Lactose intolerance, milk allergy what are the differences

Unlike cow's milk protein allergy, with which it is often confused, lactose intolerance mostly affects adults.

Lactose intolerance, milk allergy what are the differences
Lactose intolerance, milk allergy

Cow's milk protein allergy is the first food allergy to appear in children: 2 to 3% of infants before the age of 2 are affected. As with any allergy, this is an inadequate response of the immune system to non-aggressive substances normally present in the environment: allergens.

"This pathology results in a wide variety of signs such as eczema, urticaria, edema, colic, diarrhea, asthma," explains Professor Gisèle Kanny, an allergist at Nancy hospital. When the allergy is proven, which necessarily requires skin tests by an allergist, all traces of milk in the child should be removed from the diet for a period of a few months.

An approach to be practiced with a dietician in order to avoid food imbalances or cross allergies. "After this period of eviction, the allergist gradually reintroduces milk into the diet in order to shift the immune system back to tolerance. All this is done under medical supervision because the risk of anaphylactic shock, which can be fatal, is real ”, continues Professor Gisèle Kanny.

Intolerance, an enzyme deficiency

After the age of 6, most milk allergies go away. This is why very few of them are found in adults. "However, it is not completely impossible. We have, for example, seen allergic reactions in athletes who swallowed high-protein diet supplements, concentrated in milk proteins, ”emphasizes the specialist.

So, if allergies are rare, how is it that many adults complain of gastrointestinal upset when they swallow milk? This is simply because they are not allergic, but intolerant to lactose, the main sugar in milk. The food and the symptoms are the same, but the mechanisms involved have nothing to do with those of the allergy. "In lactose intolerance, you can't stand milk because of a deficiency in lactase, a digestive enzyme that breaks down this sugar," explains Prof. Gisèle Kanny.

Cheeses and yogurts

In Europe especially in France, 30 to 50% of adults have incomplete lactose digestion because, in most humans and almost all mammals, lactase activity decreases rapidly after weaning. Lactose intolerance is common and can be particularly uncomfortable, but it is not life-threatening. To avoid digestive disorders, it is enough to avoid the consumption of fresh milk and to prefer milk with reduced lactose content, or even hard cheeses and yogurts. The digestion of semi-solid (yogurt) or solid (cheese) foods is slower than that of milk and promotes digestion.

Above all, it is advisable not to remove dairy products from your diet because they provide important nutrients such as calcium and vitamin D. “In addition, if the digestive disorders were ever caused by an allergic reaction, a withdrawal of dairy products could worsen the clinical expression of the allergy, ”insists Professor Kanny. The doctor urges people who suspect a digestive allergy or intolerance to milk to consult an allergist before disrupting their diet.

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