Eosinophilic Esophagitis

Welcome to the Mayo Clinic Eosinophilic Esophagitis page. EoE is a relatively new diagnosis and is most commonly experienced via food sticking with swallowing in adults. This is a result of an allergic response in the esophagus. We are a leading center for research and clinical care.

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PUBLIC PAGE
Jun 5, 2019

Meet the SFED Food: Milk

By Crystal Lavey, @crystallavey

You've decided to pursue the six food elimination diet and are at the beginning of your journey.

You’ve always been a huge milk drinker and now you have to give up dairy. How will you survive? Where will you get your calcium from? Some of your friends have lactose intolerance, can I still eat lactose free foods?

Read on for answers and solutions.

Milk

Next to wheat, milk is the most common cause of food allergy in adults and is the most common allergy among children. People with a milk allergy must avoid milk in any form, including cheese, yogurt, butter, cream, pudding and others. Milk is also added to other foods in the form of whey, casein, lactalbumin and other milk derived ingredients. Milk derivatives can be found in some unexpected places such as hot dogs, margarine and even nondairy products, so it is important to read labels on all foods. A food can be labeled "nondairy" even if it has casein in it. The ingredient statement on nondairy products will list casein and the word milk if it is an ingredient. Learn to read food labels for milk ingredients.

Nutrition

Milk provides a good source of many nutrients essential for general health and especially bone health. These nutrients include protein, calcium, vitamin D, vitamin A, vitamin B 12, riboflavin and phosphorus. When you eliminate milk, you may lose these essential nutrients from your diet and will need to choose foods to replace these lost nutrients. Meat, poultry, eggs, fish, nuts and legumes can easily provide protein. However, dairy foods are our richest source of calcium and vitamin D. Most adults need 1000 mg calcium per day and 600 units of vitamin D . You can get calcium from nondairy foods but you would have to eat a lot more, as shown in the below chart. If you drink nondairy milk, make sure it has been fortified with calcium and vitamin D. Most nondairy milks do not contain these nutrients naturally. Also review the nutrition information on the package to check the amount of protein. Soy milk and pea milk are generally the closest in protein content to cow's milk. Most nondairy milks contain very little protein. If you are not able to get your quota of calcium from your diet, there is nothing wrong with taking a calcium supplement, as long as you choose one that is allergen free.

Dairy Food Calcium (mg)
Milk, 8 oz 300
Yogurt, 8 oz 300
Cheese, 1 oz 200
Nondairy Foods
Most nondairy milks, 8oz 300+
Orange juice, calcium fortified, 8 oz 300
Fortified cereals

(such as Cheerios, Rice Chex),   1 cup

100

 

Leafy green vegetables (collards, spinach), 1/2 cup cooked 120
Kale, 1/2 cup cooked 50
Tofu, 1/2 cup 150
Soybeans, 1/2 cup cooked 90
Other beans (pinto, navy), 1/2 cup cooked 40-60

 

Vitamin D is more difficult to get unless you drink milk. It may be better to take a supplement. A multivitamin will provide the daily requirement of vitamin D.

Milk Substitution

There are many milk alternatives made of seeds, grains and other foods. These include rice, hemp, flax, coconut, oat, pea and others. If you are not allergic to soy or nuts, you can also use soy, almond, cashew or macadamia nut milks. Most of these milks can be substituted 1 for 1 in recipes. Many are available in original or plain, flavored, sweetened and unsweetened. The unflavored varieties work best in recipes.

You can make your own buttermilk by adding a tablespoon of vinegar to 8 ounces of nondairy milk. Substitutes for cream include canned coconut milk or nondairy creamer. Again, always check the ingredients.

In cooking, you can substitute nondairy margarine or oil for butter. The nondairy margarine also works as a tasty spread.

Nondairy yogurt, sour cream and cream cheese products are available in many grocery stores. Milk free ice creams and other products are also available. Be sure to check ingredient statements to make sure they contain no milk ingredients. Cheeses made from soy are available in chunks or shreds for recipes that call for cheese.

Depending upon the function of the dairy product in your own recipe, sometimes you can create a safe version of the original recipe, but sometimes you're better off finding a different recipe altogether.

Have any tips or tricks for substituting dairy?

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