Allergen Guidelines in the UK to Make Foods Safer

When I learned I was lactose intolerant (LI) in 1978, I had literally never heard the term before. That was just a few years after the notion that the vast majority of human beings on the planet were in fact LI hit the medical world like a grant-funding bombshell. In the 1970s doctors went to every corner of the earth to test native and ethnic populations, discovering high percentages of lactose intolerance everywhere except for northern Europe.

In the 1980s, products aimed at the lactose intolerant begin hitting store shelves in the U.S. Lactaid pills were the big breakthrough in 1984, although Lactaid powder and a few other small brands were there first. In the 1990s, Lactaid and Dairy Ease went head-to-head on television with multi-million dollar advertising campaigns, making lactose intolerance known to just about everybody.

In the U.S., that is. In the U.K. and much of the rest of Europe, the explosion never took place. No big ad campaigns combined with a much smaller percentage of the public who were genetically LI meant that the issue never quite gained any prominence.

And that also meant one other major distinction. The U.K. government never required changes in the labeling laws that forced food and drug manufacturers to list all potential cross-contamination factors, similar to the The Food Allergen Labeling and Consumer Protection Act that went into effect in the U.S. on January 1, 2006.

Georgina sent me an email from the U.K. in which she said:

One of the main problems I have found in the UK is you can get caught out very easily. They may be better in the US, but here the food industry is very bad at labelling foods. It is improving slowly but they seem to add lactose to almost everything and not put it on the ingredient, or they label it as sugar or whey, salt and vinegar crisps for instance and even the birth control pill. The information on your site is very interesting because when I asked my pharmacist for a lactose free pill they claimed there wasn’t one and on some pills, because it is not an active ingredient, it is just labelled as a filler!

The timing is great because there's news. The U.K.'s Food Standards Agency (FSA) has just issued a report, Guidance on Allergen Management and Consumer Information: Best Practice Guidance on Managing Food Allergens with Particular Reference to Avoiding Cross-Contamination and Using Appropriate Advisory Labels (e.g. "May Contain Labelling), a cheery 63 pages of bureaucratic lawyer-proof guidance.

FoodNavigator.com summarizes the report's import:

The allergen management and advisory labelling guidance, which is voluntary, uses examples of 'best practice' to help businesses of all sizes provide appropriate advisory labels that are clearer for consumers to understand.

It is also designed to help businesses assess the risk of cross-contamination with allergens.

"Up to 1.5 million people in the UK have food allergies, and it is vital that they are fully informed about the contents of the foods they are buying," said Sue Hattersley, head of the FSA's food allergy branch.

"Advisory labelling should only be used when, following a thorough risk assessment, there is a real risk of allergen cross-contamination. Excessive use of warning labels about the possible presence of allergens, can restrict consumer choice and devalue the impact of warning labels."

Indeed, the agency claims that a variety of warnings such as 'may contain nuts' are used so widely on pre-packed foods that many consumers are unable to assess the risks and simply ignore them. Unlike the situation for deliberately added ingredients, there are no statutory controls governing the labelling of the possible presence of allergens due to cross-contamination of foods along the supply chain.

These recommendations will take current regulations one step farther:

Allergen labelling regulations that came into force on 25 November require companies to label all pre-packed foods if they contain any of the 12 listed allergenic foods as an ingredient. The mandatory inclusion on food labels of the most common food allergen ingredients and their derivatives covers cereals containing gluten, fish, crustaceans, egg, peanut, soybeans, milk and dairy products including lactose, nuts, celery, mustard, sesame seed, and sulphites.

As a result of these consumer concerns, the UK free-from food market, including dairy-, gluten- and wheat-free products, is set to double, according to market analyst Mintel. …

Meanwhile, dairy-free products are valued at £32 million, with sales of products such as soy milk and yoghurts growing by 28 per cent over the same three year period.

You can also take a look at the numbers I posted in April in "Free From" Foods Grow in Sales.

What are the practical implications of these regulations for consumers like Georgina? Mark Tyler and Jessica Burt wrote the following for Law-Now, CMS Cameron McKenna's free online information service. Registration is required for the full article.

The guidance also provides a useful breakdown of measures relating to "allergen free" claims. A positive claim (e.g. gluten free) is often regarding by consumers as meaning a guarantee of a complete absence; whereas usually this only means that samples of the food were shown to be below the analytical limit of detection for that allergen on one or more occasion. The FSA confirm that appropriate limits for a claim that a product is free from a particular allergen can be set. It is also stated that if manufacturers produce lists of foods free from particular allergens, these should be regularly reviewed and updated.

An example of the potential pitfalls of "allergen free" labelling may be found earlier this year in relation to the nutritional information providing by McDonalds on their french fries, which stated they were dairy, wheat and gluten free. This was amended, to much public outcry and threatened lawsuits, and then reversed after further testing. Food producers need to be aware that as soon as a positive assertion is made it is their responsibility to substantiate this claim, check that food complies with it and keep this under regular review; in particular in respect of changing suppliers, processes and testing methods.

The provision of an incorrect claim would open a food producer up to potential food safety and consumer protection litigation as well as potential damage to brand reputation. The making of an allergen free claim is therefore a commercial decision for each food producer based on an appropriately documented quality system. To this end, the guidance on allergen management and consumer information will be a useful practice to follow to illustrate best practice in due diligence.

While it appears that the lawyers will be arguing "best practice" for the foreseeable future, guidance such as this will make a significant difference for those with dairy allergy, among other allergies, and those who have problems with lactose. And with both the U.S. and U.K. moving in this direction, it wouldn't surprise me if the European Union were shortly to follow. Some bureaucracy really is good for everybody.

Myths About Lactose Intolerance

Since I complain so loudly when people get the facts about lactose intolerance wrong, it's only fair that I compliment the ones who get them right.

The Daily Advertiser of Lafayette, LA, published an unfortunately uncredited article, Learn the truth about lactose intolerance, that debunked some common myths about LI and also gave a list of "Easy Ways to Enjoy Milk and Milk Products If You're Lactose Intolerant."

All the advice is straight from the book (i.e. my book: Milk Is Not for Every Body) so it looks good. And they credit the information to the LSU AgCenter, which means that even doctors, notoriously slow to understand LI, have finally caught on.

Good work, all.

Vegan World Fusion Cuisine

Next time you happen to be passing through Hawaii (is that four subway stops or five)…

Who am I kidding? Getting to Europe from upstate New York is ten times easier - and cheaper – than traveling to Hawaii. So a visit to Mark Reinfeld's Blossoming Lotus restaurants and his ideas of Vegan Fusion cuisine isn't likely to happen real soon. (Though maybe the one in Portland, OR, or the one coming soon to Mountain View, CA.)

What I really liked is the ideas in Jeff Yang's article on SFGate.com musing about what is needed to attract people to vegan foods, using Reinfeld's restaurants as a launching pad.

Unfortunately, for those of us used to the ways of the flesh, the vegan path is a difficult one to walk. I have my share of veggie friends and relatives -- Hindus, Buddhists and health junkies -- and I've tried to make the transition. But meat and dairy, like any other delightfully unhealthy addiction, are hard habits to break, and the vegan equivalent of nicotine patches -- the meat and dairy substitutes that vegans call analogues -- are consistent in that they provide an experience that's almost totally unlike the products they're trying to emulate. (In fact, the only thing that doesn't taste like chicken when you cook it is vegan "chikken.")

There are other problems with analogues. As anyone who's ever eaten at a Buddhist-style Chinese restaurant knows, the art and science of getting things that are not meat to look, feel and taste like meat often involves saturating perfectly good vegetable matter with sodium, fats and nitrates. And at the end of the day, there's something a bit dubious about going vegan but relying excessively on the crutch of "veat." ...

[At the restaurants] It's all market-fresh fare prepared according to strict vegan principles, incorporating a diverse and cross-pollinated variety of cooking styles and flavors. The vegan world fusion palette intersperses Asian ingredients from Indian, Thai, Chinese and Japanese food traditions with those of Greek, Italian and Tex-Mex cuisine. Though the names of the dishes are familiar (spanakopita, burritos, pasta and spring rolls all make an appearance), the focus is on flavor rather than verisimilitude: Analogues are used sparingly, though the references to "cheez" and "mylk" still pop up on occasion. …

Good vegan food is something totally different -- inspired by carnivore cuisine but in a category unto itself, a bold variation on the theme. And that, ultimately, is Blossoming Lotus's big magical secret. …

"At the end of the day, we want to offer this option as just another alternative," says [Reinfeld's partner] Zingaro. "We're not asking you to 'convert.' We're not preaching to you. It's really great food -- enjoy it! And maybe if you enjoy it enough, you'll make the decision to go vegan on your own."

That's the right philosophy, and one that all of the pioneers trying to develop dairy-free versions of foods should take to heart. I don't eat bad versions of "normal" food: I make my own dishes designed not to need dairy to taste right. Dairy-free isn't a punishment. It's an excuse to release your creativity. If you're lactose intolerant, or allergic, or vegan, pamper your taste buds with fresh foods and creative combinations. Or at least seek out those who do it well.

Slice Non-Dairy Pizza

Yet another restaurant featuring specialty non-dairy food? Could it be a… revolution?

Nah. But compared to zero anything is still nice to have.

The latest entry into the pizza wars is Slice, in New York City. According to the article by Anita Malik in EastWest Magazine Slice is the brainchild of "Miki Agrawal, a former semi-professional soccer player who has been on a quest to eat her favorite foods despite being lactose intolerant."

