Dairy, Dairy quite contrary!
As explained in previous posts after I became unwell earlier this year I looked into what I could do to help myself to improve my symptoms of Rheumatoid Arthritis and if there were any lifestyle changes I could make.
Last year I was introduced to the girlfriend of a friend of mine, madeline. She was diagnosed with Arthritis in her early twenties and received very little support so decided to not take any medications after some time as they made her feel so unwell and completely changed her diet; mainly cutting out dairy. Although she does still struggle from time to time madeline has managed to set up her own business and lives independently. everything she has done is amazing and she is so inspiring to me.
Going dairy-free was something that I kept thinking about but was very reluctant to do as I LOVE butter on my toast or hot cross buns as thick as the bread itself, I could eat cheese until it comes out of my ears, and clotted cream is just on another level. However after discussion with my husband, we came to the conclusion that I had nothing to lose. I would not eat dairy for 3 months and see if I felt any better. If there was little or no difference then no love would have been lost but if it did, it would be worth the small sacrifice.
At first I was conscious of it all the time. Everything seemed to have dairy in it! I wasn’t keen on making substitutions – soy spread replacing butter, almond milk in my tea, vegan cakes or no cakes at all! – so found myself not drinking tea, no more toast in the mornings and eating less sweet treats. One interesting thing I did find was that most vegetarian options at the supermarket or restaurants replace meat with cheese. This meant I cooked even more than usual and really increased the amount of vegetables I was eating.
I decided I was not going to be awkward and if we went out I would not say I couldn’t eat dairy but just try to choose something that didn’t have any in, or not have a pudding. Slowly I stopped thinking about it and with Liverpool being such an amazing place to eat at the moment you cannot go to a coffee shop or restaurant without there being plant-milks and vegan options, which makes things a lot easier. i even have liverpool's only vegan supermarket about 250 yeards from my house!
After 3 months I was amazed at how I felt (albeit on lots of steroids, which muddied the waters slightly). I had also cut down my alcohol content by about 90% to about 1 glass of wine a fortnight and I thought this had helped too.
A few weeks ago I was feeling so well; spinning 4 times a week and back to working almost full time, so I found myself slacking on my food. I went back to drinking milk in a few cups of tea a day, was eating snacks at work without thinking of the ingredients and started buying slices of cake when I went to my friend’s house! I went out for dinner twice and everything I ate had an element of dairy in it. I started feeling so rubbish - my joints were hot, swollen and painful, I was more tired and my concentration wasn’t as good.
I realised there must be a correlation to my symptoms and dairy.
We then went on holiday to the South of France (possibly the worst place to go when there is cheese and pastries everywhere to be seen) and I decided to cut it out again completely. At first it was a little depressing seeing all the beautiful local produce and not diving straight in but I started feeling better again and despite lots of driving and walking my joints improved without any changes to my medication. I even drank local wine everyday and found that this had no detrimental effect (although a lot of it was vin naturale – sulphite free and so delicious) and I also ate lots of seafood more than red meat but I came to the happy conclusion that dairy really does affect the inflammation in my joints.
There is contradictory evidence for a dairy-free diet in chronic disease and no evidence that I can find advocating a dairy-free diet in Rheumatoid Arthritis. In fact calcium is very important for maintaining bone strength, which is something I need in abundance! I take calcium and Vitamin D supplements everyday anyway and have done for a long time so if you are considering a dairy-free diet then please ensure you get enough calcium and vitamins from elsewhere. I don’t personally believe the moderate amount of dairy I was consuming will have a large impact on my bone composition but I am not a metabolic expert! Dairy also contains protein and vitamin B12 so that is something to be mindful of.
Cows milk allergy can be found in children and this is a reaction to the protein within the milk. Normally it becomes evident within the first few months of life and would be very unusual for an adult to develop this in later life.
Lactose intolerance is different and is when the body is not able to digest this part of the dairy product, causing bloating or diarrhoea and lots of tummy pain. There are different levels of severity so some people eat dairy and prepare themselves for the consequences, others have severe intolerance and cannot have any dairy at all. I don’t believe I have an allergy or intolerance to lactose and have not found a significant different in my gut.
In developed countries dairy comprises 14% of consumed calories in our diets <1> and we are thought to drink 100litres of milk a year each! So the amount consumed allows theories of milk on disease to be made.
A large literature review by Alessandra Bordoni et al in 2015 <2> of 52 scientific papers about the inflammatory reaction of dairy products in adults reveals interesting conclusions. Although there is no direct mention of autoimmune disease, there is mention and consideration of obesity, diabetes and heart disease which all involve a chronic pro-inflammatory state and hyperinsulinaemia (generally higher levels of inflammation and insulin). Across the papers ‘The IS of this data set indicates an anti-inflammatory property of dairy products in subjects with metabolic disorders’. I do not have heart disease and I am not obese, but with chronic pro-inflammatory responses going on in my body too, it is interesting that I think I have had an opposing effect.
Amongst all the studies, over 50 different inflammatory markers were monitored. The most frequently looked at was CRP, TNF-α and IL-6 – a common inflammatory marker tested across all medical specialties and two others that are targeted in the biologic therapies used for autoimmune diseases. The studies varied with some showing pro-inflammatory responses after dairy, some having anti-inflammatory changes and most showing no change at all, as seen in the graph below.
Fermented dairy products that aid with good gut health are also known to be very good for us all. The Belgian Bone Club (awesome club name) wrote a paper in January of last year concluding that there is no evidence to support cutting out dairy in Rheumatoid Arthritis and is outweighed by the benefit on bone health (3). Several studies also advocate low-fat yoghurt and milk to maintain bone strength and reduce risk of frailty and stroke in later life <4,5>.
Many people will dismiss my theory but some of you may want to consider it if your chronic disease is playing up a lot. I know now that after cutting out then re-introducing dairy my body is very sensitive to it, and I have concluded that I’d rather eliminate it from my diet and help myself knowing that I have seen what positive results it can have.
I now make my own nut milk or buy it from @nutsaboutmilkliverpool, I eat less bread and cakes or eat vegan options like those from @cakeholeliverpool and I have stopped snacking at work so the knock-on affects have only been beneficial to me. I miss cheese, I miss pizza and as a true cheese lover I do not feel ready to try a vegan substitute. I’d rather leave my taste buds craving the real stuff than try to find a second best!
I cannot stress enough that everyone is different. There is no harm cutting out dairy to see if it works, but if after a few months you find no improvement then there is no point continuing it. Some people think certain supplements help, or drinking apple cider vinegar (I also recommend this for everyone, not just people with medical problems) but we have to find what works for us.
Cutting out dairy in children is something to be far more wary of as they are continuing to grow and their bones develop. Cutting down and cutting out are two different things, so as a parent this is something to think carefully about and possibly mention to your child’s doctor.
I would love to hear from those of you who are dairy-free. Why did you stop? What changes have you seen and what products have you found yourself missing, or new ones you have tried and love! Let me know as I’m always looking to try new things.
Love, Harriet x