Lactose intolerance affects millions
By David Neville
Intermountain Healthcare Blog

We’ve all been there. We’ve enjoyed our milk and cookies for dinner, or decided that ice cream and a movie sounds lovely. And halfway through the movie your stomach starts making audible noises, you become excessively gassy, your stomach cramps up, and you walk faster-than-normal to the bathroom to try and relieve the discomfort.

     It could be indigestion from the overindulgence in food. It could also be lactose intolerance. After all, near 70 percent of the global population is intolerant to lactose. But how? And why?

     Milk provides a good source of vitamins A & D, calcium, protein, and carbohydrate, but it’s the last ingredient that causes problems with those who are lactose intolerance.  The human body needs to digest foods to be able to absorb and use the food’s nutrients. The carbohydrate in milk, called lactose, needs to be broken down before it can be absorbed and used as an energy source.  People who are lactose intolerant have difficulty breaking down that lactose – leading to the symptoms described above.

     How many people are lactose intolerant?

     Estimates for lactose intolerance vary by race. African American and Asians see a 75-95 percent lactose intolerance rate, while northern Europeans have a much lower rate at 18-26 percent lactose intolerance.

     For some people, drinking milk with their morning cereal is all the dairy they need for the day. Others have a bowl of ice cream to end the day. If the combination of those two results in stomach cramps or churning, or a 3 a.m. emergency run to the bathroom, it’s probably safe to conclude that you don’t digest cow’s milk as well. You’re in good company.

      Genetically, you likely inherit your lactose intolerance from your parents, and they inherited it from theirs. For most people, lactose intolerance starts developing as a toddler and gets stronger as you grow up because your body reduces or eliminates the production of lactase, the enzyme that breaks down lactose into an absorbable form.

      How can I tell if I’m lactose intolerant?

     Testing for lactose intolerance can be done a few different ways; most are performed in a physician’s office or laboratory. The easiest way to see if you’re lactose intolerant is to run your own test. Consume dairy in different amounts and see how you feel 30-90 minutes after consumption.

     Even with lactose intolerance, most people can digest small amounts of cow’s milk without having severe symptoms. A cup of milk (eight ounces) is a good test threshold for a day’s consumption. Then see how you feel. This will give you a level for how much dairy you can tolerate in your diet. As you remain symptom-free, add dairy to your diet to find your threshold. This threshold can change over time, so be aware of how your body feels after consuming dairy.

     What are the symptoms?

     Some people complain of minor symptoms like excessive amounts of gas or audible stomach churnings while others suffer more major symptoms like painful cramps or explosive diarrhea. In either case, it’s important to understand the dose response of dairy to your lactose intolerance level. And keep in mind, these can change as you get older.

     Some people crave milk and want it at every meal. If you’re lactose intolerant, but don’t want to give up your dairy products, you have options. A small lactose pill taken with a meal containing dairy can help you digest milk. Some people recommend trying to increase your tolerance to dairy products with a few simple tips. Drink milk with other foods instead of on an empty stomach so it digests easier. Consider smaller portions, then gradually increase the level of milk you drink. Try whole milk instead of skim milk because the fat can help the passage of dairy through your digestive system. Remember, too, that cow’s milk isn’t the only way to get calcium and other nutrients in your body.

     Going dairy-free isn’t a must for treating lactose intolerance. Hard cheeses, like cheddar, have low amounts of lactase so they can often be consumed without the side effects associated with milk. Yogurts, too, have probiotics that help with digestion.

      Non-dairy alternatives

     Similar to milk in form and function, each plant milk option has a unique taste profile. You’ll know after you’ve tried them for a few days and learned to grow accustomed to them. Non-dairy alternatives have different quantities than cow’s milk when it comes to protein, calcium and vitamin D. Some alternatives have calcium and vitamin D added to them. If you choose options that are not fortified, adding protein, calcium, and vitamin D from other sources will be important. Of note: plant milks are not a good substitute for small children and infants.

  • Almond milk is made by grinding almonds with water and straining out the pulp. It’s high in calcium and monounsaturated fat, a heart-protecting oil, and low in calories.
  • Coconut milk is made by combining the grated meat of a mature coconut with water. It is often used in cooking recipes, and can also be used as a drink.
  • Hemp milk is made from hemp seeds soaked in water. It resembles a cream, and is often used in coffee shops as a replacement for people intolerant or allergic to cow or soy milk.
  • Oat milk is made from hulled oat grains and water. It has good nutrition and includes more calcium than a typical cup of milk.
  • Rice milk is made by milling brown rice. It’s often fortified with calcium to match the levels found in cow’s milk so you get more nutrients and a similar taste.
  • Soy milk is made by soaking dried soybeans and grinding them in water. Popular for drinking and cooking, soy milk is a popular substitute with good nutritional content.

      David Neville is a communications specialist at Intermountain Healthcare with a focus on digital marketing.

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