Dairy-Free Diet
What is the Dairy-Free Diet?
The Dairy-Free is a diet in which all dairy products are removed from the diet. There are two main types of proteins in milk, whey and casein. Some people have an allergy or sensitivity to one or both of these milk proteins. You may have also heard of people avoiding dairy because they are lactose intolerant. Lactose is a milk sugar, not a protein. People that are lactose intolerant typically experience gastrointestinal upset after eating dairy foods because they are not able to break down this sugar in their gastrointestinal tract.
The dairy-free diet is often used in combination with the gluten-free diet because some people that have a sensitivity to the protein gluten are also sensitive to casein, because the two proteins have a similar molecular structure. When used together, the gluten-free, casein-free diet is referred to as GFCF.
Gluten and casein are often referred to together because it has been hypothesized that when these proteins are improperly digested (which is often the case among those with autism), the result is large peptides, gluteomorphins and caseomorphins, which can be absorbed through the damaged and permeable gut lining, and have an opiate-like effect on the body by crossing the blood brain barrier and binding to opiate receptors in the brain. This is called the “opioid excess theory” and it has neither been confirmed nor disproved. [1]
What about Lactose-Free, A2 Milk, or Milk Alternatives?
Lactose is the sugar in milk while casein and whey are the proteins. Removing the lactose in milk will help those who are lactose intolerant and cannot breakdown the sugar, but it will not help those who are sensitive or allergic to the protein(s) in milk: whey and casein. It is not possible to remove whey or casein from milk, so the person will have to consume a milk alternative if sensitive or allergic to milk proteins.
For those that are sensitive (not allergic) to casein, they may be able to consume A2 milk. This is because within the casein family, there are different forms including A1 and A2 beta-casein. The breed of cow determines how much A1 or A2 beta-casein will be present in the milk. Goat and sheep milk are also predominantly A2 milk. Some people that are sensitive to A1 may be able to tolerate A2 milk. This would still not be appropriate for those who have a dairy allergy.
Lastly, you can choose to avoid dairy altogether by choosing milk alternatives. While these can be great, you certainly want to watch out for added ingredients and sugar. Read the milk alternatives note to learn more!
Is the Dairy-Free Diet Beneficial for Autism?
In many cases a dairy-free diet can be beneficial, especially for those that test positive for dairy sensitivity, casein antibodies, or those that notice reactions to dairy products.
The true effect of a dairy-free diet for children with autism is hotly debated in the research. It is common for researchers to look at the combination of a gluten and casein-free diet. Some studies show a clear benefit while others show none. [2, 3]
One study reported that most children with ASD (79.5%) had increased levels of specific IgG antibodies to casein, indicating that sensitivity to casein is quite common among children with ASD. [4]
Some of the reported benefits include improved gut health and a reduction in autism symptoms, with gluten-free diets, casein-free diets, pre- and probiotic and multivitamin supplementation. [5] One meta-analysis showed that a GFCF diet can reduce stereotypical behaviors and improve the cognition of children with ASD. [6]
Should Everyone on the Spectrum Go Dairy-Free?
There is no one diet, supplement, or lifestyle for everyone on the autism spectrum. Autism is called a spectrum for a reason, and your child’s body is so much more complex than that! That being said, we do see that a dairy-free diet can be life-changing for some individuals! This is because they have a dairy sensitivity, an allergy, or leaky gut to begin with. If your child has one or some of the following symptoms, it may be worth trialing a dairy-free diet with the support of a dietitian:
Abdominal pain or cramping
Diarrhea or constipation
Skin rashes
Gas and bloating
Joint pain
Excess mucus production
Frequent ear or sinus infections
People who experience the above reactions to dairy foods are most likely to benefit from this diet. These reactions indicate an inflammatory response within the body and removing the most likely offending foods may reduce these symptoms.
