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During the DRIA test , milk, butter and cheese are tested separately. However, even if a patient shows reactivity to only one or another of these substances, the dietary therapy is the same because, in any case, the reaction signals hypersensitivity to bovine proteins and fats.
For this reason, the diet excludes the entire group of substances and sometimes, if the doctor deems it necessary, beef is also excluded. The cow as a whole seems to provoke a degree of reactivity in some individuals. Even if a person only shows reactivity to cheese or butter, he must nevertheless eliminate or rotate within his diet all of the products listed below that are linked to milk.
The principal diet refers not only to milk, but to all of its by-products as well. With this in mind, it is important to realize that numerous preparations distributed by the food industry contain milk as a whole or it is present in the form of ‘milk serum, lactose or milk protein’; therefore, particular attention must be paid to contents labels that list “milk serum”, “lactoalbumin”,“lactoglubulin”, “casein”, “lactose” or “milk or bovine proteins”.
The diet also excludes milk from other animal species: the terminal part of the lactoalbumin molecule of any type of animal milk seems to rapidly give rise to a crossed reaction.
In a situation of intolerance, it’s better to gradually re-introduce milk instead of substituting it with products that are difficult to find and that can only provide temporary benefits.
Milk is present in the following products:
— Milk and milk by-products: any type of fresh or UHT milk, lactose-free milk, cream, yogurt, butter, any type of cheese whether fresh or aged and all types of prepared milk (powdered, flavored, malted, condensed, etc.). This list obviously includes parmesan and mozzarella cheeses even though for some odd reason, some people don’t consider them as “cheeses”.
— Pastries and sweets: cookies, milk chocolate and dark chocolate, pastry dough, snack cakes, pastries, wafers, cake mixes, some crackers, sweets in general such as ice cream, creams, caramel, puddings, etc., some flaked cereal mixes or muesli (like Alpen) and some special breads (read the label or ask at the bakery).
— Cold cuts and packaged meats: cooked ham, mortadella, sausage, hot dogs, ravioli meat stuffing, etc. Prosciutto (cured, raw ham), coppa, bresaola(dried salt beef), culatello ham and dried meat usually don’t contain milk or milk serum. Due to the greater attention that people are paying to food intolerances, some cooked hams are guaranteed by the manufacturer as milk-free; in this case they can be used.
— Baby foods: cookies, pasta, many strained foods, freeze-dried meats and fish, cereals.
It is also important to check the following products for the presence of milk by-products:
Many dietetic products, high protein and vitamin supplements, and mineral supplements for athletes are derived from milk protein (therefore you must always check for the presence of casein, milk serum, lactose, etc.).
Many pharmaceutical products contain lactose among the excipients: lactose doesn’t always come exclusively from milk extracts, so it’s always best to consult your doctor to find out whether a product you are using should be changed.
Many cosmetics contain milk by-products.
If the evaluation shows a crossed reaction between milk and beef, your doctor may exclude from your diet all beef and its by-products (see the profile “Beef”) as well: meat, marrow, bone, giblets, stuffed pasta, beef or mixed cold cuts, bouillon and meat extracts, ragout, paté.
Alternatives
Since it’s easy to cook without butter, the difficulty mostly arises from finding substitutes for milk itself (many people find it hard to give up), for sweets and cheese and cold cuts, foods that often solve the problem of elaborate cooking or a quick snack. As far as bread is concerned, you can ask your bakery for bread that is milk-free. If your bakery can’t guarantee it, it’s best to purchase bread elsewhere.
Milk can be replaced by all vegetable milks: almond, rice, oat, soy, and nut milk. Keep in mind that almond milk is a tasty beverage and rice and soy milk are excellent substitutes for milk in all food preparations.
It is important to note that the substitution of cow’s milk with soy milk should not be automatic, but must be evaluated during the test, since reactivity to soy in recent years (perhaps because of its wide use in the food industry) has almost reached the proportions of that of cow’s milk, that is, around 30 % of the population.
