The Paleo Ketogenic Diet - PK Dairy

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(By Dr Sarah Myhill and Craig Robinson)

Stylistic note: Use of the first person singular refers to me, Dr Sarah Myhill. One can assume that the medicine and biochemistry are mine, as edited by Craig Robinson, and that any classical and mathematical references and quotes or historical and linguistic notes are Craig’s!

Please see My book "The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds" for more detail.

Preface

This page is one of 4 pages on the Paleo Ketogenic Diet. Please see also:

The history of dairy products and humans

Many passages and quotes from bygone days extol the virtues of dairy products, especially milk. Exodus 33.3 talks of the “land flowing with milk and honey” as a promised land. Lady Macbeth fears that her husband is too full of the “milk of human kindness”, again placing “milk” as a positive notion in our psyche. So, the belief that dairy products are healthy for us is very entrenched in our culture. It is well then to pause and consider this Received Wisdom and consider the facts.

“We do not receive wisdom; we must discover it for ourselves.”
Marcel Proust, 10 July 1871- 18 November 1922, French novelist, critic and essayist.

So, with that in mind, let us return to why it is that dairy products, even when not mixed with Cleopatra’s poisons, are so dangerous to us…..

Why dairy products from the cow, the goat and the sheep are so dangerous to health

Dairy products have created numerous health problems in Westerners for the following reasons:

  • Dairy products are major allergens

Dairy products cause allergy reactions in, I estimate, at least 20% of the population. The allergen (ie milk protein) remains the same throughout life but the target organ changes. New-born babies may suffer projectile vomiting due to the pyloric stenosis triggered by milk protein. Even if mum is breast-feeding this tough protein will get into the breastmilk if mother is consuming it. Three-month colic is typical of dairy allergy. But then, the target organ changes – next we see toddler diarrhoea. The tot may grow out of this problem but then becomes catarrhal with snotty nose, snoring, cough and recurrent upper respiratory tract infections including otitis media, tonsillitis, sinusitis and bronchitis. Asthma may be diagnosed and inhalers prescribed.

Later on in life, dairy allergy manifests with snoring, migraine, irritable bowel syndrome, depression and arthritis. I get a painful hip if I eat dairy products - as a child I was told I had “growing pains” – what a joke! Indeed, I used to chat away with the late Dr Honor Anthony, Consultant Allergist. She maintained that nearly all cases of arthritis were caused by allergy. At the time I dismissed this notion – I now know she was absolutely spot on! If arthritis is not from allergy to foods then it probably results from allergy to microbes spilling over into the blood stream from the fermenting gut (this is called bacterial translocation). Dr Anthony’s obit can be found here - Honor Anthony, MBChB Obit

In the long term, chronic undiagnosed allergy often results in fatigue. I see many patients with chronic fatigue syndrome. A particularly common progression is the undiagnosed dairy allergic child picking up recurrent infections, especially tonsillitis, then getting glandular fever and switching in to a post viral chronic fatigue syndrome. See "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis"

  • Lactose Intolerance

This results when one lacks the enzyme to digest milk sugar (lactose). It occurs in 5% of Northern Europeans and 90% of Africans and Asians. If lactose cannot be digested it gets fermented in the gut by microbes to produce some, or all, of the symptoms of upper fermenting gut such as bloating, pain, reflux, nausea, indigestion and diarrhoea. Please see my book “Sustainable Medicine – whistle blowing on 21st medical practice” for much more detail on this. Many cultures, such as those in the Near and Far East, do not drink fresh milk or use cream for this reason. They can only eat fermented milks or ghee.

For those who are interested in learning more about this topic, there is an interesting website, complete with links to studies – please see here - Lactose Intolerance by Ethnicity and Region

  • Dairy products are growth promoters

Milk has evolved over millions of years as the perfect nutrition for the mammalian baby. These babies are highly dependent on good maternal care for their survival. They need to grow and become fit and strong very quickly so that they can escape predators. This would be especially true of the ancestors of our modern cows, goats and sheep. Once born there was little mother could do to protect them from predators. Within a few hours of birth, they had, at least, to keep up with the herd. Think of those wildlife programmes, with baby wildebeest being chased by carnivores! Milk was and still is full of growth promoters. Those calves, kids and lambs grew very quickly.

