January 9

Rheumatoid Arthritis Diet Plan – Can You Have Milk and Dairy Foods?

Dairy And Rheumatoid Arthritis

Most Westerners like cows milk because of lifelong strong positive associations with it. We think it is healthy for us. We also think that it is perfectly natural to drink and that it will strengthen our bones. Most would argue that it tastes good. But is it a human food?

Humans are the only animals that continue to drink newborn lactation fluid after weaning from their mothers. Yet it’s not even from our own kind. Humans are also the only species that drink this lactation fluid from another animal. Since this cross-species milk consumption is so unusual, it’s no surprise that about 75 percent of the world’s population is lactose intolerant. Your mother was not a Friesian heifer. Thus, humans are genetically unable to properly digest the milk from cows, and the related dairy products [1]

Casein is a protein that makes up about 80% of the total protein found in milk [2]. When ingested, casein is broken down into smaller peptides that can enter the bloodstream and cause various negative effects on the body.

One of casein’s most significant negative effects is its impact on gut health. Casein has been found to increase inflammation in the gut [3], which can lead to increased leaky gut [4]. Evidence suggests that casein may trigger an autoimmune response in some individuals, particularly those with a genetic predisposition to autoimmune diseases. Casein is a protein similar in structure to some of the body’s own proteins. Some research has suggested that consuming casein may stimulate the immune system to attack these proteins, leading to autoimmune reactions [5]. Casein has been linked to several autoimmune conditions, including type 1 diabetes [6], multiple sclerosis [7], and celiac disease [8]. Casein is also one of the most common food allergens and can cause a wide range of allergic symptoms, depending on the severity of the allergy and the amount of casein consumed. While an allergic response to casein is more common in children, it can be severe in adults [9].

It is no wonder that the scientific studies reveal negative health effects on dairy consumption:

  • When all dairy products were removed from the diet of patients with seronegative RA,  7 out of 15 went into remission [10].
  • A study in 2018 found an association between developing Rheumatoid Arthritis and the bacteria found in cows and dairy foods [11].
  • Cow’s milk consumption by humans was associated with increased gastrointestinal inflammation, worsening of digestive discomfort, delayed bowel transit time, and decreased cognitive processing speed and accuracy [12].

What about calcium?

The World Health Organization (WHO) recommends a daily calcium intake of 500mg to prevent bone fractures and maintain overall health. However, this recommendation is adjusted to 800-1000mg per day to compensate for unhealthy diets with increased calcium losses caused by high sodium intake and processed foods [13]. The EPIC-Oxford study provides evidence that both vegetarian and non-vegetarian participants who consumed at least 525mg of calcium daily had a similar risk of fractures [14]. This data suggests that meeting the daily calcium requirement, regardless of the source, may be more important for bone health.

Research shows that sourcing calcium from dairy consumption does not translate to improved bone health. According to an analysis published in the British Medical Journal, most studies fail to show any link between dairy intake and a reduction of bone breaks or fractures. In one study, researchers tracked the diets, exercise, and stress fracture rates of adolescent girls and concluded that dairy products and calcium do not prevent stress fractures [15]. Another study of more than 96,000 people found that the more milk men consumed as teenagers, the more bone fractures they experienced as adults [16].


Paddison Program - Rheumatoid Arthritis Diet plan

Two lessons – firstly, there is a lot more to achieving strong bones than just calcium intake. Secondly, we can’t label milk as a whole healthy because it contains 1 mineral that is good for us. Strong bones require a multi disciplined approach for success:

  • Calcium. However, research suggests that surplus calcium is not beneficial. Getting more than about 600 milligrams per day, which can be easily achieved without dairy products or calcium supplements, does not make bones stronger [17].
  • Vitamin K. Found in plant foods like kale and broccoli. Kale is a particularly good option, since it has an exceptionally high absorption rate of calcium
  • Vitamin D. Without enough vitamin D, only 10-15% of the calcium you consume is absorbed [18].
  • Exercise. Loading the bones increases bone density and decreases the risk of osteoporosis [19,20].
  • Fibre. Significant increases in calcium absorption occurs with the intake of prebiotic fibre called galactose-oligosaccharide which are naturally present in legumes such as lentils, chickpeas, and beans [21].

