About Lactose Intolerance
Who is at risk for lactose intolerance?*
Lactose intolerance is a common condition that is more likely to occur in adulthood, with a higher incidence in older adults. Some ethnic and racial populations are more affected than others, including African Americans, Hispanic Americans, American Indians, and Asian Americans. The condition is least common among Americans of northern European descent. Infants born prematurely are more likely to have lactase deficiency because an infant's lactase levels do not increase until the third trimester of pregnancy.
How is lactose intolerance diagnosed?
Two common methods include:
- Hydrogen breath test
The hydrogen breath test is the preferred method. It measures the amount of hydrogen in the air you breathe out. You will be asked to breathe into a balloon-type container. Then, you will be asked to drink a flavored liquid containing lactose. Samples of your breath are collected at set time periods and the hydrogen level is checked. Normally, very little hydrogen is in your breath. But if your body has trouble breaking down and absorbing lactose, breath hydrogen levels increase.
- Lactose tolerance blood test
The lactose tolerance blood test looks for glucose in your blood. Your body creates glucose when lactose breaks down. For this test, several blood samples will be taken before and after you drink the lactose solution described above.
What is the purpose of a lactose-restricted diet?
A lactose-restricted diet can alleviate bloating, gas, cramping and abdominal pain caused by lactose intolerance. This happens when your body produces little or no lactase, the enzyme needed to break down milk sugar. Lactose intolerance may be the result of irritable bowel syndrome or show itself after surgery or an acute illness.
Which products contain lactose?
Lactose is found in milk, cottage cheese, cheese spreads and other soft cheeses, yogurt, buttermilk, eggnog and cream. There are many other products that surprisingly contain milk so reading labels is imperative. Smaller amounts of lactose are found in milk chocolate, hard cheese and a variety of prepared and dried foods including instant potatoes, cream soups, instant cereals, breakfast drinks and cocoa. It is also found in party dips, puddings, many types of bread and bakery products, some baby foods, powdered drinks and prepared mixes for biscuits, cakes, cookies, muffins and pie fillings.
Is there a product that is used to reduce the effects of lactose?
Several products are on the market, such as Lactaid. Lactaid contains the lactase enzyme. This means that it has the enzyme that lactose-intolerant people lack. Therefore, it helps them break down the lactose sugars in dairy products and they don't get gas Lactaid drops can be added to reconstituted dry milk, half and half, cream, eggnog, baby formula, evaporated milk and condensed milk. It should not be used in cultured milk products such as buttermilk, sour cream or yogurt or in semi-solid or solid milk products such as ice cream.
Living with lactose intolerance
- Some casein and caseinates may have very small amount of lactose and should be avoided only if you are very sensitive
- Lactate and lactic acid does not contain lactose
- The degree of lactose intolerance is different for everyone and may depend on the amount of lactose you consume at one time.
- Try small amounts of milk several times a day instead of one glass at a time.
- Milk-containing foods that are heated may be more easily tolerated than cold food.
- Many find that yogurt is well tolerated. The bacterial lactase breaks down the lactose in the yogurt. Fruit yogurt, frozen yogurt, ice milk, and ice cream may or may not be tolerated.
- There are many milk-free products including Horizon Organic, and Dairy Ease, in which the lactose is "predigested" (hydrolyzed).
Getting enough calcium is important for people with lactose intolerance when the intake of milk and milk products is limited.
- The vitamin C in calcium-enriched orange juice helps the calcium to be absorbed. Five 4-ounce glasses have 800 mg of calcium.
- Other good sources of calcium are salmon or sardines (canned with the bones). Use your blender or food processer to emulsify the bones.
- Tofu that is made of calcium sulfate (read labels) is also a good source. Others include broccoli, kale as well as collard, mustard, and turnip greens.
- Calcium is important, especially for women to prevent osteoporosis. If you are not getting adequate calcium from your diet your doctor may recommend a supplement.