Beth W. Orenstein explains how some people who are lactose intolerant can have small amounts of dairy, while others must avoid it entirely.
If you’re having trouble digesting dairy lately, it might be time to try a lactose-free diet.
Feeling bloated and gassy or have cramps and nausea within a few hours of drinking milk or eating milk products, it could be lactose intolerance.
Except for very rare instances, every newborn has the ability to make lactase, an enzyme that helps the small intestine digest lactose, the sugar found in milk. But as you get older, your lactase levels can start to decline, which means there’s nothing stopping the lactose you consume from going to your colon undigested, where bacteria break the sugars down and create excess gas and fluid in the process.
According to the National Institutes of Health (NIH) it is common to develop a lactase deficiency in adulthood. In fact, about 65% of the global population has a reduced ability to digest lactose after infancy.
Your genetic makeup has a lot to do with whether you'll experience lactose intolerance. The body creates lactase when it’s instructed to do so by the LCT gene, and over time that gene can become less active. The result is lactose intolerance, which can begin after age 2 but may not manifest itself until adolescence or even adulthood.
Some ethnic groups are more prone to developing lactose intolerance than others. According to the NIH, people of East Asian, West African, Arab, Jewish, Greek, and Italian descent are the most commonly affected by lactose intolerance in adulthood.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)injury to your small intestine — whether from an accident, surgery, radiation, infection, or disease — can also leave you unable to drink milk without symptoms.
Drinking poorly treated or untreated water can also cause injury to your bowel that could result in lactose intolerance.
Digestive Problems Similar to Lactose Intolerance:
But ...no need to give up on milk just yet; — digestive discomfort can be caused by other conditions, especially as you get older. Some adults think they have lactose intolerance when they really have a different gastrointestinal issue, such as celiac disease, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD).
The symptoms of lactose intolerance and these diseases, such as abdominal pain, gas, and diarrhea, can be similar.
One difference between IBD and lactose intolerance is the presence of blood in your stool. You won’t see blood if you’re lactose intolerant, but it’s possible to see blood in your stool if you have IBD.
Normal aging may make you more sensitive to digestive disturbances, such as feeling bloated after meals. And eating certain foods that irritate the lining of the intestines or stimulate the gut to contract more quickly, such as caffeine or spicy foods, can mimic lactose intolerance symptoms.
How to Determine if You're Lactose Intolerant:
A simple way to determine whether you've become lactose intolerant is to completely eliminate milk and milk products from your diet and monitor how you feel in the following weeks. If you still have symptoms on a milk-restricted diet, you know it’s not the milk.
A breath test can provide a more definitive diagnosis, according to the NIDDK. For this test, you'll drink a beverage with lactose and then breathe into a balloon-like container so that your hydrogen level can be measured. Under normal conditions, after consuming dairy, people will have only a small amount of hydrogen in their breath. If you’re lactose intolerant, you'll produce high levels of hydrogen.
Genova Laboratories offers a fantastic breath test.
How to Manage Different Degrees of Lactose Intolerance:
Some people who are lactose intolerant can still consume small amounts of milk or milk products and not feel ill, while others find their symptoms wax and wane from time to time and from food to food.
Hard cheeses, such as cheddar and Swiss, contain less lactose than soft cheeses. Yogurt is also easier to digest than other forms of dairy.
Research suggests that people who are lactose intolerant can still consume a 12-gram dose of lactose — about equal to the amount that's in a cup of milk — and experience few or no symptoms.
In the past, it's been standard practice for people with lactose intolerance to avoid all dairy products. But experts now recommend that you keep some cheese, yogurt, and even milk in your diet. If you do consume a dairy product, try to do so with other foods, as this helps to slow down digestion, giving your body more time to break down the lactose.
It's also very important to make sure you maintain a nutritionally well-balanced diet.
Milk contains numerous vital nutrients, including calcium, protein, and vitamins A, B12, and D.
Therefore, you should make sure to supplement your diet with foods enriched with these nutrients — especially calcium and vitamin D — if you're on a lactose free-diet. Without enough calcium or vitamin D, you may develop osteoporosis late in life, a medical condition in which your bones become brittle and fragile.
To maintain healthy bones, children and adults require 1000 to 1300 milligrams of calcium and 600 to 800 international units of vitamin D each day, depending on age and sex.
There are several "lactose-free" products that are sources of calcium and/or vitamin D:
Fatty fish (tuna, mackerel, and salmon)
Fish liver oil
Calcium-fortified orange juice
Vitamin D that can also be obtained through sun exposure.
If you’re concerned you are not getting adequate amounts of calcium, vitamin D, and other essential nutrients found in dairy, talk to your doctor or work with a registered dietitian.
Dietary supplements can also help you obtain the recommended amount of nutrients you may be missing while on a lactose-free diet.
Source: Everyday Health
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