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Lactose intolerance is the inability to metabolize lactose because the required enzyme lactase is absent or low.  Lactose intolerance is caused by a shortage of the enzyme lactase, which is produced by the cells that line the small intestine.  The reduction in lactase production and the amount of lactose that can be tolerated varies from person to person.  Lactose intolerance is not lethal and morbidity is low, but with lower calcium intake Osteopenia can result.  Lactose intolerance is very common in adults and is not dangerous.  Seventy percent of the world's population suffers from lactose intolerance. 

Lactose is a larger sugar that is made up of two smaller sugars, glucose and galactose.  Lactose is present in two food categories, dairy products and as a food additive in dairy and non dairy products.  Besides being present in milk products, lactose is present when ingredients include whey, milk solids, and modified milk ingredients. It is found in foods such as processed meats, sausages, hot dogs, sliced meats, margarines, sliced breads, and breakfast cereals.    

Symptoms of lactose intolerance begin about 30 minutes to 2 hours after eating or drinking foods containing lactose.  People with lactose intolerance usually cannot tolerate milk and other dairy products, all of which contain lactose.   The symptoms of lactose intolerance can be mild to severe, depending on how much lactase your body makes.  The symptoms include gas, cramping, abdominal pain, nausea, bloating, and diarrhea. Lactose left undigested in the intestines can result in diarrhea, because of the excessive amount of water that is drawn into the intestines by lactose.  A carefully chosen diet, with calcium supplements if the doctor or dietitian recommends them, is the key to reducing symptoms. 

For those who suffer lactose intolerance, lactose-reduced milk and over the counter medications are available.  Products, like Lactaid, provide the person with the missing enzyme, lactase.  Lactose-free milk is a great way to get calcium without the problems that can come with lactose.  Lactose intolerance is not the same as an allergy to milk. Symptoms of a milk allergy include a runny nose, puffy eyes, skin rash, vomiting, tightness in the throat, and difficulty breathing.  Lactose-free or lactose-reduced products do not protect a person who is allergic to dairy products from experiencing an allergic reaction.

People with lactose intolerance must make sure that they take in enough calcium, even if dairy products are not included.  Many foods can provide the calcium and other nutrients the body needs, even when intake of milk and dairy products is limited. Calcium is needed for the growth and repair of bones throughout life, and in the middle and later years, a shortage of calcium may lead to thin, fragile bones that break easily. This is called osteoporosis.  Many non-dairy foods are high in calcium, including dark green vegetables such as broccoli, salmon, and sardines.  Many people with lactose intolerance can tolerate yogurt. This may be a good source of calcium for many people with lactose intolerance.  Lactose-free milk is a great way to get calcium without the discomfort that can come with lactose.

Lactose intolerance is a frequently misunderstood condition.  It is more than just an inconvenience and is considered to be a deficiency.  Lactose intolerance is the inability to digest foods that contain lactose because the body does not produce sufficient amounts of the enzyme lactase.  It is usually a lifelong condition, but can be also be the result of an infection.  Lactose intolerance is not a life-threatening disorder, but it can be a problem, disrupting the flow of daily life.  If you think you may be lactose intolerant you must see your doctor for diagnosis and treatment.

By Karen Goeller, CSCS

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