What is Lactose Intolerance?
A health article about Lactose Intolerance from Your Health Online the A to Z directory of dealing with Health Problems & nutritional Self Care Strategies
Do you know anyway who can’t consume milk or milk-based products? The condition is not uncommon and these people are classified as lactose intolerant.
Lactose is the main carbohydrate or sugar found in milk, and in varying quantities in dairy products made from milk including yoghurt, ice cream, soft cheeses and butter.
Lactose (milk sugar) intolerance results from an inability to digest lactose in the small intestine. Back in the cave-days, the only time a person would ever ingest lactose would be when they were infants getting milk from their mothers.
During their adult lives milk was never consumed. Only with the invention of agriculture has milk become readily available to adults. Lactose is unique in that only in milk does it exist as a free form, unattached to other molecules.
Signs & Symptoms of Lactose Intolerance
Symptoms range from mild abdominal discomfort, bloating and excessive wind to severe abdominal cramps and diarrhea.
The enzyme lactase, also called beta-D-galactosidase, is synthesized if at least one of the two genes for it are present. Only when both gene expressions are affected is lactase enzyme synthesis reduced, which in turn reduces lactose digestion.
Lactase persistence, allowing lactose digestion to proceed, is the dominant allele. Physiological lactose intolerance, therefore, is an autosomal recessive trait.
However, cultures such as that of Japan, where dairy consumption has been on the increase, demonstrate a lower prevalence of lactose intolerance in spite of a genetic predisposition
The normal mammalian condition is for the young of a species to experience reduced lactase production at the end of the weaning period (a species-specific length of time). In non dairy consuming societies, lactase production usually drops about 90% during the first four years of life, although the exact drop over time varies widely.
However, certain human populations have a mutation on chromosome 2 which results in a bypass of the common shutdown in lactase production, making it possible for members of these populations to continue consumption of fresh milk and other dairy products throughout their lives.
Pathological lactose intolerance can be caused by Coeliac disease, which damages the villi in the small intestine that produce lactase. This lactose intolerance is temporary. Lactose intolerance associated with coeliac disease ceases after the patient has been on a gluten-free diet long enough for the villi to recover
Certain people who report problems with consuming lactose are not actually lactose intolerant. In a study of 323 Sicilian adults, Carroccio et al. (1998) found only 4% were both lactose intolerant and lactose maldigesters, while 32.2% were lactose maldigesters but did not test as lactose intolerant.
However, Burgio et al. (1984) found that 72% of 100 Sicilians were lactose intolerant in their study and 106 of 208 northern Italians (i.e., 51%) were lactose intolerant.
Types of Lactose Intolerance
There are three major types of lactose intolerance:
1. Primary lactose intolerance. Environmentally induced when weaning a child in non-dairy consuming societies. This is found in many Asian and African cultures, where industrialized and commercial dairy products are uncommon.
2. 3. Secondary lactose intolerance. Environmentally induced, resulting from certain gastrointestinal diseases, including exposure to intestinal parasites such as giardia.[4][5] In such cases the production of lactase may be permanently disrupted.[4][5][6] A very common cause of temporary lactose intolerance is gastroenteritis, particularly when the gastroenteritis is caused by rotavirus. Another form of temporary lactose intolerance is lactose overload in infants.
4. 5. Congenital lactase deficiency. A genetic disorder which prevents enzymatic production of lactase. Present at birth, and diagnosed in early infancy.
What Causes Lactose Intolerance?
Lactose is digested in the small intestine by an enzyme called lactase. This enzyme allows the body to break down the lactose into two simple sugars, glucose and galactose.
These are quickly absorbed by the intestine and provide energy for the body. The level of the lactase enzyme varies between individuals, as does the severity of symptoms caused by lactose intolerance.
Disaccharides cannot be absorbed through the wall of the small intestine into the bloodstream, so in the absence of lactase, lactose present in ingested dairy products remains uncleaved and passes intact into the colon.
The operons of enteric bacteria quickly switch over to lactose metabolism, and the resultant in vivo fermentation produces copious amounts of gas (a mixture of hydrogen, carbon dioxide, and methane). This, in turn, may cause a range of unpleasant abdominal symptoms, including stomach cramps, bloating, and flatulence.
In addition, as with other unabsorbed sugars (such as sorbitol, mannitol, and xylitol), the presence of lactose and its fermentation products raises the osmotic pressure of the colon contents, thereby preventing the colon from reabsorbing water, and causing osmotic Diarrhoea.
