and how the CFGF diet is an autism cure. And yes that means The Secret which, as I wrote two years ago in It's No Secret. You're a Moron, was actively dangerous in its proposition that positive thinking could beat cancer. The Secret's advice was so incredibly stupid that Oprah had to bring on a woman who was planning on using The Secret to conquer her own cancer to tell her to listen to her doctors instead. And Oprah went on to a year's worth of medical ills and weight gain right after that program, which in a rational world would turn viewers away from Oprah's medical advice. We do not live in a rational world.

The authors of the Newsweek piece do acknowledge that:

she gives excellent diet and fitness tips. Two of her longest-serving resident experts, Dr. Mehmet Oz and trainer Bob Greene, routinely offer sound, high-quality advice to Oprah and her audience on how to lose weight and improve overall health.

That's not enough.

Bloggers and commentators all over the world have been overjoyed by the audacity and scientific sensibility of the article, as Kate Dailey wrote on the Newsweek blog. They are even harder on Oprah than I've been.

The article really struck a nerve with Dr. Dave Gorski, a blogger at Science-Based Medicine (bookmark it: the site is a great source of thorough, critical reviews of both the latest research and medical fads). ...

No one, and I mean no one, brings pseudoscience, quackery, and antivaccine madness to more people than Oprah Winfrey does every week...Consequently, whether fair or unfair, she represents the perfect face to put on the problem that we supporters of science-based medicine face when trying to get the message out to the average reader about unscientific medical practices, and that’s why I am referring to the pervasiveness of pseudoscience infiltrating medicine as the “Oprah-fication” of medicine.

The article even resonated across the pond: Alex Massie at The Spectator ...

it's worth being reminded that Oprah peddles the anti-MMR nonsense that, if its supporters have their way, is much more likely to harm many more children than would be affected even if their crackpottery were based on a sound evaluation of the risks of immunisation. Which, as best I can tell, it isn't.

And of course, those kids at Gawker chimed in as well:

This lengthy article is actually far too kind (and brief) to baby-killing nut Jenny McCarthy and her anti-vaccine crusade, and yet it still manages to be a very damning indictment of how Oprah is trying to kill your poor mother.

I apologize that others have been more condemning of Oprah's pet quacks than I have. I'll try to do better - or is it worse? - in the future. Especially since I'm sure that we will now be treated to the crocodile tears of this poor maltreated billionaire with only an entire magazine, network, and top-rated talk show to fall back on crying bitterly of how badly she, who wants only good things for people, has been maligned with no opportunity to respond.

Tell her it's hogwash. She brought this down on herself. Send the message loud and clear. No more quacks. Get them off the air. Then we can strive to get them out of the pages of the women's and "health" magazines, and then maybe even off the Internet itself.

I know. I can dream, can't I?

Two New Vegan Cookbooks

I got this announcement from Fair Winds Press that I've been holding back until the books' official publication date. Today's that day.

Fair Winds Press is publishing two new cookbooks that I thought might be of interest to you and your blog readers.

The Vegan Scoop: 150 Recipes for Dairy-Free Ice Cream That Tastes Better Than the “Real” Thing by Wheeler del Torro.



The recipes feature all vegan-certified ingredients, making them suitable for both vegans and those looking for dairy alternatives. After explaining how to master the basics, including recipes for vanilla, chocolate and chocolate chip, del Torro provides a mouth-watering tour of surprising and imaginative flavors including Ginger Ginseng, Thai Chile Chocolate, Star Fruit, and Cinnamon Juniper. The author owns Wheeler’s Frozen Dessert Company, a microcreamery based in Boston, and he also opened the city’s first all-vegan ice cream parlor two years ago.

Vegan Scoop



The Vegan Table: 200 Unforgettable Recipes for Entertaining Every Guest at Every Occasion by Colleen Patrick-Goudreau of Compassionate Cooks.




From romantic meals for two to formal dinners, casual gatherings, children’s parties, and holiday feasts, Colleen answers every entertaining need. This cookbook features a delicious variety of recipes and seasonal menus. Cooking tips and ideas for entertaining are sprinkled throughout. Recipes include: Spring Vegetable Risotto, Pan-Grilled Portobello Mushrooms, Panini with Lemon Basil Pesto, Asian-Inspired Lettuce Wraps, Blackberry Pecan Crisp and Red Velvet Cake. Colleen’s also the author of The Joy of Vegan Baking (Fair Winds Press 2007).

Vegan Table

UPDATE:
You can read a review of Vegan Scoop, along with a recipe from the book at Eat. Drink. Better. in an article by Marygrace Stergakos.