I think we need to talk about dairy in detail

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I’ve talked about dairy a few times, I think it is worth taking an even deeper dive into the subject. Dairy might not be your friend, and there’s good reasons why that might be. Let’s dig in.

Back in infancy of the current keto movement, all you saw was EAT MOAR FAT! EAT MORE CHEESE AND HWC! I bucked that line of thinking right from the start. Like many of the controversial statements and information I have pushed out consistently over the years (you can’t eat all the fat you want, calories matter, protein isn’t the devil, it is a goal, fiber might not be your friend, and sugar alcohols aren’t all free), many are starting to come around to a new way of thinking. This is good. I don’t even care if these same people slammed me time after time for contradicting their beliefs, as long as GOOD information, based off science, is now being adopted. As I mentioned in an earlier post, many read one book. It was a good book, but it was high level and didn’t get into many of the nuances that make us individuals. Right, you are unique, just like everyone else. That means dairy might not be a good option for you.

First, let’s break down the basic parts of dairy products (high-level, I’m not going to list all the amino and fatty acids in it):
1) Lactose, AKA milk sugar. Pretty much anything that has “ose” on the end is some sort of carbohydrate.
2) Whey hydrolysates (all the milk proteins)
3) Whey isolates (selected milk proteins)
4) Casein, a separate milk protein
5) Fats

#1 we try to avoid because, well, it’s sugar. Some people cannot digest it properly, resulting in “lactose intolerance.” This primarily shows up as bloating, gassy, indigestion, rashes, inflammations\fluid retention, hay fever-like symptoms. Remember these points, they will be important later.

#2 Whey hydrolysates, you will find these in non-isolate protein powders\drinks but it is also used a lot in fitness\low carb commercial products. Whey hydrolysates typically also include the protein casein, though technically casein isn’t part of whey. For example, when you make cheese or yogurt, the nasty kinda yellow juicy crap that you throw out is whey, most of the casein stays behind in the stuff you keep, but not all of it. Some remains in the whey.

#3 Whey isolate is whey hydrolysates that have been processed to remove all but the amino acids, typically through a cold-filtered process (though some companies do it chemically) that removes lactose, any stray fats, casein, and heavy metals. Typically whey isolate has the lowest instance of allergic reactions, though it is not immune to them if you do have an issue with a certain protein.

#5 I’m going to hit the fat next and leave #4 for last. Milk fats are not bad for you in most cases. They are saturated and monosaturated fats which are typically considered safe, if not healthy since that is also what is in human mother’s milk and in a similar total amount, though at different ratios – human milk is split pretty much 50\50 between the two common fats, where dairy milk is 1.5x higher in saturated fat than monosaturated fats. This also means that yeh, you probably aren’t going to have a reaction to it.

Before I hit on the last ingredient, let’s take a look at the immune response typical to allergens. When the body detects something foreign that it sees as a threat – be it a splinter in your foot, something you ate, or a biological intruder like Covid-19, it’s primary defense is the immune system. I won’t get into the deep technical details of exactly how B-cells and T-cells battle infections, instead I’m going to try to simplify this a bit. While the actual immune response to an invader isn’t simple, this is pretty much how it works:

  1. The body’s immune system thinks something is harmful to you, in most food allergies, that is a protein. Now, some may say “mistakenly thinks it is harmful” but since you can have a severe immune response, it actually IS harmful. The immune system produces IgEs (allergic antibodies, little cellular warriors) to go and attack the intruder.
  2. The interaction of the IgEs and the invading protein triggers the release of body chemicals known as “histamines.” Right, all those allergy meds out there that are “anti-histamines” are there to suppress the symptoms related to this release. Histamines have many jobs in the body – digestive, neurological, and hormonal-related tasks – but for now, we are just going to focus on their job as immune responders. Antibodies attack invaders, histamines drag them out of the body kicking and screaming. They do this in a variety of ways – through mucus out the nose & mouth, saliva, and directly out of the skin. Histamines are created all over the body in “mast cells.” When you have an immune response, the mast cells release histamines to get the invaders out. As they are exiting the mast cells, they boost blood flow to the areas affected. This helps do a variety of things – increase the speed to which “good” stuff can get to the attackers, increase oxygen and water to the attacked cells, and help shuttle antibodies and other needed chemicals to combat the intruder. This sudden influx of blood and fluids is inflammation. You get bit by a bug, it swells up. The body is fighting the toxins from the insect sting (again, most of the time it is a protein). You get a splinter, it swells up. You get poison ivy, it swells up. This is a natural response, and typically it clears in a day or two once the invader has been wiped out. In some cases, the body’s reaction is over-the-top, kind of like when you flip shit on your significant other over something that in reflection, isn’t really a big deal but at the time, it sends you right to Mars. When this happens, the result isn’t sleeping on the couch for the night or 3 days of the silent treatment, it becomes dangerous inflammation, intense localized swelling in places you don’t want to swell up like your throat and lungs. Yeh, that’s not good. This is anaphylaxis. This – if left untreated almost immediately – can be fatal. The answer to this usually is epinephrine, most commonly prescribed in an epi pen. We carry both epi pens and injectable epinephrine on our ambulances. I carry several epi pens in my “jump pack” that I keep with me in my personal vehicle in case I have to respond to an emergency directly instead of from the station in the big white van with pretty lights :). Epinephrine increases blood flow to the muscles, causing them to relax and reduce the restriction as well as bind to the overflow of histamines to help stave off the overreaction from the immune response. Right. That bee sting isn’t really what will kill you, it is your own body’s reaction to it.
Pretty white van with flashing lights

