The Prairie Doc Perspective

Agriculture, Allergy, and Malabsorption

By Richard P. Holm MD

Experts estimate that some twelve thousand years ago the agriculture industry developed.  It happened concurrently when cow milk could be collected and when wheat could be ground and made into bread.  Imagine the first time when both were shared around a kitchen table.   The next step happened when these two commodities were collected in a larger amount than one family could use and so could be traded for something else.

Villages of 150 hunter-gatherers grew much larger as milk and wheat storage, bartering and exchange occurred, and thus specialization of trades developed.  In this way farming was the catalyst for community growth, which eventually resulted in cities. Despite all the societal good these two food products have caused, however, each can result in a significant problem for some individuals.

A true milk allergy is fairly rare and occurs mostly in infants when the protein of the milk is misread by the baby’s immune system as a foreign invader.  This allergic reaction triggers the release of histamine, a cellular protein, which allows white blood cells to leak through capillaries in order to fight invaders.  The symptoms of milk allergy in babies include hives, vomiting and breathing problems.

This is different than the common condition of milk intolerance, which can develop in some infants and adults.  The condition is caused by the lack of milk sugar enzyme, which is there to make milk absorbable.  The subsequent inability to absorb milk sugar in the small intestine brings milk to the large intestine where bacteria can feed and ferment, resulting in gas and bloating.  This mild malabsorption condition is not an allergy, but troublesome, nonetheless.

Another food intolerance results from what some call an allergic reaction people have to the gluten protein of ground wheat and other grains.  These individuals can have destruction of the small intestine, severe malabsorption, vitamin deficiencies, rashes and many diffuse symptoms.  This complex condition is named Celiac disease.  Some call would argue it is not a true allergy with that point since no histamine is released.  Still it is immune driven.

Putting it all together, there is an interesting societal and medical story sharing milk and bread around the kitchen table.

Dr. Rick Holm wrote this Prairie Doc Perspective for “On Call®,” a weekly program where medical professionals discuss health concerns for the general public.  “On Call®” is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. “On Call®” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at 

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