In part one of my articles on dairy I looked at why full-fat dairy can be a healthy part of a balanced diet. However, we should be aware that like grains, dairy products contain a number of inflammatory compounds that can be quite problematic for many people.

Like grains dairy is considered to be a “Neolithic food” – meaning we have not eaten it for as long as other things like meat and plants. Dairy became part of our diets when humans developed the ability to farm and raise animals and therefore there will be some people whose digestive systems do not have the capacity to properly handle these foods.

Although the fact we haven’t always eaten dairy does not constitute a valid reason to quit dairy all together, it can be a problematic food for many people. Let’s look at the particular components.

Despite what the health authorities would have you believe it is not the fat that is the problematic part of dairy.

It is carbohydrate – lactose; and proteins – casein and whey.

Some cheeses may contain varying degrees of lactose due to the fermentation process.


Lactose is a disaccharide, a sugar, found in dairy products. It is likely that you’ve heard of it and lactose allergies and intolerances are very common; however, many people also think casein intolerance (see below) is actually lactose related.

It is thought that more people in the world are thought to be lactose intolerant than not. Lactose intolerance appears to be higher in some ethnic groups including East Asians (90-100% thought to be intolerant) and Africans (70-90%). Conversely, lactose intolerance is less amongst people of English decent (5-15%). (1)

This article from Mark’s Daily Apple is a very clear explanation of the different causes and reactions associated with dairy’s problematic components. (2)

Lactose intolerance is the result of a decreased production of intestinal lactase (don’t get these two confused), which is the enzyme that breaks down lactose into glucose and galactose (monosaccharides). Lactase is found in along the walls of our small intestine, liver and kidneys. Without lactase we cannot properly breakdown the lactose carbohydrates in our small intestine and bacteria further down must do the job, which can cause flatulence, bloating, cramps and nausea.

Most humans produce lactase when they are babies because lactose is the main carbohydrate found in breast milk. Whether we continue to produce this enzyme after being weaned off of breast milk is dictated by genetics. This is referred to as lactase persistence and is the most common in people of European decent.

Lactose intolerance can also develop later in life and can sometimes just be a passing phase. It is usually as a result of damage to the epithelial cells that line the gut and are primarily responsible for lactase production. This can be the result of food poisoning or a bout of something like viral gastroenteritis. Additionally lactase production is dependent on right balance of bacteria in your gut so if things get out of whack you might end up being lactose intolerant for a while. Bacteria such as Lactobacillus should normally help to produce lactase, but when we are out of balance and have more bad bacteria it impedes this production.

Lactose can also cause problems for people that have bacterial imbalances and conditions such as small intestine bacterial overgrowth (SIBO), discussed in more detail here. The overgrowing bacteria in the small intestine ferments lactose causing significant gas, bloating and other digestive discomfort.

If you are lactose intolerant then you will probably know about it. Dairy products aren’t going to make you feel good so there is absolutely no reason why they should be part of your diet. However, not all dairy is the same and different products will have different levels of lactose and might work as good alternatives in your diet. We will look at this later on.

Lactose is a disaccharide. Many people experience symptoms of intolerance to lactose because they lack lactase, the enzyme that breaks down this disaccharide.


Casein is the primary protein found in dairy products and is structurally very similar to gluten. This is why many people that are gluten intolerant also have difficulties with casein. If you have pre-existing issues with your digestion, such as leaky gut (more) then consuming casein can be problematic, because like gluten, casein is a difficult protein for our bodies to break down. If things aren’t working properly casein can enter our gut intact, which aggravates conditions like intestinal permeability or leaky gut. With a leaky gut this can lead to the casein proteins escaping from the digestive tract and entering the blood stream, which in turn causes more of an inflammatory response throughout your body.

While casein might not be as problematic by itself, when it is in the blood stream your body will react to it because it is a foreign invader. When the body launches an attack it produces histamine, which seeks to eliminate the pathogen via sneezing, a runny, loose stools and other allergy symptoms. (3)

Symptoms of a casein allergy can be quite serious and border on anaphylactic with hives, swelling and extreme diahoerea. However, an intolerance can be much more mild but still uncomfortable. You might experience digestive issues – both ways or get a blocked nose, a foggy head or even something as seemingly unrelated as joint pain quite soon after consuming casein. Due to the impact that casein can have on the gut, many other seemingly unrelated symptoms can result. Many people who have severe acne notice improvements when they stop eating dairy.

Whey is another a protein found in dairy. You might be aware that both casein and whey are often used in body building supplements and shakes because they help to boost amino acids, which are essential for muscle building and restoration. But consuming protein in isolation is very unnatural. There is a reason that fat and protein occur together in nature and that is because protein should not be overeaten.

Giving up milk in your coffee wouldn't be the worst thing in the world. You can appreciate the hidden flavours of the coffee better.

Final words on the problematic components of dairy

Not all dairy products are structurally the same. Processes such as fermentation and whether the dairy is pasteurised or not can impact on the level of casein and lactose present, which is why butter and yoghurt might be ok for people with intolerances.

Not all dairy is created equal

Play around to see what works for you and what doesn’t. Giving up dairy doesn’t need to be the end of the world! Symptoms of a food intolerance can manifest in funny ways such as fatigue, bad skin, bloating, moodiness so removing an inflammatory part of your diet can bring huge benefits. It wouldn’t be the worst thing in the world to switch to black coffee now would it?

Please get in touch with me if you would like more support identifying food intolerances and other digestive issues.

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