Lactose Intolerance

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Lactose intolerance—the reduced ability to digest milk sugar (lactose) may not be as common or as hard to cope with as many people think.  Lactose can be digested only with the aid of lactase, an intestinal enzyme.  Most infants produce it and are able to digest breast milk. Individuals whose ancestors came from northern Europe, around the Mediterranean, and some parts of Africa, manufacture sufficient lactase all their lives. Generally they are the descendants of herders, for whom milk and milk products were staples of the diet.  But the majority of other people gradually lose the ability to make lactase starting at about age two, and this can lead to being lactose intolerant.  There is no way to predict when and how much lactase production will be lost.

 Symptoms may show up early or later in life.  They are gas, cramps, bloating, and diarrhea after consuming dairy products. It’s estimated that 15% of white Americans, 70% of black Americans, 90% of Asian Americans, and almost all Native Americans have trouble digesting lactose. Should you give up dairy?  Maybe not.

 Keep in mind:

  • A few people have an allergy to milk, which is different from lactose intolerance. Severe lactose intolerance is rare.  It is worth getting a diagnosis. There are at least two fairly simple tests for lactose intolerance, one a blood test, the other a breath test, both of which can indicate whether lactose is being digested. Genetic testing is not needed for a diagnosis.
  • If you are lactose intolerant, you may still be able to consume some dairy. Studies have shown that you may be able to drink a cup or two of milk daily without symptoms, particularly if they drink a small amount at a time and drink it with meals. They can also eat ice cream, cheese, and other dairy products in small amounts with other foods. It’s a myth, by the way, that goat’s milk is lactose-free.
  • Yogurt, with live cultures, usually causes no symptoms since the bacteria helps digest lactose.  Lactose-reduced milk is expensive.  Generic lactase drops, which you add to milk in advance, and lactase pills, taken just before eating dairy, cost less.

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