The menu features Slice’s proven pizza combinations or patrons can opt to put together their own pie, choosing from three healthy crusts – honey whole wheat, spelt and unbleached herb. There are also several organic, homemade sauces, organic and/or dairy-free cheeses and creative toppings such as tofu, sautéed veggies — including broccoli and caramelized onions — and organic free-range chicken.

“It is pizza that tastes good and is good for you,” Agrawal says while noting that most of the pizza made in the market today contains bleached flour and ingredients she says are full of fat and sugar.

Organic and low fat is definitely not a novel concept. A chicken and organic mozzarella pizza, for example, seems likely to fly with today’s consumers. But what about Slice’s vegan options? Can the concept of pies made with dairy-free cheeses really catch on? Agrawal says yes, adding that the statistics reveal a great need for what Slice is cutting up.

Followed by the true but thoroughly misleading stat that one in five Americans has lactose intolerance. Sure, but how many of them will eat a soy cheese pizza? Remind me to check back in a year or so and see if Slice is still in business.

In the meantime, Agrawal has some tips at making dairy-free pizza at home:

• When using veggies, sauté first. Don’t put raw veggies on your pizza, cook them first before the pie hits the oven.

• If you are going to use soy or rice cheese, cook the pizza without the cheese first. Put the cheese on only at the end because soy and rice cheeses burn faster due to lower fat content.

• Always keep on eye on your crust when baking. Timing is the key to a great crust.

Slice
1413 2nd Avenue
New York, NY 10021
(212) 249-4353
www.sliceperfect.com

Low-Fat Dairy Study Sparks Ignorance by Dairy Haters

One of the hardest things to do in the world of medicine is to determine the role that any one particular food plays in overall health.

Most of these longitudinal epidemiological studies are compromised by trying to tease out one food's effects in the huge range of diets, lifestyles, locations, occupations, and overall health of the respondents. Even the best of these, which may be The Nurses' Health Study, has run afoul of the changing notions of what makes for good health. The nurses, who keep detailed diaries of their food intake along with other habits, couldn't know at the beginning of the study in 1976 that trans fats may be an issue to keep track of. There would have been probably no way to do so if they had.

So I try not to jump on any individual study that proclaims the advantages or disadvantages of milk. I've seen too many of these studies either invalidated or moderated by subsequent reports.

For that reason, I don't set much store in a recent study published in Diabetes Care 2006 Jul;29(7):1579-84., A prospective study of dairy intake and the risk of type 2 diabetes in women, by Liu S, Choi HK, et al.

As Reuters reported, Low-fat dairy may lower women’s diabetes risk: Preliminary research shows trend, mirrors results shown for men:

[Liu and his colleagues] therefore looked for the relationship between type 2 diabetes and dietary levels of dairy foods and calcium in 37,183 women in the Women’s Health Study. A total of 1,603 women developed diabetes during an average follow-up of 10 years.

“The most important finding is that women who consumed more low-fat dairy foods tended to experience a lower risk of type 2 diabetes in a period of 10 years,” Liu told Reuters Health.

…

However, Liu and colleagues caution that further studies are needed to confirm their observations “before public health measures to increase dairy consumption can be recommended for prevention of type 2 diabetes.”

This is medicine at its best. A major long-term study on a population so sizable that comparisons can be made, followed by a caution that even so the results are still preliminary and no general public changes in diet can yet be called for.

So what's the problem?

This. Milk - It Does a Body Good? by Regina Wilshire on commonvoice.com.

Wilshire appears to lack all understanding of how a study such as this operates. The only way to separate out the effects of one particular food or medicine or physical routine is to try to control all the rest of the variables. This is absolutely standard in any epidemiological study. But to Wilshire, this somehow invalidates the results:

When I first started to read through the data, I was struck by just how many confounding factors they "adjusted" to reach their significant findings!

• BMI
• smoking status
• physical activity
• family history of diabetes
• alcohol consumption
• history of hypertension
• use of hormones
• high cholesterol

…

They didn't add IF you're normal weight, don't smoke, are active, don't have a family history of diabetes, drink in moderation, don't have a family history of high blood pressure, aren't using hormones and don't have high cholesterol. Basically, they forgot to add the findings apply to those who are in good health!

Which begs the question - was it the inclusion of dairy or was it an overall better dietary and lifestyle pattern that kept these women in good health?

No it doesn't. Controlling for confounding factors doesn't limit the study to just people in wonderfully good health. It just tries to set one factor against a neutral background.

I hate to say it, but this isn't science. If you ask me, it seems more like a manipulation of data to promote the dairy industry and the consumption of milk and dairy products.

I hate to say it, but Wilshire has let her bias toward milk overcome any understanding of how science works. To her, apparently, if a study comes out in favor of milk it must be wrong.

What is most bothersome is that she may be right for the wrong reasons. As I said in the beginning, and as Liu himself said, one study, even a good study, is not proof, and is most definitely not the last word. There may not be a connection between low-fat dairy foods and lowered risk of diabetes, or the connection may be weak and not applicable to most. If there is a connection, however, than those with lactose intolerance who still consume dairy have to have this important piece of knowledge. It indicates that taking lactase if you are lactose intolerant to retain dairy in the diet is a good road to health.

That is the real issue. Bias for or against a food, especially a hot-button one like milk, should never get in the way of understanding the underlying science. If you don't know enough about medicine to make a knowledgeable critique, don't spread fear and ignorance around the net.

Yogurt, Yoghurt, and Yougurt

I've been advocating yogurt for years as a way to get dairy into your diet for those who are lactose intolerant. The live and active cultures used in yogurt digest the lactose that is in the dairy and render it mostly symptom free. The lactose is then fermented into lactic acid, which gives the tart taste. From Wikipedia:

To be named yoghurt, the product should at least contain the bacteria Streptococcus salivarius ssp thermophilus and Lactobacillus bulgaricus official name Lactobacillus delbrueckii ssp. bulgaricus). Often these are co-cultured with other lactic acid bacteria for either taste or health effects (probiotics). These include L. acidophilus, Lactobacillus casei and Bifidobacterium species.

But I've also warned that modern yogurts in the United States pander to the sweet-lovers among consumers by adding sugar and extra milk products that reduce the benefits of the "good" bacteria. You should also remember that heat-treating or pasteurizing yogurt destroys these bacteria. Always look for the words "live and active" on the package.

Askdrsears.com, run by Dr. Bob Sears, has a great page on yogurt. It includes:

10 Reasons Yogurt is a Top Health Food
How to Buy the Healthiest Yogurt: 5 Tips
5 Ways to Use Yogurt as a Nutritious Substitute
6 Health Benefits of Lactobacteria

I'm tempted to quote at length, but there's too much to excerpt. Go there and read for yourself. For those who are too impatient, here's the skinny: low-sugar is better than high sugar; low-fat is better than high fat; high calcium is better than low calcium; fewer additives are better than more additives. Find the balance of these that tastes best for you, and then enjoy regularly. It'll do all those with lactose intolerance good.

Lactose and Phlegm

Excuse while I bang my head against the wall.

So much misinformation.

I won't give any names, but here's a quote from an actress about problems acting during her pregnancy:

She also had morning sickness but kept it from interfering with her work by eating hourly, mainly the cheese that she craved--problematic because products with lactose can clog the throat.

No they can't. Lactose intolerance affects the intestines. Period.

According to this page, the myth that milk causes phlegm goes back to the writings of the 12th century rabbi, Maimonides, from his treatise On Ashtma. Who knew?

Modern medicine looks at it differently. It may be possible that certain people with cow's milk dairy protein allergies may produce more phlegm. There are a million reactions that allergies can cause.

It's much more likely that you simply don't get more phlegm from milk. You may feel a film if you drink milk, or eat cheese, or you may just have heard the myth and make a false association.

But lactose has nothing, but nothing, to do with it.

Special Diet Meals Available from Disney

The biggest kid-magnet in the universe must be Disney. With 10 million or more kids going through the gates at each Disney resort each year, even a tiny percentage can add up quickly.

Bob Mervine of the Orlando Business Journal reports that Walt Disney World offers a special diets program that can accommodate 15 types of food allergies, kosher meals, and low-sodium meals. The program started in 1993 and now serves 7-8,000 meals a month. You merely request the special meals when making meal reservations.

[Joel Schaefer, manager of the special diets department] works with chefs at each of the hundreds of Disney food locations to provide alternative ingredients that can be used to create allergy-free meals, ranging from soy ice cream to a specially blended batter for the Mickey Mouse-shaped waffles that are a signature breakfast dish.

Disney adds no service fee, even working with families who want to enjoy a buffet by individually preparing the food items the guest selects.

"It's simply a guest service," says Ed Wronski, executive chef for product development in Disney's food and beverage department.

More information about the program is available from All Ears Net.

1. When making an Advance Reservation (1-407-WDW-DINE), alert the Cast Member to your special needs, and they will make a note on the file.

2. Special dietary needs can be accommodated if requested at least 72 hours in advance at 407-WDW-DINE (407-939-3463). [Note: some sites say 24 hours. This site says that the advance time increased in 2005.]

The number at Disneyland is 714-781-DINE (714-781-3463).

