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When you can't tolerate milk

Published:Wednesday | May 26, 2010 | 12:00 AM

After leaving our mothers' breasts, we continue to consume milk from other animals like cows, goats, sheep, horses, camels and donkeys! This occurs despite the fact that about 75 per cent of adults have some level of intolerance to lactose, the sugar found in milk.

We probably continue to have milk since it contains many vitamins, minerals and other nutrients. Besides, milk products like ice cream and milk shakes are often a source of comfort and pleasure.

Lactose intolerance

The main sugar in animal milk (lactose) requires the enzyme lactase to break it down into simple sugars (glucose and galactose) which are then absorbed in the small intestines. When we lack lactase or have a deficiency of it in the small intestines (most adults do), we cannot digest or tolerate milk or its products containing lactose. This is lactose intolerance. Lactose intolerance is usually genetic (from our parents) but some disorders which damage the intestines may result in lactase deficiency and lactose intolerance.

Gas galore

The lactose we consume in milk sits in the small intestines and becomes food for the bacteria which overpopulate the area. The lactose ferments and a 'shipload' of gas is produced and liberated. Bloating, cramping, excess burping, passing of unpleasant wind and diarrhoea are the results within an hour after taking milk products.

The extent and severity of lactose intolerance varies between individuals and with dose of milk intake. Lactose intolerance is different from milk allergy.

How to enjoy milk

Be lactose intelligent: Where there is no dairy milk or milk products, there is no lactose intolerance. Avoiding these products is one sure way to avoid the symptoms. However, decreasing the dose of lactose helps many people who are able tolerate up to one cup of dairy milk each day. If you choose to avoid milk, you may need to take calcium supplements.

Supplement with lactase: Since milk contains important nutrients, for those who must have it, one approach is to treat it with lactase enzyme. This is called enzymatic lactase supplementation. Timing is important. The enzyme in tablet or capsule form must be swallowed just before or with the first 'bite' of dairy foods. The capsule or tablet is designed to withstand stomach acid and to still be active lower down in the intestines.

Take lactobacillus acidophilus supplements with dairy: These bacteria actually produce the lactase enzyme to help us digest lactose-containing dairy milk. The same mechanism is exploited in manufacturing yoghurt - live, active bacterial cultures are added to milk (in fact, yoghurt is a 'lactose intelligent' alternative to milk). Capsules each containing between 40 million to 6 billion live active cells of the 'friendly' bacteria L.acidophilus, B. lactis, L. salivarius, etc. are helpful.

Speak with your pharmacist before taking medicines since many tablets are made with lactose as a filler.

Dahlia McDaniel is a pharmacist and final-year doctoral candidate in public health at the University of London; email: