Bad news cheeseheads. Lactose intolerance can strike in your 20s, 30s, and beyond. Show
We have all the dietary deets plus some top tips on how to ditch the dairy. Lactose intolerance is when your body can’t break down lactose, a natural sugar found in dairy products. It usually happens when your small intestine stops making enough lactase, an enzyme that helps you digest lactose. If you’re lactose intolerant, enjoying a glass of milk or your fave dairy goodies can cause symptoms like:
When it comes to lactose intolerance, age is nothin’ but a number. It can crop up at any time. There are four main types of lactose intolerance:
PrimaryLactase levels are usually highest when you’re a bébé and decrease as you age. In fact, about 75 percent of adults don’t produce enough lactase. If your lactase levels are too low, you can develop primary lactose intolerance. It’s the most common type of the condition and is caused by an inherited gene. CongenitalCongenital lactose intolerance is a rare condition that affects infants. It’s inherited and both parents need to carry the gene to pass it on. DevelopmentalBabies born prematurely may experience developmental lactose intolerance. It happens when the baby’s body can’t produce enough lactase because the small intestines aren’t fully developed. It tends to be temporary. SecondarySecondary lactose intolerance can develop when there’s an issue with the small intestine. It can be caused by an infection, illness, or intestinal surgery. If dairy’s giving you grief, it’s time to talk with your doc. They can give you a test to see what’s going on.
If you have a mild intolerance, you might still be able to tolerate small amounts of lactose without issue. But what if any amount of lactose doesn’t agree with you? The most obvious way to treat lactose intolerance is to avoid foods with lactose. You can also take lactase supplements (like Lactaid) before drinking or eating dairy. These may help you enjoy your fave foods without the GI side effects. Probiotics may also help, but certain strains would need to be chosen. If lactase supplements aren’t your jam, here’s how you can still get your dairy fix:
Lactose intolerance can develop at any age. It can be triggered by a health condition, like celiac disease or an intestinal infection. But it can also be heredity or a symptom of aging. The good news is that there are ways to manage your lactose intolerance. Taking a lactase supplement can often do the trick and let you enjoy dairy without symptoms. Others may need to cut dairy out of their diet or eat low lactose or lactose-free dairy products. If you’ve ever felt a foreboding rumbling in your stomach shortly after eating, you may have wondered whether you’re lactose intolerant. Lactose is a type of sugar found in milk products. Some people are unable to digest it properly, leading to unpleasant digestive symptoms after dairy intake. This article reviews what lactose intolerance is, along with how it’s diagnosed and treated. Lactose intolerance is a digestive disorder caused by the inability to digest lactose, the main carbohydrate in dairy products. It’s very common, affecting around two-thirds of the world’s adult population at minimum (1). This condition occurs if your body doesn’t make enough of the enzyme lactase, which you need to digest lactose (1). People with lactose intolerance experience digestive problems when they consume dairy, which can negatively affect their quality of life. These symptoms include bloating, diarrhea, and abdominal cramps. Can you develop lactose intolerance over time?Lactose is found in breast milk, and almost everyone is born with the ability to digest it. However, you can develop lactose intolerance at any age, even well into adulthood (1). Several types of lactose intolerance exist, and they may be caused by different factors. However, all lactose intolerance is characterized by a deficiency in the enzyme lactase. Summary If not managed properly, lactose intolerance may cause severe digestive problems. These symptoms may appear as quickly as 30–60 minutes after eating. The most common symptoms are (1):
Some people also experience an urgent need to go to the toilet, vomiting, lower belly pain, and constipation. Diarrhea occurs due to undigested lactose in your small intestine, which causes water to move into your digestive tract (2). Once it reaches your colon, the lactose is fermented by the bacteria in your gut, forming short-chain fatty acids (SCFAs) and gas. This causes bloating, gas, and pain (2). The severity of symptoms varies based on how much lactose you can tolerate and how much you’ve eaten. Fortunately, these symptoms last only briefly. You’re also typically not affected unless you consume large amounts of lactose or have another condition that’s worsened by the digestive irritation caused by lactose intolerance. summary Lactose is made up of the simple sugars glucose and galactose. You need the enzyme lactase to break lactose down into glucose and galactose, which your body then absorbs