At Disneyland Paris call Guest services Tel No: +33- (0)1 60 30 40 50. A food allergies guide is available at:
http://disneyworld.disney.go.com/wdw/common/helpFAQ?id=HelpFAQDiningPage

No- and Low-Lactose Foods and Beverages

A decade ago when I wrote Milk Is Not for Every Body: Living with Lactose Intolerance I reported that the soy "milk" industry had reached $100 million a year, making it as large as the lactose-reduced milk market.

How puny those numbers look today. The market for lactose-reduced or lactose-free products now is up to $500 million. But the dairy alternative market, which includes soy, rice, and other alternatives, is up to an astounding $1.4 billion. I saw this coming. No, I didn't buy stock. You can if you want to. Sales are expected to rise to $827 million and $2 billion, respectively, by the year 2010, a growth of about 16% a year.

Or so says Don Montuori, the publisher of Packaged Facts. In a press release for his report, No- and Low-Lactose Foods and Beverages, Montuori also says:

"As the number of lactose-free ice creams, cheeses, and cultured dairy products begins to grow, consumers are eagerly returning to dairy for both nutrition and taste. Consumers appreciate the available lactose-free choices and we expect that newer lactose removal technologies will bring on a wealth of new products along with new marketers willing to dive into this high-growth market."

Sounds good for those of us who are lactose intolerant. If you want to know more, here's your opportunity. No- and Low-Lactose Foods and Beverages will only cost you $1995. (That's right. No decimal point.) I'd be happy to read it and digest all the industry jargon, but all the lactase in the world couldn't get me past the price. Of course, if you all want to chip in…

Lactose-Free Cake Wins Best Dessert

Who says that you have to use milk to make a cake taste good?

At the 4th Annual Great American Dessert Expo - now that's a vacation destination - Ardalin Foods won the Best Pastry award:

for their flourless chocolate cake-low sugar, low fat and lactose free that still tastes amazing!

That's from the press release, which also said:

As if America's sweet tooth needed more prodding, an exclusive trade show for the desserts industry added some more great tasting desserts, winners of the first ever "Small Bite, Big Taste" Competition, which was held at the 4th Annual Great American Dessert Expo in Las Vegas June 9-11, 2006. The show, held in conjunction with Coffeefest, is the nation's first trade show dedicated exclusively to the huge dessert industry.

The Competition was sponsored by The French Culinary Institute and PastryScoop.com.

Other winners:

The Best New Product at the show went to Opera Patisserie for their delicious Mini Macaroons -- the texture is light and delicate, with a gentle richness that is surprisingly satisfying. The Best Frozen Dessert went to Howard Gordy for their Pistachio Oro Verde -- 100% pure pistachio which is grown in a very rich soil in Sicily. The winner for Best Chocolate went to Niche Import Co. for their Chocolate Santander -- the only single origin chocolate produced in Columbia well known for its exquisite and delicate flavor. The Best Confection went to Fudge Fatale for their delicious hand made fudge to live and die for! The Best Dessert Wine went to Wine-A-Rita for their Wineglace which is a mix to create a fun and delicious frozen wine beverage. All you need is ice, wine and a blender.

You can be a part of the tasting fun:

Organizers are already planning to double the size of the Great American Dessert Expo next year which will be held June 1-3, 2007 at the Cobb Galleria Centre in Atlanta, Georgia.

For additional information call 718-854-4450 ext. 104, info@dessertexpo.com or visit us at www.dessertexpo.com.

Vegan Kosher Restaurant Hits All the Bases

I've written about restaurants that cater to those with wheat allergies because those are so rare as to be worth spreading the word about.

Vegan restaurants aren't as rare. I'm sure you can find one about every ten feet in some college towns.

But a vegan kosher restaurant? That's a find.

And you'll find it at 1010 Cherry Street in Philadelphia, in the heart of Philadelphia's Chinatown. It's called, not very imaginatively, I'm afraid, the Cherry Street Vegetarian Restaurant.

Before you get worried about the "vegetarian" in the name, apparently all the meats are "mock," made from wheat gluten (sorry, celiacs) and soy. That puts the kosher in the picture, since fake shellfish - not allowed by the kosher dietary laws - is on the menu.

Lisa Kelvin Tuttle writes about the Cherry Street Vegetarian Restaurant in the July 2006 issue of The Philadelphia Jewish Voice. She said:

"Shrimp" Toast for Two? Moo Shoo "Pork"? Sautéed Mushrooms with "Ham" and Kale? Oh yes, and all of them kosher Vegan to boot. There are also "chicken," "duck," "fish," and "beef" and of course many rice, noodle, and veggie dishes to round out the enormous menu. The chefs are masters with the ancient art of working wheat gluten and soy into copycat versions of poultry, meat, fish, and shellfish so that the kosher diner can experience the best of traditional Chinese dishes while observing Jewish dietary laws.

Recipes for Fast, Easy Cold Sesame Noodles and Homemade Fortune Cookies are also included.

When Is Butter not Butter?

From dictionary.com

but·ter

n.

1. A soft yellowish or whitish emulsion of butterfat, water, air, and sometimes salt, churned from milk or cream and processed for use in cooking and as a food.

2. Any of various substances similar to butter, especially:

a) A spread made from fruit, nuts, or other foods: apple butter.

b) A vegetable fat having a nearly solid consistency at ordinary temperatures.

It's that second definition that can cause the confusion. Apple butter, peanut butter, cocoa butter, and lots of other soft spreadables made from non-dairy sources are called butters. None of them should have any lactose or any other dairy product.

Same with all products sold as "cremes" rather than "creams."

Unfortunately, every once in a while dairy products are added to the completely dairy-free original. Coconut "milk" (sometimes called cream of coconut) is non-dairy. But there are coconut milk products in the U.S. that have real dairy milk added to them for better flavor and consistency.

It's a plot to drive us crazy. When in doubt, repeat after me, always read the ingredients list.

More of these Supermarket Foolers on my web site.

No Health Risks Found for Soy Infant Formulas

I don't know exactly when soy became controversial. Seems that I just looked up one day and articles were all over the net screaming that soy caused as many problems as, well, dairy.

This is a huge concern for those parents who put their infants on soy formulas. To get it out of the way: of course breastfeeding is the best thing for infants. But not everybody can do so all the time, for various reasons. Babies may become temporarily lactose intolerant because of illnesses striking their intestines. And dairy proteins can leak through into the breastmilk and create symptoms in babies with allergies. Soy formulas are routinely suggested as the best alternatives.

Parents want to know: are soy formulas safe? The answer appears to be: yes.

On foodconsumer.org, Julia R. Barrett wrote a survey article on " The Science of Soy: What Do We Really Know?" Although she notes that experts urge caution because soy can also be an allergen, she quotes Susan Baker, a pediatric gastroenterologist at the Children's Hospital of Buffalo and former chair of the American Academy of Pediatrics Committee on Nutrition, as saying "It's always true that there could be something subtle that we didn't look for or didn't know to look for, but so far we haven't seen any major health problems." And Marisa Salcines, director of communications for the Atlanta-based International Formula Council, which represents infant formula manufacturers, says " "There haven't been any studies that have shown any negative effects in adults who consumed soy-based infant formulas as babies."

The real issue is that good long-term studies comparing soy-based formula, cow's milk-based formula, and breast milk have not yet been concluded. There are several going on now, however.

In the meantime, the evidence that soy is a major problem for any substantial number of people is lacking. And that's good news for those of us who try to avoid dairy.

Lactose in Medications

Lactose is a sugar, but it's only slightly sweet. It's the least sweet common sugar of all, as a matter of fact, less than half as sweet as ordinary sucrose, or table sugar.

This is an advantage sometimes. Manufacturers like the idea of adding just a bit of sweetness to some products, without overwhelming the taste. Lactose browns like other sugars when heated - this is called caramelizing - and leaves that pretty toasty color. So breadmakers will sprinkle lactose on top of a bread to make it look better without making the bread overly sweet. And lactose is made from whey, which is considered a waste product in the manufacture of cheese, so lactose is comparatively cheap.

One other thing that lactose can do is form a crispy shell around a pill. This makes it easier to swallow pills and alleviates their bitter taste. Lactose therefore can be used either inside as a filler to bulk out a pill or outside or both. No wonder so many pharmaceutical firms use lactose in their products.

Now the amount of lactose in any one pill is probably extremely small, on the order of 25 mg. There are 12,000 mg of lactose in an 8 oz. glass of milk. Normally, I'd say that no one who is lactose intolerant should ever worry about the lactose in medicine.

Of course, that's not much help for those who react to even the tiniest amount of lactose, or those who have severe dairy protein allergies instead of lactose intolerance, or for vegans, or Orthodox Jews, or the other who have to worry about milk or animal by-products.

You'd think that there would be a list of which medicines have lactose and which don't. But there isn't.

Unfortunately, there are good reasons for that.

When I wrote Milk Is Not for Every Body: Living with Lactose Intolerance I thought I'd create just such a list for prescription medications. I contacted someone at the firm that publishes the Physicians Desk Reference (PDR), one of the standard compilations of drug information that virtually every doctor and pharmacist uses. He searched the CD that the PDR came on (1994-style high tech!) and gave me a list of every medication whose entry contained the word lactose.

Simple, right?

Simple, no.

Virtually every drug comes in more than one strength, and often in more than one format. Believe it or not, for many of the pills, one dosage would contain lactose as a filler but the next size up wouldn't. Sometimes a controlled release pill would contain lactose but not the regular pills, or vice versa. Sometimes liquid versions would have the lactose - or not.

