Lactose Intolerance

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The Latest on Lactose Intolerance: What It Is, How It's Diagnosed, and Tips for Counseling Clients - Today's Dietitian Magazine


Lactose intolerance is a common condition that can cause extremely uncomfortable gastrointestinal symptoms.  Although the condition is benign, the nutritional consequences of being lactose intolerant are not benign. Those who are lactose intolerant will generally limit or eliminate dairy products which can lead to the lack of Vitamin D and calcium.  Lactose-free options and/or consumption of small amounts of dairy can be recommended.

Lactose (milk sugar) must be broken down into the simple sugars glucose and galactose by the intestinal enzyme lactase in order to be absorbed in the intestinal tract. Lactase is usually able to break down lactose in the small intestine.  If you are lactose intolerant, this enzyme is lacking, so lactose cannot be digested.  When the undigested lactose moves from the small intestine to the large intestine, the lactose will ferment in the large intestine by the bacteria. The bacteria give off hydrogen and methane gases and symptoms result.

According to the article by Denise Webb, PhD, RD, it is believed that as much as 80% of the African-American population is affected, 53% of the Hispanic population, and about 15% of the Caucasian population. Almost 100% of some Asian countries are lactose intolerant. Most people are born with the ability to digest lactose, but this ability may lessen significantly after about age 2.

Many with lactose intolerance feel that they cannot consume any dairy products.  However, each person may have a different “lactose threshold", which would allow them to consume some lactose without discomfort.  Each threshold is different so the individual would have to introduce lactose slowly into their diets to determine the threshold.  For those who are not willing to do this, lactose- free dairy products are available to help meet nutritional needs.

Several lactose-free dairy products are available that may make it easy for people to meet their calcium and nutrient needs. A lactose-free product, in which the lactose is hydrolyzed or predigested, is an option for lactose intolerant individuals.  Some of these products include Lactaid, Horizon Organic, and Dairy Ease lactose-free milks. Lactose-free ice cream, yogurt, and cottage cheese are also available. These products typically contain between 0 g to 2 g of lactose per serving, well under the typical threshold for symptoms.  Choosing these lactose-free options along with the introduction of small amounts of dairy into the diet can help lactose intolerant individuals meet calcium and other nutrient needs.

Webb, D. (2015).  What it is, how it’s diagnosed, and tips for counseling clients.  Today’s Dietitian, 17(5), pg. 38

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