Risk Factors:
Lactose intolerance is the inability to metabolize lactose, a sugar found in milk and other dairy products, because the required enzyme lactase is absent or its availability is lowered. It is estimated that 70% of adult humans are lactose intolerant
Prevention:
SUBSTITUTES FOR LACTOSE-CONTAINING FOODS
Lactose intolerance generally isn’t serious and can be controlled by some simple changes in your diet. They dietary changes for lactose intolerance should include the exclusion of those foods highest in lactose.
There is now a wide range of fresh soy milks, yoghurts and ice creams which are lactose free and calcium enriched. Many dairy foods actually have little or no lactose so you can continue to enjoy them.
THE POWER OF SOY PROTEIN
Soy-based products are on the rise for very healthy reasons. The humble soybean boasts some extraordinary benefits.
Lactose-free, soy protein is a “complete protein” which contains all 9 essential amino acids in the right balance to meet your body’s needs. Soy protein is the only plant protein that is complete.
This makes it a great substitute for many meats, allowing you to eliminate more saturated fat and cholesterol from your diet. While soybeans have much more to offer from a protein perspective, it is because they contain so many nutrients, such as isoflavones, that they are now the centre of so much attention.
Soy protein enhances the body’s ability to retain and better absorb calcium into the bones. Soy isoflavones help by slowing bone loss and inhibiting bone breakdown.
When to seek Medical Advice:
To assess lactose intolerance, the intestinal function is challenged by ingesting more dairy than can be readily digested. Clinical symptoms typically appear within 30 minutes but may take up to 1-2 hours depending on other foods and activities. Substantial variability of the clinical response (symptoms of nausea, cramping, bloating, diarrhea, and flatulence) are to be expected as the extent and severity of lactose intolerance varies between individuals.
When considering the need for confirmation, it is important to distinguish lactose intolerance from milk allergy, which is an abnormal immune response (usually) to milk proteins. Since lactose intolerance is the normal state for most adults on a worldwide scale, and not considered a disease condition, a medical diagnosis is not normally required. However, if confirmation is necessary, three tests are available:
Hydrogen breath test
In a hydrogen breath test, after an overnight fast, 50 grams of lactose (in a solution with water) are swallowed. If the lactose cannot be digested, enteric bacteria metabolize it and produce hydrogen.
This can be detected in the patient's breath by a clinical gas chromatograph or a compact solid state detector. The test takes about 2 to 3 hours. A medical condition with similar symptoms is fructose malabsorption.
In conjunction, measuring the blood glucose level every 10 - 15 minutes after ingestion will show a "flat curve" in individuals with lactose malabsorption, while the lactase persistent will have a significant "top", with an elevation of typically 50 to 100% within 1 - 2 hours.
However, given the need for frequent blood drawns, this approach has been largley supplanted by breath testing.
Stool acidity
Can be used to diagnose lactose intolerance in small infants, for whom other forms of testing are risky or impractical.
Intestinal biopsy
An intestinal biopsy can confirm lactose intolerance following discovery of elevated hydrogen in the hydrogen breath test.. However, given the invasive nature of this test, and the need for a highly specialized laboratory to measure lactase enzymes or mRNA in the biposy tissue, this approach is used almost exclusively in clinical research.
Treatment/Therapy:
Lactose in non-dairy products
Lactose (also present when labels state lactoserum, whey, milk solids, modified milk ingredients, etc) is a commercial food additive used for its texture, flavor and adhesive qualities, and is found in foods such as processed meats (sausages/hot dogs, sliced meats, Pâtés), gravy stock powder, margarines , sliced breads, breakfast cereals, dried fruit, processed foods, medications, preprepared meals, meal replacement (powders and bars), protein supplements (powders and bars).
Kosher products labeled pareve are free of milk. However, if a "D" (for "Dairy) is present next to the circled "K," "U," or other hechsher, the food likely contains milk solids (although it may also simply indicate that the product was produced on equipment shared with other products containing milk derivatives).
Alternative products
Milk. The dairy industry has created quality low-lactose or lactose-free products to replace regular dairy. Lactose-free milk can be produced by passing milk over lactase enzyme bound to an inert carrier: once the molecule is cleaved, there are no lactose ill-effects.
A form is available with reduced amounts of lactose (typically 30% of normal), and alternatively with nearly 0%. Finland has had "HYLA" (acronym for hydrolysed lactose) products available for many years, even though the number of lactose intolerant people there is relatively small. These low-lactose level cow's milk products, ranging from ice cream to cheese, use a Valio patented chromatographic separation method to remove lactose. The ultra-pasteurization process, combined with aseptic packaging, ensures a long shelf-life.
Recently, the range of low-lactose products available in Finland has been augmented with milk and other dairy products (such as ice cream, butter, and buttermilk) that contain no lactose at all. The remaining about 20% of lactose in HYLA products is taken care of enzymatically.
