Take over-the-counter products containing lactase enzyme when consuming foods containing lactose
Take a calcium supplement providing 500 to 1,000 mg per day regularly if you avoid dairy products
Try using reduced-lactose milk or yogurt to see if you can tolerate them
Lactose intolerance is the impaired ability to digest lactose (the naturally occurring sugar in milk). The enzyme lactase is needed to digest lactose, and a few children and many adults do not produce sufficient lactase to digest the milk sugar. The condition is rare in infants.
Only one-third of the population worldwide retains the ability to digest lactose into adulthood. Most adults of Asian, African, Middle Eastern, and Native American descent are lactose intolerant. In addition, half of Hispanics and about 20% of Caucasians do not produce sufficient lactase as adults.1
A simple test for lactose intolerance is to drink at least two 8-ounce glasses of milk on an empty stomach and note any gastrointestinal symptoms that develop in the next four hours. The test should then be repeated using several ounces of cheese (which does not contain much lactose). If symptoms result from milk but not cheese, then the person probably has lactose intolerance. If symptoms occur with both milk and cheese, the person may be allergic to dairy products (very rarely can lactose intolerance be so severe that even eating cheese will cause symptoms). In addition to gastrointestinal problems, one study has reported a correlation in women between lactose intolerance and a higher risk of depression and PMS.2 However, this study is only preliminary and does not establish a cause-and-effect relationship.
|Choose dairy products wisely||
Try using reduced-lactose milk or yogurt to see if you can tolerate them.
Although symptoms of lactose intolerance are triggered by the lactose in some dairy products, few lactose-intolerant people need to avoid all dairy. Dairy products have varying levels of lactose, which affects how much lactase is required for proper digestion. Milk, ice cream, and yogurt contain significant amounts of lactose—although for complex reasons yogurt often does not trigger symptoms in lactose-intolerant people. In addition, lactose-reduced milk is available in some supermarkets and may be used by lactose-intolerant people.
|Choose carbs carefully||
Sucrose and some indigestible carbohydrates have been shown to produce symptoms in lactose-intolerant and milk-intolerant people, work with a nutrition-oriented doctor to experiment with different foods to see if they contribute to this condition.
Many people with lactose maldigestion tolerate more lactose in experimental studies than in everyday life, in which their symptoms may result from other carbohydrates as well. Sucrose and the indigestible carbohydrates lactulose and fructooligosaccharides (FOS) have all been shown to produce symptoms in lactose-intolerant and milk-intolerant people.3
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500 to 1,200 mg daily depending on age and other calcium sources
As lactose-containing foods are among the best dietary sources of calcium, lactose-intolerant people may want to use calcium supplements as an alternative source.
Caution: Calcium supplements should be avoided by prostate cancer patients.
Researchers have yet to clearly determine whether lactose-intolerant people absorb less calcium.4 As lactose-containing foods are among the best dietary sources of calcium, alternative sources of calcium (from beverages, foods, or supplements) are important for lactose-intolerant people. A typical amount of supplemental calcium is 1,000 mg per day.
6,000 to 9,000 IU tablets chewed with a lactose-containing meal or add 1,000 IU in liquid form to 8 ounces of milk
Lactase drops, capsules, and tablets may be used to prevent symptoms of lactose intolerance when consuming lactose-containing dairy products.
Supplemental sources of the enzyme lactase may be used to prevent symptoms of lactose intolerance when consuming lactose-containing dairy products. Lactase drops may be added to regular milk 24 hours before drinking to reduce lactose levels. Lactase drops, capsules, and tablets may also be taken orally, as needed, immediately before a meal that includes lactose-containing dairy products. The degree of lactose intolerance varies by individual, so a greater or lesser amount of oral lactase may be needed to eliminate symptoms of lactose intolerance.5
Lactase (Irritable Bowel Syndrome)
6,000 to 9,000 IU tablets chewed with a meal containing lactose, or add 1,000 IU in liquid form to 8 ounces of milk
Lactase enzymes taken prior to consuming milk or dairy products may help ease IBS symptoms.
Double-blind research has shown that avoidance of lactose (present in milk and some other dairy products) by people with IBS who are also lactose intolerant will relieve IBS symptoms.6 Alternatively, lactase enzyme may be used prior to consuming milk. Several different lactase products are commercially available and the amount needed depends on the specific preparation being used.
1. Gudmand-Hoyer E. The clinical significance of disaccharide maldigestion. Am J Clin Nutr 1994;59(3):735S-41S.
2. Ledochowski M, Sperner-Unterweger S, Fuchs D. Lactose malabsorption is associated with early signs of mental depression in females: a preliminary report. Dig Dis Sci 1998;43:2513-7.
3. Teuri U, Vapaatalo H, Korpela R. Fructooligosaccharides and lactulose cause more symptoms in lactose maldigesters and subjects with pseudohypolactasia than in control lactose digesters. Am J Clin Nutr 1999;69:973-9.
4. Wheadon M, Goulding A, Barbezat GO, et al. Lactose malabsorption and calcium intake as risk factors for osteoporosis in elderly New Zealand women. NZ Med J 1991;104:417-9.
5. Gudmand-Hoyer E. The clinical significance of disaccharide maldigestion. Am J Clin Nutr 1994;59(3):735S-41S.
6. Bohmer CJ, Tuynman HA. The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol 1996;8:1013-6.
Last Review: 07-22-2014
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.
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