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Life
with lactose intolerance: Food shouldn't hurt
April 10, 03
Suzanne Havala Hobbs
If
abdominal cramps, bloating, and quick
trips to the loo frequently punctuate
your days, you may not need to look much
farther for the cause than your glass of
milk.
That's especially true if you are black,
Asian, Hispanic, Native American, or of
Mediterranean descent. In other words,
just about anyone who isn’t of
Northern European or Western European
heritage.
In fact, 50 million Americans are lactose
intolerant, as are three quarters of all
adults worldwide. That figure for the
U.S. is going to grow, considering that
Census data tell us that our nonwhite
minority is going to be close to a
majority by the year 2050.
Lactose intolerance in adults is a normal
condition in which the body is unable to
adequately break down the milk sugar
lactose, resulting in a range of symptoms
that may include nausea, gas, diarrhea,
bloating, and abdominal cramps.
Like other mammals, human babies and
young children produce the enzyme lactase
to help break down the sugar found in
mother’s milk, helping it to be
digested fully so that the body can
absorb it. As mammals age, though, they
outgrow the need for mother’s milk
and move on to solid food. Most people
produce less and less lactase until many
eventually produce none or very little.
Think about it: How many grown cows have
you seen drinking milk from their
mothers? Likewise, after weaning, humans
no longer require nor do most tolerate
human milk, never mind milk from another
species.
The exception is people from northern and
northwestern Europe – the Irish,
British, Scandinavians, and others. For
them, a genetic mutation is thought to
have led to the ability to produce
lactase throughout adulthood, enabling
them to eat large amounts of milk and
milk products without suffering symptoms
of indigestion.
If you think you may be lactose
intolerant, your doctor can conduct one
or more tests to confirm or rule out your
suspicion.
However, lactose intolerance isn’t
necessarily all or nothing. Some people
who are lactose intolerant can digest
small amounts of dairy foods without
suffering symptoms. It may be a matter of
trial and error to determine your limits.
To minimize symptoms:
• Spread it out. If you’re
eating cheese at a meal, leave the milk
for later in the day.
• Limit portions. Use less milk in
your cereal, and cut in half the amount
of cheese you use in sandwiches and
casseroles. Big bonus: You’ll slash
your saturated fat intake, too.
• Know where to look. Individuals
who are particularly sensitive may need
to avoid the small amounts of lactose in
such foods as cookies and milk chocolate.
Read food labels. Ingredients such as
whey, nonfat milk solids, margarine, sour
cream, buttermilk, and others are used to
make baked goods and other products and
are enough to give some people problems.
• Experiment. Yogurt with active
cultures and hard cheeses such as sharp
cheddar, for example, contain less
lactose than milk or cottage cheese.
• Substitute. Instead of regular
dairy products, buy reduced-lactose or
lactose-free products, such as Lact-Aid
milk. Soymilk and rice milk are widely
available in supermarkets and natural
foods stores now, and many brands are
fortified with calcium and vitamins A and
D. They can be used cup for cup to
replace cows' milk in recipes, too.
• Try enzyme tablets. Pharmacies
carry products such as Lact-Aid or Dairy
Ease tablets and drops, which can be used
before meals containing dairy products.
Results vary from person to person.
"So if I choose to reduce my dairy
intake, what about calcium?" you
ask.
Complicated topic and answer. I promise
to address this in a future column.
For now, however, suffice it to say that
many, many foods contain ample amounts of
calcium. For starters, calcium-fortified
orange juice and soymilk are similar to
cow’s milk in calcium content.
Beans and greens are also rich sources,
and that’s bringing us perilously
close to the recommendations for an
overall healthy diet. It really all makes
sense.
The bottom line: Your food shouldn’t
make you hurt, and it shouldn’t make
you sick. If it does, your body is trying
to tell you something and you should
consider the alternatives. There are some
good ones.
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