Cow's milk is a mixture of more than 20 components, including proteins such as casein, α-lactoalbumin and ß-lactoglobulin, bovine serum albumin and bovine immunoglobulins, which are involved in allergic reactions and sugars such as lactose, which is implicated in gastrointestinal intolerance reactions (1,2).
The abusive use of cow's milk has led to an increase in the incidence of diseases associated with milk consumption (2), which are divided into two groups:
a) Allergy to Cow's Milk Proteins (CMPA), which can be: mediated by IgE antibodies, not mediated by IgE antibodies or mixed (3,2);
b) Lactose intolerance, which may be due to congenital hypolactasia/lactasia, primary adult-type hypolactasia (HPTA)/acquired or secondary hypolactasia. The latter is usually associated with damage to the intestine caused by inflammatory bowel disease, celiac disease or intestinal infections (4).
The main point of the treatment of Cow's Milk Protein Allergy is the exclusion of cow's milk and its derivatives, while in Lactose Intolerance such a strict diet is not necessary, but only the reduction of the intake of foods that contain lactose (3). . In either case, it is important to know how to identify the presence of milk on the label.
Milk and milk-based products, including lactose, are part of the list of allergenic foods that must be mentioned on labels by European legislation (3,5). This list excludes whey used in the preparation of alcoholic distillates and lactitol (5). See below for an explanation of these exceptions.
In cow's milk protein allergy, cross-reaction with milk from other mammals, namely sheep, goat or donkey milk, may occur. This happens because the organism confuses the proteins of the different milks due to their similarities, reacting in the same way (1). Lactose is also present in cow's, goat's and sheep's milk (4). For this reason, the legislation contemplates the prominent labeling for all milk coming from the mammary gland of farm animals and not just from cows (1,5).
How to identify milk on labeling: (1,3,6)
Cow's milk, goat's milk, sheep's milk, condensed milk, evaporated milk, skimmed milk, powdered milk, whey, whey, cream, casein, caseinates, hydrolysates (from casein, from milk and whey), lactalbumin, β-lactoglobulin, casein rennet, lactalbumin phosphate, lactoglobulin, lactulose, lactose, flavors, butter, artificial butter flavor, butter fat, butter oil, cream, cheese, curd, yoghurt.
E966 Lactitol - although it is a derivative of lactose, the EFSA, taking into account data from scientific studies, considers it unlikely that lactitol will cause adverse reactions in lactose intolerant individuals and that lactitol is not very likely to trigger adverse reactions in individuals allergic to lactose. cow's milk under normal conditions of use, for this reason it is not mandatory to highlight it on the label (7).
Distilled beverages made from whey - include gin, genever, pastis, ouzo, aniseed, aquavit, vodka, jagertee, advocaat, slivovice and other similar spirits. EFSA has noted that proteins, peptides and lactose are not transported into the distillate during a properly controlled distillation process, at least not above 0.5 mg/L for protein and 0.04 mg/L for lactose and therefore considers that whey-based distillate is unlikely to trigger a severe allergic reaction in susceptible individuals, so its labeling is not mandatory (8).
It should be noted that the fact that a food is presented as lactose-free does not make it safe for people with CMPA – milk and its lactose-free derivatives have a protein composition identical to that of lactose-containing products, which is why they are also allergens (3).
Fidu products do not contain milk or lactose. We also do not handle any ingredient that may be contaminated with milk in our facilities. In this way, we guarantee that there is no cross-contamination by traces and that our products are safe even for the most sensitive.
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Important Note: The content of this article is merely informative and should not replace medical indications.
(1) Pereira, ACS, Moura, SM, & Constant, PBL (2009). Food allergy: immune system and main foods involved. Semina: Biological and Health Sciences, Londrina, 29(2), 189–200.
(2) Ferreira, S., Pinto, M., Carvalho, P., Gonçalves, JP, Lima, R., & Pereira, F. (2014). Allergy to cow's milk proteins with gastrointestinal manifestations. Born and Grow, 23(2), 72–79.
(3) SPAIC Food Allergy Interest Group, 2017. Food Allergy: Concepts, Advice and Precautions, 1st Edition. Lisbon: Portuguese Society of Allergology and Clinical Immunology with support from Thermo Fisher.
(4) Garcia, PB (2016). Lactose intolerance. Problematic and Food. University of Salamanca.
(5) Regulation (EU) No. 1169/2011 of 25 October 2011 of the European Parliament and of the Council of the European Union.
(6) Pádua, I., Barros, R., André, M., & Pedro, M. (2016). Food allergy in catering. In National Program for the Promotion of Healthy Eating.
(7) EFSA. (2007a). Opinion of the Scientific Panel on Dietetic Products, Nutrition and Allergies on a request from the Commission related to a notification from CEPS on whey used in distillates for spirits pursuant to Article 6 paragraph 11 of Directive 2000/13/EC. EFSA Journal, 5(10), 565.
(8) EFSA. (2007b). Opinion of the Scientific Panel on Dietetic Products, Nutrition and Allergies on a request from the Commission related to a notification from the EPA on lactitol pursuant to Article 6, paragraph 11 of Directive 2000/13/EC- for permanent exemption from labelli. EFSA Journal, 5(10), 570.