What is lactose?
Lactose is the naturally occurring sugar found in a variety of dairy food sources. Lactose intolerance, which happens when a person’s body has trouble digesting lactose, is not at all uncommon in certain ethnic groups, such as Native Americans, African-Americans, and Asians. Lactase deficiency is the main cause of lactose intolerance.
Lactose intolerance is the inability of a person to digest lactose, a sugar found in milk and dairy products. This intolerance is caused by decreased activity of the enzyme lactase, which breaks down and helps to digest gluten. Lactase levels can decrease for various reasons, including celiac disease or certain viral infections like rotavirus.
Lactose intolerance can cause abdominal discomfort and other symptoms when consuming foods containing dairy products. Symptoms may include diarrhea, bloating and flatulence. Diagnosis is based on a patient’s symptoms and can be confirmed by testing for lactase levels in the blood.
Lactose intolerance does not represent an allergy to dairy products, although both cause similar symptoms. It does not affect a person’s ability to digest other sugars, such as glucose or sucrose. Some people may have both lactose intolerance and other food intolerances, like to gluten.
Two tests are used to diagnose lactose intolerance. The hydrogen breath test (HBT) measures hydrogen production by the hydrogenase enzyme activated by lactose. The second is a test called the lactose tolerance test (LTT) in which either lactose or glucose is consumed and levels of glucose in the blood are measured an hour after ingestion. The lactose tolerance test may be used in some people with lactose intolerance who do not have symptoms after eating foods containing lactose.
Treatment occurs primarily by avoiding dairy products, although the effect is often only temporary. Commercial products containing lactase enzyme can be taken by a person experiencing symptoms. A person with lactase deficiency may also choose to consume dairy products in small amounts, gradually building up their tolerance.
Lactose intolerance is the most common food intolerance. Its prevalence varies widely among different populations, ranging from less than 5% in northern Europe to more than 80% of the population in certain areas of Asia. Lactose intolerance is more common in adulthood than during infancy. It becomes less common with age as lactase production decreases, although it may also be affected by other factors. The condition is more common among white people than among other ethnic groups, and it is most common in rural areas.
In developed countries, lactose intolerance is one of the most common food intolerances diagnosed by health professionals. It occurs in about 75% of people from the northern European population. In Africa, the prevalence is less than 5%, although it has increased in North Africa over the past decade. Lactose intolerance has been linked to an increased risk of developing asthma in some people.
Lactose-free milks and products
Milk is a great source of calcium, protein, and other nutrients that are beneficial to your health. But if you’re lactose intolerant, there’s a lot you can still get from eating dairy products while avoiding the discomfort that comes with it. Many companies have created lactose-free milk and products like yogurt, cheese, and ice cream to provide you with these necessary nutrients in safe ways.
What are some of the best sources of calcium?
Many foods contain calcium. However, if you don’t tolerate dairy products, it’s difficult to get enough from a non-dairy diet. Here are some of the best non-dairy sources of calcium:
Calcium-fortified juices and soy milk provide about 300 milligrams per serving. Baked potatoes with the skin can have up to 200 mg of calcium per large potato. Dark leafy green vegetables, such as spinach and broccoli, contain about 200 milligrams of calcium per serving. Tofu made with calcium sulfate contains about 300 milligrams of calcium per half-cup serving.
For people who do not tolerate dairy products, a dietitian can help you create a plan that ensures you’re getting enough of the right nutrients.
Dairy is a very common allergen and is estimated to affect up to 30% of the world’s population.
If you have food allergies or simply wish to avoid dairy products there are many substitutes available, ranging from “dairy-free” milk and yogurts to cheese substitutes. However, the content of these products may differ enormously so it is important to read labels carefully, even if they are labeled as “lactose-free”. Many products will contain varying levels of lactose.
Also, lactose is a natural component of many other foods so if you are trying to avoid it, you will also have to read labels carefully. Some of the most common sources of hidden lactose include:
Artificial sweeteners (e.g. saccharin)
Baking powder or baking soda (check the ingredients)
Some medicines, particularly liquid medicines that contain lactose as a filler
Processed and ready-to-eat foods (such as sauce, soup, stock cubes, and soy sauce). Always check the label.
Salad dressings, ketchup, and other sauces and condiments sometimes contain lactose. Check the label and look out for anything containing “milk solids” or “milk by-products”.
In the interest of your health, it is worth avoiding these foods, especially processed and ready-to-eat ones (such as sandwiches) as they are usually kept longer in warehouses and carry more risk of contamination.
You also have to be careful about supplements. Many contain lactose to bulk up the ingredients, particularly if they have been manufactured in another country (like the US), where lactose is often used to bulk up the ingredients.
What’s the best diet to follow if I am lactose intolerant?
The best diet to follow if you have lactose intolerance is one that provides you with plenty of vegetables and fruits such as:
Broccoli, broccoli sprouts, cauliflower, cabbage, carrots, lettuce, tomatoes
Strawberries, raspberries, and blueberries. These are rich in vitamin C and will help your body build up strong immune systems.
Cheese contains calcium and protein, but also about 30% lactose. Unfortunately, many people have problems with dairy products so the best way to work around this is by eating protein-rich foods such as nuts and seeds.
