by Kimberly Allen, R.N.
Lactose intolerance also known as lactase deficiency is a condition in which you are unable to absorb lactose, the primary sugar in milk and dairy products. Lactose intolerance is actually very common in adults with approximately 30 million American adults having some degree of lactose intolerance by the time they’re 20 years of age. Lactose usually affects Caucasian children over 5 years of age, while it frequently develops in African Americans as early as 2 years of age.
In a normal healthy intestine there are cells on the villi that live the in the small intestine that produce an enzyme known as lactase. The lactose molecule is a large sugar molecule that is composed of 2 smaller sugars glucose and galactose. Lactose must first be divided into the 2 separate sugars before the body can absorb it. Lactase is the enzyme needed to perform that task. There are three things that can cause a deficiency in lactase. It can be either congenital, developmental or secondary. Congenital lactose deficiency is caused by a mutation in the gene responsible for the production of lactase. Secondary lactase deficiency is caused by a disease that deteriorates the villi lining te small intestine. The most common cause of lactase deficiency is developmental. This type usually develops after childhood when milk is no longer the primary source of nutrition and the production of lactase decreases as you grow and your diet becomes more varied and not as dependent on milk. People that drink minimal to no milk as they get older will produce less and less lactose leading to symptoms of lactose intolerance. The rate at which the production of lactose decreases is genetically programmed therefore the prevalence of this type of lactose deficiency is highly variable among different ethnic groups. For example in Asian populations it is nearly 100% and in Native American population it is approximately 80% while the prevalence in African Americans is around 70% and in Caucasian Americans the rate is around 20%.
Most people will notice symptoms with in 30 minutes to 2 hours after consuming lactose. The most commonly experienced symptoms include diarrhea, nausea and vomiting as well as bloating, abdominal cramps and gas. Symptoms of lactose intolerance can range from mild to severe.
There is no cure for lactose intolerance. Treatment is aimed at reducing the amount of lactose in your diet. Most people with lactose intolerance are able to tolerate small to moderate amounts of lactose so frequently it only takes eliminating only those products that contain large amounts of lactose like milk, cottage cheese, yogurt and ice cream. Some people are able to tolerate yogurt because yogurt is made with bacteria that contain lactase. There are numerous substitutes for milk available today including soy and rice milk. It is also important to avoid any prepared foods that contain milk as well as any dishes that have any cream sauces in restaurants. There are also lactase tablets and caplets available that you can take with foods containing milk. Eliminating dairy products can lead to calcium deficiency so it’s important to include other foods that are high in calcium like broccoli, spinach, oranges, and rhubarb as well as canned salmon to name a few.
If you have lactose intolerance become a smart shopper. Always read food labels carefully looking for milk as well as other ingredients like milk by-products, curds and whey as well as non fat dry milk powder and milk solids, all of these contain lactose. It is also important to be aware that certain prescription as well as over the counter medications use lactose as a base including certain birth control pills
If you are having difficulty adjusting your diet your Dr may recommend a dietician to assist you.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.