So, it wasn't until she was away at college that her symptoms became regular and painful. "I went to school in Chicago. There was pizza everywhere, and every time I ate it, I'd be doubled over in pain," she recalls.
Janotta's physician father suspected lactose intolerance (LI), the inability to digest lactose, and suggested she take lactase, a pill version of the enzyme normally produced in the body to digest lactose. After taking the supplement the next time she ate pizza, she was symptom free. It worked.
By some estimates, 75% of adults suffer some degree of LI. The condition affects 90% of all Asians and half of all blacks and Hispanics. Among those of northwestern European origin, however, only 20% are affected. Symptoms include bloating, painful cramps, and diarrhea, which regularly appear within 15 to 30 minutes after eating dairy products.
Calcium Intake a Problem with LI
"With dairy products labeled as off-limits by many LI sufferers, they're cutting out the best sources of calcium in their diet," says Cecilia Pozo Fileti, R.D., a spokesperson for the American Dietetic Association.
"They still need to get calcium," Pozo Fileti says, adding that there are many ways to include it in the diet. It takes a little experimenting. Methodical trial and error can let people know just how much and which kinds of dairy products they can tolerate. Some people can tolerate a glass of milk as long as they drink it with a meal. Others are truly intolerant and must avoid even traces of milk -- even from the chocolate of a chocolate chip cookie.
Dairy Still Possible
Pozo Fileti also recommends lactase supplements, which allow people to continue to eat dairy products. Products to which lactase has already been added, such as lactase-enriched milk, make it even easier.
For Janotta, the supplements mean she can eat pizza and her other favorite dairy foods. "I have to have my little insurance pills in my purse or have my husband carry them in his pocket," she says.
Yogurt and aged cheeses are also good choices because the bacteria in these dairy foods have already broken down the lactose.
LI sufferers can also choose from a wide variety of vegetables to get their daily doses of calcium. One cup of cooked broccoli, for example, can provide up to 177 milligrams of this element, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Other sources include Chinese bok choy, collard greens, kale, turnip greens, oysters, and sardines.
The good news for those with LI is that more products that can be tolerated are being introduced. Nondairy substitutes now include those made from rice and soy; cheeses are even being made from almonds and tofu. And, as baby boomers age and the country becomes increasingly diverse, expect soy-milk mochas to become all the rage.