Volume 81, Number 4 July/August 2010
Low-fat and fat-free milk, cheese, and yogurt are nutrient-rich foods and a key component of a healthful diet. Yet, people may avoid these foods because of concerns about lactose intolerance. Eliminating dairy foods may not only be unnecessary to manage lactose intolerance, but it also may lead to nutrient shortcomings which may result in adverse health effects, concluded an expert panel convened by the National Institutes of Health (NIH) to examine lactose intolerance and health.
Lactose intolerance is described as gastrointestinal disturbances that may be experienced following intake of an amount of lactose (i.e., natural milk sugar) greater than the body’s ability to digest and absorb it. Lactose maldigestion is a genetically controlled decline in the activity of lactase, the enzyme necessary to digest lactose. A diagnosis of lactose maldigestion does not mean that an individual will experience lactose intolerance (digestive discomfort).
The NIH Consensus Development Conference on lactose intolerance and health addressed the latest research on lactose intolerance, including its prevalence, the health outcomes of dairy exclusion diets, and strategies to effectively manage lactose intolerance. The following are some of the conclusions of the NIH expert panel, along with findings from recently published research.
- The true prevalence of lactose intolerance in the general U.S. population is unknown. However, new research indicates that its prevalence may be much lower than previously estimated.
- A major concern is that individuals with lactose intolerance may avoid dairy foods and consume insufficient amounts of nutrients found in dairy foods such as calcium and vitamin D, among others. This in turn may predispose them to increased risk of osteoporosis as well as other adverse health outcomes.
- Adults and adolescents diagnosed with lactose malabsorption have been shown to tolerate at least 12 g of lactose (equivalent to the amount in 1 cup of milk or yogurt) at one time, particularly if ingested with other foods, with little or no discomfort. There is some evidence to suggest that regularly consuming lactose may increase the amount that can be tolerated by adults and adolescents with lactose malabsorption.
- Strategies to manage lactose intolerance should be individualized and can include consuming small amounts of milk at a time, preferably with food, yogurt with live and active cultures, natural cheeses, and lactose-free dairy foods (e.g., lactose-free milk). Lactose-free milk, which comes in various fat levels and flavors, is real milk just without the lactose. Although non-dairy milk substitutes such as soy beverages may be recommended for those with lactose intolerance, acceptance of such products should be considered. A recent large-scale taste acceptance study found that both lactose tolerant and lactose intolerant individuals liked the taste of lactose-free cow’s milk products more than the tested soy beverages.
In addition to the NIH expert panel, other government and health professional organizations including the 2005 Dietary Guidelines for Americans, the American Academy of Pediatrics, and the National Medical Association recommend that individuals with lactose intolerance try to keep dairy foods in their diet.
Next page »
Table of Contents: