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Lactose: How Much Can You Take?
If your doctor has just broken the news that you’re lactose-intolerant, don’t jump to the conclusion that you’ll never be able to savor another bite of ice cream again.
At first, many people fear that they’ll have to give up all dairy products, according to Dee Sandquist, MS, RD, CDE, a dietitian in Fairfield, Iowa, and a spokeswoman for the American Dietetic Association. But with some experimentation, most people with lactose intolerance discover that they can eat small amounts of dairy without triggering distressing symptoms, such as bloating, gas, abdominal discomfort, diarrhea or nausea.
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“Listen to your body and your symptoms,” Sandquist says.
Who Gets Lactose Intolerance?
Lactose intolerance occurs when the body doesn’t make enough of the enzyme lactase, which digests lactose, the sugar found in milk and other dairy products. Infants produce high levels of lactase in order to digest milk. After weaning, though, lactase levels decrease, meaning that eventually, as people age, many can no longer digest as much lactose.
Although lactose intolerance is viewed as a disorder, about 75% of all people around the globe have some degree of lactase deficiency. Lactose intolerance is much more common among Asians, Hispanics and blacks than in people of Northwest European descent.
Lactose intolerance is actually a misleading term, says Yuri A. Saito-Loftus, MD, MPH, an assistant professor in the Mayo Clinic’s division of gastroenterology and hepatology.
“The majority of the world population is lactose intolerant. It’s actually the people who are lactose tolerant that are the minority group.”
Lactose Intolerance Varies in Severity
How much dairy you can eat depends on how much lactase enzyme your body produces, Saito-Loftus says. “That does vary a little bit from individual to individual. We don’t know exactly 100% what controls that. Presumably, it’s genetically determined.”
However, some people with lactose intolerance can adapt and get fewer symptoms. “If you keep eating dairy, you can at least stimulate lactase production. Paradoxically, the more you eat -- presumably in moderation -- the better you are able to tolerate dairy products,” Saito-Loftus says.
That’s important because people with lactose intolerance can shortchange themselves nutritionally. “If you’re lactose intolerant, you tend to cut out dairy, which is a great source of calcium. People who are lactose intolerant are at higher risk for osteoporosis,” Saito-Loftus says. If people really can’t handle lactose in foods, “they need to be very good about taking calcium and vitamin D supplements.”
Fortunately, though, “Even if you are lactose intolerant, it has been shown that you can tolerate small amounts of dairy and not have a problem,” Saito-Loftus says.
Sandquist agrees. “Many people know their symptoms pretty well and so they know if they can handle just a little bit or not. They have already experimented with it.”
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