into your bloodstream for energy. Without sufficient lactase, lactose moves through your gut undigested and causes digestive symptoms. Still, there are multiple causes of lactase deficiency (1). Here are the different types of lactose intolerance. Primary lactose intolerancePrimary lactose intolerance — the most common type — is caused by a decrease in lactase production with age. As such, you lose the ability to absorb lactose over time (1, 3). This form of lactose intolerance may be partially genetic since it’s more common in some populations than others. Studies estimate that this condition affects under 10% of Northern European people, around 50% of Latin and Middle Eastern people, and 80–99% of African and Asian people (1). Secondary lactose intoleranceSecondary lactose intolerance develops as a result of another condition that affects the small intestine, where lactase is produced. This is because inflammation in the wall of your gut may lead to a temporary decline in lactase production (1, 4). Possible causes of secondary lactose intolerance include Crohn’s disease, celiac disease, chemotherapy, ulcerative colitis, and aging (1). Congenital lactose intoleranceCongenital lactose intolerance is present in newborns. It’s a rare, inherited type of this condition, and both parents must possess the particular gene mutation for congenital lactose intolerance for the infant to be born with it (1, 5). These infants are unable to nurse due to the lactose content of breast milk, and this condition may even be fatal if not caught quickly. Side effects may include severe diarrhea and high calcium levels (1, 2). This condition is also lifelong (1, 2). Developmental lactose intoleranceDevelopmental lactose intolerance occurs in infants, too. It’s typically only seen in premature babies, who are born before their digestive system is fully developed, and it causes symptoms like digestive distress (2, 5). This condition typically resolves on its own as the baby grows, but in the meantime, your infant may need lactose-free formula rather than breast milk (5). Risk factorsSome people may have an increased risk of lactose intolerance. Risk factors to look out for include having the following (1):
summary Here are the ways that your doctor can test you for lactose intolerance (1):
You can also do an elimination test by yourself if you think you have lactose intolerance. To do it, eliminate lactose from your diet for at least 2 weeks, then reintroduce dairy to see whether you experience any digestive symptoms. While an elimination test may help you understand whether you have trouble digesting lactose, seeking an official diagnosis from a healthcare professional may help you avoid unnecessarily eliminating dairy from your diet if your symptoms are caused by another condition. summary Dairy products, which include milk and all products made from milk, are highly nutritious. In fact, dairy intake is linked to higher bone mineral density, which may help reduce your risk of bone fractures as you age (7, 8 ). However, people with lactose intolerance may need to reduce or eliminate their dairy intake, potentially depriving them of key nutrients like calcium. Dairy foods are excellent sources of calcium, but eating dairy isn’t critical for your health. You can follow a very healthy diet without dairy — as long as you eat other foods that are high in calcium. Some good nondairy sources of calcium include:
For calcium-fortified juices and nondairy milks, be sure to shake the carton before use, as the calcium can settle on the bottom. Furthermore, keep in mind that calcium from plant foods is often poorly absorbed due to the presence of antinutrients like phytate and oxalate (9). summary Lactose is found in almost all dairy products, as well as foods that contain dairy. Dairy foodsThe following dairy products contain lactose (10 ):
Some of the foods above contain more lactose than others. For example, the lactose content of cheese varies significantly depending on the type. Soft cheeses like brie tend to be high in lactose, while hard cheeses like Parmesan contain only small quantities (11). Foods that sometimes contain lactoseFoods that include some form of dairy as an ingredient may also contain lactose, including:
As such, it’s best to carefully check the ingredient list of any packaged food if you have lactose intolerance. Other names for added dairyYou can check whether a product contains dairy by reading the ingredient list. Added milk or dairy products may be labeled as:
