Everybody needs milk. That is what the advertising says, but it is not really true. Milk might help people to develop strong bones, but for many it can be a downright health hazard. It seems that a growing number of people are having problems with milk. Whether it is lactose intolerance or a milk allergy, people are increasingly turning to milk substitutes made from soy, rice or other grains. The terms lactose intolerance and milk allergy are often used interchangeably. While the two are similar - those suffering from either should avoid milk and its by-products - they are two very different medical conditions. People who cannot digest the sugar found in milk, or lactose, suffer from lactose intolerance. It is generally estimated that about 90 per cent of Asians suffer from lactose intolerance. The condition is least common in persons of Northern European descent. A milk allergy results from a reaction to the protein found in milk. As there are two milk proteins - casein and whey - sufferers can be allergic to either or both. People suffering from a milk allergy often must avoid milk at all costs, and medical attention is often called for. The side-effects of lactose intolerance can be mild to severe. They can set in between 30 minutes and two hours after consumption. Symptoms range from bad breath and bloating cramps to gas, nausea and wind diarrhoea. Those suffering from an allergy to milk may experience stomach and intestinal reactions such as abdominal pain and bloating cramps, diarrhoea and vomiting. Nose, throat and lung reactions include coughing, a runny nose, shortness of breath, sneezing, watery or itchy eyes, and wheezing. To confuse the issue, some of the reactions due to lactose intolerance and milk allergies overlap, and symptoms for allergies to shellfish, nuts, bananas, eggs, mosquito bites and certain drugs can mirror those for milk. Avoiding milk is easier said than done. Milk is found in obvious products such as butter, cheese, ice-cream and yoghurt, but it is often added to other foods like salad dressings, snacks, spaghetti sauce, and so on. Those advised to avoid milk should learn to read closely the ingredients of nearly everything they consume. Even nominally milk-free products such as coffee whiteners and soy milk sometimes contain ingredients derived from milk. 'Smart shoppers learn to read food labels with care, looking not only for milk and lactose among the contents but also for words such as whey, curds, milk by-products, dry milk solids and non-fat dry milk powder,' says the American Gastroenterological Association. 'If any of these are listed on a label, the item contains lactose.' But eliminating milk and its by-products from your diet means that you should find other sources of calcium and key nutrients, which are necessary for a balanced diet. If you cannot consume milk, you should increase your consumption of certain green vegetables. Broccoli, bok choy, collard greens, kale and turnip greens all contain calcium. So do fish and seafood. Other sources include molasses and tofu. Another approach is to try taking lactase enzyme, which allows the digestive system to absorb lactose without unpleasant side effects. It is available in drops and capsules. Milky ways Lactose intolerence is the inability to digest significant amounts of lactose, the predominant sugar in milk. The common symptoms include abdominal discomfort, bloating, diarrhoea, gas, nausea and bad breath. Treatment depends on individual response. Avoidance is the key to preventing lactose intolerance. Asians are most prone to this disorder, which affects 30-50 million people world-wide. Lactose can be found in many prepared foods, medications, and some household products. Read product labels carefully.