Nutritious non-dairy options for health freaks and the lactose-intolerant

There is a wide range of nut butters, lactose-free yogurts that are a tad expensive but great for health. Just make sure you understand the ingredients before you buy

It used to be regarded as the 'white gold' and a powerhouse of good health once upon a time, for its dense nutrients and its immunity-building properties. Over the years, however, milk began falling out of favour with a health-conscious urban dweller for a variety of reasons such as dairy allergy, lactose intolerance, hormonal imbalances and a fad-driven shift to veganism. And the figure-conscious, of course, ditched it in order to shed a few pounds here and there.

But if no milk, then what? How does one get one's dose of butter, curds, cottage cheese, ice-creams and a whole lot of other goodies? The answer lies in a host of alternatives such as nut butters, coconut-milk sundaes, and several other dairy-free products that have begun inundating retail stores and cookery books. In fact, a whole new profession in vegan nutrition has spawned over after the urban consumer began regarding milk as a health inhibitor, instead of an enhancer. It might interest you to know that almost half of those intolerant to wheat gluten are also dairy intolerant.

Product differentiation

Yet, there is a fine line that divides trend and tolerance, or the lack of it. "Lactose-free, dairy-free and veganism are all different," says Delhi-based renowned nutritionist Ishi Khosla, “Lactose-free individuals can have yoghurt, buttermilk and some types of cheese, butter and ghee. Dairy-free individuals cannot consume any form of milk, yoghurt, paneer or cheese. They can eat butter and ghee while vegans usually do not consume milk, butter and ghee.” But these terms are often used, interchangeably. While lactose-free foods are dairy products stripped of the sugar, dairy-free has no dairy at all—the food is made from plants or nuts instead. Vegans avoid eating foods of animal origin and therefore the vegan diet is devoid of all animal products, including meat, eggs, dairy and even honey in certain cases.
 

What is lactose intolerance?

Simply put, it is the inability of the body to absorb lactose, a type of sugar found in dairy products. The small intestine produces an enzyme lactase that helps breakdown lactose or milk sugar into smaller sugars, such as glucose and galactose. These finally get broken down into glucose and get absorbed and used as energy. When a lactose-intolerant person takes milk or other dairy products, the lactose remains undigested and ferments in the colon, causing abdominal cramps, bloating and diarrhoea.

There are ethnic and geographic variations of lactose malabsorption and many studies point out that Indians are genetically predisposed to having more lactose intolerance than any other race. A recent study recorded abnormal lactose results in 80 per cent of South Indians and 60 per cent from the north.

Delhi-based Subhash Tandon, who developed lactose intolerance in his seventies, says it is difficult to point out exactly when it all started but “it must been there for a long time. Due to diabetes and IBS (irritable bowel syndrome), it may have worsened over the years.” He says he got the tests done by a lab suggested by 1MG and while gluten was negative, lactose intolerance was prominent. He currently uses Amul Lactose-free milk and follows his diabetologist’s advice on controlling blood sugar, and says he feels much better. “I used to feel bloated after having milk earlier, but today I still enjoy my bowl of curd,” Tandon says.

Yogurt is the one dairy product that a lactose-intolerant person can consume. Indian digital weight loss platform HealthifyMe, which provides calorie tracking and on-the-cloud fitness coaching, says people with lactose intolerance must avoid milk and all dairy products except curd and yogurt. Says a HealthifyMe spokesperson: "The bacterial cultures in yogurt can digest the lactose it contains and also aid overall digestion. Homemade yogurt is recommended as it contains live bacterial cultures. Besides, hard-aged cheeses such as parmesan and cheddar are relatively low in lactose and may be easier to tolerate than other dairy products. Be sure to add other calcium-rich foods in the diet such as leafy greens, figs, broccoli, tofu and sesame seeds to make up for lack of calcium one would get from dairy. Avoid trying out lactose-containing foods on an empty stomach when intolerance is maximum. Butter does not have any lactose and can be consumed by a lactose intolerant person."

Lactose intolerant people learn how to live with the problem. The remedy is to have a lactose-free lifestyle. Retired NRI teacher Usha Garg, who is in her late sixties, says, “I have come to terms with the disorder and today, I even make kheer with lactose-free milk and puddings with soy or almond milk.”
 

Diagnosing the problem

A simple blood test can detect lactose intolerance, says Dr Nilesh Shah, President and Chief of Science & Innovation, Metropolis Healthcare Ltd. “The lactose tolerance test determines the body's reaction to a lactose-rich drink. A blood sample is drawn after two hours of consuming the liquid to measure the blood glucose levels. If the blood glucose levels do not rise after two hours, the most likely cause is lactose intolerance." For infants and children who are unable to undergo a blood test, a stool acidity test may be used. The fermenting of undigested lactose creates lactic and other acids that can be detected in the stool sample. A hydrogen breath test also may be used at times to determine lactose intolerance but blood tests are the most reliable method of diagnosis.

