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LACTOSE INTOLERANCE AND DIET : How Can It Be Managed?

Lactose intolerance also called lactose malabsorption is a condition that develops when the body is unable to digest a type of sugar called lactose that is found in milk. When a person with lactose intolerance consumes dairy products, foods, drinks or beverages containing milk, they will experience gastrointestinal issues. The condition is generally harmless but the symptoms can be uncomfortable. The signs and symptoms of lactose intolerance usually appear within 30 minutes to two hours after consuming lactose-containing food or drink. Symptoms include :

  • Diarrhea
  • Abdominal cramps
  • Gas
  • stomach bloating
  • nausea /vomiting

 

WHAT CAUSES LACTOSE INTOLERANCE

Lactose intolerance and diet requirements can be quite controversial. So, how does lactose digest? In the body, the small intestine naturally produces an enzyme called lactase which breaks down milk sugar(lactose) into two simple sugars, glucose and galactose that are absorbed into the bloodstream.

Lactose malabsorption occurs when your small intestine doesn’t produce enough of the lactase enzyme. In this case, the lactose in the food consumed moves directly into the colon without being absorbed or broken down by the small intestine. Once inside the colon, the undigested milk sugar(lactose) interacts with the normal flora (bacteria) of the colon which causes the gastrointestinal symptoms of lactose intolerance.

Most people are lactase deficient (have low levels of lactase in their body) but are able to fully digest the sugar in milk and dairy products without any symptoms. However, lactase deficient people who experience gastrointestinal symptoms after consuming milk or dairy products are referred to as being lactose intolerant. There are three major types of lactose intolerance caused by different factors. They are:

Primary lactose intolerance: This is the type of lactose intolerance that commonly occurs in people. It gradually starts from birth when infants produce a sufficient amount of lactase enzyme that is vital to their growth, this is because Infants get all the nutrition they need from breast milk.

As they grow and replace milk with other foods, the amount of lactase they produce decreases but it is still sufficient to digest the lactose in food. Primary lactose intolerance occurs when there is a drastic drop in lactase enzyme on reaching adulthood which makes it difficult for the person to digest lactose-containing food and drinks. Primary lactose intolerance is genetically influenced and it is common among people with Asian, African, and  Mediterranean descent.

Secondary Lactose Intolerance: This is characterized by a drastic decline in the levels of lactase enzyme in the body after an illness, surgery, or injury that affects the small intestine.

Common illnesses that affect the small intestine that may contribute to lactose intolerance include Crohn’s disease, celiac disease, and bacterial overgrowth. Treatment can help to increase lactate levels and alleviate signs and symptoms of the disease but it may take time.

Congenital and developmental lactose intolerance: Congenital lactose intolerance occurs when babies are born with lactase deficiency (they have zero to little lactase production in their small intestines). This type of lactose intolerance is a genetic disorder and it is very rare. It is also referred to as being autosomal recessive which means that both parents have to pass on the same gene to their child for the condition to develop in the child.

Developmental lactose intolerance, on the other hand, happens in babies who are born prematurely and it usually resolves on its own shortly after birth.

 

IS THERE A CURE FOR LACTOSE INTOLERANCE?

Sadly, there is no known cure for lactose intolerance or ways to increase the body ‘s production of the lactase enzyme, but the good news is that the symptoms can be managed. Managing the symptoms of lactose intolerance is majorly through making dietary changes. However, it is important to note that before taking up any diet plan for this condition, you should first discuss it with your doctor.

 

LACTOSE INTOLERANCE AND DIET

Avoiding or cutting down on foods and drinks containing lactose is usually enough to control the symptoms of lactose intolerance. Some people have to completely eliminate lactose-containing foods from their diet, while others can handle just a small amount of these foods without having problems.

 

Limiting or Avoiding lactose Containing Foods

The amount of lactose-containing food or drinks you can consume depends on how sensitive you are to lactose. You can figure this out through trial and error by watching your body’s reaction to lactose-containing foods and drinks after taking them one at a time.

This will help you decide on which of the foods and drinks you can consume without having symptoms and those you have to completely eliminate from your diet because of the resulting discomfort.