Sweets, especially mass produced, can be substituted with homemade sweets (see the recipes at end of profile), and it’s often simply a question of replacing butter with oil and milk with vegetable milk.
The cookies that accompany breakfast can be substituted by milk-free products that are readily available on the market ( be sure to check the ingredients listing to avoid lactose and milk proteins), from ladies’ fingers, amaretti, breakfast cereals, simple bread or puffed rice cakes with jam or honey.
Instead of creams, zabaglione (hot or cold) can be used and in place of ice cream, ice pops and sorbets (be sure that they are milk-free, because some are not). If reactivity to soy isn’t found, soy ice cream can be used. Now it’s even possible to find milk-free chocolate that can be used as long as the doctor consents to it.
As far as snacks, appetizers and aperitifs are concerned, the classic tartlets can be replaced by slices of grilled cornmeal mush or bread slices (read the contents because bread often contains some sort of milk) spread with various types of mousse (for example, a mousse of cooked fish that is simply processed with herbs and maybe a little mayonnaise, or of legumes, see recipe), raw vegetable matchsticks served with mayonnaise or a mousse, a vegetable frittata cut into cubes, meat or fish appetizers (see recipes that follow) or dried fruit.
When the urge for a quick snack comes on, in addition to the foods that have already been mentioned, you can always reach for a slice of prosciutto, coppa salami, bresaola or culatello ham.
In addition to the recipes below, many others can be found along with directions for the rotational diet, in the books by Attilio Speciani “Le allergie: cause, diagnosi, terapie” (with Marina Speciani Necchi), “Resistere all’inquinamento” e “Superare le intolleranze alimentari” (with Francesca Speciani), all published by Tecniche Nuove, Milan.
It is important to remember that milk (especially biological milk) is a very healthy food, rich in important nutrients and easily assimilated as long as specific forms of reactivity do not exist, for those who are intolerant, milk can be the cause of many problems.
In order to get an idea of how often phenomena such as Colitis, Constipation, Diarrhea and Anemia can be related to this form of intolerance, type the search words: “milk colitis ” or “milk anemia ” on our website.
Weekly abstinence even for those who aren’t intolerant
Even if a specific reactivity hasn’t been found, since milk and milk-based products (together with Yeast, Salt and Wheat) are among the most common food substances, it’s worth the trouble to consider taking one day per week of “abstinence” in order to free the body of any possible overload, not only of a particular food, but also from the many pollutants that it often contains (for example, the antibiotics used on the livestock).
Recipes
Homemade almond milk
100g shelled almonds, 1 liter of water
Place the almonds in a pan of boiling water and remove the peels. Chop them finely in the mixer and then place them in a container and cover them with a liter of boiling water. Let rest for 1 hour, then filter by placing a piece of cheesecloth over the strainer. After 1 hour, wring the cheesecloth containing the almonds in order to squeeze out all of the remaining liquid. The milk can be kept, refrigerated for a few days; be sure to agitate before using.
Walnut milk
100 g shelled walnuts, 1 liter of water
Process the walnuts with a glass of the water until a smooth mixture is obtained, then add the remaining water. Keeps for a few days in the refrigerator; always agitate before using.
Vegetable béchamel sauce
60 g oil, 60 g flour, 6 dl vegetable broth or soyor rice milk, pepper, nutmeg, salt
Warm the oil in a saucepan. On a low flame, add the flour and combine the two ingredients until well amalgamated. Before the flour changes color, add about ¼ of the broth, raise the flame slightly in order to heat the broth a little, then mix well. Mixing constantly, add the rest of the liquid a little at a time. If necessary, when the sauce begins to become fluid, you can use a whip in order to eliminate any lumps. Taste for salt and pepper, add a pinch of freshly grated nutmeg. When the sauce is of the desired consistency, remove from heat and use immediately. This sauce is ideal for baked pasta dishes and vegetable gratins. Instead of broth, or halfway through the cooking process, vegetable milk may be used for a creamier consistency.
