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Got Milk? Not If You Have Lactose Intolerance

Dairy products are off the menu for 50 million Americans

BHM Edit Staff | 8/5/2013, 7:54 p.m.
How can you add dairy to your life if you're lactose intolerant? Thinkstock

That belly pain you’re experiencing could be lactose intolerance, a reaction to too much milk sugar in your diet. The disorder, which may cause mild to severe diarrhea, nausea, abdominal cramps, bloating and gas about 30 minutes after eating or drinking foods that contain lactose, occurs when you don’t make enough of the enzyme lactase, which breaks down the sugar in milk. It can be uncomfortable, but it is not life threatening. About 50 million Americans suffer from lactose intolerance, many of them African American.

Why Do I Have This?

Several factors that make you or your child more prone to lactose intolerance include:

Age. Lactose intolerance becomes more common as you age; the condition is uncommon in babies and young children.

Ethnicity. Lactose intolerance is most common in black, Asian, Hispanic and American Indian people. Some research suggests 75 percent of African Americans are lactose intolerant; other studies note that only 49 percent of us experience physical discomfort after eating dairy foods, with only 24 percent actually being lactose intolerant. Roughly 50 percent to 80 percent of Latinos have lactose intolerance.

Premature birth. Infants born prematurely may have reduced levels of lactase because this enzyme increases in the fetus late in the third trimester.

Diseases affecting the small intestine. Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn’s disease.

Some cancer treatments. If you have received radiation therapy for cancer in your abdomen or have intestinal complications from chemotherapy, you have an increased risk of lactose intolerance.

How Can I Treat Lactose Intolerance?

For starters, eat fewer dairy products. This is a sure-fire way to reduce symptoms.

For many, however, dairy products are a convenient way to get vitamins and nutrients, such as calcium. You can find calcium in foods other than dairy, including:

  • Broccoli
  • Calcium-fortified breads and juices
  • Canned salmon
  • Milk substitutes, such as soy and rice
  • Oranges
  • Pinto beans
  • Rhubarb
  • Spinach

If you give up dairy products, you’ll need to make sure you get enough vitamin D, which isn’t found in significant amounts in many foods (only eggs, liver and yogurt). Your body makes vitamin D when exposed to the sun, but only if you’re not wearing sunscreen. (Note: You should always wear sunscreen to protect against skin cancer.)

You may not have to avoid dairy foods completely. You may be able to tolerate low-fat milk products, such as skim milk, better than whole-milk products. It also may be possible to increase your tolerance to dairy products by gradually introducing them into your diet.

How Can I Build Up Tolerance?

  • Choose smaller servings of dairy. Sip small servings of milk—up to 4 ounces at a time. The smaller the serving, the less likely it is to cause gastrointestinal problems.
  • Save milk for mealtimes. Drink milk with other foods. This slows the digestive process and may lessen symptoms.
  • Try an assortment of dairy products. Not all dairy products have the same amount of lactose. Hard cheeses, such as Swiss or cheddar, have small amounts of lactose and usually don’t cause symptoms. You may be able to tolerate cultured milk products, such as yogurt, because the bacteria used in the culturing process naturally produce the enzyme that breaks down lactose.
  • Buy lactose-reduced or lactose-free products. Find these at most supermarkets in the refrigerated dairy section.
  • Keep an eye out for hidden lactose. Milk and lactose are often added to prepared foods, such as cereal, instant soups, salad dressings, nondairy creamers, processed meats and baking mixes. Check the ingredient list for milk and lactose. Also look for other words that indicate lactose—whey, milk byproducts, fat-free dry milk powder and dry milk solids. Lactose is also used in medications. Let your pharmacist know if you have lactose intolerance.
  • Use lactase enzyme tablets or drops. Over-the-counter tablets or drops containing the lactase enzyme (Dairy Ease, Lactaid) may help you better digest dairy products. You can take tablets just before a meal. Or add the drops to a carton of milk. (A word of caution: Not everyone with lactose intolerance is helped by these products.)