LACTOSE
INTOLERANCE
Lactose
is the complex sugar that is present
in milk and milk-containing products such as ice cream, yogurt, cheese, butter,
as well as many baked goods and processed foods. Lactose, as a natural sugar, provides energy or calories. However, lactose must be broken down into
simple sugars by the body before it can be absorbed and used for energy. The breakdown of milk sugar is accomplished
by a natural chemical or enzyme called “lactase.”
Lactose
intolerance is the inability of the
body to break down or digest the lactose in a given quantity of milk or
milk-containing products due to an insufficiency of lactase. Lactose intolerance/lactase deficiency
can be diagnosed by a breath hydrogen test or a lactose tolerance test (ingesting a given load of lactose). It can also be suspected after observing that an elimination diet of all lactose-containing products results in improvement or disappearance of symptoms.
Lactose Intolerance is NOT an allergy to milk, but simply a situation of indigestion caused by eating excessive quantities of a substance that the body has a hard time digesting.
2. What
CAUSES Lactose Intolerance?
A gradual reduction of lactase production by the body after weaning is actually a normal situation for most of the world’s population. Since most cultures do not drink milk as adults, there is no need for continued lactase production. (i.e., the genes “shut off” lactase in adults in certain ethnic groups like African-Americans, Hispanics, North and South American Indians, Orientals and Jews. Other ethnic groups like northwestern Europeans tend to produce more lactase into adulthood and have fewer digestive problems regarding milk products.)
Lactose intolerance can also occur secondarily to the following situations: severe gastritis, colitis, Crohn’s disease, gluten (wheat)-induced enteropathy, intestinal parasites or post-surgery (like gastric bypass, gastrectomy and gastric resections).
Degrees of lactose intolerance and/or lactase deficiency vary considerably in affected individuals. Some do well with small amounts of milk products in the diet. Others cannot have any lactose without suffering ill effects. Some individuals do well using products like Lactaid that break down lactose to be better utilized.
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3. What
are the SYMPTOMS of Lactose Intolerance?
The most common symptoms of lactose intolerance are: gas, bloating, diarrhea, and abdominal pain following the consumption of milk or milk-containing products. These symptoms can occur as quickly as one half hour after consuming lactose, or may be delayed up to more than 8 hours after eating depending on the amount and type of food eaten and your own particular rate of digestion and individual level of intolerance.
It may take as long as 3-5 days for severe lactose intolerance symptoms to clear, once on a lactose-free diet.
4. What
Can I Do About Lactose Intolerance?
The best treatment is to avoid milk and milk-related products as much as possible. Labels should be read carefully with attention to the words: milk, lactose, milk solids, whey, curds, skim milk powder, and skim milk solids. AVOID THESE.
In addition, the following foods may contain
lactose: breads, candy and cookies, cold cuts, hot dogs and bologna;
commercial sauces and gravies; cream soups, dry
cereal, frostings, frozen breaded fish and chicken; prepared and
processed foods; salad dressing containing milk or cheese, some
sugar substitutes and instant drink mixes, milk-based instant
formulas. Small amounts of lactose may
be present in non-dairy creamers, some fats(substitute spreads); liqueurs and
cordials.
If you choose to consume dairy products, try to make the portions as small as possible and to eat or drink them as close to room temperature as possible. Try to consume them as part of a meal or snack, for example: a small glass of milk with dinner would not cause as much upset as would an ice-cold glass of milk on an empty stomach.
Some individuals do well using Lactaid products that break down the lactose for you. These products include: Lactaid milk and Lactaid cottage cheese, for example. You can also buy Lactaid drops to add to lactose-containing beverages and Lactaid tablets, to be ingested prior to a lactose-containing meal.
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5. Which
Foods Contain Lactose?
ITEM Grams
Lactose
Milk, 1 cup
Whole 11
1% and 2% 9-13
Skim 12-14
Evaporated 24
Sweetened, condensed 30
Chocolate 10-12
Buttermilk 9-11
Lactaid-treated <3 grams
Yogurt**, low-fat, 1 cup 11-15
Cottage cheese, 1 cup 5-8
Pasteurized processed cheese food, 1 oz. 0.5-2.0
Other cheeses, 1 oz. 0.4-0.8
Ice cream, 1 cup 9
Ice milk, 1 cup 10
Sherbet, orange, 1 cup 4
Half and half, light cream whipped cream
Topping, 1 Tablespoon 0.5
Sour cream, 1 Tablespoon <1 gram
Level of lactose restriction is recommended on a case-by-case basis. Some people can tolerate 3-8 grams of lactose per given intake, especially if this is part of a regular meal. Others cannot.
6. How
can I get enough CALCIUM?
Reducing intake of dairy products may result in a reduction in your calcium intake. Calcium is essential for healthy bones and teeth. Alternative calcium sources are as follows:
PRODUCT AMOUNT CALCIUM(mg)
Sardines 3 oz. 372
Collards 1 cup 289
Cabbage, raw 1 cup 252
Turnip greens 1 cup 252
Oysters 1 cup 226
Spinach, cooked 1 cup 212
Rhubarb 1 cup 212
NOTE: 1 cup milk= 300 mg calcium; 1 cup yogurt (non-fruit) = 400 mg calcium