Human children fed dairy products also grow quickly. It is entirely natural that they suckle human breast milk but entirely unnatural that they consume the milk of other mammals. When challenged by the question “Are dairy products not natural foods”, a long stand advocate of paleo diets replied:

“Have you ever tried milking a wild bison?”
Dr Loran Cordain (1950-)

We now have a generation of youngsters who are taller and fatter than ever before. Of course, carbohydrates in the form of sugar and refined starches further impact on height and weight. Being tall and fat are both known risk factors for getting cancer. Indeed, the first positive nutritional step for preventing and treating cancer is to cut out all dairy products, sugars and carbs.

The Million Women Study concluded that:

“Cancer incidence increases with increasing adult height for most cancer sites. The relation between height and total cancer RR is 
similar in different populations.”'

See Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk Lancet Oncol. 2011 Aug; 12(8): 785–794. Jane Green, Benjamin J Cairns, Delphine Casabonne, F Lucy Wright, Gillian Reeves, Valerie Beral

We all produce about 10,000 DNA mutations every second. Some will be early cancers. The immune system is well able to identify these rogue cells and kill them off before they cause problems. But if they grow too quickly, driven by dairy products and carbohydrates, they overwhelm the immune system’s ability to cope with them and so tumours develop. As we age the imperative to avoid all dairy products increases.

  • Dairy Products increase the risk of auto-immunity

We are currently seeing epidemics of autoimmunity with 1 in 20 of the population currently affected. Of particular concern is the rise in type I diabetes in children. The three known major risk factors for this are vaccination, vitamin D deficiency and consumption of dairy products. The mechanism of this is probably due to circulating antibodies against cow’s milk protein which then cross react with self, in the case of type 1 diabetes, with the Islets of Langerhan in the pancreas.

There are numerous studies linking the consumption of dairy products with Type 1 Diabetes. The study, “Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature.”, concluded that:

“Early cow's milk exposure may be an important determinant of subsequent type I diabetes and may increase the risk approximately 1.5 times.”

Many of the studies, on which this overview study was based, were much more direct in their conclusions.

The study “Early Introduction of Dairy Products Associated with Increased Risk of IDDM in Finnish Children” (IDDM - Insulin-Dependent Diabetes Mellitus, meaning in this context, Type 1 Diabetes) concluded that:

“This is the first observational study to show that early introduction of dairy products is independently associated with an increased risk of IDDM. Adjustment for mother's education and age, child's birth order, or birth weight did not affect the results.”
  • Dairy products increase the risk of osteoporosis

When I suggest people stop consuming dairy the immediate riposte is “What about my calcium?”. “Will I not get osteoporosis?” In fact, calcium is a side issue - there is plenty of calcium (and more important than calcium is magnesium) in PK foods – but two greater issues are:

  • how well is calcium (and magnesium) absorbed? …...and
  • where is it deposited?

Vitamin D is the key. Vitamin D greatly enhances the absorption of calcium (and magnesium) but, as importantly, stimulates its deposition in bone.

Indeed magnesium is more important than calcium in the prevention and treatment of osteoporosis. The proportion of calcium to magnesium in dairy products is 10:1 but our physiological requirements are 2:1. Since calcium and magnesium compete for absorption, dairy products induce a magnesium deficiency. It may be that this is the mechanism by which dairy products increase the risk of osteoporosis.

  • Dairy products are a risk factor for heart disease

A good friend and colleague, Dr David Freed, produced a paper called “The Cow and the Coronary”. It concluded that the non-fat aspects of milk (the poor calcium/magnesium ratio, lactose and milk factor antibodies) strongly correlated with deaths from heart disease. Milk factor antibodies bind to platelets resulting in sticky blood.

Conclusion: do not eat dairy products but butter may be OK

If you suffer no symptoms or diseases and are otherwise completely well then the only dairy product I permit is butter. Dairy fat is the safest part of dairy products. Better than butter is ghee. This is butter which has been warmed so the dangerous cow’s milk protein floats to the top and is scraped off as a white scum leaving a clear yellow pure fat behind.

