Were your ancestors raising dairy cattle and drinking milk hundreds of years ago? If so, you are probably drinking milk quite happily today. If not, you are likely lactose intolerant, at least to some degree.
Don’t worry; it’s not a disease nor an abnormality; in fact, you’re in the majority. About 70 percent of people in the world are lactose intolerant. Some experts say the term should be lactose persistent, applied to the minority 30 percent.
Lactose is a natural sugar found in milk and dairy products; young mammals of all species are nourished on it. When weaning occurs, however, and milk is no longer needed, the body begins to produce smaller quantities of lactase, an enzyme necessary for complete digestion of lactose in the small intestine.
When they reach a certain age, nearly all mammals, with the exception of humans, become lactose intolerant, unable to properly digest milk and milk products. Adult cats will drink milk, if they are given it by their keepers, but it will likely give them diarrhea.
Most humans are programmed the same, although that message is rarely given to American children and adolescents. “Milk monsters” who drink four or more glasses a day, as they are told, have no problems if they are lactose persistent, as most fair-skinned individuals of northern European descent are.
A Cultural Connection
Only 5 percent of Americans, Australians and Britons are lactose intolerant, compared to 100 percent of Asians, 80 percent of Native Americans and 70 percent of African Americans. The rate is 17 percent in Finland and northern France. There is a definite cultural connection.
The theory–still unproven–is that the minority trait, lactose persistence, evolved by natural selection among groups of people who turned to dairy farming and drinking of milk during periods of famine approximately 10,000 years ago. Archaeological DNA suggests that lactose persistence was rare in northern Europe prior to that time.
The symptoms of lactose intolerance can be dramatic: bloating, cramps, gas, a gurgling sound in the belly and loose stools or diarrhea, occurring 30 minutes to two hours after consuming milk or milk products. If you’ve experienced these symptoms, you may not have linked them to lactose.
Try keeping track of what you eat before the symptoms occur. If you avoid milk and other dairy products, and the symptoms go away, your problem is probably lactose intolerance. Then start drinking milk again and see if your symptoms recur,
It’s important, though, to see your doctor and get a proper diagnosis because symptoms of lactose intolerance are similar to those of more serious disorders such as irritable bowel syndrome. Lactose intolerance is not a food allergy to milk, and you don’t have to quit drinking milk completely to manage your discomfort.
The incidence of lactose intolerance varies with age as well as ethnic origin. For Caucasian Americans, lactase production starts to decline in the 50s or 60s; for Asians; around the age of 5; for blacks and Mexican Americans, the age of 10.
Lactase production can also be hindered by gastrointestinal surgery or an illness such as celiac sprue.
The major concern for persons who are lactose intolerant is nutrition. In our culture, milk is a major source of calcium, vital to strong bones and teeth. But you can get calcium from broccoli, okra, kale, turnip greens, mustard greens, fortified juices and cereals, canned sardines and salmon, almonds and fortified soy products.
And it’s not necessary to restrict yourself from all dairy products. Adult Americans rarely drink 8 to 12 ounces of milk at one time, which is the amount that is likely to bring on symptoms.
Some individuals with a mild deficiency never have symptoms and are not considered lactose intolerant. They don’t have to make any changes in their diet.
Lactose is a part of milk that is typically found in the water-based portion (along with whey and casein) but not in the fat-based portion. There is very little lactose in butter unless it has been fermented to produce cultured butter.
Traditionally made cheeses–both hard and soft-ripened–have less lactose as well. Aging of cheeses reduces the lactose content, so a well aged brie or cheddar will pose little or no threat to a lactose intolerant person.
Commercialization of food, though, has increased vulnerability to lactose. Milk solids are added to processed meats (sausages, hot dogs, deli meats), pates, gravy stock powder, margarine, sliced breads, breakfast cereals, potato chips, prepared foods, barbecue sauces and even medications and supplements.
If you’re trying to avoid lactose, examine labels carefully. Lactose-heavy ingredients include lactoserum, whey, milk solids, fat free dry milk powder and modified milk ingredients.
If avoiding high-lactose foods just isn’t enough, you can try lactase supplements such as Lactaid and Dairy Ease. Probiotics, available in some yogurts or in capsule form, may help the body digest lactose. There are also lactose-free and reduced lactose products.
When you do eat foods high in lactose, you should consume other foods at the same meal to slow digestion.
With lactose intolerance, there is always the interplay between excess lactose and insufficient lactase to digest it. By contrast, a milk or dairy allergy is an immune reaction to one or both of the milk proteins, casein and whey. Whenever the immune system detects one of these supposed invaders, it causes an allergic reaction, releasing chemicals such as histamine that can cause breathing problems, tightness in the throat, a drop in blood pressure, vomiting and diarrhea.
While dairy allergy is rare, it is usually more serious. A severe reaction, known as anaphylaxis can be life threatening.
If you have a milk allergy, you should know about it and carefully avoid the milk protein triggers. Lactose intolerance, by contrast, is a digestive rather than an immune system reaction. You can have milk but with some degree of moderation.
REFERENCES:\
Steve Carper’s Lactose Intolerance ClearingHouse, “Lactose intolerance versus milk allergy.”
Emma Hitt, Ph.D., “Lactose intolerance management guidelines issued by NIH panel,” Medscape MedicalNews, February 25, 2010.
“Lactose intolerance–topic overview,” WebMD Medical Reference by Healthwise, last updated July 19, 2011.
M.C.E.. Lomer, G.C. Parkes and J.D. Sanderson, “Review article: lactose intolerance in clinical practice–myths and realities,” Aliment Pharmacological Therapy, 2008;27(2):93-103.
Jay W. Marks, M.D., “Lactose intolerance,” MedicineNet.com, 2013.
National Digestive Diseases Clearinghouse (NDDIC), “Lactose intolerance,” last updated April 23, 2012.
W. Steven Pray, Ph.D., D.Ph, and Joshua J. Pray, Pharm.D candidate,” “Lactose intolerance,” U.S. Pharmacist, July 1, 2004.
U.S. Department of Health and Human Services’ Office on Women’s Health, “Milk allergy,” reviewed by Archana Mehta, M.D., and Sheelagh M. Stewart, RN, MPH, October 2011.
05/10/2013
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