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Milk - not always "the perfect food." (lactose intolerance)

Although milk is not indispensable for adults, it is a high-quality food because of its palatability and high protein and calcium contents, both essential components to good adult nutrition. Unfortunately, not all of us can tolerate milk because of temporary or permanent reduction in the amount of lactase-an enzyme that breaks down lactose, the sugar contained in milk-produced in the small intestine. Lactose, a combination of two single sugar molecules, glucose and galactose, cannot ordinarily be absorbed in the intestinal tract unless it is broken down to these two simple sugars.

Lactase levels are highest immediately after birth and decrease markedly after weaning. By adulthood, levels are very low. Although most adults can adequately absorb lactose with these levels, as many as 50 million Americans simply cannot and thus must suffer watery diarrhea, abdominal distention and pain due to gas formation. The incidence of this disorder varies greatly among racial/ethnic groups-21 percent in whites, 51 percent in Hispanics, 75 percent in blacks, and 79 percent in native Americans. Although intestinal infections may temporarily reduce lactase activity, the cause of chronic lactose intolerance is still not known.

The obvious solution is to eliminate lactose-containing foods from the diet, but because so many food products today contain the substance, this is not always easy or convenient. In some cases, lactose can be broken down by treating it during a product's commercial processing with laboratory-produced lactase enzymes. Lactase-treated milk, cottage cheese and American process cheese are now available in many parts of the country; Dean Foods Co., the second largest producer of dairy products after Borden, began introducing Easy 2%, a low fat milk that contains 70 percent less lactose than ordinary milk. The new product also sells for about 10 percent more than whole milk.

Lactase enzyme for home use can be purchased at many pharmacies and some food outlets under the names Lactaid or Lactrase. The liquid form can be added directly to milk; the tablet or capsule form can be swallowed just before eating, or chewed along with the meal. One tablet works for about a half-hour, and if the meal lasts longer, additional tablets can be taken. Because the direct treatment of milk requires up to 24 hours, depending upon the temperature and amount of enzyme used, oral usage may be more convenient.
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Publication:Medical Update
Date:Jul 1, 1990
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