Don’tmilk it

Anjali Mukerjee

Many of us complain of stomach disorders after consuming milk. Normally, when a person consumes milk or milk products, an enzyme named lactase (manufactured in the small intestine) breaks down lactose, (the sugar present in milk), into simple sugars (glucose and galatose) in the small intestine. These simple sugars are then absorbed and converted into energy. People suffering from lactose intolerance are unable to produce adequate amount of lactase. Without lactase, the lactose from milk products cannot to be digested. This is termed as lactose intolerance.

Lactose intolerance is caused by the body’s inability to digest sugar present in milk i.e. lactose. Undigested lactose persists in the gut, gets broken down by bacteria, and stimulates gas production, bloating, stomach cramps and diarrhoea. Lactose intolerance is quite common but not dangerous.

About 70 per cent of the world population is affected by lactose intolerance. It is usually genetic and common in Asia and Africa. Many people with lactose intolerance don’t even know that they have it. How much bloating milk can cause depends on the severity of your lactase deficiency. Many people with lactose intolerance can drink a single glass of milk without distress. As we grow older we have minimal quantities of lactase in our small intestine and hence we are unable to digest large quantity of lactose. Most of us may develop lactose intolerance as we cross 40. However, some people’s body continues to produce considerable quantities of lactase even in adulthood. Such people are able to tolerate milk without any problem.

Those prone to it

People suffering from Celiac or Crohn’s disease, an inflammatory disease of upper small intestine, have reduced levels of lactase so they become lactose intolerant.

nCertain antibiotics cause short-span lactose intolerance by hindering intestine’s ability to produce lactase.

nFew children develop temporary lactose intolerance after suffering from diarrhoea, which gets better after a few days.

nAs age advances, the body stops producing lactase and most people become lactose intolerant over time.

nPeople from Asia, Africa and Native America background are more likely to acquire lactose intolerance at a young age.

Symptoms

If you experience abdominal pain, diarrhoea, flatulence, bloating, bad breath and nausea after consuming milk or milk products you may be lactose intolerant. However, other conditions may show the same symptoms. Also, the severity of symptoms of lactose intolerance varies from person to person and is dependent upon the amount of lactose that can be tolerated. A simple method of diagnosing lactose intolerance is the ‘milk challenge’. In this, a person fasts overnight and then drinks a glass of fat-free milk in the morning. Nothing else is eaten or drunk for next few hours. The milk produces symptoms within few hours of ingestion in a lactose-intolerant person. If there are no symptoms, or if symptoms are considerably milder than the usual symptoms, then lactose intolerance is not the culprit.

Dietary guidelines

Lactose intolerance can be controlled by making adjustments in the diet. The amount of lactose that can be tolerated varies from person to person. Most people who are lactose intolerant can tolerate small or even moderate amounts of lactose. It often requires eliminating major milk-containing products to get relief from the symptoms. Thus, it may be necessary to eliminate only milk, curd, paneer, and ice cream. However, curd is often well-digested by lactose intolerant people though it comprises large amounts of lactose. This is because the culture present in yogurt digests the lactose it contains so it does not cause the symptoms. Individuals, who are intolerant to even small amounts of lactose, should, however, avoid all products containing milk.

The long-term health aftermath of lactose intolerance is calcium deficiency which can lead to osteoporosis. Milk and its products are best sources of calcium. Howver, to get your quota from non-milk sources, include broccoli, methi, palak, rajma, kabuli chana, cabbage, tofu and fish in your diet and take calcium supplements.

For most adults, lactose intolerance is actually a normal condition. The best way to combat lactose intolerance is to have knowledge and information about the foods which cause its symptoms and learning the ways to avoid these.

— The writer is nutritionist, founder director, Health Total. Her website is www.health-total.com

Some tips for dealing with lactose intolerance

• Try a milk substitute like soy milk.
• At times when you cannot avoid milk, eat something with it to avoid acute symptoms. E.g. with a milkshake, eat a sandwich. This helps reduce the symptoms.
• Eat a variety of dairy-free foods that are rich in calcium, such as broccoli, beans, tofu, or soy milk. Hard varieties like cheddar cheese is lower in lactose. 
• Curd is easier to digest and much less likely to cause lactose problems. 
• While purchasing, read food labels carefully. Look not only for milk and lactose in contents but also for whey, curds, milk by-products, dry milk solids and non-fat dry milk powder. 
• Drink small quantity of milk at one time( if you have mild symptoms)
• Drink milk with meals (if you are marginally lactose intolerance).
• Try soy milk or non-dairy milk to ensure adequate calcium intake.

Foods to avoid

Milk and foods made from milk are the only natural sources of lactose. However, lactose is hidden in foods to which it has been added. Foods containing lactose include:

• Bakery products like bread
• Processed breakfast cereals
• Breakfast drinks
• Candies and cakes
• Soups
• Salad dressings
• Pre-mix for pancakes, biscuits, and cookies