An introductory diet lasting two or three days precedes fuller implementation of The Specific Carbohydrate Diet. One of the suggested foods on the"intro diet" is a cheesecake made with dry curd cottage cheese from cow's milk; it is 73% protein and very low in fat. The mention of food like this strikes fear into the heart of a person who follows the gluten-free casein-free diet They usually arrive believing dairy consumption is a most contentious protocol. making it vital to understand the nuances associated with consumption of the various dairy foods on the Specific Carbohydrate Diet.

My friend Jenny, who is celiac makes her cheesecake by dripping yogurt through a filter or cheesecloth. She cannot tolerate the dry curd cottage cheese. She makes her yogurt for cheesecake with cow's milk and drips he yogurt through a filter to drain off the galactose liquid. I use the default dry curd cottage cheese method and can react on occasion with classic bloating, itchy knees and stuffy nasal passages .

Two  separate issues arise around dairy difficulties. There is a great deal of confusion between milk allergy and lactose intolerance, Both adverse reactions are attributable to milk.

Lactose Intolerance
Lactose intolerance is a non-allergic food hypersensitivity, arising from a lack of production of  lactase, the enzyme which is required to digest the predominant sugar in milk. Lactose intolerance is a condition but not actually a disease or malady, and  affects 70% of the world's population. Both lactose intolerance and allergies are more prevalent than most people realize.

Among those over the age of five, approximately 90-95% of black individuals and 20-25% of white individuals world wide have a partial or complete lactose intolerance.

Casein Intolerance
Milk allergy is a true food allergy, the adverse immune reaction to a protein in food that is normally harmless to the non-allergic individual.

The milk protein intolerance produces a non-IgE antibody and it cannot be detected by allergy blood tests.  The protein intolerance invokes a range of symptoms very similar to milk allergy symptoms, and may also include blood and/or mucous in the stool. Treatment for milk protein intolerance is the same as for milk allergy.

A protein can become denatured when its native structure is modified, even slightly modified. "Denaturation" means that the natural structure of the protein has been disrupted and consequently the protein has taken on a new structure, a change even if  minimal.  Heat and pH variations will cause whey protein to change structure. Once that structure change occurs, in chemical the protein is considered denatured.

Once again, it is vital to understand that lactose intolerance and cow’s milk intolerance are not related.

Inability to tolerate cow’s milk is an allergic reaction triggered by the immune system.

Problems with Lactose intolerance are caused by the digestive system.

These differences have caused the gluten-free casein-free diet community to misunderstand and appear critical to the Specific Carbohydrate Diet because the diet allows dairy that has been treated to eliminate the lactose. In consideration of the true casein intolerance, the Specific Carbohydrate Diet is clear that dairy is not mandatory.

On the other hand, home incubated yogurt has powerful probiotic properties that they have the ability to neutralize bad digestive bacteria. Yogurt is highly promoted for use on the Specific Carbohydrate Diet.  Some of those who initially react to casein may  be able to eventually tolerate yogurt since the protein molecule is somewhat denatured in the fermentation process.

Seven percent (7%) of U.S. children show symptoms of cow-milk allergy such as wheezing, congestion, frequent ear infections, eczema, skin rashes and digestive troubles. In the vast majority of cases, these problems are eliminated when goat milk is substituted for cow's milk.

Goat's milk lacks the group of proteins that are the main stimulants of allergic reactions to cow dairy products.  Thus, goat milk may be tolerated once tuned into yogurt if it no longer  stresses and depresses the immune system. Those who transition from gluten-free casein-free diet to Specific Carbohydrate Diet frequently find that they tolerate the goat yogurt when it is introduced gradually in tiny amounts once thre is some healing to the damaged gut.

Cheese
The story is similar when it comes to cheese. Bacterial culture used in cheese making consumes lactose during a minimum aging period of thirty days. Soft immature cheeses still contain lactose. Soft ripened cheese like Brie is permitted but used less often than firm cheeses like Havarti, Swiss and Gouda, for example ( Cheddar is permitted but some people have a problem with the enzymes in Cheddar cheese). We suggest cultured butter on Specific Carbohydrate Diet because it has added bacterial cultures or Ghee which has had the whey skimmed off. None of the cultures in any of the approved dairy may contain bifidus.

So Harry and Mary, "How now brown cow?" (or maybe later) because, as you make progress, happily you may be able include the Specific Carbohydrate Diet correct dairy in your daily menus.

As always, Celiac.com welcomes your comments (see below).