Dairy! To eat or not to eat, that is the question?

Have you ever experienced an intense stomachache after eating dairy products? Boy, I have! My most memorable experience with dairy discomfort was in the winter of 2021 when I was leaving Unite, a weight loss program in Utah. Unite is a pre-planned weight loss program focused on helping clients regain their health one step at a time. If you are interested in attending Unite for your own health here is a link to their site.

After I completed 3 weeks with the Unite program I returned home to Texas. On the drive home I was with Wendy & Evan, my two best friends, we decided to stop for ice cream as a program completion celebratory treat. Oh, what a mistake that stop was! My system had not had dairy for 3 whole weeks and a couple of bites of ice cream sent my stomach into a tizzy. Realizing this while rolling around my bed in pain that night, I connected the dots to eating the ice cream and the dairy contained in that product. It was that night I realized my body and digestive system are sensitive to dairy.

Picture of Wendy and I at Unite<3

For this reason, when I went to school to be a dietitian, I doubled down on the questions about lactose intolerance and issues with eating dairy for some people. Lactose intolerance is defined as individuals unable to digest the sugar in milk. This sugar found in milk and dairy products is called lactose.

The cause of lactose intolerance is too little of the enzyme lactase, which is created in our small intestine. This lactase enzyme is responsible for breaking down lactose into glucose and galactose which are then absorbed in the small intestine. It is important to remember that we can still process dairy if we have low levels of lactase active in our small intestine. However, if we reach exceptionally low levels of lactase enzymes, we may become lactose intolerant. Prevalence of lactose intolerance is at an increased risk in some minorities such as Asian, African, Hispanic, or Indian descent.

This picture from Wikipedia does a great job at showing the percentage of the populations around the world struggling with some form of lactose intolerance.

Symptoms of Lactose Intolerance:

• Abdominal pain

• Bloating

• Excessive flatus

• Watery stool

4 Leading Types of Lactose Intolerance:

1. Primary Lactase Deficiency – Most commonly experienced. With this intolerance, as the patient ages lactase enzyme activity decreases.

2. Secondary Lactase Deficiency – related to the experience of infection, disease or inflammation. For example: Celiac disease, Use of Antibiotics, Chemotherapy treatments, Gastroenteritis, Chron’s disease or Ulcerative colitis.

3. Congenital Lactase Deficiency – decreased or lack of lactase enzyme since birth. This is normally due to a recessive inheritance. This is recognized early on once a newborn ingests milk. (Rare cause)

4. Developmental Lactase Deficiency – this is seen during pregnancy, due to an underdeveloped intestine. As the child ages this type can improve due to the intestine growing and being able to produce enough lactase.

Lactose intolerance is common for a variety of reasons. If you struggle with lactose intolerance but still want to consume dairy products, you have a few options. First you can choose to reduce your dairy to only yogurt and cheese, this may ease the symptoms. You can also opt to use Lactose-free dairy products to still enjoy dairy like items that have the lactose removed. Another option while working with your doctor is to see if taking lactase enzyme supplements is right for you, please only attempt this under strict doctor supervision.

If you're experiencing symptoms of lactose intolerance, I recommend you speak with your doctor about treatment options available to you. Managing lactose intolerance can be heavily focused on diet changes. It is important to remember that if your doctor recommends removing or reducing dairy, calcium and other vitamin levels must be monitored. Prebiotics and probiotics can also support the treatment of lactose intolerance. Strong commitments to lifestyle and diet changes are important with lactose intolerance to have continued relief from upsetting symptoms.

~Ro

References:

Hutyra T, Iwańczak B. Nietolerancja laktozy: patofizjologia, objawy kliniczne, rozpoznanie i leczenie [Lactose intolerance: pathophysiology, clinical symptoms, diagnosis and treatment]. Pol Merkur Lekarski. 2009;26(152):148-152.

Malik TF, Panuganti KK. Lactose Intolerance. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532285/

Swagerty DL Jr, Walling AD, Klein RM. Lactose intolerance [published correction appears in Am Fam Physician. 2003 Mar 15;67(6):1195]. Am Fam Physician. 2002;65(9):1845-1850.