Am I lactose intolerant?

People with lactose intolerance are not able to fully digest the sugar, called lactose, in milk. They have diarrhea, nausea, stomach cramps, bloating and gas 30 minutes to two hours after eating or drinking foods that contain lactose.

Lactase is an enzyme in your small intestine. This enzyme helps digest the lactose in milk and milk products. If your level of lactase is too low, you can become lactose intolerant. Infants need lactase to digest milk. As children grow and choose other foods, the amount of lactase they produce typically decreases. Still, it usually is high enough to digest the lactose consumed in a typical adult diet. If lactase production continues to fall, lactose intolerance may show up at any age.

Lactose intolerance appears to run in families and is most common in people of African, Asian, Hispanic and American Indian descent. Others who may become lactose intolerant include those with celiac disease, Crohn’s disease and bacterial overgrowth, and those who have undergone some types of cancer treatments and gastrointestinal surgery.

Many people with lactose intolerance may be able to consume small amounts of dairy products, such as yogurt and hard cheeses like cheddar and Swiss, but not regular milk. Taking lactase supplements before having milk and dairy products may help.

Lactose-containing milk products include milk, cheese, yogurt, cottage cheese, butter, whipping cream, half and half, dry milk powder and evaporated and condensed milk. Lactose-free versions of dairy products are often available.

If you cannot tolerate lactose, you will need to find other ways to receive calcium and vitamin D.

Calcium is in sardines, canned salmon, tofu, shellfish, turnip greens, collards, kale, broccoli, dried beans, calcium-fortified soy milk and other plant-based beverages, almonds and blackstrap molasses. Vitamin D is in eggs, salmon and other fatty fish, and fortified orange juice, soy and other plant-based beverages.

If you are lactose intolerant, check the nutrition label ingredient list for any butter, cream, milk solids or whey. Also, avoid foods whose label states they “may contain milk.” Some other packaged food items that may include dairy products are lunchmeats, hot dogs, baked goods, instant potatoes, instant soups, margarine, salad dressing, candies and pancake and cake mixes. If the ingredient list includes casein, lactalbumin, lactate or lactic acid, these ingredients do not contain lactose.

If you have symptoms of lactose intolerance after consuming dairy, avoid dairy products and see if the symptoms improve. If symptoms become better and you want to try small amounts of dairy, start with aged cheese, yogurt or ricotta cheese. Tolerance varies with each individual.

You can find lactose in milk and milk products, but it also is a common additive in other foods and medicines. It is critical that you learn to read labels if you are very sensitive to even small amounts of lactose.

If you have further questions, please contact your physician or call Columbus Community Hospital dietitians Joan Plummer at 402-562-4462, or Susan Olmer at 402-562-4460.

The above information is from Joan Plummer, dietitian and diabetes educator at Columbus Community Hospital.