Chick pea puree
350 g boiled or canned chick peas, 1 clove of garlic, salt, juice of 1 lemon, 1 hot chili pepper, chopped parsley, extra virgin olive oil for taste
Place all ingredients in the food processor and process them , diluting the mixture with a little of the cooking water if necessary. Legume mousse 1½ cups of boiled beans (or lentils or chickpeas), 2 onions, a handful of almonds (or walnuts or hazelnuts), salt, chilli pepper (or ginger). Slice the onions and sauté them in a skillet with a little oil. Add the legumes and taste for salt. Blend the mixture in the food processor, adding a little water until the mixture is of a spreading consistency.
Milk-free crepes
125 g whole wheat flour, 1 egg, pinch of salt, 300 cc soy or rice milk, a little sugar, 1 tablespoon olive oil
Beat the ingredients together with a whip or a fork until the mixture is smooth, but not too liquid. If necessary, add a little flour. Heat a non-stick skillet, passing a little oil on the surface if necessary and pour in enough mixture to just coat the bottom (move the pan to distribute the mixture evenly). After a half of a minute, turn the crepe on the other side with a spatula to cook the other side. The crepes can be covered with sugar, maple syrup, jam or vegetables.
Chocolate and almond dessert
3 egg yolks, 5 egg whites, 50 g raw cane sugar, 25 g unsweetened cocoa, 50 g white flour, vanilla, 50 shelled almonds
Heat oven to 170°C. Beat the yolks with the sugar until creamy. Add cocoa, flour, and vanilla and beat (mixture will be stiff and sticky). Chop the almonds, without removing the peels, and incorporate them into the mixture. In another bowl, beat the egg whites until quite stiff and fold carefully into the mixture. Grease a small non-stick pan, pour contents inside and level. Bake for 20-25 minutes. Remove from oven when a toothpick inserted in the center comes out clean.
Breakfast rings
250 g flour, 200 g sugar, 5 egg yolks, 1 egg white, a few drops of anis extract, vanilla (or any other flavoring), a pinch of salt
Heat the oven to 170°C . Place flour, egg yolks, sugar, salt and favoring in the bowl of the food processor and combine. Beat egg white until stiff and add to other ingredients. Turn mixture onto a floured board and knead for a few minutes, adding a little water if the dough is too stiff. Divide into 12 pieces, form rolls and close each in a ring shape, overlapping the ends. Place the doughnuts on a baking sheet lined with parchment and place in oven for 15 minutes (reduce temperature if they brown too quickly); when they are done they should be slightly golden.
Apple strudel
For the dough: 300 g flour, 4 tablespoons olive oil, a pinch of salt, water; for the filling: 1,5 kg sour, firm apples (or 1 kg apples and ½ kg pears), 100 g raisins, 150 g walnuts, grated lemon peel, 150 g raw cane sugar, extra virgin olive oil, cinnamon
Combine and knead the flour with the salt, oil and water. The dough should be relatively soft and must rest for at least one half hour. Peel the apples (and pears, if using them) and cut into slices. Place them in a bowl and cover them with half of the sugar. Chop the nuts and soften the raisins in a little water. Roll the dough into a very thin layer in order to form a wide sheet and spread the apples, drained raisins, nuts, grated lemon peel, a few pinches of cinnamon, the remaining sugar and a little oil. Roll the sheet up to form a cylinder and seal the ends firmly. Place on a parchment covered baking sheet, drizzle a little oil on the surface and bake in a 180°C pre-heated oven for 30-40 minutes.
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© This food profile is copyright of SMA Srl Servizi Medici Associati, Via Ariosto 28, 20145 Milan,
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. Health director: Dr Attilio Speciani, M.D., Clinical allergist and immunologist. This material may not be used or reproduced without the publisher’s permission.
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