About one in nine Americans develops gastrointestinal distress when they consume dairy products containing substantial amounts of lactose, particularly milk. Normally, the intestinal cells produce enough of the enzyme lactase to ensure that the lactose found in milk is not digested and absorbed efficiently. Lactase activity is highest immediately after birth. Lactase activity declines dramatically during childhood and adolescence to about 5-10 percent of the activity at birth. Such individuals lack the enzyme lactase and cannot metabolize lactose in the digestive track.
Because people’s tolerance to lactose varies widely, lactose-restricted diets must be highly individualized. A completely lactose-free diet can be difficult because lactose appears not only in milk and milk products but also as an ingredient in many nondairy foods such as breads, cereals, breakfast drinks, salad dressings, and cake mixes. People on strict lactose-free diets need to read labels and avoid foods that contain include milk, milk solids, whey, and casein. They also need to check all medications with the pharmacist because 20 percent of prescription drugs and 5 percent of over-the-counter drugs contain lactose as a filler.
Lactose intolerance is a common condition that occurs when there is insufficient lactase to digest lactose found in milk and milk products. Symptoms include GI distress. Because treatment requires limiting milk intake, other sources of riboflavin, vitamin D, and calcium must be included in the diet.
Symptoms
The most common symptoms of lactose intolerance are gas, bloating, abdominal pain, and diarrhea, although headache and fatigue may also occur. If you experience problems such as gas and diarrhea after consuming milk, abstain from all dairy products for 2 weeks and then evaluate the results. It the symptoms resolve, and then reoccur when you resume dairy food consumption, you may need to reduce the amount of lactase in your diet. Unfortunately this usually means a reduce intake of dairy foods, which are considered the main source of lactose and calcium. Lack of calcium may prevent the achievement of adequate peak bone mass in young adults and may make them predisposed to osteoporosis.Prevalence
The prevalence of lactose intolerance varies widely among ethnic groups, indicating that the trait is genetically determined. The prevalence of lactose intolerance is lowest among Scandinavians and other Europeans and highest among native North Americans and Southeast Asians.Dietary Changes
In some cases, milk may be consumed in small amounts, such as ½ cup of milk, without triggering adverse effects, for the intestinal track may be able to process smaller amounts. Reduced-lactose milk is available, as are enzyme supplements, such as Lactaid, to help prevent indigestion. Other dairy products which have been fermented, like yogurt, may be tolerated and provide a good calcium source. Cheese may also be a good source of calcium, but it is very high in fat. Dark green leafy vegetables, tofu, sardines, and salmon are all nondairy sources of calcium.Because people’s tolerance to lactose varies widely, lactose-restricted diets must be highly individualized. A completely lactose-free diet can be difficult because lactose appears not only in milk and milk products but also as an ingredient in many nondairy foods such as breads, cereals, breakfast drinks, salad dressings, and cake mixes. People on strict lactose-free diets need to read labels and avoid foods that contain include milk, milk solids, whey, and casein. They also need to check all medications with the pharmacist because 20 percent of prescription drugs and 5 percent of over-the-counter drugs contain lactose as a filler.
Lactose intolerance is a common condition that occurs when there is insufficient lactase to digest lactose found in milk and milk products. Symptoms include GI distress. Because treatment requires limiting milk intake, other sources of riboflavin, vitamin D, and calcium must be included in the diet.
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