Lactose Intolerance

BATTLING

LACTOSE INTOLERANCE

It is estimated that around 68 per cent of people in the world have lactose malabsorption, as reported by the National Institute of Diabetes and Digestive and Kidney Diseases in the UK. When lactose malabsorption produces specific symptoms – including nausea, bloating, diarrhoea, cramps, and gas – it is referred to as lactose intolerance – a condition that is not to be confused with milk allergies. These symptoms usually start within half an hour to two hours of consuming foods with lactose. Being lactose intolerant does not mean you can never enjoy milk products, but you may need to experiment until you discover your personal dairy intake limits.

WORDS MARISA CUTILLAS

WHAT CAUSES LACTOSE INTOLERANCE?

Your small intestine cannot digest lactose if it has low levels of the digestive enzyme, lactase. The latter normally breaks down lactose into two simple sugars – glucose and galactose – which are absorbed into the bloodstream through the intestinal wall. In individuals who are lactose intolerant, lactose moves directly into the colon, where it reacts with bacteria, thus causing an array of symptoms. Scientists at the University of California - Los Angeles have found that there is a specific genetic mutation that is present in lactose intolerant people. This mutation was found across adults of different ethnicities (African, Asian, and European), which revealed that it was very old. Researchers said, “We believe that the variant we identified in patients is the original form of the gene – which (subsequently) mutated to tolerate milk products when early humans adopted dairy farming. This suggests that everyone was originally lactose intolerant.”

Milk-like products from alternative sources

TYPES OF LACTOSE INTOLERANCE

There are three types of lactose intolerance: primary, secondary, and developmental. In primary lactose intolerance, babies start their lives producing the required amount of lactase (since babies obtain their nutrition from milk). As they start weaning and replacing milk with other foods, lactase production decreases. When lactase levels decrease sharply, digesting dairy products can become problematic. Secondary lactose intolerance can occur if the small intestine suddenly decreases lactase production after an illness, injury, or surgical procedure. In developmental lactose intolerance, babies are born with a complete absence of lactase activity. This occurs when a baby’s mother and father pass a specific gene variant. This problem can also affect premature babies.

RISK FACTORS FOR LACTOSE INTOLERANCE

The specific risk factors for this condition include: Z Adulthood (simply growing older). Z Having diseases that affect the small intestine such as celiac disease, Chrohn’s disease, or severe diarrhoeal illness. Z Receiving certain treatments (for conditions such as cancer). Z Ethnicity (the condition is more common in people of Hispanic, American Indian, Asian, and African descent). Z Genetics (having a lactose intolerant parent can increase your chances of having the same issue).

THE DANGERS OF LACTOSE INTOLERANCE

If you have symptoms of lactose intolerance, it is a good idea to see your doctor so the latter can formulate a prevention plan. This condition may predispose you to low calcium intake (since the number of lactose-free foods is limited) so you need to ensure you are obtaining enough of this nutrient from other sources. Lactose intolerance may lead to reduced bone density and fragility fractures when it is accompanied by the avoidance of dairy foods. As stated in a study (Hodges, 2019) published in the journal Nutrients, “multiple public health organisations recommend that all individuals— including those who are lactose intolerant—consume three servings of dairy per day to ensure adequate nutrient intakes and optimal bone health.” The researchers also stated that people who identify themselves as lactose-intolerant may mistakenly attribute abdominal symptoms to milk intolerance. It is therefore important for doctors to diagnose patients with symptoms using tests such as the hydrogen breath test, which can reveal the existence or absence of authentic lactose maldigestion.

LACTOSE INTOLERANCE MANAGEMENT

Although lactose intolerance cannot per se be prevented, its symptoms and effects can be ameliorated with dietary changes. These include opting for low-lactose dairy products such as aged cheese, cultured yoghurt, and lactose-free dairy products. You should also keep up your calcium intake for bone strength. Top sources of calcium include leafy green vegetables (such as cabbage, broccoli, and kale), nuts, fish with edible bones (like sardines, salmon, and pilchards), tofu, and soya beans. Check with your dietician or family doctor, since they may recommend that you also take combined Vitamin D and calcium supplements. e

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