I am lactose intolerant: can I still eat dairy?
Between 30 and 50 million people in the United States have lactose intolerance , which means their bodies cannot properly break down lactose, the sugar found in milk.
The result can be uncomfortable gas, bloating , nausea, diarrhea and abdominal pain — symptoms that typically appear within 30 to 60 minutes after eating a lactose-rich food , explains Beth Ferrell Jenks, a registered dietitian and assistant professor of nutrition at the University of North Carolina at Chapel Hill.
The good news: While individual tolerance to dairy products may vary, certain dairy products with lower lactose content, such as hard cheeses and yogurts, may help keep lactose intolerance symptoms at bay .
Lactose intolerance problems tend to begin in adulthood, when the body gradually produces less lactase, an enzyme that breaks down lactose.
Some people might not notice this change in their digestion , says Suneeta Krishnareddy, MD, a gastroenterologist at Columbia University Irving Medical Center in New York City. But others may have symptoms so severe that they experience nausea and vomiting after eating certain foods, adds Nitin K. Ahuja, MD, a gastroenterologist at Penn Medicine in Philadelphia.
To understand what your triggers are, it takes a bit of trial and error. You can start by eliminating all dairy products from your diet and then gradually reintroduce small amounts of certain lactose-containing foods and drinks to see how you feel afterwards.
Listed below are dairy products that are most and least likely to aggravate symptoms.
Skimmed milk: One percent, two percent and whole milk contain between 12 and 12.5 grams of lactose per cup. “That’s about the maximum amount of lactose that people with lactose intolerance can consume per day without symptoms,” says Ella Haddad, a registered dietitian and professor emeritus of nutrition at Loma Linda University in California. So she suggests limiting yourself to one glass of milk per day, or less if you consume other types of dairy products.
Unaged (or fresh) cheese: Cheese generally contains less lactose than milk, but some varieties have more than others. Cheeses that haven't been aged (meaning they haven't been allowed to ripen for weeks, months or years) typically contain more lactose than aged cheeses, Jenks says. That's because during the aging process, bacteria break down lactose and convert it into lactic acid.
Unaged cheeses tend to be soft and moist and often come in jars. A half-cup serving of cottage cheese with 2 percent milk fat contains about four grams of lactose. Two tablespoons of fat-free cream cheese has almost two grams. While unaged cheeses are probably more tolerable than cow's milk, Jenks recommends limiting their consumption whenever you have the choice.
Ice creams: Many ice creams, which are made primarily from milk and cream, are high in lactose and should therefore be limited. However, some versions contain more lactose than others. “ If an ice cream contains more milk than cream (you can tell if milk appears before cream on the ingredient list), it is likely to be high in lactose and therefore harder to digest,” explains Haddad. This is because milk contains more lactose than cream.
Hard cheese: Varieties like Parmesan, Cheddar and Swiss have been aged and therefore contain very little lactose and are often easier to digest than softer varieties that haven’t been aged, Krishnareddy notes. Harder cheeses tend to have a stronger flavor and include an outer rind. A 40-gram serving of Parmesan or Cheddar, for example, contains less than one-tenth of a gram of lactose.
Other fermented dairy products: Fermented dairy products like yogurt, kefir and sour cream contain bacteria that help break down lactose , Krishnareddy says. This reduces the load on the small intestine, making those foods easier to digest.
Butter: “This kitchen staple is made from milk, cream, or both, separating the fat from the rest of the liquid, leaving behind most of the lactose,” Haddad adds. A serving of butter and a tablespoon of cream each contain about half a gram of lactose or less.
Many supermarkets sell lactose-free dairy products, such as milk, cheese, yogurt and ice cream. “These are regular dairy products made from milk, but with the enzyme lactase mixed in . This makes them more tolerable if you are lactose intolerant,” Jenks says.
Dairy-free products such as almond, soy or oat milk, nut cheese, and soy or coconut ice cream are also lactose-free.
Over-the-counter lactase enzyme supplements, which can be swallowed or chewed, may help reduce indigestion symptoms if taken with a meal. “They contain the lactase enzyme, so the body doesn’t have to produce it on its own,” Krishnareddy says.
While many people can figure out on their own that they are lactose intolerant, Ahuja adds that it's usually a good idea to see a doctor for a proper diagnosis. Other conditions, such as food allergies or inflammatory bowel disease, can cause similar symptoms.
By Caroline Hopkins Legazpi.
The New York Times
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