These typically cost 2 - 4 times more than equivalent products containing lactose. Valio also markets these products in Sweden.
Alternatively, a bacterium such as L. acidophilus may be added, which affects the lactose in milk the same way it affects the lactose in yogurt (see above).
Plant based milks and derivatives are the only ones to be 100% lactose free (soy milk, almond milk, oat milk, rice milk, peanut milk).
Lactase supplementation
When lactose avoidance is not possible, or on occasions when a person chooses to consume such items, then enzymatic lactase supplements may be used.
Lactase enzymes similar to the those produced in the small intestines of humans are produced industrially by fungi of the genus aspergillus. The enzyme, β-galactosidase, is available in tablet form in a variety of doses, in many countries without a prescription.
It functions well only in high-acid environments, such as that found in the human gut due to the addition of gastric juices from the stomach. Unfortunately, too much acid can denature it, and it therefore should not be taken on an empty stomach.
Also, the enzyme is ineffective if it does not reach the small intestine by the time the problematic food does. Lactose-sensitive individuals should experiment with both timing and dosage to fit their particular need.
But supplements such as these may not be able to provide the accurate amount of lactase needed to adequately digest the lactose contained in dairy products, which may lead to symptoms similar to the existing lactose intolerance.
While essentially the same process as normal intestinal lactose digestion, direct treatment of milk employs a different variety of industrially produced lactase. This enzyme, produced by yeast from the genus kluyveromyces, takes much longer to act, must be thoroughly mixed throughout the product, and is destroyed by even mildly acidic environments.
It therefore has been much less popular as a consumer product (sold, where available, as a liquid) than the aspergillus-produced tablets, despite its predictable effectiveness. Its main use is in producing the lactose-free or lactose-reduced dairy products sold in supermarkets.
Enzymatic lactase supplementation may have an advantage over avoiding dairy products, in that alternative provision does not need to be made to provide sufficient calcium intake, especially in children.
Rehabituation to dairy products
For healthy individuals with Secondary lactose intolerance, it may be possible to train bacteria in the large intestine to break down lactose more effectively by consuming small quantities of dairy products several times a day over a couple of weeks.
Reintroducing dairy in this way to people who have an underlying or chronic illness, however, is not recommended, as certain illnesses damage the intestinal tract in a way which prevents the lactase enzyme from being expressed.
However, other studies have shown that lactase production does not seem to be induced by dairy/lactose consumption
Self Care strategies for Living with Lactose Intolerance
For persons living in societies where the diet contains relatively little dairy, lactose intolerance is not considered a condition that requires treatment.
However, those living among societies that are largely lactose-tolerant may find lactose intolerance troublesome. Although there are still no methodologies to reinstate lactase production, some individuals have reported their intolerance to vary over time (depending on health status and pregnancy).
Lactose intolerance is not usually an all-or-nothing condition: the reduction in lactase production, and hence, the amount of lactose that can be tolerated varies from person to person.
Since lactose intolerance poses no further threat to a person's health, managing the condition consists in minimizing the occurrence and severity of symptoms. Berdanier and Hargrove recognise 4 general principles: 1) avoidance of dietary lactose; 2) substitution to maintain nutrient intake; 3) regulation of calcium intake; 4) use of e
nzyme substitute.
Avoiding lactose-containing products
Since each individual's tolerance to lactose varies, according to the US National Institute of Health, "Dietary control of lactose intolerance depends on people learning through trial and error how much lactose they can handle."
Label reading is essential as commercial terminology varies according to language and region. Lactose is present in 2 large food categories: Conventional dairy products, and as a food additive (in dairy and non dairy products).
Dairy products
Lactose is a water soluble molecule. Therefore fat percentage and the curdling process have an impact on which foods may be tolerated. In the curdling process lactose is found in the water portion along with whey and casein, but is not found in the fat portion.
Dairy products which are "fat reduced" or "fat free" generally have a slightly higher lactose percentage. Additionally, low fat dairy foods also often have various dairy derivatives such as milk solids added to them to enhance sweetness, increasing the lactose content.
Milk. Human milk has the highest lactose percentage at around 9%. Unprocessed cow milk has 4.7% lactose. Unprocessed milk from other mammals contains similar lactose percentages (goat milk 4.1%, buffalo 4.86%,yak 4.93%,sheep milk 4.6%)
Butter. The butter making process separates milk's water components from the fat components. Lactose, being a water soluble molecule, will not be present in the butter unless milk solids are added to the ingredients.
Yogurt and kefir. People can be more tolerant of traditionally made yogurt than milk because it contains lactase enzyme produced by the bacterial cultures used to make the yogurt. However, many commercial brands contain milk solids, increasing the lactose content.
