Who Gets Lactose Intolerance?
Lactose intolerance occurs when the body doesn’t make enough of the enzyme lactase, which digests lactose, the sugar found in milk and other dairy products. Infants produce high levels of lactase in order to digest milk. After weaning, though, lactase levels decrease, meaning that eventually, as people age, many can no longer digest as much lactose.
Although lactose intolerance is viewed as a disorder, about 75% of all people around the globe have some degree of lactase deficiency. Lactose intolerance is much more common among Asians, Hispanics and blacks than in people of Northwest European descent.
Lactose intolerance is actually a misleading term, says Yuri A. Saito-Loftus, MD, MPH, an assistant professor in the Mayo Clinic’s division of gastroenterology and hepatology.
“The majority of the world population is lactose intolerant. It’s actually the people who are lactose tolerant that are the minority group.â€
Lactose Intolerance Varies in Severity
How much dairy you can eat depends on how much lactase enzyme your body produces, Saito-Loftus says. “That does vary a little bit from individual to individual. We don’t know exactly 100% what controls that. Presumably, it’s genetically determined.â€
However, some people with lactose intolerance can adapt and get fewer symptoms. “If you keep eating dairy, you can at least stimulate lactase production. Paradoxically, the more you eat -- presumably in moderation -- the better you are able to tolerate dairy products,†Saito-Loftus says.
That’s important because people with lactose intolerance can shortchange themselves nutritionally. “If you’re lactose intolerant, you tend to cut out dairy, which is a great source of calcium. People who are lactose intolerant are at higher risk for osteoporosis,†Saito-Loftus says. If people really can’t handle lactose in foods, “they need to be very good about taking calcium and vitamin D supplements.†**
Fortunately, though, “Even if you are lactose intolerant, it has been shown that you can tolerate small amounts of dairy and not have a problem,†Saito-Loftus says.
Sandquist agrees. “Many people know their symptoms pretty well and so they know if they can handle just a little bit or not. They have already experimented with it.â€
Find Out How Much You Can Eat
If you’re not sure which foods you can handle, or how much, start experimenting with one dairy food and see how much you can eat without prompting symptoms, Sandquist says. For example, start out by drinking a half-cup of dairy milk and see how well you tolerate it. If milk doesn’t agree with you, try other dairy products that have less lactose. For example, an ounce of American, Swiss, cheddar, or Parmesan cheese has 1 to 2 grams of lactose, compared to 10-12 grams in one cup of milk, she says.
Typically, any discomfort from lactose intolerance arises 30 minutes to two hours after a person eats milk or dairy products. If a food triggers symptoms, you can still try to cut back on amounts to see if you can handle a smaller portion. You can also try a variety of lactose-free dairy options or find a substitute non-dairy product.***
Although some people keep a mental tally of foods or amounts to avoid, others might gain better understanding by jotting down notes. “A diary is extremely helpful because then they can log what symptoms they have, what they’ve eaten,†Sandquist says. “They can look back and see if there’s a pattern.â€
To reduce symptoms, also try eating dairy products with other foods to slow digestion. *“I think that makes a huge difference,†Saito-Loftus says. “If you eat [lactose] with other foods, it mixes and it empties out of your stomach at a slower rate. It’s not like eating ice cream and suddenly, you have all this lactose coming out all at once. If you eat dairy with meat or rice or other such things, it gets mixed in and diluted. It’s easier for your body to tolerate in that context.â€
SOURCES:
Yuri A. Saito-Loftus, MD, assistant professor, division of gastroenterology and hepatology, Mayo Clinic.
Dee Sandquist, MS, RD, CDE, Fairfield, Iowa; spokeswoman, American Dietetic Association.
Merck Manual Online: “Lactose Intolerance.â€
National Institutes of Health: “How Is Lactose Intolerance Managed?â
Lactose: How Much Is Too Much?
Lactose intolerance occurs when the body doesn’t make enough of the enzyme lactase, which digests lactose, the sugar found in milk and other dairy products. Infants produce high levels of lactase in order to digest milk. After weaning, though, lactase levels decrease, meaning that eventually, as people age, many can no longer digest as much lactose.
Although lactose intolerance is viewed as a disorder, about 75% of all people around the globe have some degree of lactase deficiency. Lactose intolerance is much more common among Asians, Hispanics and blacks than in people of Northwest European descent.
Lactose intolerance is actually a misleading term, says Yuri A. Saito-Loftus, MD, MPH, an assistant professor in the Mayo Clinic’s division of gastroenterology and hepatology.
“The majority of the world population is lactose intolerant. It’s actually the people who are lactose tolerant that are the minority group.â€
Lactose Intolerance Varies in Severity
How much dairy you can eat depends on how much lactase enzyme your body produces, Saito-Loftus says. “That does vary a little bit from individual to individual. We don’t know exactly 100% what controls that. Presumably, it’s genetically determined.â€
However, some people with lactose intolerance can adapt and get fewer symptoms. “If you keep eating dairy, you can at least stimulate lactase production. Paradoxically, the more you eat -- presumably in moderation -- the better you are able to tolerate dairy products,†Saito-Loftus says.
That’s important because people with lactose intolerance can shortchange themselves nutritionally. “If you’re lactose intolerant, you tend to cut out dairy, which is a great source of calcium. People who are lactose intolerant are at higher risk for osteoporosis,†Saito-Loftus says. If people really can’t handle lactose in foods, “they need to be very good about taking calcium and vitamin D supplements.†**
Fortunately, though, “Even if you are lactose intolerant, it has been shown that you can tolerate small amounts of dairy and not have a problem,†Saito-Loftus says.
Sandquist agrees. “Many people know their symptoms pretty well and so they know if they can handle just a little bit or not. They have already experimented with it.â€
Find Out How Much You Can Eat
If you’re not sure which foods you can handle, or how much, start experimenting with one dairy food and see how much you can eat without prompting symptoms, Sandquist says. For example, start out by drinking a half-cup of dairy milk and see how well you tolerate it. If milk doesn’t agree with you, try other dairy products that have less lactose. For example, an ounce of American, Swiss, cheddar, or Parmesan cheese has 1 to 2 grams of lactose, compared to 10-12 grams in one cup of milk, she says.
Typically, any discomfort from lactose intolerance arises 30 minutes to two hours after a person eats milk or dairy products. If a food triggers symptoms, you can still try to cut back on amounts to see if you can handle a smaller portion. You can also try a variety of lactose-free dairy options or find a substitute non-dairy product.***
Although some people keep a mental tally of foods or amounts to avoid, others might gain better understanding by jotting down notes. “A diary is extremely helpful because then they can log what symptoms they have, what they’ve eaten,†Sandquist says. “They can look back and see if there’s a pattern.â€
To reduce symptoms, also try eating dairy products with other foods to slow digestion. *“I think that makes a huge difference,†Saito-Loftus says. “If you eat [lactose] with other foods, it mixes and it empties out of your stomach at a slower rate. It’s not like eating ice cream and suddenly, you have all this lactose coming out all at once. If you eat dairy with meat or rice or other such things, it gets mixed in and diluted. It’s easier for your body to tolerate in that context.â€
SOURCES:
Yuri A. Saito-Loftus, MD, assistant professor, division of gastroenterology and hepatology, Mayo Clinic.
Dee Sandquist, MS, RD, CDE, Fairfield, Iowa; spokeswoman, American Dietetic Association.
Merck Manual Online: “Lactose Intolerance.â€
National Institutes of Health: “How Is Lactose Intolerance Managed?â
Lactose: How Much Is Too Much?