I had to go through every single one of the several hundred listings given me and check which varieties had lactose and which didn't. It took forever. And I realized that I would have to do the same thing every single year when a new PDR was released. And there was no way to get this information for generic versions.

Now multiply that by ten and you have the problem of over-the-counter medicines. There are thousands and some of them have dozens of variations. (Check how many versions of Tylenol there are, for example.) There isn't any one central registry that I know of that lists them either, so they can't be searched for. And they change formulas, names, strengths, and varieties frequently.

Nobody has ever even tried to compile a complete list of lactose in any type of pills since my one attempt. While I hope that the future might bring about a simple way to find this info, I'm not optimistic.

The only advice I can give you is the same advice I always give for all products: check the ingredients list. Doctors and pharmacists should have access to information about the inactive ingredients in prescription medication. Virtually all manufacturers of over-the-counter (OTC) medications print the ingredients on the package. If you can't find it, try asking a pharmacist. Or call the consumer information number given. Or check the firm's website.

I wish there was an easier way. Not today, though, not yet.

FAAN: Walk for Food Allergy

Milk and dairy allergies are among the commonest food allergies in the world. They're problem with the immune system running amok. Nobody really understand why they happen, or why they seem to be getting worse.

So FAAN - The Food Allergy & Anaphylaxis Network – is holding its third annual Walk for Food Allergy, to be held in cities across the country this fall.

Their press release says:

Beginning August 19 and ending on November 18, thousands of families nationwide will be taking part in the third annual nationwide Walk for Food Allergy: Moving Toward A Cure campaign intended to increase awareness and raise research funding for a disease that currently has no cure. The disease is food allergy, which currently affects 12 million Americans. The Food Allergy & Anaphylaxis Network (FAAN), the nation's leading nonprofit, patient advocacy organization, dedicated to increasing education and advancing research on food allergy and anaphylaxis, will be spearheading these events in 18 cities across the nation.

The Walk for Food Allergy will be occurring in Arizona, California, Colorado, Georgia, Illinois, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Pennsylvania, Texas, Washington, D.C., and Wisconsin. Registration is now open for walk enthusiasts from every walk of life to benefit FAAN's ongoing research and education efforts. For registration and a complete list of all of the walk locations and dates, please visit FAAN's Web site at www.foodallergy.org.

Lactates not Lactose

I recently received an email asking if there was milk in potassium lactate.

The answer is no. In fact, there is no lactose in any of the "lac" additives found in ingredients lists.

I know this surprises some people, because there are lists of what not to eat - compiled by the lazy or ignorant - that include these items.

There are three main groups of "lac"s. Lactates, lactylates, and lactic acid.

The lactates appear in combination with calcium, sodium, potassium or, rarely, other elements. Calcium lactate is common.

The lactylates are more complicated, with forms like calcium stearoyl-2 lactylate or sodium isostearoyl lactylate.

As far as I can tell neither type will ever contain lactose. If you have lactose intolerance you don't need to worry about them.

Same is true if you have a dairy protein allergy. These ingredients have no protein in them. FAAN (The Food Allergy & Anaphylaxis Network) says:

They do not contain milk protein and need not be restricted by someone avoiding milk.

Lactic acid is a bit more complicated, for some. It does not contain lactose and presents no problem for the lactose intolerant.

But it can be derived from dairy. However, lactic acid derived from dairy (from whey, to be precise) seems to only be used in foods like ice cream or cheese, which are dairy products themselves.

Other foods use lactic acid that is not derived from whey.

So people with milk allergies need only to use some common sense. If the food is a dairy product, and you're trying to avoid dairy products, it doesn't matter if it also contains lactic acid.

If there is otherwise no dairy in the product, then don't worry about the lactic acid. Again FAAN says that lactic acid:

not contain milk protein and need not be restricted by someone avoiding milk.

All this and much much is contained in Dairy or Nondairy? The Experts Speak on my web site.

Lactation Station Breast Milk Bar

O, Canada!

Some things just have to be presented without comment.

Funding draws Tory ire by Bruce Cheadle, Canadian Press.

The federal Conservative government says it won't lay a hand on the Lactation Station Breast Milk Bar.

A Toronto performance artist is offering the public an opportunity to sample human breast milk, in the spirit of wine tasting, and the lesbian single mother is using a $9,000 grant from the Canada Council for the Arts to help get the creative juices flowing.
…

Jason Kenney, parliamentary secretary to Prime Minister Stephen Harper, reacted with bemusement rather than anger to the breast milk sampler, which is scheduled for July 13 at the Ontario College of Art & Design Professional Gallery.

"Personally I think we should be funding cultural endeavours that actually draw an audience, that people are actually interested in,'' said Kenney. "I'm not sure that's the case here.''

The breast milk, provided by six different women according to artist Jess Dobkin, will be pasteurized for health and safety reasons. But that consideration didn't seem top of mind for federal Health Minister Tony Clement.

"A chacun son gout,'' -- to each his own tastes, said Clement, before quickly adding, "It's not for me.''

Dobkin herself said to the Toronto Star:

"This project re-contextualizes something often regarded as indecent or repellent, offering a celebratory view.

"A substance that nourishes us in our infancy later becomes a curiosity in adulthood. Though many drink it exclusively for the first months of life, the memory of that taste and the sensation of drawing milk from the breast are forgotten. No two women's milk tastes the same, and is influenced by things we ingest and our unique biology."

Technically, breast milk isn't drinkable by those with lactose intolerance, and may not be so by those with cow's milk dairy protein allergy, since the proteins can leak through into the breast milk. So, technically, this doesn't belong in this blog. Sue me.

Prebiotics and Probiotics

Everyone who has lactose intolerance should know by now that one of the major sources of symptoms can be the bacteria that live in your colon. More than 500 known species of bacteria have been found living in people, and like any group of 500 you find a range from the very good to the very bad.

For us, the bad bacteria are the ones that ferment any lactose that reaches them. The fermentation process releases gas, just like it does when beer is made. And you probably know all too well what the gas can do.

You can change the "bad" bacteria into "good" bacteria, the type that digests lactose rather than ferments it by using probiotics. Probiotics, literally "for life" contain the good bacteria and the idea is that the good bacteria will dominate the bad ones. I've written many times before about probiotics. The live and active cultures in yogurt are probiotics. You can also buy the bacteria in pill form in such products as Digestive Advantage and Lactagen.

What are prebiotics? Wesley Canfield of the Grand Forks Human Nutrition Research Center talks about them in his column.

Prebiotics ("before life") are nondigestible or fiber components of foods, usually complex carbohydrates that beneficially affect the host by stimulating the growth of intestinal bacteria. Certain bacteria prefer a particular prebiotic to use as a source of energy.

There are some potentially major advantages to eating more prebiotics, he says.

In addition to making vitamins, intestinal bacteria also produce other nutrients of benefit. We've all heard advice about limiting our intake of fats, especially saturated ones. However, not all saturated fats are bad for us. Many of the gut bacteria ferment digestion-resistant fiber to short-chain saturated fatty acids. These fats have two to four carbon atoms.

Acetate, propionate and butyrate all are examples of SCFA. Some scientists estimate that up to 10 percent of a person's daily energy needs can be met by using the SCFA as fuel. Butyrate, in particular, has been shown to have anti-cancer effects in animals. In addition, a probiotic containing butyrate-producing bacteria also reduced cancer formation in an animal model.

Another way of increasing butyrate production by intestinal bacteria is to eat prebiotics similar to the high-galactose type found in breast milk. Inulin, for example, is a type of high-fructose, nondigestible fiber that is present in wheat and onions. Many studies in both humans and animals have demonstrated the bifidobacteria-promoting benefits of inulin and other high-fructose prebiotics.

Prebiotics and probiotics. All part of a good healthy diet. Eat enough of them and hopefully you won't have to take any antibiotics.

Yogurt Changed the Way We Eat

Harry Balzer knows more about the way you eat than anyone in America. His title is nothing special, vice president at the NPD Group. His job is. He studies Americans and food. Every day.

And you're weird.

Every day, someone from the NPD Group is calling 3500 Americans, asking them whether they're gone to a restaurant, and if so, what they ate. The number one food ordered by women? French fries. Burgers are number two, pizza, number three. Salad comes in seventh. Men eat burgers, French fries, pizza in that order.

And NPD hands out notebooks to 3000 families at a time so that the can record everything they eat and drink for 14 days.

Then NPD combines the info and sells it for big bucks in their unique study, Eating Patterns in America, now in its 20th year.

Other findings, according to an article by Robin Mather Jenkins in the Chicago Tribune:

The No. 1 item the average American is most likely to have between meals is . . . .gum!

The fastest growing appliance used by Americans to prepare a meal is . . . the power window. Last year, for 22 percent of all meals purchased at a restaurant, we did not even get out of our cars, a new high! (Would this trend have happened if we still had to hand-crank the windows in our cars?)

The No. 1 snack by children (under 6 years old) is . . ....fruit! Don't be surprised. Parents still control the intake of toddlers and babies. Once they have their 6th birthday, however, look out!

In 1985, 56 percent of all in-home meals included at least one fresh, prepared-from-scratch dish. Last year, that dropped to 46 percent, an all-time low.

It is true that nearly 50 percent of our food budget is spent on meals purchased outside the home, but 77 percent of all meals we eat still come from the home. Restaurant meals are three times the cost of making an in-home meal.

On a typical night, 55 percent of all dinners are prepared by women, and that's unchanged since 1998.

