Useful Information On Lactose Intolerance
Lactose intolerance is the inability to digest significant amounts of lactose, the
predominant sugar of milk. This inability results from a shortage of the enzyme lactase,
which is normally produced by the cells that line the small intestine. Lactase breaks down
milk sugar into simpler forms that can then be absorbed into the bloodstream. When there
is not enough lactase to digest the amount of lactose consumed, the results, although not
usually dangerous, may be very distressing. While not all persons deficient in lactase
have symptoms, those who do are considered to be lactose intolerant.
Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about
30 minutes to 2 hours after eating or drinking foods containing lactose. The severity of
symptoms varies depending on the amount of lactose each individual can tolerate.
Some causes of lactose intolerance are well known. For instance, certain digestive
diseases and injuries to the small intestine can reduce the amount of enzymes produced. In
rare cases, children are born without the ability to produce lactase. For most people,
though, lactase deficiency is a condition that develops naturally over time. After about
the age of 2 years, the body begins to produce less lactase. However, many people may not
experience symptoms until they are much older.
Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial
populations are more widely affected than others. As many as 75 percent of all
African-Americans and Native Americans and 90 percent of Asian-Americans are lactose
intolerant. The condition is least common among persons of northern European descent.
Fortunately, lactose intolerance is relatively easy to treat. No treatment exists to
improve the body's ability to produce lactase, but symptoms can be controlled through
diet.
Young children with lactase deficiency should not eat any foods containing lactose.
Most older children and adults need not avoid lactose completely, but individuals differ
in the amounts of lactose they can handle. For example, one person may suffer symptoms
after drinking a small glass of milk, while another can drink one glass but not two.
Others may be able to manage ice cream and aged cheeses, such as cheddar and Swiss but not
other dairy products. Dietary control of lactose intolerance depends on each person's
learning through trial and error how much lactose he or she can handle.
For those who react to very small amounts of lactose or have trouble limiting their
intake of foods that contain lactose, lactase enzymes are available without a
prescription. One form is a liquid for use with milk. A few drops are added to a quart of
milk, and after 24 hours in the refrigerator, the lactose content is reduced by 70
percent. The process works faster if the milk is heated first, and adding a double amount
of lactase liquid produces milk that is 90 percent lactose free. A more recent development
is a chewable lactase enzyme tablet that helps people digest solid foods that contain
lactose. Three to six tablets are taken just before a meal or snack.
Lactose-reduced milk and other products are available at many supermarkets. The milk
contains all of the nutrients found in regular milk and remains fresh for about the same
length of time or longer if it is super-pasteurized.
Milk and other dairy products are a major source of nutrients in the American diet. The
most important of these nutrients is calcium. Calcium is essential for the growth and
repair of bones throughout life. In the middle and later years, a shortage of calcium may
lead to thin, fragile bones that break easily (a condition called osteoporosis). A concern,
then, for both children and adults with lactose intolerance, is getting enough calcium in
a diet that includes little or no milk.
In planning meals, making sure that each day's diet includes enough calcium is
important, even if the diet does not contain dairy products. Many nondairy foods are high
in calcium. Green vegetables, such as broccoli and kale, and fish with soft, edible bones,
such as salmon and sardines, are excellent sources of calcium.
Clearly, many foods can provide the calcium and other nutrients the body needs, even
when intake of milk and dairy products is limited. However, factors other than calcium and
lactose content should be kept in mind when planning a diet. Some vegetables that are high
in calcium (Swiss chard, spinach, and rhubarb, for instance) are not listed because the
body cannot use their calcium content. They contain substances called oxalates, which stop
calcium absorption. Calcium is absorbed and used only when there is enough vitamin D in
the body. A balanced diet should provide an adequate supply of vitamin D. Sources of
vitamin D include eggs and liver. However, sunlight helps the body naturally absorb or
synthesize vitamin D, and with enough exposure to the sun, food sources may not be
necessary.
Although milk and foods made from milk are the only natural sources, lactose is often
added to prepared foods. People with very low tolerance for lactose should know about the
many food products that may contain lactose, even in small amounts. Food products that may
contain lactose include:
Some products labeled nondairy, such as powdered coffee creamer and whipped toppings,
may also include ingredients that are derived from milk and therefore contain lactose.
Smart shoppers learn to read food labels with care, looking not only for milk and
lactose among the contents but also for such words as whey, curds, milk by-products, dry
milk solids, and nonfat dry milk powder. If any of these are listed on a label, the item
contains lactose.
In addition, lactose is used as the base for more than 20 percent of
prescription drugs and about 6 percent of over-the-counter medicines
(including Asprin). Many types of birth control pills, for example,
contain lactose, as do some tablets for stomach acid and gas. However,
these products typically affect only people with severe lactose
intolerance.
Even though lactose intolerance is widespread, it need not pose a serious threat to
good health. People who have trouble digesting lactose can learn which dairy products and
other foods they can eat without discomfort and which ones they should avoid. Many will be
able to enjoy milk, ice cream, and other such products if they take them in small amounts
or eat other food at the same time. Others can use lactase liquid or tablets to help
digest the lactose. Even older women at risk for osteoporosis and growing children who
must avoid milk and foods made with milk can meet most of their special dietary needs by
eating greens, fish, and other calcium-rich foods that are free of lactose. A carefully
chosen diet (with calcium supplements if the doctor or dietitian recommends them) is the
key to reducing symptoms and protecting future health.
