Wednesday, August 10, 2011
Lactose Intolerance & Chocolate Milk...the Conundrum
Does your child tell you they CAN drink chocolate milk, but their stomach hurts after drinking "regular" milk? I'll share that when I told MY parents this, they laughed and thought I was simply asking for more sweets. As an adult, I was often puzzled that certain milk products did not agree with me, while others did. People asked if I was allergic to milk, or whether or not I had lactose intolerance...and I simply said that I do not like milk, because I didn't know the answer.
So, here it is. That kid that can down chocolate ice cream but not skim milk may indeed be lactose intolerant, and she is telling the truth! Lactose intolerance refers to the inability to digest lactose (the main milk sugar). Lactase lives on the inside surface of our intestines. Symptoms typically appear 30 minutes to 2 hours after consuming a product that contains lactose. The degree of symptoms produced (abdominal bloating, cramping, gas and/or diarrhea) depend on several variables:
1. The amount of lactose consumed
2. The level of lactase enzyme present
3. The SPEED of gastric emptying- the faster the gut transit, the worse the symptoms
Higher fat content will SLOW gastric emptying, which reduces the symptoms, so voila! There is your explanation for the chocolate milk. Of course, adding lactase in the form of a powder or capsule will also reduce the symptoms.
Who gets lactose intolerance? 80% of Blacks and Hispanics, nearly 100% of Native Americans and Asians, and roughly 15% of Caucasians develop it. Symptoms usually appear later in childhood or even as an adult. Also, anyone can transiently develop lactose intolerance after a serious bout of diarrhea, because that temporarily strips off the lining of the gut (which houses the lactase). Avoiding dairy products for a few days typically takes care of this type of intolerance.
The easiest way to tell if you have lactose intolerance is to eliminate it from your diet, and see if your abdominal complaints disappear. Remember, though, to read labels carefully, looking for "milk sugar, whey, or curd" as well as plain "milk". Note, too, that many prescription and OTC medications also use lactose as a base. Typically, however, even a lactose intolerant person is fine with SOME lactose (roughly 12 g) so it is not necessary to eliminate lactose 100% to see results.
If you are lactose intolerant, remember you will still need calcium to protect your bones, so talk with a registered dietician to be sure you are getting all you need.
BOTTOM LINE: Lactose intolerance is all about degrees, not simply "yes, you have it" or "no, you don't". Try a simple lactose elimination diet for a few days if you are concerned about abdominal complaints and think you may have lactose intolerance.