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Page: Managing Lactose Intolerance
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There is no "cure" to lactose intolerance. There have been some cases where the intolerance has somehow diminished with time; this has not been studied scientifically, however, and whether it is a case of desensitization remains to be seen. It should be remembered that lactose intolerance is not a binary (all-or-nothing) condition: the reduction in lactase production, and hence, amount of lactose that can be tolerated varies from person to person, and may change with age. The management of lactose intolerance involves avoiding lactose-containing products, use of alternative products, such as soya-derived milk substitute, or lactase enzyme medication (such as pills that are taken when eating or drinking a product containing lactose).
However, it is possible to digest an artificial agent from the pharmacy, that aids the system congest lactose. They are available under different names, depending on what your pharmacy decides to sell. These tablets normally contain a concentrated preparation of the enzyme lactase, and are thus known as "lactase tablets". There are a number of well known brands, including, Lactaid, Lactrase, Dairy Ease, and many generic versions. There are various formulations with different lengths of activity.
Acclimating the body to dairy products
A study by Purdue University found that people can acclimate themselves to dairy products. Consuming small quantities of dairy products several times a day over a couple of weeks will train bacteria in the large intestine to break down lactose more effectively.
Avoiding lactose-containing products
Since each individual's tolerance to consumed lactose varies, according to the National Institute of Health, "Dietary control of lactose intolerance depends on people learning through trial and error how much lactose they can handle."
Many people are more tolerant of yoghurt than milk because it contains lactase produced by the bacterial cultures used to make the yogurt. Also, hard cheeses (e.g. Swiss) produce far less reaction than the equivalent amount of milk because the cheese making and ageing processes greatly reduce the amount of lactose. A typical Swiss or Cheddar might contain 5% of the lactose found in whole milk, while long-aged cheeses contain almost no lactose at all.
Because lactose is a common commercial food additive (it is used for texture, flavor and its adhesive qualities), it is important for lactose intolerant people to be especially careful in avoiding products that whilst not apparently dairy (or are dairy but normally contain low amounts of lactose) nonetheless contain lactose. Such products include commercial sausages (notably frankfurters), medications which may contain lactose as a filler, most meal replacement powders and protein bars, cottage cheese, many "granola" style cereals, pancakes, crepes, custards, 90% of margarines (added for texture), 70% of flavored potato/corn chips (added as an adhesive for the spices), most frozen meals, "double wrapped" sliced bread, some dried fruit, even yogurts containing carageenan or gelatin, at the other end, full fat yogurts are nearly lactose free.
Because lactose is a water soluble molecule, milk based dairy products have more lactose than cream based dairy products: full ice creams, real camembert, real brie, full fat sour cream, full fat yogurts, butter, etc contain little to no lactose. Conversely "low fat" and "diet" dairy products are rife with lactose, especially products such as "I can't believe it's not butter", which is mostly buttermilk and is very high in lactose. Partially lactose tolerant people may still be able to eat dairy foods, such as butter and whipped cream, so long as they are not the diet versions. Since lactose is a sugar, one can get an indication of the lactose content of any dairy product by checking the nutritional analysis. For many butters and cheeses, the sugar content is zero or less than 0.1%, showing that they must either be free of lactose or contain only a negligible amount.
Kosher products labeled as Pareve or Meat do not contain any dairy products and therefore should be lactose free. However, individuals with extreme intolerance, or a strong allergic sensitivity to dairy products, may need to take extra precautions, as some "loopholes" in kashrut may allow the introduction of negligible dairy residues to such labeled products. For instance, dairy manufacturing equipment can be cleaned well enough that the rabbis will grant pareve status to products manufactured afterward. Nevertheless, someone with a strong allergic sensitivity to dairy products might still react to the dairy residue, and that is why some products will have a "milk" warning on a product which is legitimately pareve.
Alternative products
Reduced or entirely lactose-free products (using milk substitutes, soy milk, almond milk, oat milk, or rice milk) are available allowing lactose-intolerant people to maintain approximately the same diet as those who are tolerant, without having to purchase medication or significantly alter their eating habits.
The food industry has successfully managed to create high quality low-lactose or entirely lactose-free products to replace the regular items. 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 almost 0%. (the same effect can be produced by adding one's own lactase tablets.) Alternatively, a harmless 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).
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.
Many countries have similar product lines, and new consumer products continue to become available. In America over recent years (1990–2000) there has been a notable increase of available lactose-reduced and lactose-free dairy products; examples being cottage cheese, American cheese and ice cream.[citation needed]
Lactase-enzyme medication
When lactose avoidance is not possible, or on occasions when a person chooses to consume such items, then lactase enzyme medicinal products may be used.[4] This reduces symptoms and allows an "increase (in) the dairy consumption and promote health of people".
Milk may be preincubated with liquid lactase-enzyme drops but is of limited practicality as this must be prepared some hours before consumption. More commonly ?-galactosidase is provided in tablet or capsule formulations which are taken with food. However the enzyme is inactivated by gastric acidity, making these both more expensive and less effective than prehydrolyzed milk. They are appropriate for use with solid dairy products.
Lactase-enzyme medication has an advantage over non-dairy products in that alternative provision does not need to be made for adequate calcium intake, especially in children.
Lactose levels in foods
The following are lactose levels in foods which commonly set off lactose-intolerance symptoms [6]. Reducing lactose intake, without cutting it out completely, is helpful for some sufferers.
Dairy product Lactose Content
Yoghurt, plain, low-fat, 240 mL 5 g
Milk, reduced fat, 240 mL 11 g
Swiss cheese, 28 g 1 g
Ice cream, 120 mL 6 g
Cottage cheese, 120 mL 2-3 g
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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