Since we can meet all of the requirements for excellent bone health without dairy consumption, we can thus avoid it’s pitfalls. Consuming dairy has been linked to increased risk for prostate cancer [22,23]. Dairy products—including cheese, ice cream, milk, butter, and yoghurt—contribute significant amounts of cholesterol and saturated fat to the diet just like meat and fish. Diets high in saturated fat can increase the risk of heart disease and stroke and can cause other serious health problems [24.25]

The most common question at this point is usually ‘what about soy milk or oat milk?’ These are included in the Paddison Program, so in the future you can enjoy these if you wish, but they are not tested until late in the reintroduction sequence since we want to first prioritise whole foods which have known gut-health properties.


[1] Silanikove, N., Leitner, G., & Merin, U. (2015). The Interrelationships between Lactose Intolerance and the Modern Dairy Industry: Global Perspectives in Evolutional and Historical Backgrounds. Nutrients, 7(9), 7312–7331. https://doi.org/10.3390/nu7095340

[2] Davoodi, S. H., Shahbazi, R., Esmaeili, S., Sohrabvandi, S., Mortazavian, A., Jazayeri, S., & Taslimi, A. (2016). Health-Related Aspects of Milk Proteins. Iranian Journal of Pharmaceutical Research : IJPR, 15(3), 573–591.

[3] Jianqin, S., Leiming, X., Lu, X., Yelland, G. W., Ni, J., & Clarke, A. J. (2016). 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. Nutrition Journal, 15, 35

[4] Al Dera, H., Alrafaei, B., Al Tamimi, M. I., Alfawaz, H. A., Bhat, R. S., Soliman, D. A., Abuaish, S., & El-Ansary, A. (2021). Leaky gut biomarkers in casein- and gluten-rich diet fed rat model of autism. Translational Neuroscience, 12(1), 601–610.

[5] Vojdani A. (2015). Molecular mimicry as a mechanism for food immune reactivities and autoimmunity. Alternative Therapies in Health and Medicine, 21 Suppl 1, 34–45.

[6]Chia, J. S. J., McRae, J. L., Kukuljan, S., Woodford, K., Elliott, R. B., Swinburn, B., & Dwyer, K. M. (2017). A1 beta-casein milk protein and other environmental pre-disposing factors for type 1 diabetes. Nutrition & Diabetes, 7(5), e274.

[7] Chunder, R., Weier, A., Mäurer, H., Luber, N., Enders, M., Luber, G., Heider, T., Spitzer, A., Tacke, S., Becker-Gotot, J., Kurts, C., Iyer, R., Ho, P. P., Robinson, W. H., Lanz, T. V., & Kuerten, S. (2022). Antibody cross-reactivity between casein and myelin-associated glycoprotein results in central nervous system demyelination. Proceedings of the National Academy of Sciences of the United States of America, 119(10), e2117034119.

[8] Kristjánsson, G., Venge, P., & Hällgren, R. (2007). Mucosal reactivity to cow’s milk protein in coeliac disease. Clinical and Experimental Immunology, 147(3), 449–455.

[9] Lam, H. Y., van Hoffen, E., Michelsen, A., Guikers, K., van der Tas, C. H., Bruijnzeel-Koomen, C. A., & Knulst, A. C. (2008). Cow’s milk allergy in adults is rare but severe: both casein and whey proteins are involved. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 38(6), 995–1002.

[10] Ratner, D., Schneeyour, A., Eshel, E., & Teitler, A. (1985). Does milk intolerance affect seronegative arthritis in lactase-deficient women?. Israel Journal of Medical Sciences, 21(6), 532–534.

[11] Sharp, R. C., Beg, S. A., & Naser, S. A. (2018). Polymorphisms in Protein Tyrosine Phosphatase Non-receptor Type 2 and 22 (PTPN2/22) Are Linked to Hyper-Proliferative T-Cells and Susceptibility to Mycobacteria in Rheumatoid Arthritis. Frontiers in Cellular and Infection Microbiology, 8, 11.