And yogurt? Well, in Belzer's 28 years in the business, he's only named a "food of the day" that's changed America's eating patterns twice. The first was pizza, and now the second is yogurt.

Belzer told Janet Zimmerman of the Press Enterprise that:

"Pizza was what yogurt is today." It is a product that appeals to the fast-growing older and younger generations, a food "they can eat alone, for a main dish, dessert, breakfast, lunch, it doesn't require cleaning up, it's a meal unto itself and it has the perception of being healthy."

(Yes, Belzer gets around. He's a man with an extremely expensive study to promote. He's spends three months a year getting the data together and nine months trying to sell it to clients. He's been quoted in every major paper in the country in June alone.)

And why is yogurt suddenly magic?

Last year, 20.5 percent of all consumers ate yogurt at least once every two weeks, nearly double from 9.6 percent 20 years ago, NPD research shows. The $3 billion-a-year industry has outgrown every other grocery product of the last three decades, and consumption has doubled about every seven years.

Much of the growth can be attributed to yogurt's rise from diet food to favorite snack, now in a dizzying array of colors, textures and packaging, from squeezable tubes to drinkable containers.

The latest craze is probiotics, the "good" bacteria that work to turn milk into yogurt.

The bacterium cultures are now known to have health benefits, including aiding digestion, boosting immunity, treating diarrhea, decreasing yeast infections and possibly, lowering cholesterol. More preliminary studies show that the ancient food may also reduce the incidence of colon tumors and ease allergic reactions.

What's not known is how much and which types of bacteria work.

Not knowing how or why something works might stop me, and those of you who read me and look for some actual science behind a claim. The rest of the American public… Well, look at what's available in the pill aisle at any supermarket or natural food store and you know that we must not care at all about what we put into our mouths. Yogurt and its beneficial bacteria have to be a thousand times healthier than some of the concoctions that come in pill form.

"When you eat the yogurt, you help to help reestablish the good bacteria in your intestinal tract," said Redlands dietician Elaine McFadden, director of nutrition education for Nature's Path foods.

Most commercial yogurt does not contain probiotics because it is pasteurized, a process that kills bacteria, [Chris Krese, spokesman for the National Yogurt Association] said. The National Yogurt Association is pushing the Food and Drug Administration to establish minimum levels of live and active cultures for a product to be called yogurt.
McFadden favors Mountain High yogurt, with its label boasting "billions of live and active cultures." Stonyfield Organic Yogurts are also high in beneficial bacteria.

And there are a host of new products pushing probiotics. Among them: Breyers Light! Probiotics Plus Yogurt, which promises "complete nutrition in a cup"; Activia yogurt, which manufacturer Dannon says regulates the digestive system when eaten daily for two weeks; and DanActive, also from Dannon, a cultured dairy drink.

Health-conscious consumers should read labels, McFadden said.

In addition to containing live and active cultures, the most good-for-you yogurts have less than 20 percent of calories from sugar and less than 30 percent of calories from fat.

I won't argue with that. It's good advice. And the vast majority of people with lactose intolerance can tolerate yogurt with live and active cultures with few if any symptoms.

Big News! Test May Tell if Your Infant Will Always Be Allergic to Milk

When I was diagnosed with lactose intolerance way back in 1978 I had literally never heard the words before. Today, just about everybody knows what LI is. That's great, except sometimes when it's a problem.

It's a problem because too many people now think that any problem with dairy products stems from LI. That's just not the case, and it's especially not the case for infants.

Lactose intolerance is the inability to manufacture the lactase enzyme. This ability does not even start to go away until about the age of weaning. You'll find very few healthy children under the age of three LI anywhere in the world.

Admittedly, any illness, surgery, medications, or injury that affect the small intestine can knock out the lactase-making ability. The most common cause of this is the old-fashioned "stomach flu," in reality a gastrointestinal illness. But this Temporary Lactose Intolerance (or Secondary LI) is, as the name indicates, normally temporary. It will go away in a few weeks as the intestines heal. (Truly serious damage from other causes may not heal, but this is extremely rare in comparison.)

How to explain the problems suffered by otherwise healthy children, who never seem to be able to tolerate dairy products? The most likely answer is a milk protein allergy. An allergy is an immune system reaction to the proteins in milk, a totally different process than the inability to digest the milk sugar, lactose.

The good news is that even a milk protein allergy is temporary, even though it seems to go on forever. I always reassure parents that the majority of infants will simply grow out of the allergy, usually by the normal time of weaning.

Of course, the parents always want to know how they can tell if their child will be one of them. I didn't have an answer. Until now.

On June 11, Timo Vanto, MD, of Turku University Hospital in Turku, Finland, gave a formal presentation titled "Persistent Cow's Milk Hypersensitivity: IgE Antibodies to Milk Have a Peak Earlier Than Skin Prick Test Wheals. Poster 579" at the 25th Congress of the European Academy of Allergology and Clinical Immunology (EAACI) in Vienna, Austria. You can found a report on the study at Doctor's Guide.

He did a double-blind study (the best kind) of 156 children who had been diagnosed with milk allergy at an average age of seven months. He then retested them at the ages of 1, 2, and 4 with the standard skin-prick test and measured the size of the wheals (swellings) that developed.

In the children who lost their allergies, the wheals were an average 2 mm in size in the diagnostic test, peaked in size at one year, and then dropped to 0.5 mm at 4 years. A full 77% of the children fit this pattern, meaning that three-fourths of them lost their allergies by age four.

The rest has a totally different pattern. Their diagnostic wheals were much larger, at 5.3 mm. They kept rising until the age of two, when they reached 8 mm. And they remained that average size even at age four. This clearly indicated that the allergy would persist.

Blood tests also showed two completely different patterns for antibody levels. The first group's S-f2 levels were 0.5 kU/L throughout the study. Those with a persistent allergy "started at a mean of 6 kU/L at diagnosis and peaked at 10.5 kU/L by 1 year. By 2 years they had dropped to 8 kU/L, and by age 4, they were at 4 kU/L."

So there are two independent ways of determining whether your child will grow out of a milk allergy. And they work best at different times, with the antibody serum levels predicting best up to the age of two and the skin-prick tests after that age. This should lead to much better diagnoses.

I have to warn everybody that one test is not necessary meaningful. Tests have to be replicated by independent researchers to ensure that chance or error didn't bias the results.

But this is great news. A readily available, easily performed test that predicts allergy persistence with high accuracy. This is the big one. Talk to your pediatricians or allergists about this. It may take some time before the results are accepted and the procedures are widely understood, but at least make sure that your doctors are looking into it.

Manischewitz Makes Nondairy Cake Mixes

Last fall Duncan Hines announced that it was adding dairy products to its line of previously pareve cake mixes. Pareve is a term in the Jewish dietary laws for "neutral" foods, those with no meat or milk ingredients. Pareve foods are perfect for people with lactose intolerance or dairy allergies as well as those who are vegans, so this was a major loss.

Let the consternation cease. Manischewitz, the big-name Kosher food products firm, has stepped in with the first two flavors of a new line of pareve cake mixes. They're starting with the basics – Vanilla and Chocolate – but promise to add more flavors as time goes on. The web site even offers a Pareve Fudge Frosting recipe, made with soy milk.

And Manischewitz gets points for mentioning lactose intolerance as a reason for offering the cake mixes. Yes! Let's remind them that we're a major market. Support companies that recognize LI.

Nondairy Frozen Desserts with No Bad Fat

Yesterday I wrote about Sorbets for Summer. Whipped and blended frozen fruit is about as dairy-free as you can get, but it's not the only category of nondairy frozen treat.

The report I mentioned from Nutrition Action Healthletter, June 2006, also featured a number of soy- and rice-based desserts that are both nondairy and, I believe, vegan, so they should be acceptable both for people with lactose intolerance and those with dairy allergies. Here's how they rate them: Best Bites have no more than 1 gram of "bad fat" (saturated fat plus trans fats) in a half-cup serving, no more than 170 calories, no acesulfane potassium, and also have fruit, fruit puree, or fruit juice (other than grape, apple, or pear) as the first or second ingredients. Honorable mention products are the same but may have up to 2 grams of "bad fat." They all tend to be higher in total fat than sorbets are, however, with 2-9 grams of fat per serving.

One company with many names, Turtle Mountain had several Best Bites, including Its Soy Delicious, So Delicious Organic, and Soy Delicious Purely Decadent, Purely Vanilla flavor.

Imagine Foods' Rice Dream and Soy Dream didn't have all their many flavors listed, but only Rice Dream Vanilla Swiss Almond got downgraded for too much "bad fat."

Celestial Seasonings, a sister company of Imagine Foods under the Hain Celestial conglomerate, adds tea flavoring to Rice Dream for an unusual and equally trans-fat free frozen dessert.

Several of Tofutti's lines scored high, with Super Soy Supreme, Low Fat, and No Sugar Added leading the list. Premium and Cheesecake Supreme had a bit too much "bad fat."

All of these will taste more like conventional ice cream than sorbet does, so they may bridge the gap when the cravings hit.

Sorbets for Summer

Summer is here for most of us. Well, not up here in Rochester. Friday I wandered through the tents at the Rochester International Jazz Festival in a cold, rain-misted wind with temperatures in the 40s. The ice cream truck closed down early as everybody searched for a vendor, any vendor, who sold hot drinks. Hot jazz warms the spirit but my umbrella turned inside-out and threatened to become a satellite.

