Low lactose diets – not as straightforward as you might expect
Lactose intolerance is the inability to digest lactose, the natural sugar that is found in milk and dairy foods. It is much more prevalent in people of Asian, African or Southern European descent.
Most people are born with the ability to digest lactose as this is necessary for the baby who is dependent on breast milk. However apart from people who originated in Northern Europe, most become permanently lactose intolerant as they begin to lose the ability to produce lactase, the enzyme in the intestine that breaks down lactose into its component sugars, glucose and galactose, and allows milk to be digested.
Lactose intolerance may also be just a temporary problem after a gastrointestinal disease which affects the lining of the intestine and, in this case, the sufferer needs to avoid milk for a few weeks until the ability to produce lactase returns.
The symptoms of lactose intolerance are stomach pains, bloating, flatulence and, in severe cases even nausea, vomiting and diarrhoea. (Keep in mind that these symptoms can also be signs of other diseases and it is important to discuss them with your doctor to be sure of a correct diagnosis).
Not all lactose intolerance is the same and symptoms often differ from person to person. Some people can manage small amounts of milk and only have a problem if they drink a lot of milk. Most people can manage to eat low lactose dairy foods such as butter, margarine, yoghurt and mature cheeses, where the lactose has been reduced in the product as a result of the processing of the food. Some people can even manage chocolate milk, full fat milk or milk drunk with a meal.
These variations in the low lactose diet can be very confusing for the kitchen trying to send the correct diet.
On the other hand, others are very sensitive and need to avoid all milk products in their diet.
Labels should be carefully read as ingredients such as milk solids, non fat milk solids, whey, casein, caseinate and milk sugar contain varying levels of lactose.
Good substitutes for milk are soy milk with added calcium (as well as soy yoghurt, soy custard and soy cheese) which are lactose free and special low lactose milks where the milk has been processed to split the lactose into its component sugars.
Lactase enzyme eg Lacteeze may be purchased from the pharmacist, A few drops added to milk or milk containing foods such as milk desserts and sauces, breaks down the lactose and they can be eaten and digested without problems.
If you have this condition it is important to work out your individual tolerance to lactose and how much milk you can actually manage before developing symptoms. Remember that milk is an important source of nutrients, especially protein, riboflavin and calcium, and if milk is reduced or eliminated from the diet other sources of these nutrients should be included eg. soy milk* and soy milk products* or lactose free milk, as well as cheese and yoghurt. It is a good idea to talk to a dietitian about your calcium intake if your diet is severely restricted.
*Read the labels to ensure that the soy products has been fortified with calcium (ie had calcium added).
Article by Christine Borthwick 0418 437 291