A lesson on lactose intolerance

If dairy causes you gut symptoms you’d rather forget, it may pay to delve a little deeper before saying goodbye to this highly nutritious food group.

Unlike being allergic to dairy, which is always an immune-system reaction to the protein in cow’s milk, it’s possible to be intolerant to either the protein or the lactose found in cow’s milk – and knowing which camp you’re in can have a big effect on what you can and can’t eat. Here, we’ll take a more in-depth look at lactose intolerance, for those in the latter group. 

Lactose is the carbohydrate, or sugar, found in milk.

It’s about 30 times less sweet than cane sugar and made up of two smaller sugar molecules chemically bonded together. Lactose can’t be digested without an enzyme called lactase that breaks the two sugar molecules apart, allowing them to be absorbed by the blood stream and used for energy. If lactose isn’t broken down, it moves through the gut undigested, causing symptoms such as nausea, cramping, bloating, gas and diarrhoea. This is ‘lactose intolerance’ and isn’t though to cause non-gut symptoms.

We make the enzyme lactase in our small intestines.

Due to advancing age, ethnicity or other factors, some people are unable to make enough – this is called primary lactose intolerance and is relatively common in adults, but rare among young children. Secondary, or temporary, lactose intolerance occurs when there’s damage or inflammation in the small intestine. Infections, coeliac disease and other bowel diseases can cause this. Sometimes, newly diagnosed coeliacs need to reduce their lactose intake temporarily while their small intestine recovers on a gluten-free diet. Once this has happened, lactase production generally resumes and lactose-containing foods can be reintroduced.

There’s no need to go dairy free.

Being lactose intolerant doesn’t mean that you need to avoid dairy and its health benefits completely. Milk products provide us with protein, minerals (calcium, zinc, phosphate, magnesium, sodium, potassium and chloride) and vitamins (A, B6, B12, C, D, K, E, thiamine, niacin, biotin, riboflavin, folate and pantothenic acid). Some dairy products, including hard cheeses, naturally contain low levels of lactose, and there are many lactose-free milks, yoghurts and cheeses available — these have all the goodness of their lactose-containing counterparts but the lactose has been broken down for you by a commercially produced lactase enzyme. You can even purchase lactase tablets in supplement form, should you wish to enjoy lactose-containing foods once in a while; ask your pharmacist for guidance.

If reading this has left you wondering whether you might be lactose intolerant and you’d like more information, please feel free to get in touch or book a consultation with me. 

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