But I hear that other parts of the nation have their air conditioning up and running. It'll happen up here as well. Summer is scheduled for a Thursday this year. Try not to miss it.

What to do when it's 95° and you're dripping and want something cold and smooth to wash the dryness out of your throat? Skip over that ice cream. If you're lactose intolerant or milk allergic there are better treats, and they're becoming a lot easier to find.

The two main types of non-dairy confections are sorbets and granites. Here's a handy definition from The Tennessean:

Sorbet: Fresh, ripe fruit puree or fruit juice and sugar then churned to incorporate air to make it smooth. It has no eggs or dairy products to camouflage the taste of fruits at their peak of ripeness. They can be made with liquors, wine and herbs, too. The less sweet ones are sometimes offered as a palate cleanser between courses at a fancy dinner.

Granite: Frozen mixture of fruit juice or other liquid such as coffee or wine and sugar, then frozen in a shallow tray. The proportion is usually four parts liquid to one part sugar. It's stirred frequently with a fork to break up the crystals and has an icy, coarse texture. Called granite in France and granita in Italy.

That's pronounced gra-NEE-ta, BTW, not like the rock.

The June issue of the Nutrition Action Healthletter, published by the Center for Science in the Public Interest, also was thinking summer and ran an article on frozen scoops. Saturated fat is their biggest bugaboo, followed by sugar content, so it's not surprising that sorbets grabbed a bunch of "Best Bites" and honorable mentions. Best Bites have no more than 1 gram of "bad fat" (saturated fat plus trans fats) in a half-cup serving, no more than 170 calories, no acesulfane potassium, and also have fruit, fruit puree, or fruit juice (other than grape, apple, or pear) as the first or second ingredients. Honorable mention products are the same but may have up to 2 grams of "bad fat." Tough grading.

They liked Edy's Whole Fruit brand No Sugar Added sorbets, sweetened with Splenda, but also gave a Best Bite to their regularly sweetened sorbets, except for Coconut and Boysenberry. It's hard to take the fat out of coconut, so all the coconut sorbets have black marks against them.

Haagen-Dazs has at least half a dozen sorbets with all them being Best Bites, except for chocolate, tropical, and zesty lemon, which are honorable mention.

Ben and Jerry have a tasty line of sorbets that should be widely available in most supermarkets. Their current flavors are Strawberry Kiwi Swirl, Berried Treasure, and Jamaican Me Crazy, with its swirls of pineapple and passionfruit. They all get honorable mentions.

Ciao Bella has a huge line of sorbettos, many of which are certified kosher. All are Best Bites except for chocolate, which rates as honorable mention, and the dread coconut.

Lots of other brands of sorbets, granites, and ices (sometimes called Italian ices) are on the market, of course. You should find other brands that weren't part of the ratings in local stores and natural foods markets everywhere. Keep the Best Bites qualities in mind when you buy. Fruit, not sugar, should be high on the list. You want the real fruit flavor to shine through.

I'm finding that many better restaurants now offer home-made sorbets in unusual and intense flavors for those of us who literally wouldn't live through a Death by Chocolate mound of fat. The best of these burst into fruity sense-bombs with the smallest spoonful.

You can also make your own sorbets. Check out the Non-Dairy Frozen Desserts Cookbooks page in the Product Clearinghouse on my website for a list of cookbooks that cover sorbets, granites, and ices.

When you experiment with the recipes, keep in mind that you can add other flavors than just fruit. Sorbet on the side by Kristi L. Gustafson in the Albany Times Union, tells us that herbs are the latest hot ingredient in cool summer dishes.

Lavender, rosemary, tarragon, basil and lemon verbena are just a few oft-found sorbet additives.

"Lemon verbena is amazing. It has a scent and flavor that's like an acidless lemon," says Michel Nischan, known as the Healthy Chef. "It causes the flavor to fill your entire mouth."

…

Mint goes better with fruit sorbets than just about any other herb, say chefs. It's expected, because mint often accompanies fruit -- or at least dessert. But these sorbets aren't always after-meal treats.

Instead they're used as intermezzos or even side dishes.

"Rosemary is sharp enough (that) it's more interesting as a meat accompaniment or a palate-cleanser," according to Lou Pappas, author of "Sorbets and Ice Creams: and Other Frozen Confections." She suggests a lemon-rosemary sorbet with lamb. Diners treat it as a side dish, as they would a potato or vegetable.

…

A fruit base is typical (even tomatoes work). Add a sugar-based syrup, stick it in an ice cream maker, and you'll have a perfect-consistency sorbet. Different herbs can be incorporated differently, says [Paul Krebs, professor of culinary arts at Schenectady County Community College].

"Herbs can be chopped finely and mixed in, but if you don't want to have the chopped herb in your sorbet, you can also strain it," says Krebs. You can also chop the herbs, steep them in the sugar-and-water mixture and strain it out.

Check the article online for recipes on unusual flavors Spring Rhubarb-Tarragon Sorbet, Pineapple-Sage Sorbet, and Citrus-Basil Sorbet.

No dill, though. Dill doesn't work. Nor does combining lavender, maple and chocolate. Remember, just because you can think it up doesn't mean you can choke it down.

The Future of Soy Milk

Soy "milk" probably tops the list of all alternative dairy milk beverages. Sales are large and growing, growing much faster than dairy milks sales are, although of course starting from a much smaller base.

And the future will see tastier, healthier, and more varied forms of soy milks, according to an article on the foodingredientsfirst.com site, Taking Soy Protein beyond Milk , by Henk Hoogenkamp & Paul Evers of Netherlands' Alko Research.

The article is a bit technical in spots, but you can easily skip the protein globulin discussion and not worry about what organoleptical means as you skim by to get to the good parts.

A few excerpts:

Major flavour innovation is on its way when by 2007 improved organoleptical quality soy protein isolate will become available. Using plant-breeding technology, a specific Monsanto patented soybean variety will then provide high levels of beta-conglycinin, a naturally occurring texture and flavour improving compound. Beta-conglycinin is a highly soluble protein, especially suitable for beverage applications. Beta-conglycinin does not bind flavours so at higher levels it does not hold in the typical soybean taste, creating a more neutral taste profile, which subsequently will be carried over in the end product.

...

As an eye-opener: soy and its specific health claims remain a highly controversial topic.

According the Associated Press (January 24, 2006) the American Heart Association panel of expertise has derided soy claims that soy protein can significantly lower cholesterol.

Soy industry sponsored research studies indicate that the soybean is more than a high-yielding source of premium protein. Soybeans also contain relatively high amounts of phytochemicals, such as genistein, daidzein and glycitein.

Epidemiological studies have suggested an association with lowered risks for prostate, breast and colon cancers, reduction of cholesterol, improved bone health, a delay in the onset of osteoporosis, reduced blood pressure, protection against heart disease, and an easing of menstrual and menopausal symptoms. Soy protein is also a significant source of essential fatty acids, minerals, and calories. Given below is the important nutritional information for soy milk produced with a low-flavour profile type of soy protein isolate.

...

Basically, functional drinks are defined as a concept that provides a health benefit beyond the basic nutritional content by virtue of their physiologically active added components. Yakult Japan is not only the pioneer of the probiotic functional drinks but also still the world leader of the distinctive ‘one-shot size’ drink format. It has taken a while, but in recent years a wave of me-too products has been introduced by giants like Yoplait, Danone and Nestle.

...

Soy protein is also considered a ‘satiety-protein’. And as such, DSM’s new ‘Fabuless’-satiety ingredient could be an ideal fit to co-introduce in a personal weight management drink. Looking into the crystal ball, DSM also has near market introduction a milk beverage, yet without all the classical attributes such as taste or appearance of milk.

Further down the horizon soy based nutraceutical beverages appear which are based on nutrigenomics, and these technologies will set the stage for personalised nutrition beyond 2012. After all, there is increasing evidence of links between small DNA changes and the development of chronic disease, which ultimately will prove that there is a direct relation between genetic changes, lifestyle and food. Following this pathway, it even can be hypothesised that some food companies of today even might transform towards food diagnostics as their main creation of shareholder value.

The whole article is much longer than this, but I recomend going through as much of it as you can. While distinctly on the pro-soy side, it's the best summary of the current state of the international industry that I've seen.

Answers! Really, Answers to Your Questions!

Hi, everyone. Back from a break, and time to catch up on some of the questions that have come in.

=======

In the Lactose Free Yogurt and Cottage Cheese post, Joel asks:

Thanks for keeping us LI individuals up to date with your helpful information. I heard only last week that approximately 40% of Eastern European background americans, 60% of Afican-Americans and 100% of Asian-Americans are LI. With numbers like this, they are either false, or I would say that LI is a large enough market now for food compnaies to focus more on LI products. Do you agree with these numbers?

Those numbers are completely accurate, but misleading without some context to them.

What does it mean to say that 60% of African-Americans are LI? Simply that if you were to look at the DNA of every African-American, about 60% of them would retain the original gene that told the body to stop making the lactase enzyme after the age of weaning, and that about 40% have the mutated gene that never sends out this signal. This is one technical definition of lactose intolerance.

It's not the common one, though. Most people say that they have lactose intolerance if they get symptoms after eating or drinking dairy products. How is that different? Well, if you never have dairy products you won't get symptoms. If you have small amounts of dairy products, you likely won't have symptoms. If you stick to dairy products with low amounts of lactose, you won't get symptoms. If your colon is full of acidophilus or other "good" bacteria that digest lactose, you won't get symptoms.

