It's a beautiful, hot summer day. What would taste better than an ice cream cone after enjoying time poolside with the family?
You happily eat the ice cream, but on the way home you develop intestinal cramps, gas and then — oh no! — quick, find the bathroom!
If this experience sounds familiar, you might be lactose-intolerant.
You are not alone.
About 50 million Americans are lactose-intolerant. It is a worldwide problem — 70 percent of the world's adults are estimated to be among the sufferers. The disorder affects all ages and both genders. Certain ethnic and racial groups are more widely affected than others. As many as 75 percent of black Americans and 90 percent of Asian-Americans have this trouble.
The condition is rooted in the body's inability to digest lactose, a natural sugar found in milk and dairy products. Lactose normally is broken down in the small intestine by the enzyme called lactase. People who are lactose-intolerant do not produce enough of this enzyme. Instead of being absorbed into the bloodstream like other nutrients, the undigested lactose remains in the gut, where it attracts water into the intestines. Diarrhea results.
The symptoms of lactose intolerance include nausea, cramps and bloating as well as diarrhea; they begin about 30 minutes to two hours after eating or drinking foods that contain lactose. The severity of the symptoms vary, depending on how much lactose a person can tolerate. Affected people often can consume small amounts without discomfort.
In rare cases, children are born unable to produce lactase. Any amount of lactose can trigger the symptoms, which means that parents must closely monitor their diets.
It's more common, however, for lactose intolerance to develop over time. Dairy foods that were well-tolerated in the past suddenly are connected with discomfort, especially when certain foods are eaten in a large volume. There also is what is called "secondary" or "acquired lactose intolerance," which occurs after intestinal surgery or injury, intestinal infection or other types of intestinal diseases, even the flu. This often is temporary and resolves itself as the intestines heal.
Lactose intolerance can be diagnosed by a physician through a blood test or a hydrogen breath test. If you suspect you might be lactose-intolerant, see your doctor to find out whether another medical problem is not the cause of your discomfort.
While there is no cure for lactose intolerance, diet can help. Foods that contain lactose are the culprits — they should be eliminated or chosen with caution. Because the severity of lactose intolerance can vary, the diet might call for strict avoidance of all lactose-containing products to decreased portion sizes of these foods.
Diet is a personal issue. Reading labels becomes important. Obviously, milk and foods made with milk — including ice cream and frozen yogurt — are potential culprits. Aged cheese, yogurt and other cultured milks might be well tolerated, especially in amounts under 1/2 cup or 2 ounces. Bacterial cultures in yogurt might even help aid in the digestion of lactose in the intestine.
Ingredients to avoid are milk solids, whey, curds, cheese flavors and nonfat milk powder. These would be listed on food labels in the ingredients list. Possible hidden sources of lactose include breads, candy, cookies, cold cuts, hot dogs, processed meats, sauces and gravies, cream soups, some ready-to-eat cereals, pancake and biscuit mixes, desserts, salad dressings and even some medications.
Milk and other dairy products are important sources of calcium, phosphorus, vitamins D and A, and riboflavin in the American diet. If milk is eliminated, nutrient-rich alternatives must be substituted. Lactose-reduced dairy products available at the grocery store, such as lactose-reduced milk, are good choices because they contain the same nutrients as milk. The amount of lactose in these products varies, so you need to monitor to determine your tolerance.
Lactase enzyme tablets and drops are sold in drug and grocery stores. You take them at the same time you consume conventional dairy products.
And if you are looking for an alternative to put onto breakfast cereal, calcium-fortified soy or rice milks might be the answer. Vitamin and mineral supplementation is another alternative, but try food first as your nutrient source.
Lactose intolerance is something millions live with. If you are concerned about the nutritional quality of your diet or would like individual counseling about lactose intolerance, contact a registered dietitian. Visit www.eatrightpittsburgh.org and click on "Find an R.D."
