Don’t Milk It
By Anna Sachse
According to the National Digestive Diseases Information Clearinghouse (NDDIC), lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk, due to a shortage of the enzyme lactase produced by the cells that line the small intestine. Lactase breaks down milk sugar into two simpler forms called glucose and galactose, which are then absorbed into the bloodstream. But without lactase, the unprocessed lactose moves on to the colon, where the normal intestinal bacteria are forced to contend with it and it basically ferments. As a consequence, lactose intolerant people like me experience a variety of sexy symptoms such as nausea, cramps, bloating, gas, diarrhea and, in my experience, nasty breath.
The severity of symptoms depends on a number of factors, including your age, ethnicity, digestion rate and just how lactase deficient you happen to be. Turns out a lot of people are lactose intolerant to some degree—somewhere between 30 and 50 million Americans. Some of the causes are clearly established. Normally, your body produces large amounts of lactase at birth and during early childhood, when milk is the primary source of nutrition. But then it starts to decrease as your diet becomes less reliant on the moo juice. As a result, many people don’t experience signs of lactose intolerance until they are much older. This is called primary lactase deficiency. Secondary lactase deficiency occurs when injury to the small intestine or certain digestive diseases (like celiac, inflammatory bowel and Crohn’s disease) reduce the amount of lactase a person produces. Babies that are born prematurely are also more likely to be lactose intolerant, because lactase levels do not increase until the third trimester of a woman’s pregnancy, says the NDDIC.
In an interesting example of evolutionary adaptation, people from cultures in which dairy farming occurred earliest are less likely to suffer from lactose intolerance. For example, up to 80 percent of African Americans, 80 to 100 percent of American Indians and 90 to 100 percent of Asian Americans are lactose intolerant, versus two to five percent among people of northern European descent.
A doctor can certainly diagnose lactose intolerance for you, but simply eliminating cow’s milk from your diet for a while is cheaper and easier. If you feel a ton better, you’re probably lactose intolerant. That said, you may not need to forgo all those yummy dairy products completely. Some people can handle yogurt due to the additional helpful bacteria, but can’t drink milk; some people can drink one glass of milk but not two; some people can eat anything, but have to stick to small amounts; and some people can’t tolerate anything, even baked goods that contain milk powder. I can eat aged cheese and butter, for example, but no milk, yogurt or ice cream. You can also purchase tablets or drops that contain the lactase enzyme, which, when eaten with dairy products, may make it easier to digest.
Just make sure you’re getting enough calcium from other foods or supplements—somewhere between 1,000 and 1,500 milligrams, depending on your age. Fortified soy milk, canned salmon and sardines with edible bones, broccoli, oranges, pinto beans are all good sources, and way preferable to horrible gas.