Lactose Intolerance

Lactose Intolerance Student Created

Definition • The inability to digest and absorb lactose (the sugar in milk) that results in gastrointestinal symptoms when milk or products containing milk are drunk or eaten.

Causes • It is caused by reduced or absent activity of lactase that prevents the splitting of lactose. This is due to three reasons: congenital, secondary or developmental. • Congenital: Absence from birth of lactase due to a mutation in the gene responsible for creating lactose. • Secondary: Due to diseases that destroy the lining of the small intestine along with the lactase. • Developmental: A decrease in the amount of lactase that occurs after childhood and persists into adulthood.

Risk Factors • Age: Lactose intolerance usually starts after age 5 — the condition is uncommon in babies and young children. • Ethnicity: Lactose intolerance is more common in certain ethnic and racial populations. Lactose intolerance is more common in black, Asian, Hispanic and American Indian populations. • Premature birth: Infants born prematurely (28 to 32 weeks of gestation) may have reduced levels of lactase, because this enzyme increases in the fetus late in the third trimester.

Symptoms • Abdominal bloating • Abdominal cramps • Gas • Malnutrition • Nausea • Slow growth • Weight loss Symptoms often occur after you eat or drink milk products, and are often relieved by not eating or drinking milk products. Large doses of milk products may cause worse symptoms.

Elimination Diet • Most common way to test lactose intolerance. (eliminating obvious milk and milk products) • Some problems with this are: • 1. Milk products are so common in prepared foods that it is likely that the diet is not as rigorous as it should be. • 2. Some people do too short a trial. • 3. There is a possibility of a “placebo” effect where people think they feel better when they actually aren’t.

Treatment • Removing milk from the diet usually improves symptoms; however, not having milk can lead to a shortage of calcium, vitamin D, riboflavin, and protein. Add other sources of calcium to the diet if you remove milk products. • You can add lactase enzymes to regular milk or take them in capsule or chewable tablet form. • You may need to find new ways to get calcium into your diet (you need 1,200 - 1,500 mg of calcium each day): • Take calcium supplements • Eat foods that have more calcium (leafy greens, oysters, sardines, canned salmon, shrimp, and broccoli) • Drink orange juice that contains added calcium

Treatment cont. • These milk products may be easier to digest: • Buttermilk and cheeses (they have less lactose than milk) • Fermented milk products, such as yogurt • Goat's milk (but drink it with meals, and make sure it is supplemented with essential amino acids and vitamins if you give it to children) • Ice cream, milkshakes, and aged or hard cheeses • Lactose-free milk and milk products • Lactase-treated cow's milk for older children and adults • Soy formulas for infants younger than 2 years • Soy or rice milk for toddlers

Lactose in non-dairy products • Sometimes found in • Sausages/hot dogs • Sliced meats • Gravy stock powder • Margarines • Sliced bread • Breakfast cereals • Potato chips • Dried fruit • Processed foods • Medications • Protein Supplements

Alternatives to Soy Milk Many people have difficulty digesting soy products. Some people can tolerate soy but only if it is cooked, others only in small amounts. There are several alternative choices available with Rice, Almond or Oat milk, each has a different flavor so try the various brands until you find one you like. Be sure to buy the enriched varieties as they provide as much calcium and vitamins A and D as cows milk and remember to read the labels, some brands of rice, almond, and oat milks are blended with soy.

Resources • https://www.lactaid.com/index.jhtml • http://www.mayoclinic.com/health/lactose-intolerance/DS00530 • http://kidshealth.org/teen/food_fitness/nutrition/lactose_intolerance.html

Lactose Intolerance