Lactose-free alternativesLactose-free alternatives exist for most foods that contain lactose. Some dairy products can be made lactose-free by removing the lactose, which is usually broken down during manufacturing into glucose and galactose (11, 12). On their own, these simple sugars are naturally sweeter than lactose, giving lactose-free milks a slightly sweeter taste than conventional versions (12). Most lactose-free dairy products are prominently labeled “lactose-free.” Lactaid is just one well-regarded brand. Plant-based dairy products — such as almond milk, coconut yogurt, soy ice cream, and cashew cheese — are also naturally lactose-free. summary If you don’t want to give up dairy, a few natural treatments may alleviate lactose intolerance. Enzyme supplementsEnzyme supplements may help your body digest lactose. However, the effectiveness of these products may vary widely, from no discernible effect to reduced lactose intolerance symptoms with more favorable hydrogen breath test results (2, 10). Others may experience reduced symptoms with no change in their hydrogen breath test results, suggesting a placebo effect (2, 10). As such, it may be best to consult a doctor before trying these supplements. Lactose exposureIf you are lactose intolerant, regularly consuming lactose may help your body adapt to it (13). So far, studies on this strategy are limited, but initial results show positive signs. Through regular lactose exposure, your gut microbiota may be able to produce enough lactase on its own to ease lactose intolerance symptoms — despite your body itself having a lactase deficiency (14). Consistency is key with this method, and high fat milk like whole milk may be the best choice because your body digests it more slowly, potentially giving your gut bacteria more time to digest the lactose (2, 14). Still, further research is necessary. Probiotics and prebioticsProbiotics are microorganisms that provide health benefits, while prebiotics are types of fiber that function as food for these microorganisms, feeding the beneficial bacteria in your gut. Both probiotics and prebiotics have been shown to reduce symptoms of lactose intolerance, although most studies are small (2, 15). Some types of probiotics and prebiotics may be more effective than others. The most beneficial probiotics are thought to be Bifidobacteria and Lactobacillus strains, which are often found in probiotic yogurts and supplements (2). summary All dairy foods contain lactose, but this doesn’t mean that they’re completely off-limits if you have lactose intolerance. Most people with this condition can tolerate small amounts of lactose. For example, some people can stomach a splash of milk in tea but not the amount you would get from a bowl of cereal. It’s thought that people with lactose intolerance can tolerate up to 18 grams of lactose throughout the day. In fact, research reveals that many people can tolerate up to 12 grams in one sitting, which is approximately the amount in 1 cup (240 mL) of milk (2, 16). Some dairy products are also naturally low in lactose when eaten in their usual portions. For instance, butter only contains trace amounts of lactose (11). Certain cheeses like Parmesan, cheddar, and Swiss likewise have less than 1 gram of lactose per 1-ounce (28-gram) serving. Generally, firm cheeses are lower in lactose than soft cheeses (11, 17, 18, 19). Interestingly, yogurt tends to cause fewer symptoms than other types of dairy in people with lactose intolerance. This may be because the probiotics — or beneficial bacteria — in yogurt possess the lactase enzyme, helping your body break down lactose (20, 21). summary Lactose intolerance is a set of symptoms caused by a deficiency in lactase — the enzyme that breaks down the milk sugar called lactose. If you have this condition, symptoms occur after you consume lactose, which is found in dairy products like milk, yogurt, and cheese. These symptoms, which may arise shortly after eating, include abdominal pain and diarrhea. Many people are lactose intolerant, and there are many ways to easily adjust your diet to avoid or limit lactose. These strategies include buying lactose-free foods. If you’re concerned that you can’t tolerate dairy, rest assured that there are numerous foods and beverages you can have, along with a number of treatment options to help prevent or alleviate symptoms. Can you make yourself lactose intolerant?Turns out, it is possible to suddenly make yourself lactose intolerant. “To some extent, our ability to handle lactose is a use-it-or-lose-it phenomenon,” Barrett says.
How much milk does it take to trigger lactose intolerance?How much lactose can lactose-intolerant people have? Researchers have found that lactose-intolerant people can usually tolerate the following amounts: Up to 12 g of lactose at once (about 250 ml of milk) Up to 24 g of lactose spread out across the day (about 500 ml of milk)
Why did I suddenly become lactose intolerant?Sometimes, lactose intolerance develops when the small intestine's production of lactase decreases after an illness, injury or surgery involving the small intestine. This is called secondary lactose intolerance.
What happens if you drink too much milk?Too much milk can lead to health problems such as iron deficiency anemia and protein loss from the gut. While it is true that milk can be a great part of a healthy diet for children, too much milk can lead to health problems such as iron deficiency anemia and protein loss from the gut.
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