What is LACTASE NON-PERSISTANCE? (and how to improve lactose intolerance)
WHAT IS LACTOSE?
Lactose is a sugar found in all mammalian milks.
It is broken down by a digestive enzyme called lactase.
WHAT IS LACTOSE NON-PERSISTANCE?
Because milk is designed for infants, it is normal for the body to stop producing this lactase enzyme after childhood (known as lactase non-persistence).
Some people (usually of northern European descent) have developed a genetic mutation that causes their bodies to continue producing lactase, allowing them to consume dairy without symptoms.
However, it is typical for adults to experience gas, bloating, stomach cramps, gut sounds, and diarrhea after consuming high-lactose dairy.
In short, lactose non-persistance (aka lactose malabsorption) is normal.
Even with lactase non-persistence, most people can tolerate small amounts (up to 12 g) of lactose without issue.
HIGH-LACTOSE FOODS
milk (whole, skim, goat, etc)
condensed milk
evaporated milk
cream
ice cream
cottage cheese
lactose (added ingredient)
LOW-LACTOSE FOODS
most cheese (esp hard)
sour cream
cream cheese
butter
ghee
What about yogurt and kefir?
While technically containing higher amounts of lactose, the added cultures make fermented dairy easier to digest.
MANAGING LACTOSE INTOLERANCE
1. ELIMINATE
Some people with lactose intolerance choose to eliminate dairy completely. In these cases, it is important to incorporate other calcium-rich foods such as sardines (with bones), fortified milks, tofu, molasses, almonds, and tahini to ensure adequate calcium.
2. SUPPLEMENTAL ENZYMES
Another option is to take a lactase enzyme supplement whenever consuming high-lactose foods.
3. PROBIOTICS
In addition, certain probiotics strains (Lactobacillus acidophilus LA5 or Lactobacillus casei Shirota combined with Bifidobacterium breve Yakult) have been studied to improve lactose digestion.
4. TRAIN YOUR GUT
A final strategy is to increase tolerance by consuming dairy every day for a few weeks. The symptoms may not be pleasant at first, but your gut will eventually adapt.
HOW IS A DAIRY ALLERGY DIFFERENT?
While lactose intolerance symptoms are experienced in the gut, milk allergy symptoms can be experienced anywhere in the body.
If dairy consumption leads to headaches, lethargy, brain fog, depression, acne, muscle or joint aches, or sore throats, you are likely reacting to other compounds (immune factors, hormones, etc) or proteins (casein or whey) in the milk.
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References
Almeida, C. C., S. L. S. Lorena, et al. (2012). "Beneficial Effects of Long-Term Consumption of a Probiotic Combination of Lactobacillus casei Shirota and Bifidobacterium breve Yakult May Persist After Suspension of Therapy in Lactose-Intolerant Patients." Nutrition in Clinical Practice27(2): 247-251.
He, T., M. G. Priebe, et al. (2008). "Effects of yogurt and bifidobacteria supplementation on the colonic microbiota in lactose-intolerant subjects." Journal of Applied Microbiology104(2): 595-604.
Hertzler, S. and D. Savaiano(1996). "Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance." The American Journal of Clinical Nutrition64(2): 232-236.
Lin, M.-Y., D. Savaiano, et al. (1991). "Influence of NonfermentedDairy Products Containing Bacterial Starter Cultures on Lactose Maldigestionin Humans." Journal of Dairy Science74(1): 87-95.
Lomer, M. C. E., G. C. Parkes, et al. (2008). "Review article: lactose intolerance in clinical practice –myths and realities." Alimentary Pharmacology & Therapeutics27(2): 93-103.
Shaukat, A., M. D. Levitt, et al. (2010). "Systematic Review: Effective Management Strategies for Lactose Intolerance." Annals of Internal Medicine.