Lactose intolerance occurs when your digestive system is unable to break down lactose, the natural sugar found in the milk of all mammals (cows, sheep and goats) and all milk products. It is caused by a lack of lactase, a digestive enzyme that breaks down lactose into simpler sugars. It can be either permanent (primary lactose intolerance) or temporary (secondary lactose intolerance).
Liz Tucker, nutritionist, health consultant and author of Understanding Food Intolerance, tells us what questions she would ask her doctor if she was diagnosed as lactose intolerant.
Do I have to avoid all dairy foods completely?
It depends. When you have secondary lactose intolerance, it's generally better to avoid dairy products until your gut has healed, and your ability to digest lactose returns. With primary lactose intolerance, you may find that you can tolerate a certain quantity of dairy foods without symptoms, such as a small pot of yoghurt, or a small chunk of cheese. If you can carry on eating these foods without any problems, continue to do so. If you experience unpleasant symptoms with even very small amounts, you’re probably better off avoiding all dairy. Remember that you may be able to tolerate dairy foods better if you consume them with your meals, rather than on their own or on an empty stomach. Your test results will reveal the severity of your lactose intolerance.
If I have to permanently avoid all dairy foods, or cut down on them drastically, am I at risk of calcium deficiency?
Yes, this is a possibility. It's a good idea to ensure you eat other calcium-rich foods in order to compensate, such as sardines and other bony fish, tofu, broccoli and other dark green vegetables, and nuts. Most soya milk is calcium-enriched too, and makes a good substitute for cows’ milk. Some people may need calcium supplements, particularly those at risk of osteoporosis. Your doctor can advise you.
Am I at risk of developing a more serious reaction to milk, like an allergy?
You are at no greater risk than people who are not lactose intolerant. Milk allergy and lactose intolerance are two completely different conditions. Allergy involves the immune system, and is usually much more serious than intolerance. Milk allergy occurs in a small percentage of children, who may experience symptoms such as rashes and wheezing, but is rare in adults. It is also very rare to develop a milk allergy in adulthood. However, if you do have other food allergies in addition to lactose intolerance, it may be worth seeing a dietitian to ensure your limited diet is a balanced one. Your doctor may be able to refer you.
Will my lactose intolerance get worse?
Yes, it’s possible. Although it won’t develop into something serious, it's possible that your lactose intolerance will get very gradually worse as you age. You will also notice over the years that you're able to eat less dairy than you used to, in order to keep symptoms at bay. However, this is an extremely slow process.
Are my children likely to develop lactose intolerance because I have it?
Primary lactose intolerance is inherited, so yes. If you're permanently lactose intolerant, it's possible that your children will develop it at some stage before adulthood, and it’s probable if your partner is also lactose intolerant. Children are very prone to secondary lactose intolerance because they have young digestive systems that are sensitive to everyday infections. Usually though, they recover quickly, within a few weeks, and can start introducing dairy foods again gradually.
Is there any cure for lactose intolerance?
There is no ‘cure’ for lactose intolerance because it’s not really a disease, it’s just a natural part of getting older. However, some people think that if you have primary lactose intolerance, it's a good idea to continue to eat a small, safe quantity of dairy food in order to keep your body ‘used’ to digesting a small amount of lactose. It’s also good to help top up your calcium intake. Secondary lactose intolerance usually improves of its own accord.
