& Joannie Dobbs Wednesday,
Even lactose intolerant
can drink milk
After eating, do you frequently suffer from bloating and gas? If so, you may have irritable bowel syndrome. A report by Beth A. Kapes of WebMD Medical News indicates 35 million Americans suffer from IBS, making this syndrome the second leading cause of missing work. The characteristics of IBS are chronic abdominal pain associated with bloating, constipation, and/or diarrhea.
In the medical world, "syndrome" describes a group of symptoms where there is no obvious cause.
The symptoms for IBS are very similar to those occurring in people with lactose intolerance, the inability to digest lactose, the natural sugar in milk. Studies show that patients with IBS also have problems with lactose.
In order for lactose to be digested and absorbed into the body, an intestinal enzyme, lactase, is required. Individuals with low levels of lactase in the intestine are considered to be lactose intolerant and can suffer discomfort due to the malabsorption of this sugar.
It is thought that there may be a gene putting individuals at higher risk for IBS. Similarly, lactose intolerance in adults varies in different genetic populations. The prevalence of lactose intolerance is greatest in adults from Asia and Africa and lowest in individuals from northern Europe. However, a person who has avoided dairy products for some time may also experience temporary lactose intolerance.
It is commonly believed that persons of Asian or African ancestry cannot consume dairy products without experiencing gastrointestinal problems. However, recent research has found that most individuals, even if lactose intolerant, can consume moderate amounts of milk. By increasing milk consumption slowly over a couple weeks, most people can increase their ability to comfortably digest milk products. Up to 8 ounces of milk can usually be handled, especially when consumed with a meal.
Research by Dr. Dennis Savaiano at Purdue University indicates the adaptation to milk consumption in previously intolerant people is due to changes in the relative amounts of different bacteria that live in the colon. This research challenges the notion that people of some racial groups simply cannot tolerate milk. In southern Africa it is common to see adult male Africans consuming a full quart of milk with lunch. Also, in milk producing provinces in China, milk products are a major part of the diet.
Other popular sources of confusion about lactose intolerance include confusing it with a milk allergy. The allergy occurs when a person's immune system reacts to the protein in milk, not the sugar. It is a completely different reaction found in less than 2 percent of the juvenile population and even fewer adults. The rare individuals with a true milk allergy should never consume milk.
Those who are lactose intolerant or have IBS are not destined to a diet void of high-calcium milk products. Yogurt processed with natural microorganisms contains little lactose, with the exception of yogurt thickened by gelatin or gums. Cheeses, such as cheddar, mozzarella, ricotta, cream and cottage, contain only trace amounts of lactose. Some milk products have added lactase to aid in the digestion of lactose. Lactase pills are also available. So it is possible for just about everyone to obtain calcium from foods rather than from supplements.
Alan Titchenal, Ph.D., C.N.S. and Joannie Dobbs, Ph.D., C.N.S.
are nutritionists in the Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, UH-Manoa.
Dr. Dobbs also works with the University Health Service
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