The bad news is that the problem isn't reversible. Says Dr Shah, “There is no way to boost the body’s production of lactase, but it is possible to minimise the symptoms with dietary interventions.” Avoiding large servings of milk and other milk products is helpful. Intake of small portions of dairy products with regular meals is seen to be helpful. Typically, doctors may also advise intake of probiotics that greatly aid digestion. Also, it is important for lactose intolerant people to consume other foods rich in calcium and make sure that optimal vitamin D is maintained for bone health.

Dairy-free in the Indian market

For those going dairy-free either out of choice or compulsion, there are many alternatives such as almond milk, soy milk, tofu, rice milk, coconut milk, oat milk, peanut butter, cashewnut butter and such like. Dairy-free milk can be made at home from a variety of nuts or seeds like almond, cashew, pumpkin seeds. Soak the nuts and blend them with water. Strain the mixture and add any natural sweetener like honey or maple syrup. Refrigerate and consume within a day or two.

With growing demand, there is increasing supply of such products, with large FMCGs entering this segment. Says a Nestlé India spokesperson, “As a part of the consumer-centric approach our brands adopt, we are always looking at emerging trends and customising our portfolio accordingly. We have products in the food and beverage space which do not contain lactose.“

Epigamia's yoghurts and artisanal curds are also finding takers for their range of lactose- and dairy-free yoghurts. For Rohan Mirchandani, CEO, Epigamia, who grew up in the US and made Greek yoghurt an integral part of his diet, it was important to bring in high-protein, low-fat products that contained the goodness of natural fruits. “Our products have no preservatives and are 99.5 per cent lactose-free,” he assures. The takers are people in the 28-35 age bracket.

Drupe Foods India Pvt Ltd sells almond milk, peanut butter and vegan chocolates on Amazon India. "Our biggest consumer is the millennial mother, says Meeta Madhok, Founder, Drupe Foods India. "Today’s new-generation mother has made up her mind not to feed her child with dairy. She understands that the cow is a lactating mother when you are milking her, and all those hormones are being carried forward. No wonder so many 15- or 16-year-old children are on birth control pills because they are going through PCOD, PCOS, hormonal imbalance, anger and mood swings.” She says the problem with tetra pack milk is that it is pasteurised at 145 degrees Celsius and everything natural evaporates, so it has to be fortified with nutrients externally. ”It's just like having synthetic vitamin and calcium pills. There is nothing natural about the milk left.” 

Drupe pasteurises the almond mix at lower temperatures of 60-80 degrees. Such products come at a premium – while a litre of milk in the market costs Rs 40 in pouches and Rs 75 in tetra pack, here a 200-ml pack made from pure almond comes for Rs 100. Reading the ingredients is sacrosanct, advises Madhok, “If you read the ingredients you would know that there are many that you cannot even pronounce. But every consumer must read the ingredients – the golden rule to follow is that if you can read and pronounce them easily, then you should consume the product."

Recipe: Lactose-free kheer

Portion: One serving

Prep time: 30 minutes

Cooking time: 40 mins

Total time: One hour and 10 minutes

Ingredients

• 1 litre Drupe Almond Milk
• ¼ cup Rice
• 6 qts Green powdered cardamoms
• 5 tbsp Date syrup (as required)
• 15 Almonds (sliced)
• A pinch of Saffron
• 1 tbsp Raisins

Method

1. Heat the drupe almond milk, until it comes to a boil.
2. Drain the rice in the meantime and keep it aside.
3. Reduce the flame of the drupe almond milk and add rice.
4. Stir continuously and simmer the drupe almond milk, letting the rice grains cook.
5. Cook in a low flame for 35-40 mins.
6. Add date syrup, according to the requirement.
7. Peel the almonds and slice them.
8. Rinse the raisins and powder the cardamom after removing the peels.
9. Add the almonds, cardamom powder and saffron.
10. Serve hot or cold in bowls.

Courtesy Drupe Foods

Price list of lactose- and dairy-free products
Regular Dairy	Price (Rs)	Lactose-free/dairy-free	Price (Rs)
Milk (1 litre)	40	Lactose-free milk (1 litre)	100
		Soy milk	150
		Oat milk	380
		Rice milk	500
		Almond milk	450-600
Curd (400 g)	40	Epigamia curd vegan (400 g)	70
Paneer (1 kg)	275-350	Tofu (1 kg)	500
Butter (250 g)	110	Peanut vegan butter (250 g)	475
		Cashew nut vegan butter	550
Cheese (200 g)	215	Cheese lactose-free (200 g)	450
Chocolates (150 g)	125	Vegan chocolates (150 g)	400
Ice-cream (500 ml)	100	Dairy-free ice-cream (500 ml)	350