A little glimpse of one of the many compartments in Hobbit’s Jump Pack

From top to bottom: 15g glucose gel for moderate hypoglycemia, 2mg Naloxone AKA Narcan, green and yellow tubes are epi pens.

So, now we get to the heifer in the room – casein. Casein is found in most dairy products, with the highest concentrations in milk, 1/2 & 1/2, soft cheeses, cream cheese, cottage cheese, yogurt, cheese, cheese, and cheese. Get the hint? Cheese might not be your friend, as much as we all love cheese. The worst offenders when it comes to casein in cheese, again, are the soft cheeses like mozzarella, cream cheese, Monterey, Colby, Jack, Gouda. Those sound familiar, don’t they? Like all the cheeses bloggers insist you use in keto recipes (note: I’m a little different, you won’t find a lot of cheese in my recipes for this exact reason, plus cream cheese is for bagels and cheese cake, not freaking bread). Lots of bloggers and recipes use cheese & casein specifically to replace gluten. Casein is what makes the soft cheeses stretchy, exactly what gluten does to wheat products. This gives structure and chew to wheat-free recipes (whey isolated and glucomannan can help a little in replacing casein, btw). Unfortunately, it isn’t always the perfect solutions.

Unlike lactose intolerance which is the inability to digest it, casein is an allergen. Remember me saying most allergens are proteins? Casein is a protein. The response to casein can be bloating, gassy, indigestion, rashes, inflammations\fluid retention, hay fever-like symptoms. In severe cases can result in severe inflammation, localized swelling of the lips, tongue, and esophagus, as well as anaphylaxis, a potentially fatal allergic reaction. Some of that sound familiar? Kinda like lactose, huh? Well, without the dying part. Here’s the thing, like some allergies, you might not see the symptoms in this way or at all. Every spring I get a crappy rash under my Apple watch. At first I thought it was a reaction to the nickel they use in the casing and clasp so I put on a cover and used a band with a plastic clasp. Didn’t help at all. Turns out, it is seasonal pollen allergies – specifically birch and maple pollen – that the histamines being released through my skin react with sweat under the watch and pollen on my skin, causing the irritation. Yup, no sneezes, puffy and weeping eyes, I get an intense itch trying to keep track of time. Bah, time is overrated anyway :D. Casein is ingested. The affected cells might not be visible, which means the inflammation might not be visible. Remember, inflammation is the increase of fluid to cells. That means fluid retention. Fluid has weight. You could be having an immune response and the related inflammation and not see it because it is internal. Or, you might see it and think that your body isn’t burning off the fat you want to get rid off. It might be doing just that, but you are holding onto fluids so it cancels out.

Here’s the thing with an immune response like this which isn’t immediately visible: you don’t know it is happening. You continue to eat the thing that is causing it, which means your body is constantly thinking it is under attack. If you have a casein allergy, what you are eating isn’t doing you any favors. Easiest way to determine if this is you? Cut the dairy for minimum of two weeks. See if there’s any change. If so, you found your answer. If not, it’s time to look at other things. I can tell you from my experience helping people for years, a majority of people who say “I’ve been doing keto for XXX weeks and nothing has changed” are also the people that are getting a lot of their fats from dairy products. Once they nix the dairy, things start to move. Try it, what do you have to lose except a few pounds? Wait, that ‘s the goal, isn’t it? :).

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1 Comment

  1. […] half n half? As we’ve discussed recently (and I’ve been preaching this for years), dairy isn’t always your friend. While yes, you can cut it out completely, that kinda sucks when it is iced coffee weather or if […]

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