The problem behind lactose intolerance is a deficiency of lactase. Lactase is an enzyme produced by the lining of your small intestine. It is a clinical syndrome, with symptoms including abdominal pain, diarrhoea, nausea, flatulence, and/or bloating after ingesting lactose-containing substances. The condition should not be confused with milk allergies, which is an immune response.
Because the lactose is not absorbed in the gut, it can draw fluids into the intestine by osmosis, which produces softer stools (diarrhoea), and the carbohydrate can be metabolised by certain intestinal bacteria that produce carbon dioxide, methane and hydrogen as waste products, thereby leading to flatulence.
Nutritional guidelines to minimise symptoms of lactose intolerance:
Drink less milk more often. Rather have small servings of milk, no more than 100ml at a time. The smaller the serving, the less likely it is to cause gastrointestinal problems.
Save milk for mealtimes. Drink milk with other foods, rather than drinking milk alone. This slows the digestive process, so you reduce your chance of experiencing lactose intolerance.
Experiment with an assortment of dairy products. Not all dairy products have the same amount of lactose. For example, hard cheeses such as Swiss or cheddar have small amounts of lactose and generally cause no symptoms. You may well be able to tolerate cultured milk products, such as yogurt, because the bacteria used in the culturing process naturally produce the enzyme that breaks down lactose.
Go for dairy alternatives. There are many alternatives to bovine milk such as goat or soya milk and dairy products. Although these products may take a little getting to, after time they be enjoyed as much as their dairy counterparts!
Watch out for hidden lactose. You may be overloading on lactose without realising it. Although milk and foods made from milk are the only natural sources of lactose, this sugar is often added to prepared foods, such as cereal, instant soups, salad dressings, milk chocolate and baking mixes. Before putting these items in your grocery cart, check their labels for milk and lactose in the ingredient list. Also look for other words that indicate lactose, such as whey, milk by-products, fat-free dry milk powder, malted milk, buttermilk and dry milk solids. In addition, you'll need to look for lactose in any prescription and over-the-counter medications you're taking. Many medicines contain lactose, but because they contain only very small amounts, they typically affect only people with severe lactose intolerance. Read more about allergies and food intolerances.
Seek other sources of calcium. If you can't tolerate dairy products in large amounts, you can get calcium in broccoli, leafy greens, canned salmon, almonds, oranges, certain kinds of tofu and soy milk, and calcium-fortified breads and juices. Consult a dietitian if you need ideas for getting more calcium into your diet.
Supplements may help you manage lactose intolerance:
Lactase enzyme tablets. These tablets contain the enzyme that breaks down lactose, reducing the amount your body must digest on its own. You can take tablets just before a meal or snack. Improvement of symptoms may vary from one person to another, but tablets do help many people.
Take a calcium supplement. Calcium supplements are helpful for many people, but especially if you have lactose intolerance and are unable to eat dairy products.
Try probiotics. Probiotics are living organisms present in your intestines that help maintain a healthy digestive system. These are sometimes used for gastrointestinal conditions such as diarrhoea and irritable bowel syndrome. They may also help your body digest lactose. Probiotics are generally considered safe if used properly and may be worth a try if other methods don't help.
Did you know?
Goat milk has become increasingly popular as an alternative for people who have allergies to cow milk.
- The fat in goat milk is easier to digest.
- The protein in goat milk is easily and rapidly digestible.
- Goat milk contains only trace amounts of the allergenic ‘casein’ protein, alpha-S1, found in cow milk.
- Goat milk contains slightly lower levels of lactose (4.1 percent versus 4.7 percent in cow milk).
- Goat milk is deficient in folic acid and has to be fortified before considering it as an infant formula.
You might also want to read this letter to sugar mommies.