Research has shown that people with lactose intolerance can consume an average of a single 12-gram dose of lactose (which is equivalent to the amount of lactose present in one cup of milk) without experience little to no symptoms. To manage lactose intolerance, It is important to maintain a lactose – free diet or keep it’s consumption to the 12-gram limit. You can start by taking note of foods that have a high lactose content. Some of these foods include :

  • Ice cream
  • Condensed and evaporated milk
  • Milk or creams (includes heavy, light, and whipping creams)
  • Yogurt
  • Butter
  • Cheese (e.g cottage, feta, and ricotta cheese)

You can  manage your symptoms through diet by:

  • consuming a small amount of milk or any dairy product along with other foods. This will help to increase your tolerance for lactose as milk slows the digestion process and reduces the symptoms of intolerance
  • Taking small portions of milk or dairy products at a time, because the smaller the serving, the less likely it is to cause discomfort.
  • Experiment with a lactose-free diet for a duration of about two weeks and then gradually adding lactose back into your diet to check for any resulting symptoms. This can help you reach a decision on the foods that trigger your symptoms and the amount of certain lactose-containing foods and drinks you can tolerate without experiencing discomfort.

 

 Lactose in processed foods and in medicine

It is important to note that aside from milk and some dairy products like butter and cheese, a variety of processed foods contain lactose. Ensure to always read the label on processed food products carefully for any ingredient such as milk, butter, cream or cheese that contains lactose.

The labels may not necessarily list lactose as an ingredient on its own, so checking for any lactose-containing food used as part of the ingredients will help you decide if the food is for you or not. However, some ingredients listed on food labels such as lactic acid and sodium lactate may seem like they contain lactose but they do not.

Some processed foods that may contain lactose include:

  • Cereals
  • Pancake or other snack mixes
  • Baked foods such as cakes, cookies, bread, and biscuits.
  • Chocolates
  • Salad dressings and cream
  • Margarine
  • Instant soups
  • Dried vegetables

Aside from processed foods, some medications also contain lactose. Always check with the doctor or pharmacist when you suspect a drug you need to take contains lactose. It is also important to always notify the doctor about your condition before a drug is prescribed for you.

 

Lactose free-foods and substitutes

Due to the severity of symptoms, some lactose-intolerant people have to completely cut off lactose- rich foods from their diet. If you are taking very few amounts of foods containing lactose or not consuming it at all, you are bound to miss out on some important food nutrients. you will have to replenish the nutrients you are missing through lactose-free dairy products, supplements and lactose-free foods that contain those nutrients.  l

Lactose-free dairy products contain the same vitamins and minerals as conventional dairy products. These products are available in some supermarkets and they contain an additional lactase enzyme that helps in the digestion of lactose in the body, which aids in eliminating symptoms that result from lactose indigestion.

Some lactose food and drink substitutes include:

  • Soya milk, yogurt, and cheese
  • Almond milk
  • Coconut milk and yogurt
  • Rice beverages such as rice milk
  • Lactose-free milk and dairy products

There are a number of supplements containing lactase that you can take in form of pills or liquid drops. These supplements help in boosting lactase activity in your body by breaking down lactose contained in your diet easily. They also help to alleviate your symptoms. They can be taken along with milk or just before taking foods containing lactose.

 

Adding Calcium to diet

Limiting or avoiding dairy products means a lack of sufficient calcium in your diet. This can prove to be detrimental to your health as calcium is important for good bone health, blood clotting and regulating muscle contractions.

Calcium deficiency can put you at risk of developing Osteoarthritis and other health conditions. One of the major food sources of calcium is through dairy products but there are other food alternatives you can include in your diet to augment your calcium intake. Some of these foods include:

  • Leafy green vegetables such as broccoli and kale
  • Nuts
  • Fish such as salmon and Sardine
  • Soya beans and soya bean products such as tofu

You can also choose to take calcium and vitamin D supplements to boost your calcium intake, but you would have to consult your doctor in advance. This is important because there is a recommended dietary allowance for calcium that is specific to age, gender, and pregnancy. Exceeding these limits can lead to serious health consequences.

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