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Understanding lactose intolerance

Lactose intolerance can cause uncomfortable symptoms. We found out more about this condition and how it can be managed.

One small thing: Check food labels for ingredients such as milk, buttermilk, whey and cream as these products could contain significant amounts of lactose.

Lactose is a natural sugar found in milk and milk products. When your body digests a food with lactose, an intestinal enzyme called lactase breaks it down into smaller, more easily digested sugars. But when your body is unable to digest lactose, it may start to ferment in your intestinal tract. The result? Uncomfortable symptoms, such as nausea, cramping, bloating, abdominal pain, gas and diarrhoea.

How to manage an intolerance to lactose

The severity of lactose intolerance varies from person to person and how much and when lactose is consumed in relation to other foods. This means that most people who suffer from lactose intolerance can eat dairy products in varying amounts.

If you do have an intolerance to lactose, it’s important to learn how to manage the amount of lactose you can tolerate.

Here’s what you can do:

  • Start with small amounts of foods that contain lactose and gradually increase the serving until you experience negative symptoms.
  • Eat foods that contain lactose as part of a meal or snack but never alone. Mixing the foods can slow down the release of lactose into the digestive system, which makes it easier for your body to digest.
  • Eat smaller, more frequent servings of lactose-rich foods, rather than a large amount at one time.
  • Check product labels for ingredients that suggest the product might contain lactose, such as milk and dry milk solids, buttermilk, whey and whey protein concentrate, cream and margarine.
Dairy swaps

If you cannot tolerate any dairy, switching to alternatives will help avoid symptoms and keep your digestive system healthy.

A cup of milk contains about 600kJ, 8g of protein and 8g of fat. It also contains important nutrients and minerals, such as calcium and potassium. You can replace cow’s milk with:

  • Almond milk – a popular alternative that contains around 160kJ per cup, 3g of healthy fat, and 1g of protein.
  • Rice milk – this tastes sweeter than other dairy alternatives, but is also low in protein. A cup contains about 470kJ, less than 1g of protein and a little more than 2g of fat.
Be aware of these deficiencies

Dairy is an important source of calcium, protein and vitamin D, but when you cut out milk and other dairy foods from your diet, you’re at risk of certain nutrient deficiencies.

  • Calcium is vital for healthy bones and teeth. A cup of low-fat milk has 293mg of calcium and most adults need about 1 000mg a day. You can get small amounts of calcium from other sources, such as spinach and kale, fish with edible, soft bones (canned sardines), almonds and calcium-fortified products like cereals, breads and juices.
  • Protein is another important benefit you get from drinking milk. A cup of low-fat milk or yoghurt has around 8g of protein, similar to the protein in a matchbox-size block of cheese. Other non-dairy foods that are great sources of protein include meat, poultry, fish, eggs, nuts and legumes.
  • Vitamin D is a fat-soluble vitamin found in milk and fish that your body needs to absorb calcium. If you are avoiding milk, look for dairy-free alternatives, such as vitamin D-fortified soya and almond milk. Or plan to eat eggs and fish more frequently, and step out into the sun for a few minutes every day.

If you suspect that you are lactose intolerance, don’t rely on self-diagnosis – the discomfort you experience after eating dairy could be caused by a number of other conditions, such as irritable bowel syndrome or even coeliac disease. It’s best to see your doctor to discuss your options.

If you have a question for our dietitians, click here, or to find a dietitian in your area, visit adsa.org.za. To get in touch with us, email healthhotline@pnp.co.za.

References:
http://www.eatingwell.com/article/290343/how-to-start-eating-dairy-free/
https://www.medicalnewstoday.com/articles/323411.php
https://www.eatright.org/health/allergies-and-intolerances/food-intolerances-and-sensitivities/lactose-intolerance