|What is lactose intolerance?
Lactose intolerance is one type of food sensitivity. People who are lactose intolerant don’t have enough lactase, the enzyme that breaks down lactose (a sugar naturally found in milk). Lactose intolerance describes gastrointestinal disturbances following the consumption of an amount of lactose greater than the body’s ability to digest and absorb.
Lactose intolerance is not the same as having a cow’s milk allergy. An allergic reaction to cow’s milk is triggered by the immune system and is associated with protein, not the digestive system as is the case with lactose intolerance, which is associated with lactose, a carbohydrate.
What are the symptoms of lactose intolerance?
Lactose intolerance is a highly individual condition with a broad range of symptoms which vary from mild to severe and may include abdominal pain, bloating, gas and diarrhea. These common symptoms are similar to other digestive disorders, which contributes, in part, to misconceptions regarding the true presence of lactose intolerance.
Whether, and to what extent, symptoms develop depend on many factors including the amount of lactose consumed, how much lactase is present in the body, as well as gastrointestinal transit time, and an individual’s age and genetic background.
How do I know if I have lactose intolerance?
It is difficult to confirm the presence of lactose intolerance based on digestive symptoms alone. It’s important to identify the true source of discomfort, because it may not be lactose intolerance - digestive illnesses can cause these same problems. A physician can help determine if it is due to lactose intolerance by doing a Lactose Tolerance Test or a Hydrogen Breath Test. Both are reliable ways to measure the lactose absorption in the digestive system.
How many people have lactose intolerance? Are some people more likely to have it than others?
The actual presence is unknown. According to one study that assessed data from a national sample of three ethnic groups the age-adjusted, self-reported lactose intolerance rate in the U.S. is 12 percent. These results suggest that the national prevalence of self-reported lactose intolerance may be significantly lower than previous estimates.
The 2009 study, which uses data from a national sample of three ethnic groups, reveals the following prevalence numbers by demographic:
- About 8 percent of European Americans
- Roughly 10 percent of Hispanic Americans
- About 19.5 percent of African Americans
Can children be lactose intolerant?
Lactose intolerance is less common in young children, even in minority populations. If you think your child is lactose intolerant, there may be an underlying medical cause, so talk to your family doctor, pediatrician or a dietitian.
If a child is indeed lactose intolerant, it’s important to remember that the American Academy of Pediatrics (AAP) notes
that children with lactose intolerance can still consume dairy foods to help meet calcium, vitamin D, protein and other nutrient needs essential for bone health and overall growth. AAP advises that lactose intolerance usually does not require avoidance of dairy foods.
I am lactose intolerant. Do I need to have a dairy-free diet?
No. Different people can handle different amounts of lactose and there's a solution to meet most needs in the dairy case. Because lactose intolerance is an individualized condition, it’s important for people to find the dairy options and strategies that work best for them, as reducing consumption of dairy foods due to concerns about lactose intolerance can result in a lower intake of milk’s nine essential nutrients, including calcium and vitamin D.
In fact, a National Institutes of Health (NIH) expert panel, the 2010 Dietary Guidelines for Americans, the American Academy of Pediatrics (AAP), the National Medical Association (NMA) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) agree it is important for people with lactose intolerance to get the health and nutritional benefits associated with milk and milk products, and encourage daily consumption of dairy foods.
Health professionals, such as registered dietitians, can work with individuals to help customize a dairy-friendly diet that is right for them.
What kinds of dairy can people with lactose intolerance have?
While lactose intolerance is a very individual condition, many people with lactose intolerance can still consume dairy foods in varying amounts or forms. Following are some strategies that may help people with lactose intolerance enjoy the three daily servings of low-fat or fat-free milk or milk products recommended by the 2010 Dietary Guidelines for Americans 9 years and older without experiencing discomfort or embarrassment:
- Try It. Opt for lactose-free milk and milk products. They are real milk products, just without the lactose. They taste great and provide the same nutrients as regular dairy foods.
- Sip It. Start with a small amount of milk daily and increase slowly over several days or weeks to determine tolerance.
- Stir It. Mix milk with other foods, such as soups and cereal; blend with fruit or drink milk with meals. Solid foods help slow digestion and allow the body more time to digest lactose.
- Slice It. Top sandwiches or crackers with natural cheeses such as Cheddar, Colby, Monterey Jack, mozzarella and Swiss. These cheeses contain small amounts of lactose.
- Shred It. Shred your favorite natural cheese onto veggies, pastas and salads. It’s an easy way to get dairy that contains minimal amounts of lactose.
- Spoon It. Enjoy easy-to-digest yogurt. The live and active cultures in yogurt help to digest lactose.
Try other dairy foods in small amounts and with meals to find out which ones, and which amounts, work well for you.
Is lactose-free milk dairy-free?
No. Lactose-free milk is regular cow’s milk, just without the lactose. Lactose-free milk is a great choice for people with lactose intolerance and comes in a variety of flavors, including chocolate.
A wide variety of lactose-free dairy products—including reduced-fat, low-fat, fat-free , chocolate milk, ice cream and cottage cheese—are available in many grocery stores.
In addition, there are a variety of dairy products that naturally contain small amounts of lactose, like natural cheeses (such as Cheddar, Colby, Monterey Jack, mozzarella and Swiss). Yogurt, including Greek-style varieties, contains live and active cultures that help digest lactose.