Lactose Intolerance: Your Complete Guide
The Dairy Alliance’s mission is to provide accurate, reliable information about lactose intolerance, a common digestive disorder. This guide will shed light on its symptoms, causes, and testing, plus, offer advice for your daily diet. Just know that you are not the only one with lactose sensitivity. In the U.S., about 36% of the adult population overall experiences some degree of lactose intolerance.
Lactose intolerance is the inability to digest the natural sugar lactose, which is found primarily in dairy foods. What causes lactose intolerance, also known as lactose maldigestion, is some people do not have enough of the enzyme called lactase. This breaks down the sugar in their digestive system. Lactose sensitivity symptoms include abdominal pain, diarrhea, gas, and uncomfortable bloating. This food sensitivity can be difficult to diagnose since symptoms can be attributed to a range of health issues such as irritable bowel syndrome known as IBS.
Let’s look at why people who are lactose intolerant can still
enjoy the goodness of drinking and eating dairy.
Two Common Misconceptions About Lactose Intolerance
Misconception 1
People who are sensitive to lactose should avoid all dairy foods.
TRUTH: Most people who are lactose intolerant can enjoy many dairy foods. For example, there is a lactose-reduced or lactose-free milk, aged hard cheeses like Cheddar or Monterrey Jack, and yogurts with live, active cultures.
Research shows most lactose-sensitive individuals can drink up to two glasses of regular milk a day with no symptoms if consumed in small quantities with food. Cooking with milk, yogurt, or cheese is an easy way to get the health benefits of dairy and avoid uncomfortable symptoms. The key is to build slowly and know your limit. Think of all the calcium you’re missing out on!
Misconception 2
Lactose intolerance means you are allergic to milk.
TRUTH: Many people confuse being intolerant with having a milk allergy. The truth is milk allergies are extremely rare. Only about 1 percent of adults and 3 percent of children are allergic to milk.
A milk allergy is a reaction to milk proteins and can cause symptoms like hives, wheezing, itching, and in severe cases, anaphylaxis. The good news is most children typically grow out of a milk allergy in their first few years. Lactose intolerance is not a disease or allergy — it is simply the digestive system’s inability to break down and digest lactose, a milk sugar.
Managing Lactose Intolerance
Being lactose intolerant doesn’t require you to avoid dairy foods. Try these easy tips for enjoying milk, cheese, yogurt, and other foods from the dairy aisle:
➪ Include natural hard cheeses such as Cheddar, Monterey Jack, Gouda, and Parmesan. When milk is made into cheese, most of the lactose is removed.
➪ Choose yogurts with live, active cultures, which help to break down lactose. Introduce small amounts of milk or milk products to help reduce symptoms.
➪ Try chocolate milk. Sometimes it is easier to digest than white milk.
➪ Try lactose-free products such as lactose-free milk and lactose-free ice cream.
➪ It's important to read food labels carefully to avoid hidden sources of lactose.
➪ Work with a healthcare professional can help you develop a personalized lactose-free diet and make informed choices about lactose-free foods.
The Implications of Untreated Lactose Intolerance
If you suspect you have lactose intolerance, testing can confirm this. Both tests measure your body's ability to process lactose and can provide valuable insights. Once diagnosed, managing lactose intolerance usually involves dietary modifications.
Untreated lactose intolerance can have long-term effects, particularly on bone health and calcium intake. Since dairy products are a primary source of calcium, lactose intolerance can lead to calcium deficiency, increasing the risk of osteoporosis and fractures.
Moreover, undigested lactose can ferment in the colon, causing symptoms like bloating, gas, diarrhea, and abdominal pain. Part of managing lactose intolerance is ensuring you get enough calcium from other sources. Lactose-free dairy products can provide the same nutritional benefits without causing discomfort. By understanding and addressing lactose intolerance, you can maintain a balanced diet and manage your condition effectively.
Common Questions about Lactose Sensitivity
What are the Symptoms of Lactose Intolerance?
Lactose intolerance includes a possible uncomfortable feeling about 30 minutes to two hours after consuming milk and milk products. Symptoms range from mild to severe, based on the amount of lactose consumed and the amount a person can tolerate. Common symptoms include abdominal pain, bloating, gas, diarrhea, and nausea.
What are the Causes of Lactose Intolerance?
This is best explained by describing how a person develops lactase deficiency. Primary lactose intolerance occurs or develops over time and begins after about age two when the body begins to produce less lactase. Most children who have lactase deficiency do not experience lactose intolerance symptoms until late adolescence or adulthood.
Can You Develop Lactose Intolerance Later in Life?
Absolutely. Lactose intolerance can occur at any age due to a decrease in lactase production.
How is Lactose Intolerance Managed and Diagnosed?
Symptoms can be managed with dietary changes. Many can tolerate some amount of lactose in their diet. Gradually introducing small amounts of milk or milk products may help some people adapt with fewer symptoms. Often, people can better tolerate milk with meals.
