Lactose intolerance is a condition, which affects millions of Americans alone, not to mention millions of individuals throughout the rest of the world. In fact, it’s estimated that about 75% of the world’s population is lactose intolerant.
And while it isn’t a harmful condition, like a nut allergy is, lactose intolerance is definitely inconvenient and uncomfortable for those people who have it. So, how do you live with lactose intolerance to stay comfortable and well? Keep reading to learn all about this common problem.
What is lactose intolerance?
To understand lactose intolerance, you first need to know what lactose is.
Lactose is the main carbohydrate, or sugar, in milk. It’s a disaccharide, made up of two sugars: glucose and galactose. But before the body can make use of this two-part sugar, it first has to separate it into it’s two parts before they can enter the bloodstream and provide energy for the body.
The body breaks down lactose within the small intestine with the help of an enzyme called lactase. But if the body doesn’t produce enough lactase, it can’t break down lactose. This is what causes the body to be intolerant of lactose.
And this undigested lactose continues through the digestive tract, causing pain and discomfort along the way.
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Is lactose intolerance different from a dairy/milk allergy?
Even though a lactose intolerance has to do with milk and other milk products, it is not the same thing as a dairy/milk allergy.
As we now know, a lactose intolerance occurs when there’s an insufficient amount of lactase to break down the sugar in milk. It’s an uncomfortable condition, but not harmful. Instead, a milk allergy is when the immune system overreacts to the protein in the milk – namely casein or whey.
The immune system’s response to milk protein can prompt many symptoms, which can be both mild and serious, and even lead to anaphylaxis.
Therefore, here are the main differences between a lactose intolerance and a milk allergy:
- Lactose intolerance has to do with milk sugar, or lactase
- Milk allergy has to do with milk proteins, like whey and casein
- Lactose intolerance is uncomfortable, but not harmful
- Milk allergy is a serious, immune system condition
When can you develop lactose intolerance?
Increase in age, or primary lactose intolerance
It’s estimated that about 40% of humans stop producing enough of the enzyme lactase needed to properly digest milk. This occurs anywhere between the ages of two and five.
Otherwise, the body can gradually decrease lactase production, leading to lactose intolerance as people move through adulthood. This is referred to as primary lactose intolerance.
Compromised digestive system, or secondary lactose intolerance
This is a far less common way to develop lactose intolerance. If the digestive system is inflamed, and the individual suffers from a serious condition such as Crohn’s disease or celiac disease, the small intestine may not produce enough lactase enzyme.
This can contribute to a lactose intolerance.
Are certain people more prone to lactose intolerance?
Lactose intolerance is stronger among certain populations than it is among others. For example, Central and South American have high incidences of lactose intolerance. As do Asian countries, including China, Japan as well as the Middle East. Africa, too, is strongly affected by this condition.
Therefore, Asian-, African-, Mexican, and Native Americans can experience this condition more frequently than those people of European descent.
Common symptoms of lactose intolerance
Since lactose intolerance is a condition occurring within the digestive track, the common symptoms are digestive problems.
Because the milk sugar, lactose, doesn’t get broken down properly, it makes its way to the colon where it interacts with bacteria and starts to ferment.
This can lead to symptoms like:
- Abdominal cramps
- (Painful) gas
- Stomach pain
When do lactose intolerance symptoms show up?
Symptoms usually appear shortly after a dairy product has been consumed. So, an individual can experience the above-listed symptoms anywhere from 30 minutes to two hours after eating (or drinking).
Depending on the individual, the symptoms can range from mild to severe.
How to treat lactose intolerance
There is no cure for lactose intolerance. Therefore, the simplest way to live with lactose intolerance is to simply avoid dairy products. This can be hard news to take – especially if you love dairy products.
Depending on your situation, you may be able to still enjoy lactose-containing products, as long as you don’t overdo it.
For example, it’s believed that even if you’re lactose intolerant, you can tolerate about 18 grams of lactose per day, if it’s consumed over the course of an entire day. Therefore, while your body might not like it if you have a big glass of milk at breakfast, you might be able to have a tablespoon of milk in your morning coffee or tea.
Another thing to keep in mind is that not all dairy products are made equally. Some milk products contain more or less lactose than others. For example butter contains very little lactose – only 0.1 grams for ever 20-gram serving.
Hard cheeses, such as cheddar, Swiss, and Parmesan, which have aged for at least six months, contain less lactose than other cheese varieties. This is because the enzymes used during production help to break down lactose, making it easier for the human body to digest it.
Finally, yoghurt may also be easier to tolerate than other types of dairy. That’s because although Greek yogurt is still made with dairy milk, it’s rich in protein, and low in sugar, making it a viable option for people who need to avoid lactose.
Therefore, even if you’re lactose intolerant, you can still enjoy small amounts, as well as a nice variety of dairy products.
