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Living with lactose intolerance: if you take some simple steps, you can continue to enjoy a variety of dietary favorites.

Do you love milk, ice cream, cheese and other dairy products, but find that eating such appetizing items gives you some discomfort? If so, then you might be one of the millions who are lactose intolerant. Between 30 million to 50 million Americans suffer from the digestive condition and about 75 percent of African-Americans are lactose intolerant, a condition that affects only about 21 percent of Whites.

Lactose intolerance is the inability or decreased ability to digest lactose or milk sugar. This occurs when there is a shortage of the enzyme lactase, which is produced by the cells that line the small intestine. The enzyme breaks down the milk sugar (lactose) into simple forms, so that it can be absorbed into the bloodstream. When there is not enough lactase to digest the amount of lactose eaten, the result (about 30 minutes to 2 hours after eating or drinking foods containing lactose) could include stomach cramps, bloating, painful gas, flatulence, diarrhea and nausea.

As we get older, the lactase in our gastrointestinal tract begins to diminish and symptoms of the condition usually intensify. The severity of the symptoms varies, depending on the amount of dairy products each individual can tolerate.

Unfortunately, doctors say, there is no known way to improve the body's ability to produce lactase, but lactose intolerance can be controlled and treated easily, with diet being the most effective defense. If you suspect that you are lactose intolerant, nutritionists and medical experts suggest that you try to eliminate all dairy products for a week, then reintroduce them one at a time. When your symptoms begin, you should have a good idea of how much dairy you can tolerate before you experience discomfort. Some people can tolerate small amounts of lactose without problems, but eating large amounts within a short period cause uncomfortable symptoms.

If your symptoms are severe, see your doctor to be certain that you are experiencing lactose intolerance, and not a more serious condition. If diet limitations don't assure that you are lactose intolerant, there are tests to help your doctor make that determination. For those who react to small amounts of lactose or have trouble limiting their intake of foods containing lactose, lactase enzymes are available without a prescription. The enzyme, available in tablets and liquid form, help people digest foods that contain lactose. Lactose-reduced and lactose-free milk and other products are also available at most supermarkets.

Milk and other dairy products play an important role in the American diet because they provide calcium, which is essential for the growth and repair of bones. The nutrient also plays an important role in regulating other body functions such as blood clotting, blood pressure, nerve transmission, and contraction and relaxation of muscles (including normal heartbeats).

For those who are lactose intolerant, getting the proper amount of calcium is a major concern, but there are other foods that contribute to a calcium-rich diet--collard greens, kale, broccoli, kidney beans, almonds sardines, canned salmon, canned tuna and calcium-fortified orange juice.

Grocery shoppers should be aware that lactose is often found in prepared foods. People with very low tolerance should read food labels, looking not only for milk and lactose but for such ingredients as whey, curds, milk by-products, dry milk solids and dry milk powder. Additionally, many types of prescription drugs and over-the-counter medicines (birth control pills and antacid tablets) use lactose in their production. Remember to ask your pharmacist if medications you take contain lactose.

If you have trouble digesting lactose, be aware of which dairy products and other foods you can eat without discomfort and which ones to avoid. A carefully chosen diet is the key to reducing symptoms and protecting your health.


* Drink milk in small servings of one cup or less.

* Eat hard cheeses (like cheddar) that are low in lactose.

* Include yogurt with active cultures in your diet.

* Drink milk with a meat or other foods.

* Take lactase enzyme tablets before eating dairy products.

* Substitute lactose-reduced dairy products, such as nonfat, low-fat and calcium-fortified milk, cottage cheese and ice cream for regular dairy foods.

* Add lactase enzyme drops to regular milk.

* Read food labels carefully.
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Date:Oct 1, 2002
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