Lactose intolerance is the inability to digest significant amounts of lactose, the
predominant sugar of milk. This inability results from a shortage of the enzyme lactase,
which is normally produced by the cells that line the small intestine. Lactase breaks down
milk sugar into simpler forms that can then be absorbed into the bloodstream. When there
is not enough lactase to digest the amount of lactose consumed, the results, although not
usually dangerous, may be very distressing. While not all persons deficient in lactase
have symptoms, those who do are considered to be lactose intolerant.
Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about
30 minutes to 2 hours after eating or drinking foods containing lactose. The severity of
symptoms varies depending on the amount of lactose each individual can tolerate.
Some causes of lactose intolerance are well known. For instance, certain digestive
diseases and injuries to the small intestine can reduce the amount of enzymes produced. In
rare cases, children are born without the ability to produce lactase. For most people,
though, lactase deficiency is a condition that develops naturally over time. After about
the age of 2 years, the body begins to produce less lactase. However, many people may not
experience symptoms until they are much older.
Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial
populations are more widely affected than others. As many as 75 percent of all
African-Americans and Native Americans and 90 percent of Asian-Americans are lactose
intolerant. The condition is least common among persons of northern European descent.
Fortunately, lactose intolerance is relatively easy to treat. No treatment exists to
improve the body's ability to produce lactase, but symptoms can be controlled through
diet.
Young children with lactase deficiency should not eat any foods containing lactose.
Most older children and adults need not avoid lactose completely, but individuals differ
in the amounts of lactose they can handle. For example, one person may suffer symptoms
after drinking a small glass of milk, while another can drink one glass but not two.
Others may be able to manage ice cream and aged cheeses, such as cheddar and Swiss but not
other dairy products. Dietary control of lactose intolerance depends on each person's
learning through trial and error how much lactose he or she can handle.
For those who react to very small amounts of lactose or have trouble limiting their
intake of foods that contain lactose, lactase enzymes are available without a
prescription. One form is a liquid for use with milk. A few drops are added to a quart of
milk, and after 24 hours in the refrigerator, the lactose content is reduced by 70
percent. The process works faster if the milk is heated first, and adding a double amount
of lactase liquid produces milk that is 90 percent lactose free. A more recent development
is a chewable lactase enzyme tablet that helps people digest solid foods that contain
lactose. Three to six tablets are taken just before a meal or snack.
Lactose-reduced milk and other products are available at many supermarkets. The milk
contains all of the nutrients found in regular milk and remains fresh for about the same
length of time or longer if it is super-pasteurized.
Milk and other dairy products are a major source of nutrients in the American diet. The
most important of these nutrients is calcium. Calcium is essential for the growth and
repair of bones throughout life. In the middle and later years, a shortage of calcium may
lead to thin, fragile bones that break easily (a condition called osteoporosis). A concern,
then, for both children and adults with lactose intolerance, is getting enough calcium in
a diet that includes little or no milk.
In planning meals, making sure that each day's diet includes enough calcium is
important, even if the diet does not contain dairy products. Many nondairy foods are high
in calcium. Green vegetables, such as broccoli and kale, and fish with soft, edible bones,
such as salmon and sardines, are excellent sources of calcium.
Clearly, many foods can provide the calcium and other nutrients the body needs, even
when intake of milk and dairy products is limited. However, factors other than calcium and
lactose content should be kept in mind when planning a diet. Some vegetables that are high
in calcium (Swiss chard, spinach, and rhubarb, for instance) are not listed because the
body cannot use their calcium content. They contain substances called oxalates, which stop
calcium absorption. Calcium is absorbed and used only when there is enough vitamin D in
the body. A balanced diet should provide an adequate supply of vitamin D. Sources of
vitamin D include eggs and liver. However, sunlight helps the body naturally absorb or
synthesize vitamin D, and with enough exposure to the sun, food sources may not be
necessary.
Although milk and foods made from milk are the only natural sources, lactose is often
added to prepared foods. People with very low tolerance for lactose should know about the
many food products that may contain lactose, even in small amounts. Food products that may
contain lactose include:
- Bread and other baked goods
- Processed breakfast cereals
- Instant potatoes, soups, and breakfast drinks
- Margarine
- Lunch meats (other than kosher)
- Salad dressings
- Candies and other snacks
- Mixes for pancakes, biscuits, and cookies
Some products labeled nondairy, such as powdered coffee creamer and whipped toppings,
may also include ingredients that are derived from milk and therefore contain lactose.
Smart shoppers learn to read food labels with care, looking not only for milk and
lactose among the contents but also for such words as whey, curds, milk by-products, dry
milk solids, and nonfat dry milk powder. If any of these are listed on a label, the item
contains lactose.
In addition, lactose is used as the base for more than 20 percent of
prescription drugs and about 6 percent of over-the-counter medicines
(including Asprin). Many types of birth control pills, for example,
contain lactose, as do some tablets for stomach acid and gas. However,
these products typically affect only people with severe lactose
intolerance.
Even though lactose intolerance is widespread, it need not pose a serious threat to
good health. People who have trouble digesting lactose can learn which dairy products and
other foods they can eat without discomfort and which ones they should avoid. Many will be
able to enjoy milk, ice cream, and other such products if they take them in small amounts
or eat other food at the same time. Others can use lactase liquid or tablets to help
digest the lactose. Even older women at risk for osteoporosis and growing children who
must avoid milk and foods made with milk can meet most of their special dietary needs by
eating greens, fish, and other calcium-rich foods that are free of lactose. A carefully
chosen diet (with calcium supplements if the doctor or dietitian recommends them) is the
key to reducing symptoms and protecting future health.
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