Tolerating Lactose
For: What You Need to
Know About Enzymes, November 2002
"Lactose intolerance" is an overworked phrase. Lactose is milk sugar, which has to be broken down in the intestine by an enzyme called lactase in order to be absorbed. Some people, usually those of northern European descent, plus some of Mediterranean descent and a few Africans, retain their ability to digest lactose throughout life, while producing less lactase than in childhood. But many people, including those of Asian origin, develop lactose intolerance. When they drink milk or eat ice cream, they may get such symptoms as gas, stomach cramps, or diarrhea. This reduced ability to digest milk sugar is not a disease or even a serious or harmful condition.
Dairy products are the chief source of calcium in the American diet. Marketers of lactose-reduced milk and lactase tablets have convinced a lot of people that they need these products. Lactose-free milk costs nearly twice as much as untreated products, and lactose-free yogurt three to four times as much. Lactase tablets, which you swallow, cost a whopping 50 cents per dose and are not very effective. Lactaid drops, added to milk preferably two or three days in advance, are more economical. But why go to all this trouble and expense if you don’t need to?
Two years ago a study led by Dr. Fabrizis Suarez at the Minneapolis Veterans Affairs Medical Center showed that people who identified themselves as lactose-intolerant could drink a cup of milk a day without symptoms. And in a newer study, Dr. Suarez found that two cups a day, at breakfast and in the evening, produce few if any symptoms in the same people.
This is not to say that lactose intolerance doesn’t exist. If you have given up milk and dairy products on the basis of a self-diagnosis of lactose intolerance, though, it might be a good idea to talk to a doctor. There’s a fairly simple test to detect lactose intolerance. If milk turns out not to be your problem, you may be able to find out why you do have abdominal discomfort.
If you are a lactose "maldigester," you can still consume regular dairy products in small amounts, if you don’t wish to resort to expensive treated products. Cheese has a lot of calcium and very little lactose. And yogurt, also rich in calcium, is usually low in lactose, though this varies from brand to brand. Buy yogurt with active cultures, since the bacteria break down the lactose.
UC Berkeley Wellness Letter, October 1997
