According to the National Institutes of Health, an estimated 30 to 50 million American adults are lactose intolerant. If you have been diagnosed as lactose intolerant or are avoiding lactose containing foods because you suspect you are, you may be missing out on important nutrients.
About Lactose Intolerance
Lactose is a sugar found in milk. The small intestine contains the enzyme lactase, which breaks down lactose into glucose and galactose. Some individuals do not produce the lactase enzyme in sufficient amounts. Lactase deficiency causes undigested lactose to be broken down by bacteria in the large intestine, causing bloating, cramping, nausea, gas and diarrhea.
Lactose in Food
Dairy products and processed foods with dairy products as ingredients contain varying amounts of lactose. The higher the sugar contents of the food, the higher the lactose. Milk is higher in lactose with about 11-14 grams of lactose per eight ounce cup, while one cup of cottage cheese has about 6-8 grams and one ounce Swiss cheese has only about 1 gram lactose. Read the labels on all processed foods -- if the food contains milk, lactose, curds, whey, milk by-products, dry milk solids or dry milk powder, then it contains lactose.
Lactose in Moderation
Generally, individuals who are lactose intolerant are able to tolerate about 6 grams of lactose. Most people can gradually add small amounts over about three months to build up lactose tolerance to 12 grams -- the equivalent of eight ounces of milk -- without symptoms. If you still experience symptoms with small amounts of dairy, there are products available such as Lactaid brand milk or enzymes which help digest lactose. Also, you may be better able to tolerate lactose when taken with a meal. Yogurt with live cultures may be well tolerated as well.
Potential Nutrient Deficiencies
If you are avoiding all dairy products, you may not be getting adequate amounts of calcium and vitamin D. Dairy foods are also a good source of vitamin A and phosphorus. Eating small amounts of dairy as tolerated will provide some of the necessary nutrients. Include non-dairy foods that contain calcium into your daily diet such as almonds, calcium fortified orange juice, calcium fortified milk alternatives, kale, broccoli and rhubarb.
Supplements May Be Beneficial
Calcium is important in bone health and reducing risk of osteoporosis later in life. Vitamin D increases absorption of calcium. Adults should get about 1,000 mg of calcium per day. If you are not able to meet this recommendation through diet, then it is important to take a calcium and vitamin D supplement. Calcium absorption is best when you consume no more than 500 mg at one time, so split the dose if you are taking 1,000 mg per day.
Get Help
If you are lactose intolerant, you may be able to tolerate dairy foods in small amounts, with meals, or with the aid of lactase enzymes. Working with a registered dietitian can help you plan a diet that includes the foods you enjoy, provides adequate amounts of calcium and vitamin D, and minimizes the uncomfortable symptoms of lactose intolerance.
References
- "US Department of Health & Human Services -- National Institutes of Health": Lactose Intolerance Information for Health Care Providers.
- "Nutrition and Diagnosis -- Related Care Sixth Edition"; Sylvia Escott-Stump; 2008
- "National institute of diabetes and digestive and kidney diseases": Lactose Intolerance
