Milk is the first source of nourishment that we introduce during our life. In fact, through breastfeeding, the baby feeds on a real food capable of completely satisfying its nutritional needs. With the growth, however, the ability to digest the sugar present in milk (lactose) and its protein (casein) can be reduced.
Misura's interview with Dr. Andrea Del Seppia
Let's talk about the topic with our nutritionist, Dr. Andrea Del Seppia.
Dr. Del Seppia, what kind of sugars are present in the milk and how are they digested?
The sugar most present in milk is lactose. Chemically, lactose is a "disaccharide", or a compound sugar that during the digestive phase is broken down into two smaller units of glucose and galactose, which are then absorbed in the intestine. Physiologically, the assimilation of lactose, linked to the production of specific enzymes such as lactases produced by the intestine and the intestinal bacterial flora, may decrease over time, creating phenomena known as lactose intolerance. This condition prevents the assimilation of this sugar, which will be found in the intestine creating gastrointestinal disorders related to osmosis, or the recall of water in the faeces and fermentation in hydrogen and methane by the bacterial flora, symptoms translated into liquid stools, abdominal pain and swelling.
How do lactases behave and how does lactose intolerance develop?
Lactases are produced by our genes during the first years of life. Their production is stimulated by the intake of breast milk by the newborn. After weaning, however, gene transcription is regulated (programmed genetic decrease), which leads to a consequent and lower production of intestinal lactases. This reduction is observed in about 75% of the adult population.
What, then, is the eating behavior that must be faced with a lactose intolerance?
People with this problem will have to consume foods called delattosate, that is "lactose-free" or with low residues (such as, for example, highly matured cheeses).
From lactose sugar to casein protein ...
The milk also has a rich protein component, mainly composed of whey proteins and casein. The latter, of which cow's milk is very rich, is necessary for the coagulation of milk for the formation of cheese, but it is also the main cause of allergy to milk and derivatives.
What is an allergy and how does it differ from an intolerance?
Allergy is a very different phenomenon from intolerance, in this case, in fact, there is a real immunological response that involves our immune system and is characterized by the production of IgE antibodies. In the case of milk allergy, casein therefore behaves as an allergen, or a foreign molecule (called antigen) towards which our immune system is triggered. An allergic reaction occurs a few minutes after the ingestion of milk (10-20 minutes) and with symptoms much more violent than those of intolerance, and on various districts, such as, for example, the gastrointestinal, respiratory and skin with reactions that can lead to anaphylactic shock.
So how should you behave if you have a casein allergy?
In general, casein allergy is addressed through a dietary intervention that completely excludes milk and all its derivatives from the diet, including the so-called delactosate products that were instead recommended for those suffering from intolerance.
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