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Milk and Constipation

May 17, 2010 Written by JP       [Font too small?]

This is my second entry in a series of columns that will be carried on the Healthy Monday web site. As a reminder, the goal of the Healthy Monday program is to offer practical suggestions that may help reduce the incidence of preventable disease. In my opinion, one of the best ways to accomplish this objective is to address the underlying issues that lead to health disorders in the first place. Get to the root of the problem rather than simply rely on medications to manage symptoms.

There are certain health conditions that affect people of all ages. Chronic constipation is a good example. This reality is evidenced by the multitude of laxative drugs that are targeted to virtually every stage of life. But what’s rarely analyzed is why such disparate populations struggle with irregularity in the first place. A recent study in the May 2010 edition of the Journal of Pediatric Gastroenterology Nutrition suggests one plausible cause.

Researchers at the Hospital de Cruces, Spain conducted a trial examining the effects of dairy consumption in children living with chronic constipation. Sixty-nine youngsters took part in an examination of the relative impact of cow’s milk vs. rice milk in increasing the number of bowel movements per week.

  • 51% of the children who avoided cow’s milk (CM) demonstrated improvements.
  • A  group consisting of developmentally delayed children exhibited a 78% response rate to the CM-free diet.

The authors noted that there wasn’t any significant differences in fiber intake among the cow’s milk and rice milk groups. They also failed to find a consistent pattern of allergic reactions in the children who responded to the CM-free diet and those that did not. This determination was based on various “immunologic parameters”. This suggests that the regulating activity of CM-free diets was not the result of removing allergenic milk proteins, a previously suspected cause of constipation. (1)

If milk allergies/intolerances aren’t the culprits for the constipating symptoms found in children, then what is? I have a theory. High calcium concentrations (hypercalcemia) are known to promote constipation. Many modern diets feature a preponderance of calcium enriched foods and dairy products, and a relative lack of dietary magnesium. Magnesium is well documented as having a normalizing influence in promoting regular bowel function. Therefore, this imbalance between the levels of dietary and supplemental calcium/magnesium may be a powerful contributor to the current problem. (2,3)

Milk-Related Allergic Reactions
Source: Ital J Pediatr. 2010; 36: 5. (link)

Foods that are rich in magnesium, including green leafy vegetables, nuts and seeds are often plentiful sources of dietary fiber as well. This is relevant  because numerous studies indicate that consuming more fiber can be as effective as using over-the-counter laxatives. However, there are few distinct advantages to fiber when compared to laxatives: 1) fiber doesn’t stimulate peristaltic movement of the intestines which can lead to dependence; 2) fiber may allow for greater bioavailability of certain vital nutrients such Vitamin B12. (4,5,6)

Please keep in mind that not all dairy products are equal. In fact, select probiotic yogurts have been shown to yield “drastic and constant” benefits in patients living with constipation. As an added bonus, a recent Japanese study discovered that specially cultured yogurts also resulted in improvements in liver function and a reduction in LDL (“bad”) and total cholesterol. Not bad for a common breakfast food. (7)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well,

JP

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7 Comments & Updates to “Milk and Constipation”

  1. Mallory Says:

    i thought i was lactose intolerant, and always constipated when i ate dairy, as well as having my face break out.

    i took the advice from cooling inflammation, and started eating sauerkraut, live yogurt, kefir, pickles etc

    after a month i tried raw cheese from goats… SCORE!!!! it all went well… i think a healthy gut plays a HUGE role in constipation and milke sensitivity!!!!!!!

  2. JP Says:

    Thank you for sharing your experience, Mallory! :)

    This is great/welcome news for those that enjoy dairy and struggle with constipation. Much appreciated!

    Be well!

    JP

  3. Mark Says:

    I do not suffer from this problem, but should one consider supplementing the amount of magnesium daily along with eating more green vegetables? Is there one type of magnesium better absorbed by the body?

  4. JP Says:

    Mark,

    I think most people would benefit from adding some supplemental magnesium to their daily routine. An exception might be if your diet is already abundant in magnesium-rich foods and not top-heavy in calcium. People with poor kidney function are also advised to consult with their physicians prior to supplementing with added minerals such as magnesium.

