Let's Talk Lactose!

Happy New Year Friends

In the spirit of fresh starts, I thought I'd write my first post of the year 2014 about the heartwarming topic of... Lactose Intolerance!

That's right, I'm talking about being a milk bigot.  Why, you might ask?  Or maybe you've already stopped reading, in which case, it doesn't matter.

I stopped being able to "comfortably" eat many dairy products in college.  The weekly lunch of cream of tomato soup in the dorm cafeteria started giving me the tell-tale symptoms:  extremely uncomfortable gas and other digestive issues.  And that's as descriptive as I'll get!  Somehow I figured out it was the milk, and when I stopped eating regular milk I felt much better.

Over the years I have heard many comments about lactose intolerance.  These range from confusion with dairy allergy to suggesting that "eating a good American diet" will help digestion.

So what exactly is Lactose Intolerance? 

According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), part of the National Institutes of Health: 

• 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.

Wikipedia offers some additional information. 

• In most cases this causes symptoms which may include abdominal bloating and cramps, flatulence, diarrhea, nausea, borborygmi (rumbling stomach), or vomiting after consuming significant amounts of lactose. 
• Some studies have produced evidence that milk consumption by lactose intolerant individuals may be a significant cause of inflammatory bowel disease.

• Most mammals normally cease to produce lactase, becoming lactose intolerant, after weaning, but some human populations have developed lactase persistence, in which lactase production continues into adulthood. It is estimated that 75% of adults worldwide show some decrease in lactase activity during adulthood. 
• Did you know borborygmi is a real word?

Lactose Intolerance is NOT an allergy!  The Food Allergy Research and Education website explains the difference:

•  A food allergy is an overreaction of the immune system to a specific food protein. When the food protein is ingested, in can trigger an allergic reaction that may include a range of symptoms from mild symptoms (rashes, hives, itching, swelling, etc.) to severe symptoms (trouble breathing, wheezing, loss of consciousness, etc.). A food allergy can be potentially fatal.

• Unlike food allergies, food intolerances do not involve the immune system.  While lactose intolerance can cause great discomfort, it is not life-threatening.

Which foods contain the most Lactose?

• Whey (a byproduct of cheesemaking which may be an ingredient in many processed foods), powdered and condensed milk, and coffee creamer have the highest percentages.  
• Whole and low-fat milk (cow, goat and sheep) are next highest.  People who have an allergy to cow's milk may be able to tolerate goat's milk, but this is different than lactose intolerance.
• Wikipedia has a great chart that lists the lactose content of various foods.

What can you eat if you are Lactose Intolerant?

• Yogurt with live and active cultures usually has lower levels of lactose.  According to the Yoplait website:  The live and active cultures Lactobacillus bulgaricus and Streptococcus thermophilus are the two cultures added to milk to create yogurt. Yoplait also adds Lactobacillus acidophilus to some of our yogurts.  The live and active cultures help break down lactose, the natural milk sugar found in dairy products.  

• Some people are able to eat cheese, especially hard cheese which is aged longer and has less lactose remaining.  There is some interesting info on cheese here

• Lactose-reduced milk is a good alternative for most people.
•  Some people may be able to eat some high-lactose foods occasionally or in combination with other foods.  Some will be very sensitive to the smallest amounts.  
• Unfortunately, heating or baking with dairy foods does not reduce the lactose content.  Most commercially available milk is already heated as part of the pasteurization process anyway, and further heating will also not change the chemical structure of lactose.  

Remember, this is a very individual thing.  Everyone has different tolerance levels for different foods and eating patterns.  Experiment to find what works for you!

Happy Eating!

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