What is Lactose Intolerance? 5 Ways to Manage It

What is Lactose Intolerance?

Lactose maldigestion, also known as lactose intolerance, is a condition that up to 36% of Americans have. [1] It's when a person’s body does not produce enough lactase enzymes to help absorb lactose in the body. These enzymes help to digest, and breakdown disaccharides (two sugar molecules) called lactose, a milk sugar that can be found naturally in cow’s milk or milk products including, cheese, yogurt, cottage cheese, ice-cream, cream cheese, and also goat’s milk. Types of lactose intolerances can vary and are differentiated by 4 main categories, primary, secondary, and congenital or developmental lactose intolerances.

Signs & Symptoms

When insufficient quantities of lactase enzymes are not produced in the body, it can lead to digestive symptoms involving stomach cramps, bloating, gas, and/or diarrhea after eating or drinking lactose. Reasons are due to being lactose hypolactic (malabsorption), which means a person is unable to properly digest or breakdown the lactose they eat or drink. [1] In normal conditions, lactose is ingested by mouth, digested, broken down into simple sugars by lactase enzymes, then absorbed in the body through the small intestines. For lactose intolerant individuals, carbohydrate lactose are ingested by mouth, traveled undigested (due to the lack of lactase enzyme production), passes through the small intestines to the large intestine (colon), where it begins fermentation by gut microbiomes (colonic bacteria). During this process, excessive production of hydrogen gas is created by gut bacteria, absorbed in the body, and exhaled through the breath. Signs of a lactose intolerance can be determined by using a Hydrogen Breath Test and is diagnosed by a medical physician.

Most at Risk

The highest worldwide frequency of lactose intolerances have shown to be more common in Native Americans with 15-30% of the population and 60-100% in people of Asian, African, and Middle Eastern descent. The lowest frequency of individuals are white individuals, originating in northern European countries where 0-15% of the populations have malabsorption. [2]

5 Ways to Help Individuals Manage Lactose Intolerance

1. Individuals who are lactose intolerant may consume lactose-free products. Some of these products include lactose-free milk, yogurt, cheese, cream-cheese and ice-cream and are all often found marketed in local grocery stores.
   

2. A variety of plant-based milks are great options. Substituting milk products with plant-based milks including, soy milk, almond milk, coconut milk and oat milk are all great alternatives.
   

3. Individuals who enjoy cheese products and would like to continue incorporating them into their diet may also consider use of hard aged cheeses such as, Parmigiano Reggiano, cheddar, and mozzarella cheeses are good alternatives. These types of cheeses are low in lactose, compared to soft cheeses that are much higher.
   

4. Moderately prepared milk or milk products may also be tolerated in lactose intolerant individuals, with allowance intake of a glass of milk (about 1 cup or 250 mL). However, consumptions of milk and milk products sensitivity varies person-to-person and is recommended in low or small serving amounts.
   

5. Use of Lact-Aid, an enzyme preparation supplement. This method provides lactase in a tablet form and used with the consumption of cow’s milk or milk products to aid in hydrolyzing lactose during digestion. Other products supplements are also available on the market in both tablet or liquid-drop forms.

The good news is, living life with a lactose intolerance is manageable. Thankfully, with today’s nutritional science and market of food products, there are several methods for individuals to enjoy their favorite milk items. Making a few diet changes and product modifications that limit or remove lactose can help individuals cope with the condition. Finding out which approach to take, can help those diagnosed from having to cancel the next pizza night with family and friends, or ice-cream on a warm sunny day!

Best In Health,

Melissa Marie

Bibliography

1. Fisher R. Lactose intolerance . U.S. Department of Health and Human Services Web site. https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance. Accessed February, 2024.

2. Gropper SS, Smith JL, Carr TP. Advanced Nutrition and Human Metabolism. 8th ed. Boston, MA: Cengage Learning; 2022.

3. Fisher R. Lactose intolerance . U.S. Department of Health and Human Services Web site. https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance. Accessed February, 2024.

4. Metzger M. Goat Milk Versus Cow Milk: A Comparison. Michigan State University Web site. https://www.canr.msu.edu/news/goat-milk-versus-cow-milk-a-comparison. Updated 2022. Accessed February, 2024.

5. Mayo Clinic Staff. Lactose intolerance. Mayo Foundation for Medical Education and Research Web site. https://www.mayoclinic.org/diseases-conditions/lactose-intolerance/symptoms-causes/syc-20374232. Updated 2022. Accessed February, 2024.