Are you increasingly bloated or gassy (flatulent) and do you have cramping or diarrhea after drinking milk or eating dairy foods?
You might be developing lactose intolerance. Lactose is the sugar found in milk and other dairy foods. An enzyme in your intestines, called lactase, digests lactose. It breaks down lactose so your body can use it. If your body doesn't make enough lactase, undigested lactose stays in the colon, which leads to these symptoms.
Lactose intolerance is more common in people of Asian, African and Native American ancestry. However, lactase levels also tend to decline with age. Lactose intolerance may also be caused by underlying gastrointestinal disease, surgery on the intestines or some medications.
You may have lactose intolerance if:
- You have symptoms after more than 2 servings of dairy a day — or more than 1 serving that is not associated with a meal.
- Your symptoms resolve after avoiding lactose-containing foods for 5-7 days but return when you resume eating dairy.
- Your symptoms are severe or persist despite a lactose-restricted diet. If this is the case, see your doctor.
Keep in mind that the amount of lactose that causes symptoms varies among individuals. Milk and foods made with milk also vary in how much lactose they contain.
What should you do if you have lactose intolerance?
- Eat less dairy and eat it along with other foods. Food slows down the release of lactose into the intestine. Studies have found that people may tolerate up to 1 cup of milk daily when taken with meals or up to 2 cups when taken in widely divided doses with food. Here are estimates of lactose levels in some common foods: One cup of milk has 12 grams (g) of lactose; lactase-treated milk has 3 g; 1 cup of yogurt has 4 to 17 g; 1/2 cup ice cream or ice milk has 6 g; 1/2 cup cottage cheese or ricotta has up to 6 g; 1 ounce American cheese has up to 4 g; 1 ounce of hard cheeses has up to 1 g; 1 teaspoon of butter or margarine has 1/2 g; and 1 tablespoon of cream has 1/2 g.
- Don't completely eliminate dairy if you can help it. Milk is a major source of calcium and vitamin D — both are needed for bone health. Two cups of milk or yogurt provide 60 to 80 percent of the daily value (DV) for calcium. Milk provides 60 percent of the DV for vitamin D. Not all yogurts are fortified with vitamin D, so check the label. If you're unable to drink milk, consider fortified non-dairy substitutes that contain calcium and vitamin D. These include soy, rice, almond and hemp milks, yogurts, cheeses and desserts. Be sure to check labels for amounts of calcium and vitamin D.
- Try lactase-treated dairy foods or a lactase supplement. Lactase-treated milk, yogurt, cheese and ice cream contain significantly less lactose. Chewable lactase-containing tables or drops taken with meals may improve tolerance to lactose. These supplements can be helpful if you're unsure of the lactose content of a meal, such as when you're eating out.
If you find your tolerance to lactose is diminishing, be sure to check in with your health care provider. Long-term restriction of milk and dairy products can result in inadequate intake of calcium and vitamin D, which increases the risk of osteoporosis. Your diet and blood levels should be monitored. In some cases, calcium and vitamin D supplementation may be indicated.
I hope the above suggestions are helpful. Let me know.
Oct. 05, 2016
- Montgomery RK, et al. Lactose intolerance: Clinical manifestations, diagnosis and management. http://www.uptodate.com/home. Accessed Sept. 28, 2016.
- Suchy FJ, et al. National Institutes of Health Consensus Development Conference: Lactose Intolerance and Health. Annals of Internal Medicine. 2010;152:792.
- Calcium. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/#h3. Accessed Sept. 28, 2016.
- Vitamin D. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h3. Accessed Sept. 28, 2016.
- Newcomer AD, et al. Lactase deficiency: Prevalence in osteoporosis. Annals of Internal Medicine. 1978;89:218.
- Lactose intolerance. http://www.mayoclinic.org/diseases-conditions/lactose-intolerance/basics/definition/con-20027906. Accessed Sept. 30, 2016.