Nutrition Meets Food Science

Lactose Intolerance- Know the Facts & Solutions

Have you ever heard people saying they get some gastric discomfort on consuming milk? Now, what is this all about? We have all studied since our school days that milk is a nutrient rich food that is a primary source of nutrition for infants; and consuming milk is almost a ritual among Indians. So, what is it that makes milk a “not to consume” kind of a food for some!

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So, the fact is that milk of mammals contains a natural sugar named lactose which is a disaccharide of galactose and glucose. When milk and milk products or foods containing lactose enters the human digestive system, it is hydrolysed to galactose and glucose in the intestine and the hydrolysed sugars are then absorbed into the bloodstream. This hydrolysis is possible in the presence of the enzyme lactase which is secreted in the small intestine itself. In case of insufficient amount of lactase, the undigested lactose moves downthrough the small intestine and remains unabsorbed in the large intestine. This is also known as lactose malabsorption. The microflora present in large intestinebrings about the fermentation of the undigested lactose producing large amounts of gas which causes bloating, vomiting, diarrhoea, abdominal cramps etc. which are the symptoms of the condition lactose intolerance.

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The symptoms of lactose intolerance usually begin to appear 30 minutes to two hours after consuming foods containing lactose.The severity of symptoms can vary, depending on how much lactose one can tolerate and how much has been consumed.

Lactose is also found in breast milk, and almost everyone is born with the ability to digest it. It is very rare to see lactose intolerance in children under the age of five.In some cases, your genes are the reason for lactose intolerance that can lead to low levels of lactase in your small intestine.

  • Lactase non persistence.In people with lactase non persistence, the small intestine makes less lactase after infancy. Lactase levels get lower with age. Symptoms of lactose intolerance may not begin until later childhood, the teen years, or early adulthood. Lactase nonpersistence, also called primary lactase deficiency, is the most common cause of low lactase levels.
  • Congenital lactase deficiency.In this rare condition, the small intestine makes little or no lactase, starting at birth.

Is it similar to Milk Allergy?

Lactose intolerance is not the same as milk allergy.  Milk allergy is an immune system reaction to milk protein. Milk allergy can be severe and life-threatening and may include hives, rashes, vomiting, and difficultyin breathing or other symptoms. Unlike milk allergy, lactose intolerance doesn’t cause the immune system to react. Moreover, allergy can appear even with very small amounts of milk whereas most lactose intolerant people may tolerate small amounts of milk with lactose.

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Solutions to the Problem

Where there is a problem there must be a solution too. In this case, the immediate solution would be to avoid lactose containing dairy products from the diet. Removing dairy means missingon many nutrients including the best source of highest quality protein, an excellent source of calcium and many other vitamins. This may not be a good option.

However, most people with lactose intolerance can tolerate small amounts of lactose. So these people can have either lactose free or low lactose milk products.

Not just in milk and milk derived products but lactose may also be present in products such as bread, cakes, biscuits & cookies, instant soups and a large number of  bakery &  confectionary products. Hence, the food labels will have to be carefully checked to see for the presence of lactose.

Dairy Analogues

There are dairy analogues that are now available in the market and are the best substitutes for individuals who are lactose intolerant. These include soya milk, almond milk, coconut milk, tofu, etc. that can be source of some of the nutrients missed from dairy products.

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Lactase Enzyme Supplements

One can help them to digest lactose by consuming lactase enzyme supplements that are available in the market. These are available in the form of tablets (suitable when consuming products like ice cream and sweets made of milk) and drops that can be added to food and drinks. Here, it becomes necessary to follow the instructions for consumption as different products have different amounts of enzymes of different optimum conditions.

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Probiotics are live bacteria that enhance the gut health by restoring its flora. With their ability to colonize and produce lactase in the small intestine, they have been helpful in digesting the lactose in the gut and have the effect for a longer duration.

It’s not always necessary to completely avoid dairy if you are lactose intolerant. With correct knowledge and medical advice, every health condition can be dealt with ease.


Manager - Food & Nutrition, PFNDAI

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