That makes the actual market for reduced-lactose dairy products or non-dairy milk substitutes much smaller than the gross figures would indicate. Real dairy products also tend to taste better, or at least more familiar, to those who've grown up with them, another disincentive toward buying substitutes.

That doesn't mean that there aren't any such products. I list hundreds of them in my Product Clearinghouse. But they'll never be a big mainstream product category.

=======

Earlier I had put up a post First Gluten and Lactose Free Store Opens about Splitt in Calgary, Canada and Gluten Free Store Opens about a Detroit venture supposed to be the "first" such store. Whenever you read a newspaper article that says something is the "first" take it with a big grain of salt.

Paul told me about the The Old Shepody Mill Restaurant on the South Shore of New Brunswick. And somebody who logged in anonymously mentioned a gluten-free store in Winnipeg named Lorenzos. Good for Canada.

I post references to lots of articles I spot on the Web. Sometimes I can tell immediately that they're wrong. Sometimes I have to wait until my readers give me the facts. You know the saying "Everybody knows more than anybody." That's true here as well.

=======

People love their Vitamite. But Vitamite Might not be Around Any Longer. Except that it is, sorta.

Another anonymous comment said:

Vitamite is still available, but not in a convenient size. Diehl International will sell it in a 50 lb. package. It cost $180* and ships UPS. Diehl says it will make 60 gallons. It's the perfect size for your fallout shelter. My came a couple of days ago. Here's a link for the direct consumer order form.

www.vitamite100.com/Vitamite_100.htm

*Anonymous corrected this on June 17 to only $130.

That'll take care of a year of Vitamite hunger. And in the meantime you can build up your muscles by hoisting the package every day.

=======

Here's a good suggestion that wound up as a comment in Schools Should Provide Nondairy Drinks, not the most obvious place to look for it.

I substitute cream soups in casseroles, etc with a can of chicken rice or chicken noodle soup blended in a blender until smooth. I usually add a small amount of soy sour cream, to add a bit of creaminess, but that isn't absolutely necessary. I think the blended starch (the rice or noodles) substitutes for the thickener found in cream of mushroom or cream of chicken soup and the chicken broth adds a nice flavor. I do this with canned soup that hasn't been reconstituted.

Thanks, anonymous. Subbing for cream soups is always difficult. Anyone who tries this please let me know how it turns out for you.

=======

On that same page Paula asks:

I wonder had anyone connected lactose intolerance to autoimmune disease.

No, absolutely no connection that I can think of.

=======

OK, we're back up and running. Lots more entries to be posted over the next few days. If you have any other questions or comments, I promise I'll get back to you sooner.

Lactose Free Yogurt and Cottage Cheese

J. D. from Charlotte, N.C. writes:

Why aren’t lactose-free dairy products made into yogurt or cottage cheese? I haven’t found such products at the market, and they would be a good addition to the lactose-free selection.

Unfortunately, J. D. from Charlotte, N.C., had the misfortune to write Ed Blonz, Ph.D., On Nutrition instead of me. You can read Dr. Blonz's answer here.

Here's a better answer from me.

There do exist lactose-free yogurts and cottage cheeses. Lactaid makes a 100% lowfat cottage cheese. It also makes lactose free American cheese slices and ice cream.

Continental makes lactose free yogurt in three flavors.

You can find a listing of reduced lactose milk products in my Product Clearinghouse on the Reduced Lactose Milk Products page.

You can also find store brand versions of these products in some locations. I don't keep track of them because they are too localized, but just ask your store manager.

So why the ignorance about these products? Simple. They don't sell. People with lactose intolerance are just too small of a specialized market. They don't go out of their way to buy lactose free substitutes. Either they do without or they take a lactase pill and keep on eating their favorites.

If you want to support these products, great. Buy them. Request them if they're not available in your local stores. Use that Lactaid product request form I linked to earlier. But if you don't buy them, they will go away. Again. Many lactose free products have disappeared from shelves because sales were too low. If you want to keep them on store shelves, it's totally up to you.

Babies and Probiotics

Secondary lactose intolerance, sometimes called temporary lactose intolerance, is something that hits about 10-15% of all babies at some point in infancy. It occurs when their delicate intestines are damaged by an illness or medication so that the ability to manufacture the lactase enzyme is knocked out. As the name implies, this is usually a temporary loss. After a few weeks, the intestines heal and the lactase start to flow again.

Is there anything a parent can do to help? Probiotics are one suggestion.

Are probiotics for every child? is an article on the Health.com site. It discusses a study done in South Africa:

Diarrhoea is one of South Africa’s biggest causes of death among children under the age of five. Unable to replace fluids, babies become weak and dehydrated, and the results are tragic.

It is in terms of prevention and treatment (in conjunction with oral rehydration solution) of babies with diarrhoea that probiotics work their magic most startlingly.

In one study, children aged between six and 36 months, who were hospitalised with diarrhoea, were split into two groups. One group received a probiotic called Lactobacillus reuteri and the other a placebo. Both groups also took an oral rehydration solution, essential for anyone with diarrhoea.

By the second day, the recovery rate of the probiotic group was remarkable compared to the control group.

Even when a baby has recovered from acute diarrhoea, like rotavirus diarrhoea, there is sometimes invisible damage to the digestive tract. This can cause problems with the digestion of the milk protein lactose, even if the baby tolerated milk-based formula with no problem previously.

Ongoing treatment with probiotics can help to break down the milk sugar, improving the baby’s lactose tolerance. The colonies of good bacteria will re-establish and provide the natural digestive assistance needed.

What to look for in a probiotic?

Look for one that is a human strain, clearly identified with a registration number from an international culture bank such as the American Type Culture Collection (e.g. ATTC 55730). Human-strain probiotics originate from breast milk or from the intestine itself. They are then grown in fermenters to produce enough for large scale production.

Good probiotics will have passed safety tests and have good, proven shelf life. With the pharmacist’s help, you should choose a probiotic that can survive in the acidic environment of the stomach as it passes through on its way to the intestine. An effective probiotic will deliver 100 million cfu of good bacteria.

And here's a warning:

An independent study published in the South African Medical Journal a few years ago drew attention to the fact that not all probiotics are equal and that even if you read the label you can’t be sure you’re getting what you’re promised. Other similar international studies had shown that few products really contained what the label claimed.

And one giant grain of salt: the information is being provided by Thebe Pharmaceuticals. However, I don't see anything here that is incorrect or excessively biased. Probiotics are not a cure-all, but they may be useful in reducing symptoms.

FAAN Launches Teen Allergy Awareness Site

I told you a couple of days ago that this is Food Allergy Awareness Week.

Buried down in the bottom of the press release from FAAN (the Food Allergy & Anaphylaxis Network) is a mention of www.fanteen.org. That turns out to be a new web site that was just launched on May 1.

Here comes another press release:

The Web site, “Food Allergies in the Real World,” is designed to provide all teens with practical strategies for handling food allergies in social situations such as prom, dating, and going off to college. A study of 32 cases of fatal food-allergic reactions showed that more than half of the victims were kids aged 10 to 19. Interviews with family and friends indicated that the child did not expect to have a reaction, and that their friends were often unaware of the food allergy or didn’t know how to help once a reaction began. A recent study of teen behavior indicates that teens feel educating their friends would make their lives easier, yet they don’t want to be the ones doing the educating. “Our goal with this Web site is to give teens — tomorrow’s leaders —a place to go for information about how to manage food allergies, while living life to the fullest,” said Anne Muñoz-Furlong, FAAN founder and CEO.

FAAN’s teen Web site offers “real world” strategies and provides a network of teens facing the same struggles and feelings in their everyday interactions with school administrators, classmates, neighbors, friends, and family. The “Personal Stories” section presents actual experiences of teens and college students with food allergies, and recollections from their friends. The “Advice” section offers practical answers to tough questions from young adults who’ve lived through the same situations. New interactive features such as polling questions, a “Talk Back” feature in which users can share their thoughts, and a food allergy calculator that, based on national statistics, shows how many students may have food allergies in a school and reminds teens that they are not alone in their everyday struggles with food allergy.

“Food Allergies in the Real World” was crafted with insight from members of FAAN’s Teen Advisory Group comprised of 20 nationwide adolescents and young adults who have food allergies. Food-allergic teens live with a burden of responsibility that most adolescents never face. Because there is no cure for food allergy, these teenagers can never let their guard down and must rely on strict avoidance of allergy-causing foods, ongoing vigilance detecting common ingredients in unexpected places, and consistency in never leaving home without their life-saving medication, epinephrine (EpiPen® or Twinject™). Until there is a cure for food allergy, education is the key to avoiding a reaction. FAAN’s teen Web site will help these young adults to be prepared, in all situations, and avoid tragic results.

While milk or dairy allergies are seldom anaphylactic, the possibility exists. If you're a parent, encourage your teen to check out the site. It's even interactive. Under a Watch Out banner is this paragraph:

Keep in mind that products labeled as "non-dairy" are not always milk-free. Such products often contain casein, a milk protein. Remember, there is no shortcut to label reading. Taking a few minutes to check ingredients is better than spending time treating an allergic reaction!

And then you can send in a tip.

Send in one here too!

Lactaid's Milk Moments Campaign

This is the week to be a proud member of the army of people who are lactose intolerant or dairy allergic, I guess.

Not only is this Food Allergy Awareness Week, but LACTAID is kicking off the LACTAID MILK MOMENTS campaign.

