(also referred to as...) Lactose Deficiency
Description Varying degrees of lactose intolerance occur in approximately 75% of the adult population and it is common among the Mediterranean population. Northwestern Europeans experience lactose intolerance in 20% of the population while 90% of Asians are intolerant. Approximately 75% of North American persons of colour develop intolerance between ten and twenty years of age. Lactose intolerance is caused by an enzyme deficiency in the small intestine. Lactose sugar, found in dairy products, cannot be digested by your body, passes quickly through the stomach, and remains in the small intestine. As sugars accumulate in this area, fluid is drawn into the small intestine, causing diarrhea. The undigested sugar passes into the large intestine where it is fermented by bacteria, producing acidic stool and flatulence.
Symptoms and Signs: If you have lactose intolerance, you are not able to tolerate milk and other dairy products and may consciously or unconsciously avoid them. Symptoms include audible bowel sounds, abdominal bloating and cramps, diarrhea, flatulence, nausea, and an urgent need to defecate following a meal containing lactose.
Causes: Lactose intolerance is caused by the inability to digest lactose sugar found in milk. The common sugars lactose, sucrose, and maltose are broken down by lactase, sucrase, and maltase enzymes, located in the lining of the small intestine. The enzymes break the sugars down into simple sugars such as glucose which is then absorbed into the bloodstream and used by your body. If your body lacks a particular enzyme, the sugar remains undigested in the small intestine and is not absorbed. Celiac disease, tropical sprue, and intestine infections all result in enzyme deficiency. Deficiencies may also be caused by antibiotics, particularly neomycin. Infants typically produce enough lactase to digest milk, but a large proportion lose this ability as they enter childhood.
What to Expect: Adults will experience the various symptoms and signs listed above after consuming a meal containing lactose. Symptoms occur fifteen minutes to several hours after consuming dairy. Children may not gain weight if lactose intolerant, as nutrients are quickly expelled from the body through diarrhea before they are properly absorbed. The resulting nutrient deficiency can occur in adults as well. Similar symptoms are experienced if you are deficient in sucrase and maltose enzymes.
Remedies
Foods Many people eat Kefir, which is rich in beneficial bacteria. This fermented milk is similar to yogurt and can be easily prepared at home with a Kefir maker. It has been called the champagne of milks, reflecting its tart, pleasing flavour. If you are concerned with calcium deficiency, add more broccoli, bok choy, brazil nuts, chickpeas, kale, lentils, non-dairy milks (see below), oranges, and salmon (canned, with bones) to your diet. A variety of non-diary milks are available, including almond, oat, potato, rice, and soy. Rice and soy milk are often fortified with vitamins A, B2, B12, D, calcium, and zinc. Have three servings daily, at breakfast and as part of a snack during the day. Fermented dairy products such as yogurt, buttermilk, and hard cheeses may be tolerable due to the presence of lactase-producing organisms. Yogurt is tolerable by most. It should also contain acidophilus and bifidus bacteria to promote digestion. Frozen yogurt does not contain lactase-producing bacteria and will result in typical intolerance symptoms. Buttermilk may be less tolerable -- you may have to experiment. Swiss and extra-sharp Cheddar contain trace amounts of lactose and should not pose a problem. Cocoa appears to slow transient time through the digestive system. It slows stomach emptying and reduces the rate that lactose enters the colon. This may be the reason that many people who are lactose intolerant get less of a reaction when drinking chocolate milk. Opt for cocoa powder, which has no fat, as opposed to chocolate syrup, which is high in fat. Food Supplements Acidophilus and Bifidus supplementation will restore beneficial bacteria counts in the digestive tract and help keep harmful bacteria at bay. They will also support proper digestion. Look for a dairy-free formulation with at least 2.5 billion viable cultures per capsule and keep refrigerated. Take 2 or 3 capsules daily on an empty stomach, preferably in the morning or right before bed. Supplements with Fructooligosaccharides (FOS) provide a beneficial "bed" and initial food source for the bacteria. Lifestyle Avoid foods containing dairy products and do not consume milk. Viable alternatives are available. Lactase (enzyme) preparations are available that are either taken before a meal containing dairy or poured into milk before consumed. The lactase breaks down the lactose in the milk (or in the body), allowing for more proper digestion. If using in a glass of milk, sprinkle powder in the night before, and half the lactose will be gone by the next morning. This is enough to prevent symptoms. If eating dairy products, do so with a meal. This slows the rate of stomach emptying, which is a key factor in controlling symptoms. Minerals If you are concerned about calcium deficiency, you may supplement with calcium. Take 1,500 to 2,000mg daily in divided doses, after meals. Use a chelated form for best absorption and avoid calcium carbonate, which may contain lead. See Foods, above, for dietary calcium sources. Magnesium and vitamin D should also be taken as they facilitate calcium absorption. Miscellaneous Activated charcoal will help eliminate lactose sugars from the digestive system, adsorb gas, and reduce bloating. Take 2 to 4 capsules at the first sign of discomfort. The carbon will attach to foreign molecules and aid in their elimination from the body.
Actions and Remedy Listings
For More Information ... Zukin, Jane. Dairy-Free Cookbook, Second Edition. Rocklin: Prima Health, 1998. See also Food Allergies
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