What do you know about Lactose Intolerance.

What is lactose intolerance? Lactose intolerance is the inability or insufficient ability to digest lactose, a sugar found in milk and milk products. Lactose intolerance is caused by a deficiency of the enzyme lactase, which is produced by the cells lining the small intestine. Lactase breaks down lactose into two simpler forms of sugar called glucose and galactose, which are then absorbed into the bloodstream.

Not all people with lactase deficiency have digestive symptoms, but those who do may have lactose intolerance. Most people with lactose intolerance can tolerate some amount of lactose in their diet.

People sometimes confuse lactose intolerance with cow milk allergy. Milk allergy is a reaction by the body’s immune system to one or more milk proteins and can be life threatening when just a small amount of milk or milk product is consumed. Milk allergy most commonly appears in the first year of life, while lactose intolerance occurs more often in adulthood.

What causes lactose intolerance? The cause of lactose intolerance is best explained by describing how a person develops lactase deficiency.

Primary lactase deficiency develops over time and begins after about age 2 when the body begins to produce less lactase. Most children who have lactase deficiency do not experience symptoms of lactose intolerance until late adolescence or adulthood.

Researchers have identified a possible genetic link to primary lactase deficiency. Some people inherit a gene from their parents that makes it likely they will develop primary lactase deficiency. This discovery may be useful in developing future genetic tests to identify people at risk for lactose intolerance.

Secondary lactase deficiency results from injury to the small intestine that occurs with severe diarrheal illness, celiac disease, Crohn’s disease, or chemotherapy. This type of lactase deficiency can occur at any age but is more common in infancy.

What are the symptoms of lactose intolerance? People with lactose intolerance may feel uncomfortable 30 minutes to 2 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
• abdominal bloating
• gas
• diarrhoea
• nausea

How is lactose intolerance managed? Although the body’s ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes. Most people with lactose intolerance can tolerate some amount of lactose in their diet. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by taking them with meals.

The amount of change needed in the diet depends on how much lactose a person can consume without symptoms. For example, one person may have severe symptoms after drinking a small glass of milk, while another can drink a large glass without symptoms. Others can easily consume yogurt and hard cheeses such as cheddar and Swiss but not milk or other milk products.

The Dietary Guidelines for Americans 2005 recommend that people with lactose intolerance choose milk products with lower levels of lactose than regular milk, such as yogurt and hard cheese.

Lactose-free and lactose-reduced milk and milk products, available at most supermarkets, are identical to regular milk except that the lactase enzyme has been added. Lactose-free milk remains fresh for about the same length of time or longer than regular milk if it is ultra-pasteurized. Lactose-free milk may have a slightly sweeter taste than regular milk. Soy milk and other products may be recommended by a health professional.

People who still experience symptoms after dietary changes can take over-the-counter lactase enzyme drops or tablets. Taking the tablets or a few drops of the liquid enzyme when consuming milk or milk products may make these foods more tolerable for people with lactose intolerance.

Parents and caregivers of a child with lactose intolerance should follow the nutrition plan recommended by the child’s doctor or dietician.

Lactose Intolerance and Calcium Intake Milk and milk products are a major source of calcium and other nutrients. Calcium is essential for the growth and repair of bones at all ages. A shortage of calcium intake in children and adults may lead to fragile bones that can easily fracture later in life, a condition called osteoporosis.

What other products contain lactose? Milk and milk products are often added to processed foods—foods that have been altered to prolong their shelf life. People with lactose intolerance should be aware of the many food products that may contain even small amounts of lactose, such as

• bread and other baked goods
• waffles, pancakes, biscuits, cookies, and mixes to make them
• processed breakfast foods such as doughnuts, frozen waffles and pancakes, toaster pastries, and sweet rolls
• processed breakfast cereals
• instant potatoes, soups, and breakfast drinks
• potato chips, corn chips, and other processed snacks
• processed meats, such as bacon, sausage, hot dogs, and lunch meats
• margarine
• salad dressings
• liquid and powdered milk-based meal replacements
• protein powders and bars
• candies
• non-dairy liquid and powdered coffee creamers
• non-dairy whipped toppings

Checking the ingredients on food labels is helpful in finding possible sources of lactose in food products. If any of the following words are listed on a food label, the product contains lactose:

• milk
• lactose
• whey
• curds
• milk by-products
• dry milk solids
• non-fat dry milk powder

Lactose is also used in some prescription medicines, including birth control pills, and over-the-counter medicines like products to treat stomach acid and gas. These medicines most often cause symptoms in people with severe lactose intolerance.

Many dairy products can be replaced by non dairy look-alikes such as goat, soy, and other calcium building dairy alternatives.