The doctor may first recommend eliminating all milk and milk products from the person’s diet for a short time to see if the symptoms resolve. Two tests measure the digestion of lactose. The Hydrogen Breath Test and the Stool Acidity Test help medical professionals determine the levels of undigested lactose in the patient’s diet.
Who is at Risk for Being Lactose Intolerant? Is Lactose Intolerance More Common Among Certain Ethnic Groups?
Lactose intolerance is a common condition that is more likely to occur in adulthood, with a higher incidence in older adults. Some ethnic and racial populations are more affected than others, including African Americans, Hispanic Americans, Native Americans, and Asian Americans. The condition is least common among Americans of northern European descent. It is possible to have congenital lactose intolerance. In some populations, particularly those with a long history of dairy farming, genetic mutations have led to lactase persistence, where individuals continue to produce lactase into adulthood. This adaptation is an example of human evolution in response to dietary practices.
In cultures where dairy is a staple, lactose intolerance can influence dietary habits and food preparation methods. For example, fermented dairy products like yogurt and cheese often have lower lactose levels and are better tolerated by some lactose-intolerant individuals.
What Products Contain Lactose?
All animal milk and non-fermented animal milk products contain lactose, as well as some processed foods containing animal milk or animal milk products. Other common animal milks include goat, sheep, and buffalo. Check the ingredients on food labels to find possible sources of lactose in food products. Lactose is sometimes used in prescription medicines and over-the-counter products to treat stomach acid and gas. Hard cheeses such as Cheddar, Monterey Jack, Gouda, and Parmesan contain little or no lactose.
How is Lactose Removed from Milk?
Lactose can be removed from milk if it is ultrafiltered. If milk is not ultrafiltered, lactase can be added to it to make it lactose-free. Lactase is an enzyme that breaks down the sugar lactose. Therefore, the lactose is already broken down for lactose-intolerant people.
Does Cooking Milk Remove Lactose?
No, cooking does not remove lactose.
Why is Lactose Intolerance Misunderstood?
1. Confusion with Dairy Allergy: Many people confuse lactose intolerance with a dairy allergy. While both conditions involve a negative reaction to dairy products, they are fundamentally different. Lactose intolerance is a digestive issue caused by the inability to break down lactose due to a deficiency of the enzyme lactase, whereas a dairy allergy is an immune response to proteins found in milk.
2. Variability in Symptoms: The severity of lactose intolerance can vary widely among individuals, leading to a range of symptoms that can be mild to severe. This variability can cause confusion and misinterpretation of the condition. Some people might experience only minor discomfort, while others may have significant digestive issues.
3. Delayed Symptoms: Symptoms of lactose intolerance can occur several hours after consuming lactose-containing foods. This delay can make it difficult for individuals to link their symptoms directly to lactose consumption with other foods or beverages consumed, leading to misconceptions about the cause of their discomfort.
4. Cultural Differences in Lactase Persistence: Lactase persistence, the continued production of lactase into adulthood, varies significantly among different ethnic groups. In some populations, lactose intolerance is the norm rather than the exception. This cultural variation can lead to misunderstandings about what is typical or atypical when it comes to lactose digestion.
5. Lactose Content in Foods: Many people are unaware of the lactose content in various foods and beverages. Lactose is not only found in obvious dairy products like milk and cheese but also in many processed foods where it might not be expected. This lack of awareness can lead to accidental consumption of lactose and subsequent symptoms, fostering confusion about the condition.
6. Perception of Health Issues: There is often a stigma associated with digestive issues, leading individuals to downplay or misattribute their symptoms. Additionally, the widespread consumption of dairy products and the perception of milk as a healthful food can contribute to reluctance to acknowledge lactose intolerance.
7. Misleading Labels and Marketing: Brand marketing can sometimes contribute to misunderstandings. Terms like "lactose-free" and "dairy-free" can be confusing for consumers, especially when these terms are used inconsistently.
8. Self-Diagnosis and Misdiagnosis: People often self-diagnose based on incomplete information, leading to misconceptions. Additionally, healthcare providers might misdiagnose lactose intolerance as other gastrointestinal disorders, further complicating the understanding of the condition.
Where Do I Go From Here?
Lactose intolerance, while inconvenient, doesn't prevent someone from living a regular, healthy life. Understanding personal tolerance levels allows individuals to manage symptoms effectively by moderating dairy intake rather than eliminating it completely. To highlight, lactose sensitivity is common worldwide, particularly in certain ethnic groups, and societies have adapted their cuisines and lifestyles accordingly.
Having lactose sensitivity doesn’t necessarily mean you have to miss out on dairy’s essential nutrients. There are many lactose-free or low-lactose dairy options that may work for you.
By making informed choices, individuals with lactose intolerance can maintain a balanced and healthy lifestyle.