PK dairy products

Giving up dairy products was, for me, a bereavement. I so loved cream! However, the products below have changed all that and I now enjoy PK alternatives. This is largely because coconut milk and palm oil have the almost identical medium chain fats to dairy products. These medium chain fats impart a similar smooth texture which means that we can make excellent dairy alternatives. These can be used interchangeably with dairy in the following ways:

'Diary product' PK version Notes
PK milk Soya milk, coconut milk and other such nut milks. Choose those that are non-GM and free from sweeteners
PK single cream Grace coconut milk Comprised solely of coconut milk and water. Fabulous creamy texture. An absolute essential for the PK diet Note the carton form is far superior to the tinned form.
PK double cream Grace coconut milk blended with coconut oil using lecithin – see below
PK clotted cream As above – but use more coconut oil
PK yoghurt Coyo Choose the plain yoghurt. The flavoured varieties have added fruit or sugar. See recipe below.
PK butter “Crisco butter flavour all vegetable shortening” or

“Tiano organic exquisite 3 coconut spreadable.”

The problem with margarines is that they contain hydrogenated fats which will be partly comprised of trans fats. These margarines are free of trans fats.
PK cheese The vegan cheeses are not quite the same as dairy cheeses but make an acceptable substitute.Eg vegusto cheese Eg Bute Island do a range of excellent vegan cheese A bit pricey so I use them sparingly!

They do contain yeast - so yeast allergics beware! Do check the carb content. You can get these from Goodness Direct mail order

PK ice cream An ultra quick version is simply to pour Grace coconut milk over frozen berries and put in deep freeze for a few minutes. Avoid the dairy free commercial ice creams which are high in sugar. See recipe below
PK chocolate 95 or 100% dark chocolate A bar of this last me several days. This tells me I am not addicted to it. Most people are addicted to the sugar and dairy content of chocolate – I know this from my own experience- a bar of “normal” less than 85% coco solids chocolate I cannot ignore!
PK coconut chocolate See recipe below Easy to make, inexpensive and satisfying

Recipes

'Product' Ingredients Action
PK double cream Grace coconut milk 80%. Coconut oil 20% - ½ tspn lecithin per 500ml Pour the milk and lecithin into the nutribullet or equivalent

Warm up the oil so it pours and add to the milk. Whizz up for a few seconds Put in fridge and it sets to double cream consistency

PK clotted cream As above but use coconut oil 40% As above
PK yoghurt Grow Kefir on soya milk. Pour off excess whey. Coconut oil 20%. ½ tspn lecithin per 500ml Pour the Kefir soya milk and lecithin into the nutribullet or equivalent

Warm up the oil so it pours and add to the milk. Whizz up for a few seconds Put in fridge and it sets to double cream consistency

PK ice cream-Quick version Cup of Grace coconut mil. ¼ tspn lecithin. Frozen berries – not more than a handful or it clogs up in the machine. Make this in small batches otherwise it freezes solid and will not mix.

Pour coconut milk and lecithin into the nutribullet (or equivalent). Add berries and immediately whizz it all up before it freezes. It should turn into a slush. Pour into small container and freeze. If I want a large amount I do this in several small batches - a film of coconut milk on the inside helps to prevent the setting solid in the nutribullet. I have done it wrong lots of time by being greedy and doing too big a batch at once! You will too!

PK ice cream-Long version Ingredients as above. But sieve out the skins and pips and put the slush into an ice cream maker. This stirs the mix constantly so preventing ice crystals forming. This imparts that wonderful silky smooth texture. I rarely make this because the above version is so quick, so easy and so good with minimal washing up AND contains all the goodness of the berry skins. I told you I was lazy!
PK coconut chocolate Pour a whole 460gm pot of coconut oil into a pan and warm.

For mild chocolate add the same volume of pure cocoa powder (or 1 x 125gram pot of Greens and Blacks cocoa powder) For dark choc add twice the amount ie 2 x 125 pots of Green and Blacks. Mix together. Pour into ice cube containers and put in deep freeze.

Eat this PK chocolate direct from the deep freeze. It melts in the mouth just like chocolate. Coconut oil has a lower melting point than chocolate fat - it will run off the table if served at room temperature!

You can of course make this using pure coco butter but this is rather expensive!

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