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Do you have tips for dealing with lactose intolerance?

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Approximately 25 percent of the U.S. population and 75 percent of adults worldwide are reported to be lactose maldigesters, which means they have reduced digestion of lactose due to a low level of lactase, an intestinal enzyme that catalyzes the digestion of lactose into glucose and glactose.

Here are some strategies to deal with lactose intolerance that can help those with lactose intolerance improve health and prevent osteoporosis.

* The amount of lactose that causes notable symptoms differs among people. Most lactose maldigesters can tolerate the amount of lactose in 8 ounces of milk (12 grams lactose). Double blind studies have shown that most lactose maldigesters could tolerate 4 ounces of milk twice a day, working up to 8 ounces of milk twice a day if consumed with a meal.
* Consuming lactose with a meal or a solid food slows gastric emptying (or delivery of lactose to the colon), which allows more time for lactase to work on lactose.
* Whole milk is generally better tolerated than lower fat milk. Chocolate milk is better tolerated than unflavored low-fat milk, although the mechanism by which cocoa reduces lactose intolerance is unknown.
* Cheeses generally contain less lactose than milk. In cheese processing, the whey (the main source of lactose) is removed from the curd, which reduces the lactose content greatly. The ripening process also decreases the lactose, so within 34 weeks ripened cheeses have little or no lactose.
* Yogurt is tolerated well by lactose maldigesters because of the semisolid consistency and the release of the lactase enzyme from the bacterial cultures. It is important that lactose maldigesters consume yogurts with live, active cultures.
* Frozen yogurt and ice cream may be tolerated by lactose maldigesters, but they are not tolerated as well as nonfrozen yogurt.
* Milk with bacterial starters (sweet acidophilus milk or yogurt milk) can improve tolerance, but it depends on the strain of the bifidobacteria that is used. Personal trial of products is required.
* Gradually increasing intake of dairy foods improves tolerance to lactose. Continued exposure to lactose may enhance the efficiency of colonic bacteria that metabolize lactose. Elimination of lactose from the diet probably worsens intolerance to lactose with primary lactase deficiency.

Posted on 26 Apr 1999

Nedra Christensen
Utah State University Extension Dietician

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