Going Dairy-Free
Recommended Foods
Ensuring intake of calcium rich foods is important for those eliminating dairy from their diet. Calcium rich foods include:
Calcium fortified non-dairy milks and non-dairy yogurts made from coconut, rice, cashew or almond milk
Calcium fortified juice
Calcium fortified cereals
Canned fish with bones (salmon, sardines)
Soy products (tofu, tempeh, edamame)
Almonds, sesame seeds and poppy seeds
Leafy greens (kale, collard greens, bok choy)
All other food groups may be included in the casein-free diet including vegetables, fruits, meat, poultry, fish, eggs, non-meat proteins like beans, nuts, seeds, and grains. Eggs are not a dairy product and can be eaten and are a good source of protein and fat.
Recommended Supplements
Potentially calcium if the diet is limited and adequate alternative sources are not included.
Adequate vitamin D levels are necessary to absorb calcium. It may be important to assess vitamin D status, especially if limiting access to calcium rich foods.
My favorite Dairy-Free Brands
I find that shopping for dairy-free brands is easiest at health food stores, such as Whole Foods, Sprouts, and Natural Grocers. Trader Joe’s also has many dairy-free options. My favorite brands are listed below, though availability to these brands will vary per location. If you don’t have access to health food stores in your area, you could consider signing up for Thrive Market (exclusive discount through this link). I put a ⭐️ next to my personal favorites from a taste & ingredient perspective.
Milk
The following have the cleanest & fewest ingredients (i.e. no fillers, gums, etc), and may not be widely available
⭐️ MALK (my personal favorite)
⭐️ Make your own! Learn how here.
Three Trees
Beber
Elmhurst
The following are more available but may include additional ingredients than just “nuts and water”
⭐️ Ripple Milk
Made from pea protein. Contains a great serving of protein and calcium, comparable to cow’s milk
Learn more in the pea milk note
Califia
Silk
Almond Breeze
Cheese
⭐️ Miyokos is my absolute favorite!
So Delicious
Daiya
Follow Your Heart
Violife
Siete has a delicious cashew-based queso
Butter
⭐️ Miyokos
Earth Balance
Melt
Ghee
Yogurt
Ice Cream
⭐️ Nadamoo
⭐️ Make your own “Nice Cream” with frozen bananas, maple syrup, cocoa powder, and a little cinnamon in a food processor or by using this Yonanas machine
⭐️ Cado (made with avocados)
So Delicious
Oatly
Ben & Jerry’s
Most sorbets will be naturally DF, just read the label
Others
Mac & Cheese —> Banza, Daiya, Amy’s
Pizza —> Daiya, Amy’s
Cream Cheese —> Kite Hill
Sour Cream —> Forager
Chocolate —> Enjoy Life
**Need a recommendation for a product? Post in the Community Forum!**
Foods to Avoid
All dairy products should be avoided including:
Milk
Yogurt
Cheese
Butter
Sour cream
Ice cream
Pudding/custard
Half and half
Cream-based soups
Sherbet
Cheese flavored snacks
Ghee is clarified butter, in which the proteins have been removed and it may be tolerated, though tolerance may vary from person to person
It is important to note that lactose-free dairy products are those in which the milk sugar lactose has been removed. However, these items still contain the milk protein casein. Lactaid would not be an appropriate milk choice because it still contains casein.
Be aware that casein can be added to many foods that you may not suspect, like baked goods or chocolate. Just because a food is labeled “dairy-free” or “non-dairy”, this does not mean that it does not contain casein or derivatives of casein. To determine if a product contains casein, look at the ingredients list. Any ingredient that contains casein will be listed, followed by a parenthesis around the word “milk”. At the bottom of the ingredients list you may also see , in bold print, “CONTAINS: milk”. This is not required but many manufacturers include this in their labeling. If you do not see any of these indicators, you can feel confident that the product does not contain dairy.
Casein-Free Cookbooks
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
The Bottom Line
The dairy-free diet is best suited for those that have an allergy or sensitivity to dairy proteins and/or lactose intolerance. If your child is displaying symptoms of food sensitivity and dairy is a big part of their diet, a dairy-free diet may be worth a try.
