Lactose Intolerance

Key points

  • Lactose is a naturally occurring sugar found in dairy foods. It is digested by an enzyme called lactase. Some people do not produce enough of this enzyme to break down the lactose in food. This is known as lactose intolerance

  • When your body can’t digest lactose properly it can lead to unpleasant symptoms like bloating, gas, cramps and diarrhoea.

·         It is importance to note that these symptoms can be related to many other conditions. It’s a good idea to discuss your symptoms with a GP or Dietitian before reducing or removing lactose from your diet.

  • Once diagnosed with lactose intolerance you may not need to eliminate all lactose-containing foods from your diet. People with lactose intolerance may be able to tolerate some lactose containing foods in various quantities  

Causes of Lactose Intolerance

Lactose intolerance is often due to genetic factors

Other causes include:

  • gastroenteritis can reduce the amount of lactase enzyme you produce for several weeks after you’re unwell

  • parasites can temporarily reduce your levels of the lactase enzyme, leaving you unable to break down lactose

  • intestinal inflammation from untreated Coeliac disease and other gastrointestinal conditions that cause inflammation of the intestinal lining can make it difficult for lactase enzyme to work effectively

Management

It is not necessary to remove all dairy products from your diet. People with lactose intolerance still produce a small amount of the lactase enzyme. The amount of lactose a person can tolerate varies, for example, you may tolerate a small amount of milk in a cup of tea but not a milkshake.

Recent evidence suggests you should try and continue to eat as much lactose as you can tolerate. Complete avoidance of lactose may make your body produce even less of the lactase enzyme and become more sensitive.

Tips for Managing Lactose Intolerance

  • Drink milk in smaller quantities. Most people with lactose intolerance can tolerate ½ cup milk at a time. Full cream milk can be better tolerated than low fat or calcium-enriched milk.

  • Spread lactose-containing foods out during the day. Eat them with other foods to slow down digestion.

  • Yoghurt is lower in lactose as the natural bacteria break it down. It is generally well tolerated by people with lactose intolerance.

  • Hard cheeses (such as cheddar) are very low in lactose and are generally well tolerated.

  • You can buy lactose-free milk, yoghurt, ice cream and soft cheeses. These are produced by adding lactase enzyme to the products to break down lactose for you.

  • Lactose can also be an ingredient in many processed foods such as biscuits and cakes, cheese sauce, cream soups and custards. Check the ingredient list for things like milk solids, non-fat milk solids, whey and milk sugar. However, it is only likely to be a problem if it is a major ingredient (that is, one of the first two ingredients listed).

  • Soy milk and oat milk do not contain any lactose and can be suitable substitutes for dairy products. Opt for products that are fortified with calcium