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Nutrition

Lactose Intolerance: Do You Have to Ditch Dairy?

By Christine Haran

Many Americans can remember chugging down that obligatory glass of milk at dinner, so that they would be able to eat ice cream for dessert. But some of these kids found that, later in life, milk and ice cream no longer offered the same rewards but instead caused uncomfortable gastrointestinal problems.

Between 30 and 50 million Americans are lactose intolerant, meaning that they have low levels of the enzyme required to break down lactose, the natural sugar found in milk. The degree of intolerance varies widely, however, and being lactose intolerant doesn't rule out eating all dairy products. In fact, foods such as hard cheeses and yogurt won't cause symptoms. This is crucial to understand, says Sheila Crowe, MD, an associate professor of internal medicine at the University of Virginia and American Gastroenterological Association spokesperson, so that calcium requirements can be met to keep the bones healthy.

Below, Dr. Crowe discusses how to identify lactose intolerance, and how to choose foods, so that symptoms can be avoided.

What is lactose?
Lactose is a substance found in foods such as dairy products. The enzyme lactase is an enzyme that's found in our small bowel, and it's necessary to break down the sugar lactose into its two components, glucose and galactose, so that the sugars are absorbed properly. Foods such as milk, ice cream and butter, as well as some very young cheeses like cottage cheese, contain lactose that requires breaking down once it's ingested.

What is lactose intolerance?
Lactose intolerance is a condition in which an individual does not have enough lactase enzyme in their body to be able to adequately digest lactose. Instead, the sugar is transported into the colon, where you have more bacteria. The bacteria then break down the lactose and generate byproducts that produce gas and other substances that can lead to diarrhea. That's why lactose intolerance causes bloating, diarrhea and gassiness.

It is a situation where, as the individual get older, the lactose levels decline in the intestine. There is a rare congenital disorder where the individual actually has no lactase enzyme at all; it's a true deficiency. This is a life-threatening condition because when these babies are born, they're unable to digest milk sugar in their mother's breast milk and that can cause problems.

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