An expert’s advice confuses the mother of her “strictly vegetarian” son who has developed eczema. “My 9 year old son has developed eczema on his legs, which is bumpy and itchy. The doctor has prescribed topical creams, which improve it, but friends have suggested a lactose-free diet as he also often has a runny nose. He is a strict vegetarian, so I am reluctant to cut out a food group. I have started him on soya milk but have a problem with cheese (which most vegetarian school meals contain). He takes vegetarian omega-3 and omega-6 supplements – when I remember”
Thus runs a query addressed to the Times consultant nutritionalist (Times 2, 4 April 2006, second question), who begins her advice with warnings over environmental allergic reactions accompanied by advice that “your son’s eczema may be unconnected with food, and you need to ensure that his diet does not become unbalanced or lacking in essential nutrients.”
However, the expert advice adds: “Some parents find that cow’s milk and lactose-rich products such as cream, cheese, and milk can make children more snotty; however, there is little hard evidence to back this up and lactose is an essential source of calcium. I recommend that your son continues taking the vegetarian omega-oil supplements, as these essential fatty acids can be very effective.” After more advice the response ends with a recommendation that “if your son’s eczema persists, ask your GP for a referral to a specialist pediatric dietician to help you to work out which foods to cut out and what to replace them with, as it’s essential that you don’t deprive his body of the nutrients he needs to grow.”
We wonder what the bewildered – and occasionally forgetful – parent makes of this. Lactose is a water-soluble disaccharide that would release the sugars and galactose on hydrolysis and lactic and carbonic acids in certain fermentations. It is a disaccharide sugar peculiar to animal milks. It is not a source of calcium but accompanies the element in animal milks and is used as a sweetener in foods and beverages and pharmaceuticals and dietary supplements: it has the merit in these contexts of avoiding risks presented by other sugars such as glucose (dextrose) or sucrose in causes of tooth decay. Intolerance to lactose may be declining, but some children may suffer from an inability to deal successfully with galactose. And some children react badly with milks from plant sources such as soya.
In this case, there is an inkling of another veggie peculiarity: too high a ratio of omega 6 to omega 3 polyunsaturated fatty acid, which the supplements are unlikely to redress. Veggies have also to consider the content of long-chain PUFAs, such as DHA and EPA, derived from fish, certain sea plants, and fungi, which the supplements may not correct.
Anyway, the expert advice is confusing. Parents must scrutinize those labels!