Diarrhea, Nausea, Borborygmi (rumbling or gurgling sounds in the stomach), Abdominal Cramps, Bloating and/or Gas, are all symptoms of lactose intolerance after eating foods that are not lactose intolerant. I personally am lactose intolerant and it can be difficult at first to understand the Do’s and Dont’s when you are.
What is lactose?
Lactose is the normal sugar found in your milk products. Lactose intolerance occurs when your small intestine doesn’t produce enough of an enzyme (lactase) to digest milk sugar (lactose).
What is Lactase?
Lactase is an enzyme that splits the milk sugar lactose, to produce the sugars glucose and galactose, which are absorbed into the bloodstream through the intestinal lining.
Did you know manufacturers add lactase to milk products to make them lactose-free?
There are 4 types of lactose intolerance:
1) Primary lactose intolerance – This is the most common of the 3. Primary lactose intolerance is genetically determined, occurring in a large proportion of people with African, Asian or Hispanic ancestry. The condition is also common among those of Mediterranean or Southern European descent.
2) Secondary lactose intolerance – The small intestine decreases lactase production after an illness, injury or surgery involving your small intestine. Among the diseases associated with secondary lactose intolerance are celiac disease, bacterial overgrowth, and Crohn’s disease. Treatment for this underlying disorder would be to try and lactase levels and improve signs and symptoms, though it can take time.
3) Congenital lactose intolerance – An extremely rare disorder, but can be caused by a little or complete absence of lactase activity. Inherited, usually in newborns passed down from generation to generation called autosomal recessive. Autosomal recessive disorder means two copies of an abnormal gene must be present in order for the disease or trait to develop. In this case, both parents would have to be lactase deficient.
4) Developmental lactose intolerance – Typical in premature newborns and usually lasts for a short time.
Is lactose intolerance dangerous?
It can be if you aren’t getting enough of essential nutrients, such as Vitamin D and calcium. These two nutrients work hand in hand. Taking vitamin D is essential for calcium absorption.
How is it diagnosed?
Medical tests or physical exam. However, it can also be diagnosed from family, medical and diet history including review and symptoms.
If you are lactose intolerant, you can either change your diet and/or take a lactase supplement while eating foods with a lot of lactose in them. Taking a lactase supplement can help because it contains the lactase you need.
Foods with the most lactose in them
- Milk, milkshakes and other milk-based beverages
- Whipping cream and coffee creamer
- Puddings, custards
- Cream soups, cream sauces
- Foods made with milk
- Ice cream, ice milk, sherbet
Lactose-free milk is a suitable alternative. As I mentioned before lactose-free milk is supplemented with lactase, the enzyme that people with lactose intolerance do not have enough of and that is required to properly break down lactose. If you prefer to avoid dairy you can try rice milk, soymilk or almond milk but, be aware that only enriched varieties provide the same calcium content as regular milk.
Most people with lactose intolerance can tolerate some amount of lactose in their diet and do not need to avoid milk or milk products completely. However, individuals vary in the amount of lactose they can tolerate.
Children and adults need to make sure they are getting their recommended daily allowance of calcium.
|Source: Adapted from Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, National Academy of Sciences, November 2010.|
|Table 1. Recommended Dietary Allowance of calcium by age group|
|Age Group||Recommended Dietary Allowance (mg/day)|
|1–3 years||700 mg|
|4–8 years||1,000 mg|
|9–18 years||1,300 mg|
|19–50 years||1,000 mg|
|51–70 years, males||1,000 mg|
|51–70 years, females||1,200 mg|
|70+ years||1,200 mg|
|14–18 years, pregnant/breastfeeding||1,300 mg|
|19–50 years, pregnant/breastfeeding||1,000 mg|
A U.S. Recommended Dietary Allowance for calcium has not been determined for infants. However, researchers suggest 200 mg of calcium per day for infants age 0 to 6 months and 260 mg for infants age 6 to 12 months.3
Table 2 lists foods that are good sources of dietary calcium.
|Table 2. Calcium content in common foods|
|Nonmilk Products||Calcium Content|
|sardines, with bone, 3.75 oz.||351 mg|
|rhubarb, frozen, cooked, 1 cup||348 mg|
|soy milk, original and vanilla, with added calcium and vitamins A and D||299 mg|
|spinach, frozen, cooked, 1 cup||291 mg|
|salmon, canned, with bone, 3 oz.||181 mg|
|pinto beans, cooked, 1 cup||79 mg|
|broccoli, cooked, 1 cup||62 mg|
|soy milk, original and vanilla, unfortified, 1 cup||61 mg|
|orange, 1 medium||52 mg|
|lettuce, green leaf, 1 cup||13 mg|
|tuna, white, canned, 3 oz.||12 mg|
|Milk and Milk Products|
|yogurt, plain, skim milk, 8 oz.||452 mg|
|milk, reduced fat, with added vitamins A and D, 1 cup||293 mg|
|Swiss cheese, 1 oz.||224 mg|
|cottage cheese, low fat, 1 cup||206 mg|
|ice cream, vanilla, 1/2 cup||84 mg|
Source: Adapted from U.S. Department of Agriculture, Agricultural Research Service. 2013. USDA national nutrient database for standard reference, release 26.
The best advice I can give is to go see the proper dietician and/or doctor about getting the essential nutrients needed for your individual needs.