Lactose intolerance is caused by a lack of the enzyme lactase in the body. Abdominal cramps, bloating, and diarrhoea are common symptoms. The treatment centres on avoiding dairy products, switching to lactose-free foods, or using lactase supplements.
Lactose intolerance is a common digestive issue that affects many individuals worldwide. Its a disaccharide comprising one molecule of glucose and one molecule of galactose.
And Lactose is the primary sugar found in milk. As children grow, many lose their ability to digest the large amounts of lactose found in cow’s milk, leading to a condition known as lactose intolerance. This undigested ‘milk sugar’ lingers in the bowel, escaping digestion and causing significant digestive discomfort.
Lactose intolerance occurs when the body lacks sufficient lactase, the enzyme required to break down lactose in the small intestine. This enzyme activity peaks from birth through early childhood and then declines to only about 5-10% by the age of 5 on average. When a lactose-intolerant person consumes milk or dairy products, some or all of the lactose remains undigested, retaining fluid and fermenting in the large intestine. This results in gas, bloating, and abdominal cramping, with symptoms ranging from mild to severe, typically occurring 30 minutes to 2 hours after consumption of dairy foods.
Lactose intolerance varies among populations. For example, over 70% of the population in the Philippines, Japan, Taiwan, and Peru are lactose intolerant. Similar findings are observed among African Americans and Australian Aboriginals. The condition can also occur due to gastrointestinal disorders that damage the lining of the digestive tract, such as celiac disease, irritable bowel syndrome (IBS), or ulcerative colitis.
Determining whether cow’s milk should be included in your diet can be complex and highly debated. While some people can tolerate milk and dairy products well, others experience significant health problems. Most individuals can handle small to moderate amounts of cheese and butter but start noticing digestive issues with regular cow’s milk consumption. It’s crucial to note that highly concentrated dairy products like cheese, butter, cream, and chocolate can be particularly problematic.
In New Zealand, where dairy consumption is among the highest globally, digestive and immune system issues related to dairy are common. The key is moderation and understanding your body’s tolerance levels.
For those with persistent digestive issues, it might be beneficial to eliminate dairy entirely for a trial period. In my clinic, patients with ongoing bowel or digestive problems often see improvements within three months of a dairy-free diet. This approach is typically recommended after eliminating other potential irritants like fast food and alcohol.
It’s essential to distinguish between lactose intolerance and a milk allergy. Lactose intolerance stems from a lack of the enzyme lactase, while a milk allergy is an immune-mediated response to a milk protein, such as beta-casein. Symptoms of lactose intolerance include bloating, gas, and diarrhea shortly after consuming dairy, whereas a milk allergy can trigger a broader range of immune responses.
– Avoid All Milk and Dairy Products: Eliminate or reduce your intake of milk, cheese, yogurt and other dairy products. Consider alternatives like rice milk. Soy and goat’s milk may still cause issues for some individuals.
– Symptoms Similar to Celiac Disease: Both conditions can coexist. A hydrogen breath test is the most definitive way to diagnose lactose intolerance.
– Yoghurt as an Alternative: Some people can tolerate yogurt because it contains pre-digested lactose (lactic acid). Choose yogurt with live active cultures.
– Calcium Supplementation: If avoiding dairy, ensure adequate calcium intake through foods like dried figs, broccoli, almonds, sardines, molasses, tofu, and sesame seeds.
– Check Pharmaceutical Drugs: Some medications contain lactose as a filler.
– Read Food Labels Carefully: Avoid foods containing ‘milk solids’.
– Hard, Aged Cheeses: These are lower in lactose and may be easier to tolerate in moderation.
– Lactobacillus Probiotics: Beneficial for lactose intolerance as they help ferment lactose, converting it to lactic acid. –Lactase Enzymes: Taking lactase enzyme supplements before consuming dairy can help you to digest lactose more effectively.
Eliminating dairy can lead to deficiencies in essential nutrients like calcium, vitamin D, and riboflavin. To ensure adequate nutrition:
Calcium-Rich Foods: Incorporate non-dairy sources of calcium such as leafy green vegetables, almonds, tofu, and fortified plant-based milk.
Vitamin D: Spend time in sunlight and consider vitamin D supplements if needed.
Riboflavin: Include foods rich in riboflavin like eggs, lean meats, nuts, and green leafy vegetables.
Another milk sugar, galactose, can be problematic, especially for women. A Harvard University study in 1989 linked galactose consumption with a higher incidence of ovarian cancer and the development of cataracts. About 10% of the population lacks the enzyme to metabolize galactose effectively.
Understanding lactose intolerance and its implications on your health is crucial. If you experience digestive discomfort after consuming dairy, consider eliminating it from your diet and observe the changes. Consult with a healthcare professional for personalized advice and explore alternative calcium sources and probiotics to maintain a balanced diet.
Related Reading: Food Allergy vs. Food Intolerance
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