If you kept a nutritional journal on the children in your practice, you would probably discover that dairy is among the top five products consumed daily. This is troubling because individuals who are being allergy tested or just performing their own elimination diet for themselves or their children are finding that dairy (and more specifically casein) is a contributing factor to allergy reactions and behavioral problems in those sensitive to it.
What Is Casein?
Casein is a protein primarily found in milk and other dairy products, but it is also used as a binding agent in numerous other foods. Technically, it is a phosphoprotein that accounts for nearly 80 percent of the proteins in cow's milk and cheese.
Why Eat Casein Free?
Eating casein free, when combined with a gluten-free diet, reportedly has very positive results for people suffering from autistic spectrum disorders, such as autism, Asperger's syndrome, atypical autism and pervasive developmental disorder. Additionally, many people who assume they are allergic to milk may actually be suffering from a casein allergy. The complicating factor causing a lack of awareness as to the true allergy is that casein is found in more than just dairy products. As a binding agent, it has technical uses as well as edible; it can be found in paints (including fingernail polish), other cosmetics and even glue (or industrial adhesives).
The Problem With Casein
Whether or not you or someone in your household battles with allergies, a digestive disorder, or is allergic to milk or dairy products, everyone in your home can benefit from eating casein free, or at least reducing daily intake of dairy products. In 2000, a clinical study by FitzGerald and Bundesanstalt determined that there is a "natural opiate" embedded in casein protein, which may lead to the "comfort feeling" after digestion. This may be a contributing factor to cravings for chocolate and cheese unrelated to hunger.
Studies including those by Dr. Karl Reichel, of The National Hospital in Norway, and Dr. Robert Cade, of the University of Florida, have found high amounts of the casomorphin peptide in urine samples taken from people with conditions ranging from autism to post-partum depression (PPD) to celiac disease to schizophrenia. It has been suggested that this peptide may also be elevated in other similar disorders such as chronic fatigue, fibromyalgia and depression, based on the reported benefits of a gluten-free and casein-free diet.
The Problems With Milk
While casein is most certainly a concern, it's not the sole problem with milk. A large study led by Catherine S. Berkey of Harvard Medical School and Brigham & Women's Hospital in Boston revealed that consumption of milk may be contributing to the growing problem of childhood obesity. And Dr. Robert Kradjian, chief of breast surgery at Seton Medical Center in northern California, reviewed archives of medical and scientific journals and found that milk is not the "perfect food" it is reported to be. He found that many common childhood disorders were, if not induced, certainly aggravated by an increased intake of dairy products, including but not limited to allergies, ear and tonsil infections, bed-wetting, asthma, intestinal bleeding (lesions), colic and childhood diabetes.
The American Academy of Pediatrics advises parents not to give children dairy milk before their first birthday; Dr. Frank Oski, former chief of pediatrics at Johns Hopkins University Hospital and the author of Don't Drink Your Milk, believes milk should never be given to children. Since milk has been associated with iron deficiency anemia, occult gastrointestinal bleeding and various manifestations of food allergies, he believes it prudent to recommend children avoid milk and its potential health problems altogether.
Other Dairy Products
These problems with milk most certainly carry over into all dairy products, including butter, cheese, ice cream, yogurt, etc., and in reality are compounded by the process of producing these food items. For example, the process of making cheese removes the water, lactose and whey proteins, resulting in the casein being concentrated, increasing the effect of the peptides being released during digestion.
What to Avoid
There are many foods that contain casein and should be avoided; these include but are not limited to the following:
- Milk, cream and half & half
- Yogurt
- Butter and sour cream
- Cheese (even some soy brands)
- White or milk chocolate
- Ice cream, ice milk and sherbet
- Creamed soups and vegetables
- Soup bases
- Puddings and custards
- Whey
Foods that may contain casein because it has been added as a "bonding agent" include but are not limited to: margarine, tuna fish, dairy-free cheese, artificial flavorings, semi-sweet chocolate, hot dogs, sausage, lunch meats and ghee.
Better Choices
The benefits of a casein-free diet are not new, and have been studied and considered for over a decade. As such, many alternatives are now available within the food supply, including:
- Rice, soy or potato-based milks
- Pareve creams and creamers
- Mocha Mix
- Tofutti-brand products
- Sorbet and Italian ices
- Soy ice cream (but not all flavors)
- Soymage cheese
- Coconut butter
- Imagine-brand soups
- Coconut milk
Teach your parents to substitute when necessary. When a recipe calls for 1 cup of milk, they can replace it with 1 cup of soy, rice or coconut milk or 1 cup of water mixed with 1 egg yolk. If a recipe calls for a cup of yogurt, they can consider the following substitutions: 1 cup of soy yogurt or soy sour cream, 1 cup unsweetened applesauce or 1 cup of pureed fruit.
The Bottom Line
Considering the rapid increase in the number of children who are sensitive to dairy products, and more specifically casein, you might want to suggest to parents an elimination trial period: remove these products from the family diet for 30 days and then slowly add one product back at a time, judging reactions, until they complete the dairy list. Have your parents look for any of the following possible reactionary signs in themselves or their children: irritability; acting out; mucus; redness or itchiness around the eyes, mouth or anus; craving other foods; unusually picky eating; upset stomach; bowel disruption; etc. It should be noted that children sensitive to casein are often allergic to gluten, so parents may choose to perform the elimination diet for dairy and gluten at the same time.
Suggested Resources
- Living Without: The Magazine for People With Allergies and Food Sensitivities. www.livingwithout.com
- Autism Network for Dietary Intervention. www.autismndi.com
- The Gluten-Free, Casein-Free Diet: Autism Diet Resource. www.gfcfdiet.com
- Gluten/Casein Free Grocery Shopping Guide and Gluten/Casein/Soy Free Grocery Shopping Guide available at ceceliasmarketplace.com.
- Compart P, Laake D. The Kid-Friendly ADHD & Autism Cookbook. ISBN 1-59233-223-6
- Hammond L, Rominger LM. The Kid-Friendly Food Allergy Cookbook. ISBN 1-59233-054-1