[12] Jianqin, S., Leiming, X., Lu, X., Yelland, G. W., Ni, J., & Clarke, A. J. (2016). 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. Nutrition journal, 15, 35. https://doi.org/10.1186/s12937-016-0147-z

[13] Food and Agriculture Organization of the United Nations/World Health Organization. (2001). Human Vitamin and Mineral Requirements: Report of a joint FAO/WHO expert consultation – Bangkok, Thailand. Retrieved from http://www.fao.org/3/y2809e/y2809e00.htm#Contents

[14] Appleby, P., Roddam, A., Allen, N., Key, T. and the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford Study, Group. (2007). Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. European Journal of Clinical Nutrition, 61(12), 1400-1406.

[15] Bolland, M. J., Leung, W., Tai, V., Bastin, S., Gamble, G. D., Grey, A., & Reid, I. R. (2015). Calcium intake and risk of fracture: systematic review. BMJ (Clinical research ed.), 351, h4580. https://doi.org/10.1136/bmj.h4580

[16] Feskanich, D., Bischoff-Ferrari, H. A., Frazier, A. L., & Willett, W. C. (2014). Milk consumption during teenage years and risk of hip fractures in older adults. JAMA pediatrics, 168(1), 54–60. https://doi.org/10.1001/jamapediatrics.2013.3821

[17] Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003;77:504-511. doi: 10.1093/ajcn/77.2.504

[18] Holick MF, Garabedian M. Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 6th ed. Washington, D.C.: American Society for Bone and Mineral Research; 2006:129-137.

[19] Marques EA, Mota J, Carvalho J. Exercise effects on bone mineral density in older adults: a meta-analysis of randomized controlled trials. Age. 2012;34:1493-1515. doi: 10.1007/s11357-011-9311-8

[20] Going, S., Lohman, T., Houtkooper, L., Metcalfe, L., Flint-Wagner, H., Blew, R., Stanford, V., Cussler, E., Martin, J., Teixeira, P., Harris, M., Milliken, L., Figueroa-Galvez, A., & Weber, J. (2003). Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy. Osteoporosis international 14(8), 637–643. https://doi.org/10.1007/s00198-003-1436-x

[21] Whisner, C. M., Martin, B. R., Schoterman, M. H., Nakatsu, C. H., McCabe, L. D., McCabe, G. P., Wastney, M. E., van den Heuvel, E. G., & Weaver, C. M. (2013). Galacto-oligosaccharides increase calcium absorption and gut bifidobacteria in young girls: a double-blind cross-over trial. The British journal of nutrition, 110(7), 1292–1303. https://doi.org/10.1017/S000711451300055X

[22] Qin, L. Q., Xu, J. Y., Wang, P. Y., Tong, J., & Hoshi, K. (2007). Milk consumption is a risk factor for prostate cancer in Western countries: evidence from cohort studies. Asia Pacific journal of clinical nutrition, 16(3), 467–476.

[23] Song, Y., Chavarro, J. E., Cao, Y., Qiu, W., Mucci, L., Sesso, H. D., Stampfer, M. J., Giovannucci, E., Pollak, M., Liu, S., & Ma, J. (2013). Whole milk intake is associated with prostate cancer-specific mortality among U.S. male physicians. The Journal of nutrition, 143(2), 189–196. https://doi.org/10.3945/jn.112.168484

[24] Li Y, Hruby A, Bernstein AM, et al. Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: a prospective cohort study. J Am Coll Cardiol. 2015;66:1538-1548. doi: 10.1016/j.jacc.2015.07.055

[25] Chen M, Li Y, Sun Q, et al. Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults. Am J Clin Nutr. 2016;104:1209-1217. doi: 10.3945/ ajcn.116.134460

Disclaimer: Do not take this information as personal medical advice. Do not change your diet if you are ill or on medication without the advice of a qualified health care provider (your physician, for example).


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