    Magnesium citrate, glycinate and taurinate are examples of well absorbed magnesium chelates.

    Be well!

    JP

  5. tami Says:

    I HAVE A 2 YEAR OLD DAUGHTER AND SHE STARTED GETTING BACKED UP SINCE SHE WAS ABLE TO DRINK COW MILK. WELL JUST TWO WEEKS AGO I HAD TO ADMIT MY DAUGHTER INTO THE HOSPITAL BECAUSE OF THIS. SHE WAS FULL OF S***. LITERLY. WELL THEY PUMPED HER WITH GO LIGHTLY. THERE IS NOTHING LIGHTLY ABOUT THAT. WELL HER GI DOCTOR CALLED AND SAID SHE CAN NOT HAVE ANYTHING WITH MILK OR WHEY. WELL YOU NEVER KNOW HOW MUCH STUFF HAS WHEY IN IT UNTIL YOU GET A LIST. EVERYTHING ON THIS LIST WAS EVERYTHING MY DAUGHTER ENJOYS. WHAT IS SHE SUPPOSE TO EAT HORSE GRAIN? I DON’T MIND THE SOYMILK BUT EVERYTHING. MY HUSBAND AND I WANT TO FIND SOMETHING ELSE WE CAN DO THAT CAN HELP AND SHE CAN STILL EAT EVERYTHING SHE LOVES.

  6. JP Says:

    Tami,

    Fortunately there are more dairy alternatives available today than ever before. Health food stores and various online vendors are excellent resources for such products. As an example, we only drink almond milk in our household. I also frequently use coconut milk. I understand that this challenge (avoiding milk and whey) may appear very difficult at the moment. But with a little practice and research, I’m confident you’ll find suitable replacements for the foods your daughter enjoys. Many parents in similar situations have succeeded in doing so.

    Be well!

    JP

  7. JP Says:

    Updated 04/04/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27039383

    Nutr J. 2016 Apr 2;15(1):35.

    Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk.

    BACKGROUND: Cows’ milk generally contains two types of β-casein, A1 and A2 types. Digestion of A1 type can yield the peptide β-casomorphin-7, which is implicated in adverse gastrointestinal effects of milk consumption, some of which resemble those in lactose intolerance. This study aimed to compare the effects of milk containing A1 β-casein with those of milk containing only A2 β-casein on inflammation, symptoms of post-dairy digestive discomfort (PD3), and cognitive processing in subjects with self-reported lactose intolerance.

    METHODS: Forty-five Han Chinese subjects participated in this double-blind, randomized, 2 × 2 crossover trial and consumed milk containing both β-casein types or milk containing only A2 β-casein. Each treatment period was 14 days with a 14-day washout period at baseline and between treatment periods. Outcomes included PD3, gastrointestinal function (measured by smart pill), Subtle Cognitive Impairment Test (SCIT), serum/fecal laboratory biomarkers, and adverse events.

    RESULTS: Compared with milk containing only A2 β-casein, the consumption of milk containing both β-casein types was associated with significantly greater PD3 symptoms; higher concentrations of inflammation-related biomarkers and β-casomorphin-7; longer gastrointestinal transit times and lower levels of short-chain fatty acids; and increased response time and error rate on the SCIT. Consumption of milk containing both β-casein types was associated with worsening of PD3 symptoms relative to baseline in lactose tolerant and lactose intolerant subjects. Consumption of milk containing only A2 β-casein did not aggravate PD3 symptoms relative to baseline (i.e., after washout of dairy products) in lactose tolerant and intolerant subjects.

    CONCLUSIONS: Consumption of milk containing A1 β-casein was associated with increased gastrointestinal inflammation, worsening of PD3 symptoms, delayed transit, and decreased cognitive processing speed and accuracy. Because elimination of A1 β-casein attenuated these effects, some symptoms of lactose intolerance may stem from inflammation it triggers, and can be avoided by consuming milk containing only the A2 type of beta casein.

    Be well!

    JP

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