The LACTAID® MILK MOMENTS™ consumer campaign kicks-off nationally on May 15th with a coast-to-coast children’s art contest called “Searching for LACTAID® MILK MOMENTS™.” The contest asks kids ages 11 and under to illustrate their favorite LACTAID® MILK MOMENTS™, such as having a milk and cookies treat with mom or drinking a smoothie, for the chance to win prizes worth $10,000 in value.

Three first place winners will receive a:
•Full kitchen makeover for the family that includes tableware, small appliances, refrigerator and more

•Deluxe “art studio” that includes art supplies, a digital camera and a computer

•The opportunity to see their winning artwork on LACTAID® Milk carton panels starting in October

•Second and third place winners will also be selected to receive the deluxe art studio.

A new website has been launched and consumers can visit the bilingual website WWW.LACTAIDMILKMOMENTS.COM for contest rules and more information. The deadline for entries is June 30, 2006.

Spreading the News of the Importance of Art Education

In launching LACTAID® MILK MOMENTS™ and the children’s art contest, the LACTAID® Brand is partnering with PTO Today, Inc. (PTO), a leading organization that provides expertise and support for school parent group leaders across the country.

The brand is making a $50,000 donation to the organization in support of art education in schools. More than 30 schools in select cities will receive art supplies in the Fall to host a Family Arts & Craft Night, a PTO program that enriches students’ lives with a fun and educational evening of art making.

Lactaid itself can be found at its website, www.lactaid.com.

May 14-20, is Food Allergy Awareness Week

This week, May 14-20, is Food Allergy Awareness Week. Don't check your calendars. FAAN - The Food Allergy & Anaphylaxis Network – proclaimed it themselves.

"The 2006 Food Allergy Awareness Week campaign kicks off on Mother's Day, such an appropriate day to salute the millions of mothers of children with food allergy who do so much to educate others in order to keep their children safe," said Anne Munoz-Furlong, CEO and Founder of FAAN. "The new labeling law marks a new beginning as we continue to increase awareness about this growing public health concern within our communities and ask ourselves to help keep children safe."

This past fall, The Food Allergy and Anaphylaxis Management Act of 2005 (HR 4063) was introduced requesting the federal government to create food allergy management guidelines for schools nationwide. FAAN's primary goal is for school staff across the country to have the tools they need to develop a plan for keeping food-allergic students safe.

According to Munoz-Furlong, "Scientists around the world are investigating food allergy to determine why some people become allergic, how to stop the reactions and how to cure the disease. We are hopeful that in the next ten years or so, there will be significant breakthroughs -- until then, education is key."

...

Founded in 1991, The Food Allergy & Anaphylaxis Network (FAAN) is the world leader in food allergy information. FAAN, a nonprofit organization based in Fairfax, VA, is dedicated to increasing public awareness about food allergy and anaphylaxis, to providing education, and to advancing research on behalf of all those affected by food allergies. The organization has just under 30,000 members in the United States, Canada, and 62 other countries.

FAAN provides information about food allergy and educational resources to patients, their families, schools, health professionals, pharmaceutical companies, the food industry, and government officials. Educational materials published by FAAN are reviewed for medical accuracy by the FAAN Medical Advisory Board, which is comprised of 14 of the world's leaders in food allergy science and medicine. In addition to printed materials, FAAN also sponsors awareness programs such as Food Allergy Awareness Week, Food Allergy Conferences, and the Mariel C. Furlong Awards for Making a Difference as well as fundraising walks across the country. Educational materials and information about special programs are also available online at www.foodallergy.org, www.fankids.org, and www.faanteen.org.

Enough press release talk. FAAN is a good organization. Check out their websites.

Vegetarian Express

Laurie Snyman sent me an email touting her "pre-packaged vegan foods and spices that are quick and easy to make" site, www.thevegetarianexpress.com. [Spices that are quick and easy to make? The Internet will be the death of parallelism in English sentence construction. Sigh.]

To be honest, there aren't that many products there, and only one is of real interest to those of us who have lactose intolerance or milk allergies. That's their Parma Zaan Sprinkles cheese substitute.

There are a number of articles and recipes on the site, however, and those might be useful to those who are first looking to go vegetarian and cut dairy out of their diets.

It looks as if the site is still in the process of pulling itself together. Here's hoping that they do more with it.

First Gluten (and Lactose) Free Restaurant Opens

So many firsts. Hope some of them last.

Back in March I told you about the first gluten free store to open. Now comes news about the first gluten free restaurant in North America.

Splitt isn't exactly convenient, unless you live in southwest Calgary, Alberta, Canada. And it took a lot of work just to get it open.

It has taken six months and consultation with the Canadian Celiac Association for Splitt to craft a menu that they say won't make celiacs sick.

"It's been quite challenging actually," says chef Steaphen Cleary. "There aren't a lot of products out there."

Splitt, so named because it's a restaurant during the day and a nightclub in the evening, offers everything from egg breakfasts to steak dinners. Its menu notes that all items are gluten and lactose free, with the exception of beverages, although it also offers gluten-free alcohol -- such as certain liquors and wines. Bread products are also available without gluten.

Pasta and wheat bread, for example, are no-nos for celiac sufferers. So Splitt created a Mexican lasagna that uses soft corn tortillas in place of pasta layers and offers a rice bun with its jalapeno stuffed burger.

Will it last? Who knows? The percentage of people thought to be gluten intolerant is growing but is still considered to be no more than 1% of the population, hardly enough to sustain a restaurant. Those of us with lactose intolerance are a larger percentage, though, and since most people with gluten intolerance are also LI we may be enough to make the difference.

More speciality stores; more specialty restaurants. Good signs for the future.

Digestive Advantage

I received an email from Gerti Sonderquist of Digestive Advantage with updated information about their product. I've made the changes to all the page on my web site, so it's a good time to mention them here as well.

Digestive Advantage is one of a couple of products with a different approach to combating the symptoms of lactose intolerance (LI). They all take advantage, pun intended, of the fact that LI symptoms have two causes. First, undigested lactose will pull water out into the intestines and create diarrhea. Second, undigested lactose may be fermented by bacteria that naturally live in the colon, creating gas and bloating.

Different people may get symptoms from one or both of these causes, depending on any number of factors. Lactase taken with food should help most everybody, but it's a good idea to also change the bacteria to the type of bacteria that digests lactose rather than ferments it.

Digestive Advantage does have lactase in it, but since you take it only once a day, I don't consider that a help. Lactase needs to be taken with food that contains dairy. (See When to Take Your Lactase.)

More important, from my perspective, it contains a "patented, proprietary Lactobacillus culture." Once this culture colonizes – takes over – your colon, your symptoms should improve.

I've received a large number of emails from readers who tell me that Digestive Advantage really works as advertised.

"I tried Digestive Advantage yesterday, and it worked great. I waited until Saturday so I could be at home for this experiment (I'm sure you understand why). I took two caplets in the morning, then had cheese, milk chocolate, and pizza with extra cheese throughout the day. I kept waiting to get violently ill, but I was fine all day yesterday and today. By the way, I am SEVERELY lactose intolerant---even a little bit of whey in a cookie and I am sick for hours. Hope this helps."

"I have been using Digestive Advantage for a little over a year and I love it. I take one pill a day and can now eat many things that I could not before. I still avoid high lactose foods, but can now eat things like pizza without discomfort."

"I've been taking this product for about a month and a half. It works great! I'm in sales and marking and have to take clients to lunch and dinner quite often. I was always fearful of eating out, especially with clients as diarrhea would start just about immediately after eating. I travel extensively as well and being on an airplane was nerve racking! This product is the only thing I have found that gives me confidence and relief of my symptoms. I can live my life again!"

I cannot guarantee that Digestive Advantage will work this well – or at all – for everybody. If you would like to try it, Gerti reminded me that:

we give out free 8 day samples for anyone who is interested by calling toll free 800.456.0276 or going to our website – www.ganedenbiotech.com

Other contact info:
Ganeden Biotech, Inc.
5915 Landerbrook Drive, Suite 304
Mayfield Heights, OH 44124

440-229-5200 Main Phone
440-229-5240 Fax

email: info@ganedenbiotech.com

Ganendan also makes a line of other digestive lactobacillus products. And it's now appearing in supermarkets in the digestive aids or laxatives section of supermarkets. A full page of coupons appeared in my local paper recently. You can also find them on Internet shopping sites if they're not in your local stores.

Let me know how they work for you.

When to Take Your Lactase

Back to lactose intolerance basics. Here's a question that I got an email about.

When should I take my lactase pills?

The best time to take your lactase is just before you start eating. The lactase is designed to go quickly through the stomach and enter the small intestine. That's where it works. If you take the pill before eating any of the dairy, the lactase will be sitting there waiting for it.

Should I take another pill if I have more dairy during the meal?

Food moves the intestines slowly. In fact, your system requires hours to break down and digest all the nutrients in food. If you take enough lactase at the beginning of a meal it will all still be there for any food eaten during the course of a meal.

If you're surprised by dairy you didn't expect, say by a big dairy-laden dessert, then go ahead and take more lactase. But otherwise it's not necessary.

What if I forget and don't take the lactase until the end of the meal or even later?

You want the lactase to be there first. If the lactase chases the lactose it may not catch up with the first part of the meal and some lactose can slip through undigested.

Even so, better to miss some lactose than to miss all of it. If you have lactase, take it. It should still do some good by reducing symptoms even if it doesn't eliminate them completely.