LACTOSE INTOLERANCE – CAN I STILL HAVE DAIRY?

WHAT IS LACTOSE INTOLERANCE?

Lactose is the sugar that is found in milk derived from mammals. Under normal circumstances, when consumed, an enzyme known as lactase is released in the gut. This enzyme breaks down the lactose into two smaller sugars (which are like the building blocks that make up lactose) called glucose and galactose.

A person that is lactose intolerant does not produce enough lactase to break down all the lactose in the milk. This results in the lactose travelling further along the gut, where naturally occurring bacteria ferment it and produce acids and gas which may result in abdominal discomfort and symptoms like cramps, gassiness (flatulence), bloating or diarrhoea to occur.

People with lactose intolerance can still consume smaller amounts of dairy or fermented dairy products (like yogurt, kefir, buttermilk, hard cheeses or maas) depending on how well they are tolerated.

IS THIS DIFFERENT TO A COW’S MILK ALLERGY?

Yes, despite the fact that the terms lactose intolerance and cow’s milk allergy are often used interchangeably, these are two completely different medical conditions. Where lactose intolerance means that a person has an enzyme deficiency, a cow’s milk allergy means that the person’s immune system (‘defence mechanism’ against germs) fails to recognise the protein found in milk as ‘safe’. When a person with a milk allergy then consumes milk the body basically releases an ‘attack’. Depending on the degree of the allergy, symptoms may be mild or severe and can involve symptoms like a rash or eczema occurring, a runny or itchy nose and eyes, nausea, vomiting or diarrhoea.

Cow’s milk allergies mostly occur in infants. Depending on the severity of the allergy, dairy products should either be eliminated entirely or can gradually be reintroduced back into the diet. One should consult with a doctor and a dietician before taking any steps.

HOW CAN SOMEONE WITH LACTOSE INTOLERANCE INCORPORATE DAIRY?

  • Avoid eating dairy products on an empty stomach and rather incorporate it with other foods (like cereal or porridge) instead of having it on its own.
  • Fermented milk products like maas or yogurt are generally better tolerated as the cultures in these products have already started to break down the lactose and the lactose content is lower than in milk.
  • Cheeses generally have a lower lactose content (particularly cheddar or gouda) and may therefore be tolerated better.
  • In some cases full cream milk may be better tolerated than low fat or skimmed milk. Alternatively one can look at using lactose free milk or a lactase formulation that can be obtained from a pharmacy.
  • Gradually build up your tolerance. Start with smaller amounts of dairy and gradually increase your consumption.

And there we go, now you don’t need to wonder anymore.

Compiled by Cecile Niebuhr

Cecile Niebuhr, RD(SA)

Cecile Niebuhr, RD(SA)

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