Cheeses. Traditionally made hard cheese (such as Swiss cheese) and soft ripened cheeses may create less reaction than the equivalent amount of milk because of the processes involved. Fermentation and higher fat content contribute to lesser amounts of lactose.
Traditionally made Swiss or Cheddar might contain 10% of the lactose found in whole milk. In addition, the traditional aging methods of cheese (over 2 years) reduces their lactose content to practically nothing.
Commercial cheese brands, however, are generally manufactured by modern processes that do not have the same lactose reducing properties, and as no regulations mandate what qualifies as an "aged" cheese, this description does not provide any indication of whether the process used significantly reduced lactose.
Buttermilk, sour cream and ice cream, like yogurt, if made the traditional way, will generally be quite tolerable, but most modern brands add milk solids. Consult labels.
Diet change strategies:
IDEAL MEAL- SHAKES
Chocolate Strawberry. Peach Almond. Café Mocha. You can enjoy delicious shakes like these and still lose weight. Formula 1 Nutritional Shake Mix includes heart smart soy protein and essential vitamins and minerals- all in one delicious meal!
This recipe delivers at least 29 grams of protein. The combination of protein and fruit in shakes makes them more filling to help keep you satisfied and your cravings at bay.
Replacing two meals with two shakes a day will help you lose weight. Or, you can replace just one meal a day to maintain your weight.
STRAWBERRY PARFAIT
INGREDIENTS:
29 grams French Vanilla Formula 1 Shake Mix
18 grams Formula 3 Protein Powder
170 gram carton strawberry-flavored fat-free soy yoghurt
1 cup strawberries
4 ice cubes
DIRECTIONS:
Place all ingredients in the blender and mix thoroughly until all the ice cubes are completely crushed. Ice cubes are optional.
Note: For a less pudding-like consistency, add ¼ cup nonfat soy milk and protein powder in the blender first, then add other ingredients and continue blending.
Nutritional Analysis
Calories: 240
Protein: 29 grams
Fat: 0.5 grams
Carbohydrates: 38 grams
Vitamin & Nutrient Associations
Even when we try to eat well, we're disadvantaged. The nutritional content of most food has been compromised over the years, not only by deficient soils and modern production, transportation, storage and processing methods, but also by the enormous amounts of chemical and artificial substances added to promote growth, storage life, taste and appearance.
It's for this reason that more and more medical authorities are advocating the use of vitamin and mineral supplements. However, finding them in the right combination can be both confusing and costly.
One of the best ways to supplement is with a balanced nutrition program that includes protein and well as the amino acids that your body needs every day but that it cannot produce for itself. You also need vitamins, minerals, and botanical factors (plant – living food ingredients).
The most convenient way to do this is with a protein shake and some tablet supplements.
The problem is that most “shakes” are based on a dairy base and so introduce into your diet the lactose that many people are intolerant to. If you are lactose intolerant then adding lactose will effect the digestive system of many people effectively preventing the nutrition from the supplements being assimilated into your system. (see nutrition for your cells)
Aloe Vera Juice is a refreshing and anti-bacterial drink, you might find that taking this daily, diluted in some filtered water will not only refresh you like ‘a shower inside you’ but also assists in dealing with any digestive issues you may also be experiencing.
You may find benefit from our information on detoxification as well as a bit about detoxing because of change of diet
It may be due to difficulties with your digestive system that is causing your body to be starved of key nutrients, vitamins or minerals. In this case you may find useful answers by reviewing our article on Nutrition For Your Cells. There is also more information here about why is nutrition such an issue nowadays?
It may be that your metabolism has slowed due to pressures that have been placed on your system through life in general or through specific “challenges” you have faced in the last few months or last few years. Review this by looking at our article about balancing your Metabolic Rate.
Further reading through our articles on Lactose Intolerance health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your problem through giving your body the nutrition products that will assist you body to heal from the inside out.
We wish you well in your search for solutions to this Lactose Intolerance problem and your movement towards better health in all areas.
More Resources available about Lactose Intolerance :
Food Allergy
To start with, food allergy is unusual reaction to certain type of food allergen. An allergen is the substance or thing that causes the allergic reactions.
Exposure to the allergen sets off the alarm in the human immune system which consequently releases antibodies to fight off the invasion of the perceived foreign body that is the food allergen.
(To read the rest of this article click on the Title above here.)
Allergies
An Allergy can be described as sensitiveness of the body to a substance which does not normally affect other persons.
There are innumerable substances in the environment which can cause mild to violent reactions in many people.
These reactions range from true allergies due to intolerance of certain foods and substances, to those resulting from pollution.
(To read the rest of this article click on the Title above here.)
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