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Lactose Intolerance
Lactose Intolerance and Minorities: The Real Story
How is Lactose Maldigestion Diagnosed?
How Is Lactose Maldigestion Diagnosed? Many people, minorities in particular, often assume that they can't digest milk and other dairy foods. Yet, one can't simply rely on symptoms to self-diagnose lactose maldigestion. Without testing, it's impossible to know if the symptoms are caused by lactose, a learned aversion, or some other gastrointestinal problem. Misdiagnosing lactose maldigestion could lead to unnecessary dietary restrictions, expense, and nutritional shortcomings, or failure to diagnose a gastrointestinal disorder.
Medical experts recommend an objective test, such as the breath hydrogen test, to diagnose lactose maldigestion. Undigested lactose is fermented by bacteria in the colon producing hydrogen gas, a portion of which is absorbed into the blood and exhaled in the breath. The breath hydrogen test, which can be performed on an outpatient basis, involves measuring baseline breath hydrogen levels after an overnight fast and again at regular intervals following intake of a standard dose of lactose. If breath hydrogen levels increase by 10 to 20 ppm above baseline levels, a diagnosis of lactose maldigestion is made.
To diagnose lactose maldigestion, the breath hydrogen test generally uses a challenge dose of lactose equivalent to that in about one quart of milk (i.e., 50 g lactose or more than four times the amount of lactose in 1 cup of milk). Using this very large dose of lactose given in water without other foods overestimates the number of individuals who are intolerant to usual intakes of lactose, such as found in one cup of milk (i.e., 12.5 g lactose).
Information obtained from well controlled, double-blind studies indicates that lactose intolerance among minorities and non-minorities alike is far less prevalent than commonly believed. As you'll learn below, a number of factors, including the amount of lactose consumed at any one time, as well as other factors unrelated to lactose, influence whether or not an individual will be lactose intolerant. A positive diagnosis of lactose maldigestion doesn't mean that milk, dairy products, and other lactose-containing foods should be eliminated from the diet.
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