Yogurt and other fermented milk. But watch out for those that contain wheat. Yogurts are often fortified with calcium, so you can still get the much-needed nutrients even if you are lactose intolerant.
Fruit smoothies. Add some protein to make it a complete meal. For example, almond milk, banana, and berries make a good combination. If you add regular milk, there will be some lactose but this is better than nothing. Also, include good fats such as nuts or seeds to get an instant energy boost and a balanced amount of nutrients (fat has the right balance of vitamins and minerals).
Plenty of fresh water should be taken every day.
If you are completely intolerant to lactose, then the only way you will get enough calcium and protein is by eating dairy products and taking supplemental supplements.
What about lactose-free options?
Many companies have developed lactose-free options for as many different types of dairy products as possible, from milk to yogurt, cheese, ice cream, and more. While they can be expensive, they are worth it if you have lactose intolerance.
Companies like Parmalat and Hain Celestial have formulated lactose-free milk that is easy to consume because the lactase enzyme has been removed from them. People who have difficulty digesting lactose often prefer this type of milk because it reduces the amount of disruption caused by the natural ingredient in milk, which is lactose.
Even if you have trouble digesting lactose, you can still enjoy the taste of yogurt. In many cases, even though yogurt is made from milk, there is no added lactose. This is because when the milk has been converted into yogurt, the fermentation process has removed much of the lactose and some of the natural sugars that might cause problems.
What are some good substitutes for cheese?
Cheese contains protein and calcium but it also contains a lot of lactose. One alternative is to eat tofu, which is packed with calcium and protein but has little or no lactose. But if you’re not a fan of tofu, there are now many alternatives available.
Many of these “cheese” products are made using casein, which is a milk protein that is similar to the protein in cheese. It’s still possible to find products that use soy-based caseins, but not all people can tolerate them either.
The best type of cheese substitute is made using whey protein. While lactose is present in whey, it’s not as high as in dairy-based cheeses, and therefore the person who cannot digest lactose can still enjoy the taste of cheese without harming their digestive tract. Whey protein is also known to produce greater health benefits than casein. For example, it contains no gluten, a substance that induces pseudo-celiac disease when it’s consumed by people with celiac disease.
Whey protein is also known to help people lose weight, so it’s a good choice for people who are trying to reduce calories. People can find whey protein at their local health food store, and it can be mixed with other ingredients that allow it to take the form of cheese.
A quick search on the Internet will bring up many different recipes and companies that make these types of products. Many foods are available online and through stores such as Whole Foods Markets, which carry a variety of products that contain whey protein.
For more information about lactose intolerance and allergies, ask your doctor or dietitian.
The process of removing lactose and other allergens from milk
For those who are lactose intolerant, the symptoms typically only present themselves when they ingest dairy products containing lactose. But even for people with other allergies or sensitivities, this content can provide a viable alternative to dairy without the risk of allergic reactions.
Most forms of food processing destroy allergenic proteins in raw ingredients. However, not all proteins are destroyed; some are left intact, allowing the body to recognize them as “non-threatening”, or “self”.
In nature, most proteins contain at least 6-8 individual amino acids. When these larger protein molecules are broken down into smaller peptides and amino acids, some small parts can still be recognized by the immune system as “self”, especially in mucous membranes. These small pieces of proteins that do not contain a foreign chemical structure are fairly stable and can be left intact in food processing.
When the protein source is milk, a common allergen (lactose) can be removed, while leaving the protein pieces intact. This milk is said to be hypoallergenic because it contains only 5-6 foreign proteins. By removing the lactose, a completely different protein structure must be added to the product. To achieve this, it is mixed with a naturally occurring protein called whey. This whey protein is broken down into smaller pieces at an accelerated rate, preventing the body from being able to recognize them as “non-threatening”. The lactose and whey together form what is called “hydrolyzed milk”.
The result is more similar to its natural counterparts than any other type of milk source. Ingredient names will vary per product, but they can be identified as such in the following ways: “hydrolyzed milk”, “hypoallergenic milk”, or “simply milk”.
Hydrolyzed milk is available in a few forms: 1) liquid, 2) powder, and 3) tablet. Each form has potential advantages and disadvantages, but all 3 forms can provide hypoallergenic alternatives to dairy milk.
In liquid form, hydrolyzed milk is added to water, fruit juice, and dry mix products to give a creamy consistency. It can be naturally flavored or artificially flavored.
A powder form is commonly used for making yogurt product recipes. The amount of whey protein added depends on the individual recipe, but typically between 25-35% of the total mix is used. The product is then mixed with nonfat plain yogurt or heavy cream to give a creamy consistency and taste similar to cow’s milk yogurt or cream. The resulting product is called “hypoallergenic yogurt”.
The third form of this product is a tablet. It can be used in cooking or baking and is also available pre-mixed with other complementary ingredients to make a creamy texture (such as chocolate). Oftentimes, these products are used in place of animal milk for “vegetarian and vegan” diets. For example, tofu, which is made from soybeans, and grain milk are sometimes replaced with hydrolyzed milk products.
Some major brands of hydrolyzed milk that are available in a variety of forms include: “Neocate”, “Immunocal”, and “Alernova”.
