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To Pass or Not Pass the Cheese, Please

glass pitcher of milk, fresh dairy on wooden background, yogurt, cheese wedge, butter

Could I be Lactose Intolerant?

What exactly is lactose intolerance? Lactose intolerance, which is not the same as a dairy allergy, occurs when you are unable to digest lactose, the milk sugar, found in dairy products. Lactase is the digestive enzyme that breaks down lactose. People who are lactose intolerant do no produce enough lactase. Despite the uncomfortable symptoms, the condition is usually harmless according to the Mayo Clinic.

Symptoms may include:

  • Stomach pain

  • Gas

  • Bloating

  • Diarrhea

  • Nausea

  • Vomiting

How is Lactose Digested?

Lactase is produced in the small intestine where its primary role is to break down lactose. Typically, when a person consumes milk, lactase gets secreted and breaks down lactose into two simple sugars. These sugars are glucose and galactose. Glucose and galactose are then absorbed through the intestinal wall into the bloodstream.

If you are lactose intolerant, lactose doesn’t get broken down and stays in its original form which does not get absorbed. Instead, it moves into the colon and interacts with gut bacteria resulting in the above-mentioned symptoms.

Am I At Risk?

Up to 65% of people will experience lactose intolerance at some point in their lives. There are several factors that increase your chances of being lactose intolerant.

  • Age: Lactase is produced the most when we are young, and we produce less as we age.

  • Ethnicity: If you are Native American, Asian, African, or Hispanic you have a higher risk.

  • Other digestive problems: If you have a pre-existing disease that affects your small intestine, such as Chron’s Disease, Irritable Bowel Syndrome (IBS), or Celiac Disease, then you have an increased risk.

Foods to Avoid:

  • Milk

  • Cheese

  • Yogurt

  • Ice cream

  • Butter

  • Foods that contain whey and casein

However, not all dairy is created equally! There are dairy foods that contain lower amounts of lactose and may be tolerated if eaten in small amounts:

  • Hard cheeses such as cheddar or parmesan

  • Yogurt

  • Buttermilk

Some people may find taking a lactase enzyme before eating dairy to be helpful. These can be found in the pharmacy section of your local grocery store.

What About Calcium?

If you are limiting your dairy products and worried about calcium, don’t fret. There are many alternative sources of calcium to choose from:

  • Lactose-free milk

  • Fortified almond or soy milk

  • Almonds

  • Spinach, kale, collards and turnip greens

  • Fortified cereals

  • Tofu

  • Canned sardines or canned salmon with bones

  • Cooked dry and baked beans

If you think you might be lactose intolerant, you can eliminate all dairy foods from your diet for 2 weeks to see if your symptoms stop. After 2 weeks, you can begin eating dairy again. If your symptoms return, you might be lactose intolerant. It’s important to never self-diagnose. This would be a good time to schedule an appointment with your doctor. There is a test that your doctor can perform to make the diagnosis. This test is called the hydrogen breath test.

How Does it Work?

Your doctor will have you drink a lactose containing beverage. After 15 minutes you will be asked to blow up a balloon-like bag. You will do this every 15 minutes for 2 hours. Remember, if that digestive enzyme, lactase, isn’t present then lactose goes straight into the colon and interacts with your gut bacteria. This reaction produces hydrogen and other gases which will be measurable when you exhale during your breath test. If hydrogen gases are detected, you may be diagnosed with lactose intolerance.

Bottom Line

With the raising popularity of plant based dairy alternatives you have many options to prevent feeling deprived. Make sure you are consuming adequate calcium each day and if you feel like you may be lactose intolerant, talk to you doctor.

Learn more about Wellness Workdays and our wellness program offerings by downloading our brochure.

Written by: Jennifer McGlone, Wellness Workdays Dietetic Intern



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