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Dairy-Free Diet

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A dairy-free diet contains no milk, cheese, butter, cream cheese, cottage cheese, sour cream, ice cream, whey, casein, or foods that contain any of these ingredients.

Why do people follow this diet?

Most people who follow a dairy-free diet are allergic to dairy products. However, a few people who are exquisitely sensitive to lactose—milk sugar—also need to avoid all dairy products.

People who react to lactose are called “lactose-intolerant.” They lack adequate amounts of an enzyme (called lactase) needed to digest milk sugar. Unlike people who are allergic to dairy products, most lactose-intolerant people can consume dairy products that naturally contain only traces of lactose (such as hard cheese) or those that have been treated to break down lactose (e.g., Lactaid™ milk). Many lactose-intolerant people can also eat yogurt without suffering, despite the high amount of lactose found in yogurt. The ability of many lactose-intolerant people to consume yogurt without getting sick used to baffle scientists. Now, we know that the bacteria in most yogurt products (except frozen yogurt) consume most of the lactose as soon as the yogurt moves from the stomach to the intestines. These bacteria are so efficient that they often break down the lactose before the lactose-intolerant person has a chance to react to it.

Milk allergy is an immune system response to the presence of milk protein in the body. The body perceives the protein as “foreign” and proceeds to mount an attack against it, which results in the symptoms of an allergic reaction. Cow’s milk is the most common cause of food allergy in infants and young children. Cow’s milk proteins are potent allergens and around 2.5% of infants experience cow’s milk allergy in the first years of life. However, food allergies usually diminish with advancing age. Up to 85% of children will outgrow their allergy by the age of three; the majority will outgrow it by the time they reach school.

What are the symptoms?

The symptoms of lactose intolerance occur within a few hours of ingestion of milk or milk products and include bloating, abdominal pain, gas, and diarrhea. The severity of lactose intolerance varies greatly among individuals. Lactose-intolerant people who experience these symptoms even when they eat only dairy products that contain very little lactose may require a diet free of all dairy products to avoid these symptoms.

Milk allergy symptoms may include any of the common symptoms of food allergies, including skin rashes or hives, gastrointestinal distress, breathing problems, or many other possible symptoms. Anaphylaxis, a life-threatening allergic reaction, is only rarely triggered by consumption of dairy products, even in people who are allergic to dairy.

What do I need to avoid?

To avoid milk and milk products ask about ingredients at restaurants and others’ homes, read food labels, and become familiar with the technical or scientific terms for milk. The following list is not complete. Consult with a healthcare professional if you are planning to omit milk from your diet or your child’s diet. Many Americans receive the majority of their calcium intake from dairy products. Therefore, when switching to a dairy-free diet, taking calcium supplements is often advisable.

  • Baked goods such as pancakes, biscuits, muffins, cakes, crackers, baking mixes (read labels for dairy product ingredients)
  • Au gratin foods
  • Butter
  • Buttermilk
  • Calcium caseinate
  • Candy (especially creams and chocolate)
  • Casein
  • Cheese
  • Cheese sauces
  • Chocolate milk and drinks
  • Coffeemate
  • Cold cuts (such as bologna)
  • Cottage cheese
  • Cream
  • Creamed or scalloped foods
  • Curds
  • Dry cereals containing milk powder, such as some granolas
  • Dry milk powder
  • Dry milk solids
  • Evaporated milk
  • Fondues
  • Grated cheese
  • Gravies (some)
  • Ice cream
  • Malted milk
  • Margarine (most)
  • Meat loaf and patties (some)
  • Milk: whole, skim, 1%, and 2%
  • Milk shakes
  • Milk sherbets
  • Nondairy creamers (most)
  • Non-kosher luncheon meats (some)
  • Ovaltine
  • Puddings (most)
  • Sausage (some)
  • Sodium caseinate
  • Wieners (some)
  • Whey
  • White sauces
  • Yogurt

Best bets

Milk substitutes:

Nondairy products:

Are there any groups or books?

The No Milk Page
www.nomilk.com

Food Allergy Network
www.foodallergy.org

Nondairy Milk Recipes—Leave the Cow’s Milk for the Calves
www.veganmania.com/pages/non_dairy_milk_recipes.htm

Go Dairy Free
www.godairyfree.com

Bibliography

Ahmed T, Fuchs GJ. Gastrointestinal allergy to food: a review. J Diarrhoeal Dis Res 1997;15:211–23.

Businco L, Bruno G, Giampietro PG. Prevention and management of food allergy. Acta Paediatr Suppl 1999;88:104–9.

Muñoz-Furlong A. Is It Milk Intolerance or Milk Allergy? www.aaaai.org/public/publicedmat/advocate/1999/spring/milk.stm. 10/13/00

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