Lactose Intolerance

Lactose Intolerance is a very common condition affecting most of us if we live long enough. There are a couple of different types of lactose intolerance. There is primary lactose intolerance which occurs at birth and is relatively rare. Much more common is secondary lactose intolerance which can be a product of the aging process or can follow an intestinal infection or other condition that affects the small intestine.

Milk contains lactose which is a sugar. Lactose intolerance results when you cannot digest or absorb lactose. Like table sugar, lactose is a disaccharide which means it is two sugar molecules connected together. Unlike table sugar Lactose contains different simple sugars which are connected by a bond that requires a special enzyme to break. This enzyme is called lactase. Lactase is absent in people who have primary lactose intolerance and is either absent or decreased in people with secondary lactose intolerance.

What happens as a result? The lactose that is ingested is not broken down into simple sugars. Since it cannot be absorbed as a disaccharide, it remains in the small intestine and forces water to remain in the intestine. This creates distention (bloating), discomfort and rumbling noises in your gut. When the lactose and its fluid reach the colon, they cause more problems. The colon is not able to absorb the fluid so diarrhea results. Also, the bacteria in the colon ferment some of the lactose into gas, either hydrogen or methane. Although the hydrogen is relatively harmless, the methane can slow the motility of the colon which makes you even more uncomfortable.

The simple solution to lactose intolerance is to recognize when you have it and not eat any food that contains lactose, which includes: milk, soft cheese, ice cream, sherbet and ice milk. Hard, aged cheeses like Parmesan have very little lactose. Alternatively, you can drink one of the commercially available lactose-free milks or take lactase enzyme tablets (such as Lactaid) before consuming items with lactose. These will allow you to enjoy your dairy products without symptoms.

Since we are talking about healthy nutrition here, remember that items with lactose are typically high in fat and need to be consumed in moderation. Steer clear of full-fat cheese and whole milk*. Be careful of fat-free dairy products as they contain sugar to replace the taste removed when the fat was removed. Excess sugar turns into fat so you’re not doing yourself any favors.

*Except in children under two years of age. Always speak to your pediatrician before changing your child’s diet.