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What is Lactose Intolerance, Really?

Here’s a scenario: You have always loved any food containing dairy. Yogurt with granola is your standard breakfast of choice, macaroni and cheese is your go-to comfort food, and you can’t remember the last time you were able to resist a milkshake. But recently these favorite foods have been leaving you feeling less than fantastic.

Could you be lactose intolerant?

We spoke to William Culver, MD, adult and pediatric allergist and immunologist at Banner Health Clinic in Loveland, Colorado about lactose intolerance and what it means for you.

What exactly is lactose intolerance?

Lactose is a sugar found in milk and other dairy products. Typically, this sugar is broken down by an enzyme called lactase, which is produced by cells in the lining of the small intestine. Lactose intolerance is often mistaken for a food allergy, but it’s an impaired ability to digest that particular sugar.

The most common type of lactose intolerance in adults is lactase nonpersistence, caused when less lactase is produced after infancy. The symptoms, which include bloating, flatulence, and abdominal pain, often arise after a lactose intolerant person consumes one or more servings of dairy products.

Dr. Culver explained that by far the highest concentration of lactose per serving is present in milk and ice cream. “Cheeses generally contain much lower quantities of lactose,” said Dr. Culver. “Live culture yogurt is an alternative source of calories and calcium and may be well tolerated by many lactose-intolerant patients."

Does being lactose-intolerant mean I have to avoid all dairy?

Unless you’re interested in exploring a vegan diet, there’s no need to completely avoid your favorite foods. Since lactose intolerance is a dose-dependent phenomenon, meaning its effect changes as the amount of lactose changes, Dr. Culver explained that patients can typically just restrict the amount they eat instead of having to avoid lactose-containing products altogether.

Individuals with lactose intolerance may start with a more severe dietary restriction, like initially not eating any foods containing lactose, and then work up to their individually tolerated limit of lactose-containing foods.

“Eliminating lactose from your diet is not required,” said Dr. Culver. “To treat symptoms of intolerance, it’s often sufficient to limit your intake of lactose to two cups of milk (or its lactose equivalent) daily, divided across two meals."

If limiting your intake doesn’t seem to be doing enough, talk to your doctor about supplements you can take to help treat your condition. “Patients may find success with lactose-reduced products or lactase supplements,” said Dr. Culver.

If you are concerned about your lactose intolerance and don’t feel like you have it under control, schedule an appointment with a Banner Health nutrition specialist.

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