Do you have digestive symptoms like bloating, discomfort and diarrhoea and think food intolerance may be causing it? Have you had norovirus, travellers’ tummy, food poisoning, or suffered another nasty digestive bug? Or you may have been diagnosed with irritable bowel syndrome (IBS). If yes, then the food intolerance could be lactose intolerance, intolerance to the sugar in the milk. You don’t need to worry about missing out on favourite foods, or nutrients like calcium, and it could go away over time.
Here are some facts and tips to help you if you think you might have lactose intolerance.
1. Only 30% of the world’s population can still digest lactose as adults. Luckily you, as a Northern European, are the most likely to still be able to digest it. 50-100% of adult Asians, South Americans and Africans can’t and are lactose intolerant.
2. If you catch a digestive bug, virus, or parasite that affects the part of the gut which produces the lactase enzyme that helps us digest the lactose milk sugar then you may develop lactose intolerance. This should be temporary.
3. There is a diet called the low FODMAP diet that is low in fermentable carbohydrates (or sugars) and has been shown to help 3 out of 4 IBS sufferers. Lactose is one part of the diet as lactose is a fermentable sugar. Reducing lactose alone may help symptoms if you suffer with IBS and have a lot of milk products. But it is by reducing the overall fermentable carbohydrates (including lactose), in the diet that have shown to improve symptoms.
4. Lactose Intolerance is diagnosed via your doctor with a breath test after drinking a lactose solution containing the equivalent of the lactose in a litre of milk. This tests the amount of certain gases that the bacteria further down the gut release when they ferment the lactose. They ferment the lactose because it hasn’t been properly digested in the first part of the gut.
5. You may find you have symptoms quickly after having lactose, but many people find they notice the effects about 1 ½ - 2 hours later.
6. The foods that are highest in lactose and portion sizes are usually larger are milk (think adding to cereal, milky drinks, desserts), yogurt, and ice-cream. These are the key milk products to swap for dairy alternatives or lacto-free versions.
7. You might find that little amounts of milk products don’t affect you but when you have a larger portion of milk, yogurt and ice-cream more than once in a day, you get symptoms. Most people with lactose intolerance can tolerate small quantities, and this level is different for everyone with lactose intolerance.
8. It doesn’t matter if you change to drinking skimmed milk as it has nothing to do with the fat levels; the sugar (lactose) levels are virtually the same whether it’s skimmed, 1%, semi-skimmed or whole milk.
9. The lacto-free products you can buy in the supermarket add in the enzyme lactase to digest the lactose before it gets to cause digestive symptoms. You can now buy yogurt made from coconut milk, ice-cream made from soy milk, or nut milk. There are lots of alternatives in the supermarket, so eating with lactose intolerance, is easy when you know what to look for.
10. Buying lacto-free soft cheese (Philadelphia-style) and cheddar is a waste of money as these have virtually no lactose in them anyway. Cottage cheese and cheese spreads (dairylea-style) are the cheeses with relevant amounts. There are small amounts in feta but most other cheeses have very little. Butter and margarine have virtually no lactose. Cream has about half the amount of milk but as we tend to eat it less often, and in smaller quantities, it is less of a problem.
11. Dairy alternatives are fortified with calcium to ensure you don’t miss out on this mineral. If you swap for these, or lacto-free milk products, your calcium intake doesn’t need to drop. Plus, now you know you can still eat most cheeses which give you calcium.
12. Some people may find they tolerate yogurt or cottage cheese, better than milk or ice-cream. The fermentation of the milk when making these creates lactic acid bacteria that help with lactose digestion.
If you think you have food intolerance or suspect irritable bowel syndrome please see a doctor or qualified health professional to rule out any other cause. Also you may still have symptoms after avoiding lactose and it may be another substance in milk or something different altogether that is causing discomfort.
Please get it touch if you’d like to ask me more about lactose intolerance as I can help you with foods, meal ideas, and give general advice if you want to know what to do next.