February is Lactose Intolerance Awareness Month so it’s the perfect time to learn more about lactose intolerance and the questions and misconceptions related to it. I was so fortunate to be a part of the National Dairy Council’s (NDC) Lactose Intolerance Google + Hangout discussion in December with 4 parent bloggers besides myself and experts Karen Kafer, registered dietitian with the National Dairy Council and Bob Murray, pediatric gastroenterologist with a background in Geriatric GI and nutrition. The reason for the discussion was to learn the difference between lactose intolerance and a milk allergy and the proper questions to ask our children’s pediatricians or our own doctors as well as how to diagnose lactose intolerance and diary management strategies. It was fabulous information! I have been thinking for over a year that my youngest son, Zachary, is lactose intolerant, but after this conversation, I don’t think so. Here are the videos for our conversation on how to test for lactose intolerance and well as many other questions we covered (look for me on the second video :)).
Testing for Lactose Intolerance:
- What is lactose intolerance?
Lactose intolerance is a sensitivity to lactose, the sugar in milk. Lactose intolerance is caused by a deficiency of the lactase enzyme, which normally breaks down lactose during digestion.
- What is the difference between lactose intolerance and a milk allergy?
Lactose is not a milk allergy, which is a reaction to milk protein trigged by the immune system. Another way in which lactose intolerance differs from an allergy is that lactose intolerance is a dose effect: a milk allergy will manifest if any milk is introduced, and can be life-threatening; whereas lactose intolerant individuals can usually tolerate the equivalent of up to one glass of milk with no or minor symptoms
- Who is affected by lactose intolerance?
All people are born with the lactase enzyme and successfully digest lactose provided by human milk or by infant formulas. However, sometime after weaning, in the majority of the world’s children, there is a genetically programmed decrease in lactase. This decrease in lactase affects a high but variable proportion of diverse populations in the United States, including Asian Americans, African Americans, Hispanic Americans, Native Americans, Alaska Natives, and Pacific Islanders.
- How do you diagnose lactose intolerance?
The breath hydrogen test is used to diagnose lactose intolerance. When lactose is not broken down by lactase, it passes into the colon where bacteria break it down and produce hydrogen gas, which may cause the cramping and discomfort that is symptomatic of lactose intolerance. General pediatricians, family doctors and internal medicine physicians can all order a breath hydrogen test. You usually don’t have to go to a subspecialist to get the diagnosis, however it may be worthwhile to consult a gastroenterologist with additional questions or concerns.
Dairy First Management Strategies:
- How can lactose intolerant individuals maintain dairy in their diet?
For some children who experience discomfort, it may be because they are consuming large amounts of liquid milk. If liquid milk is a staple in your family’s diet, consider serving smaller quantities of milk per feeding or serve milk with other foods, such as soup or cereal, to help slow digestion and allow the body more time to digest lactose
Yogurt is one option that many lactose intolerant people may tolerate because of live active cultures in the yogurt that help to digest lactose. Natural hard cheeses, like cheddar, Colby and Swiss are lactose intolerant-friendly, containing less than .01 grams of lactose per serving. Lactose intolerant individuals can also use enzyme treated dairy milk or pre-digested milk, which do not contain lactose. Today, there are products like lactose-free cottage cheeses and lactose-free ice cream as well.
- What is the last word when it comes to lactose intolerance?
The simple message is that whether or not you have lactose intolerance from your lactase insufficiency, the goal is to talk with your doctor, get tested, and maintain low-fat and fat-free dairy products in your diet to the extent possible. They are a nutrient powerhouse for all populations; they contain potassium, calcium and vitamin D – three of the four “nutrients of concern” in American diets as determined by the 2010 Dietary Guidelines for Americans. Consuming dairy is a way of managing health disparities that we really struggle with and we can’t afford to give up calcium, vitamin D, potassium, phosphorus, quality protein sources and B12.
Visit National Dairy Council for additional information about lactose intolerance.
This post was written while participating in my partnership with National Dairy Council, but as always, all opinions are my own.