Not Milk! – lactose intolerance: what you can do

It’s lunchtime and you are hungry. You eat your sandwich and drink a glass of milk. By the time you are putting the dishes in the dishwasher, you are bloated and gassy. Then your stomach starts to hurt, followed by a sprint to the bathroom due to nausea and diarrhea. This happens every time you have milk lately. Could it be lactose Intolerance or are you simply allergic to milk?
The symptoms to lactose intolerance are similar to milk allergy. What’s the difference? Milk allergy means you have the symptoms whenever you have any dairy (milk, cheese, yogurt, ice cream). No matter how small a taste you have, there is a reaction. This is because an allergy means you cannot tolerate the protein in the milk whether it is in a cup of yogurt, a scoop of ice cream, a slice of cheese or a glass of milk.
Lactose intolerance means you have a problem with the sugar (lactose) in dairy. Most people have an enzyme, lactase, which breaks down lactose into smaller parts (glucose and galactose) so that they can be digested. Lactose intolerance means you are missing most, if not all, of your lactase. Lactose intolerance differs from milk allergy in a significant way. People with lactose intolerance often can eat yogurt, cheese and ice cream despite being made from milk. This is because to make these products, milk must be heated which naturally breaks down the lactose.
There are two types of lactose intolerance, primary and secondary. Primary lactose intolerance usually rears it’s ugly head after age 2, typically showing up in late adolescence. This form of lactose intolerance may be genetic. Secondary lactose intolerance is the result of a disease (such as gluten intolerance, celiac, Crohn’s), in the digestive tract. Prior to this condition,you had no problems with lactose. Once diagnosed, you may develop lactose intolerance.
The good news is that some people with lactose intolerance do have small amounts of lactase to digest lactose. However, lactase is a “use it or lose it” enzyme. If you avoid dairy, having little to no exposure to the sugar in milk, your body’s ability to make the enzyme lessens and may disappear completely. Once gone, you can never make lactase again.
The Cleveland Clinic estimates that there are 30-50 million Americans with some degree of lactose intolerance. Groups at greater risk of developing lactose intolerance, include the elderly, African Americans, Hispanics, Native Americans, Asians and premature babies. If you are unfortunate enough to have lactose intolerance, there are two key nutrition recommendations that you may want to explore – avoidance of lactose and inclusion of non-dairy products on the menu.
It may sound easy to avoid lactose, simply by avoiding milk, yogurt, cheese and ice cream. However, there are many products that have Lactose that you may not think of as having any dairy. Some common foods that may contain lactose are:

Breads/grains (e.g. waffles, pancakes, muffins, biscuits, toaster cakes)
Chips & snack foods
Goat milk
Instant potatoes
Non-dairy whipped cream and coffee creamers
Processed meats (such as bacon, deli, sausages, hot dogs)
Protein bars & powders
Sheep milk
Smoothies and breakfast drinks (liquids and powders)

To be safe, make sure you read the ingredient list for all foods to make sure they are lactose-free. Be wary of foods that contain casein, curds, dry milk solids, lactose, milk, milk by-product, non-fat dry milk powder and whey. Choose another food if you can find one without these ingredients.
Next, select foods that provide protein, calcium and vitamin D (which are readily available in dairy). Most non-dairy replacements have protein and are typically fortified with calcium and vitamin D. There are many plant based non-dairy options on the market these days. Consider trying almond/hemp/soy/oat/potato/rice non-dairy beverage, yogurt, cheese, etc. Each of these selections can be used in place of dairy products.
Although they may look like milk (or yogurt, cheese, ice cream), remember that these non-dairy products won’t taste like it. Whether or not you enjoy the flavor will be up to you and your preferences. You may have to try several different types before you find one that is just right. Keep in mind that some non-dairy alternatives come in a variety of flavors as well as in sweetened and unsweetened versions. All of these products are meant to be lactose-free, but double check the ingredient list to be on the safe side. Take the time to find non-dairy alternatives you enjoy and check the ingredient list, so you can enjoy your meals without having to worry about the consequences.

Jennifer Giffune, R.D., L.D.N. is a freelance author, professional speaker and nutrition counselor. She currently is providing nutrition counseling services for Hampden County Physician Associates at their offices in Westfield, Southwick, Feeding Hills and West Springfield. If you would like to schedule a counseling session with Jennifer, please call (413) 786-1500.

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