From foodconsumer.org
Problems Digesting Dairy Products?
By FDA
Apr 4, 2008 - 7:33:51 PM
Problems Digesting Dairy Products?
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Does your stomach churn after you drink milk? Do you have diarrhea soon afterward? If so, you may be lactose intolerant.
The National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK) estimates that 30 to 50 million Americans are lactose
intolerant.
Being lactose intolerant means you can't
digest lactose—the natural sugar found in milk and other dairy
products. People who cannot digest lactose have a shortage, or
deficiency, of an enzyme called lactase, which is produced in the small
intestine. Lactase breaks down milk sugar into two simpler forms of
sugar, which are then absorbed into the bloodstream.
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Intolerance is Not Allergy
Lactose
intolerance is not the same as a milk allergy, says Kavita Dada,
Pharm.D., a senior health promotion officer in the Food and Drug
Administration's (FDA's) Division of Drug Information. "For most people
with lactase deficiency, it's a discomfort."
But a food
allergy—an abnormal response to a food triggered by the immune
system—can be life-threatening. People with food allergies must avoid
certain foods altogether. People with food intolerances can often eat
small amounts of the offending foods without having symptoms.
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Symptoms
When there is not enough lactase to digest the lactose in the foods a person eats or drinks, the person may have
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gas
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stomach cramps
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bloating
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nausea
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diarrhea
These symptoms occur within 30 minutes to two hours
after consuming food containing lactose. Some illnesses can cause these
same problems, but a health care professional can do tests to see if
the problems are caused by lactose intolerance or by another condition.
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Who Becomes Lactose Intolerant?
Lactose
intolerance is more common in some ethnic groups than others. NIDDK
estimates that up to 75% of all adult African Americans and Native
Americans and 90% of Asian Americans are lactose intolerant.
As people age, their bodies produce fewer lactase enzymes, so most people don't have symptoms until they are adults.
Most
people inherit the condition from their parents. Lactose intolerance is
not very common in children under two years of age, unless the child
has a lactase deficiency because of an injury to the small intestine.
If you think your infant or child may be lactose intolerant, talk to
your child's pediatrician.
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Managing Lactose Intolerance
There
is no treatment to make the body produce more lactase enzyme, but the
symptoms of lactose intolerance can be controlled through diet.
Most
older children and adults do not have to avoid lactose completely.
People have different levels of tolerance to lactose. Some people might
be able to have a tablespoon of milk in a cup of coffee with little or
no discomfort. Others have reactions that are so bad they stop drinking
milk entirely. Some people who cannot drink milk may be able to eat ice
cream and yogurt—which have less lactose than milk—without symptoms.
They may also be able to consume a lactose-containing product in
smaller amounts at any one time.
Common foods with lactose are
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milks, including evaporated and condensed
-
creams, including light, whipping, and sour
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ice creams
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sherbets
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yogurts
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some cheeses (including cottage cheese)
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butters
Lactose may also be added to some canned, frozen, boxed, and other prepared foods such as
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breads and other baked goods
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cereals
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mixes for cakes, cookies, pancakes, and biscuits
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instant potatoes, soups, and breakfast drinks
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lunch meats (other than Kosher)
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frozen dinners
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salad dressings
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margarines
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candies and other snacks
Dietary supplements with lactase enzyme are available
to help people digest foods that contain lactose. However, FDA has not
formally evaluated the effectiveness of these products, and you may
want to ask your doctor if these supplements are right for you.
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Look at Labels
"Lactose-free"
or "lactose-reduced" milk and other products are widely available in
grocery stores. These products may be fortified to provide the same
nutrients as their lactose-containing counterparts.
There
is no FDA definition for the terms "lactose free" or "lactose-reduced,"
but manufacturers must provide on their food labels information that is
truthful and not misleading. This means a lactose-free product should
not contain any lactose, and a lactose-reduced product should be one
with a meaningful reduction. Therefore, the terms lactose-free and
lactose-reduced have different meanings, and a lactose-reduced product
may still contain lactose that could cause symptoms.
Lactose-free
or lactose-reduced products do not protect a person who is allergic to
dairy products from experiencing an allergic reaction. People with milk
allergies are allergic to the milk protein, which remains when the
lactose is removed.
Look at the ingredient label. If any of these words are listed, the product probably contains lactose:
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milk
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cream
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butter
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evaporated milk
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condensed milk
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dried milk
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powdered milk
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milk solids
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margarine
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cheese
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whey
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curds
Beware of foods labeled "non-dairy," such as powdered
coffee creamers and whipped toppings. Some of these foods may contain
an ingredient called caseinate, which comes from milk and contains
lactose. Look for "caseinate" or "milk derivative" on the label if you
are trying to avoid milk products.
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Testing for Lactose Intolerance
A
doctor can usually determine if you are lactose intolerant by taking a
medical history. In some cases, the doctor may perform tests to help
confirm the diagnosis. A simple way to test at home is to exclude all
lactose-containing products from your diet for two weeks to see if the
symptoms go away, and then reintroduce them slowly. If the symptoms
return, then you most likely are lactose intolerant. But you may still
want to see your doctor to make sure that you are lactose intolerant
and do not have a milk allergy or another digestive problem.
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Tips for Consumers
-
If you are lactose intolerant, try
lactose-free milk or dairy products lower in lactose, such as yogurt
and cheese. You may be able to consume dairy products in small amounts
without symptoms.
-
Consume milk or other dairy
products with other foods. This helps slow down digestion, making it
easier for your body to absorb lactose.
-
If you're
eating few or no dairy products, ask your doctor or dietitian if you
are getting enough calcium in your diet. You may need to take dietary
supplements with calcium to keep your bones healthy.
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Raw Milk and Lactose Intolerance
FDA warns consumers not to drink raw, or
unpasteurized, milk. "Raw milk advocates claim that pasteurized milk
causes lactose intolerance," says John Sheehan, Director of FDA's
Division of Plant and Dairy Food Safety. "This is simply not true. All
milk, whether raw or pasteurized, contains lactose, and pasteurization
does not change the concentration of lactose nor does it convert
lactose from one form into another."
Raw milk advocates also claim that raw milk prevents or cures the
symptoms of lactose intolerance. Arguing that raw milk contains
Bifidobacteria, they claim these microorganisms are beneficial
(probiotic) and create their own lactase, which helps people digest the
milk.
"This is not true, either," says Sheehan. "Raw milk can contain
Bifidobacteria, but when it does, the bacteria come from fecal matter
(animal manure) and are not considered probiotic, but instead are
regarded as contaminants."
Drinking raw milk will still cause uncomfortable symptoms in people
who are correctly diagnosed as being lactose intolerant. But worse than
this discomfort are the dangers of raw milk, which can harbor a host of
disease-causing germs, says Sheehan. "These microorganisms can cause
very serious, and sometimes even fatal, disease conditions in humans."

For More Information
Lactose Intolerance
http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/
Food Safety and Raw Milk
http://www.cfsan.fda.gov/~dms/rawm-toc.html
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Date Posted: March 25, 2008