Are lactase enzyme supplements effective?
Enzyme supplements are available to help increase the amount of lactase in the small intestine. However, they are not effective for everyone who uses them.
Therefore, it may be useful to try them out to see whether they make it easier for the body to digest lactose. As always, it’s a good idea to consult with your primary care physician to find the best supplement for you.
Foods (and non-foods) with lactose
While lactose intolerant people may still be able to enjoy dairy products, it’s not always ideal depending on the severity of the symptoms. Therefore, it’s helpful to know where lactose shows up – especially the less obvious places.
Lactose is present in these dairy products:
- Cow’s milk
- Goat’s milk
- Ice cream
Lactose also makes its way into less obvious foods, like:
- Baked goods
- Salad dressings
- Protein powders
You might be surprised, but lactose shows up in non-food items, too, including:
- Prescription and over-the-counter medication
- Birth control pills
- Stomach acid/gas tablets
When checking ingredient lists, you can identify lactose under any of the following terms:
- Milk solids
- Milk sugar
- Dry milk solids
- Milk powder
- Malted milk
- Whey protein
- Whey protein concentrate
- Milk casein
- Milk byproducts
- Sour cream
On the other hand, even though ingredients like lactic acid, lactalbumin, lactate and casein sound like they would contain lactose, they’re actually lactose-free and safe for people with an intolerance to milk sugar.
How to get enough nutrients without dairy
Since dairy is a popular source of calcium for many individuals, people with lactose intolerance must obtain this essential nutrient elsewhere. Fortunately, there are many calcium-rich foods, giving lactose intolerant people a bunch of choices.
First off, the food industry now offers a wide variety of calcium-fortified foods, from plant-based milks to breads, cereals and juices.
Collard greens, kale, and broccoli, along with bok choy and mustard greens are all optimal vegetable sources for calcium. For a sweeter source, go for dried figs and fortified fruit juice.
Along with these food sources, you can also obtain calcium from soybeans, tofu, tempeh, tahini and almond butter. And when it comes to fish, you can enjoy sardines and whitebait, both of which are rich sources of this bone-healthy nutrient.
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Navigating restaurants and cafes when you’re lactose intolerant
If your body can’t digest and tolerate lactose, it’s important to be attentive to this when you eat out. At cafes, always request dairy alternatives, such as soy, almond, coconut or rice milk.
However, be aware that some syrups and sauces, such as chocolate and pumpkin, may contain lactose.
While dining out, always let your server know that you have a lactose intolerance, but don’t assume that they know which foods are safe or not. It might be up to you to decipher the menu and ask how certain dishes are made. And since salad dressings and sauces may contain lactose, ask that they be left out or put on the side.
Lactose alternatives and substitutions
There are more and more dairy-free milk options in today’s market, so if you’re trying to avoid dairy, you have so much to choose from. Milks are now made with soy, oats, rice, almond, cashew, coconut, walnut, flax, hemp and quinoa.
These alternatives vary in their nutritional content, and some can be quite high in calories, such as rice and oat milk. Therefore, it’s a good idea to check the nutritional facts to ensure that these milks are part of a healthy, balanced diet.
Each milk has a different flavor profile, and may also contain thickeners and gums. Therefore, they may not function the same way dairy milk does in baking recipes.
Therefore, it’s a good idea to use dairy-free cookbooks and recipes, which create recipes with specific non-dairy products to ensure that your cooking and baking endeavors are a success.
To replace butter, you can easily find a non-dairy, plant-based spread. Just be sure to avoid hydrogenated oils as these can be toxic and inflammatory substances. Coconut butter or ghee are also safe options.
If you need a good cooking oil, but need to avoid butter, you can use coconut oil, olive oil, avocado oil, or animal fats, such as beef tallow or lard.
Lactose-free resources for the home cook
A lactose-free diet can be just as delicious and satisfying as one chock-full of dairy, but it might be hard to know how to pull off your favorite dishes without the help of milk products.
So, we’ve rounded up some very comprehensive resources and top-rated books to make it easier for you to live with lactose intolerance.
Here they are:
- Go Dairy Free
- I Hate You Milk
- Dairy Free Betty
- Deliciously Ella
- Enjoy Life’s Cookies for Everyone!: 150 Delicious Gluten-FreeTreats that are Safe for most Anyone with Food Allergies, intolerances, and Sensitivities
- The Pure Kitchen: Clear the Clutter from Your Cooking with 100 Gluten-Free, Dairy-Free Recipes
- The Allergen-Free Baker’s Handbook
- Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living
Living with lactose intolerance does mean you need to avoid milk and milk products, but as you can see, you can enjoy a healthy diet without milk. And if you choose to enjoy dairy from time to time, you also can manage it by having small amounts spread throughout the day.
Do you or someone you know live with lactose intolerance? If so, what do you do to manage this condition?