Breast milk has rightfully been touted as the perfect food for infants. It contains the perfect nutrient composition to nourish babies and help them grow. Many of the nutrients are similar to what we consume as adults; however, while adults usually get their energy from a variety of different carbohydrates, infants who are breastfed rely almost completely on the carbohydrate lactose. So, what does this have to do with today’s post?
Because infants consume primarily lactose as a carbohydrate source, their little bodies are dependent on a specific enzyme to breakdown this sugar molecule to use as energy – this enzyme is known as lactase. Without lactase, they wouldn’t be able to absorb and use this sugar to supply energy to the organs, grow new tissue, move, etc.
Interestingly enough, as most adults age the body undergoes a genetically programmed decrease in lactase enzyme creation… leading to some not-so-fun digestive upset after a trip to Dairy Queen.
What is Lactose Intolerance?
Lactose is a sugar that is found in the milk of all mammals, meaning you will find it in breast milk and dairy products. Lactose intolerance stems from the inability of the body to break down lactose into its two single sugar parts (glucose + galactose) to be easily absorbed through digestion. Because infants have traditionally relied on breast milk for nourishment, they have quite a bit of lactase waiting on the lining of their intestines to break down the sugar. Adults on the other hand, have less because the adult gut produces less lactase. So instead of the lactose sugar being broken down and absorbed, it remains intact. The bacteria in the gut then take advantage of this and use it as energy for themselves – causing all of those uncomfortable symptoms of GI distress like bloating, cramping and gas.
Lactose Intolerance and FODMAPs
If you are following the low FODMAP diet, you probably know that lactose is included in the list of poorly absorbed sugars. It is included as a poorly absorbed sugar for the same reason that those who are lactose intolerant have to avoid it – some people don’t have enough lactase enzyme in their intestines to break down the lactose sugar, leading to digestive symptoms. If you have had lactose malabsorption testing (like hydrogen breath testing) or know that lactose isn’t a trigger for you, there is no need to eliminate lactose during the diet. If you haven’t had testing done or aren’t sure if it is a trigger, it is recommended that you remove lactose from your diet during the elimination phase.
Lactose Intolerance and Lactase Supplements
Unless you are living somewhere remote with very little human contact, you probably know someone who is lactose intolerant. The amount of people who identify themselves as being lactose intolerant is skyrocketing. Because this condition affects so many people, it’s definitely worth talking about potential treatment options – in particular, using lactase enzymes as a supplement.
Treating Lactose Intolerance
Thankfully, if you are lactose intolerant, you don’t have to forgo your favourite ice cream forever. There are many commercial products on the market that contain lactase to provide your body with the enzymes it’s lacking to do the job itself.
If you are avoiding lactose completely, you probably know that lactose can be hiding in almost anything! Read our article ‘Where is Lactose Lurking?’ to get some great tips on how to easily identify products that contain lactose.
Lactose-free Dairy Products
You may have noticed that now there are many dairy products, like milk, yogurt and even ice cream that are labelled as ‘lactose-free’. To make these products lactose-free, the manufacturers add lactase to the product and let the enzyme work its magic to break down the lactose molecule into smaller components that the body has no problem absorbing. The products also usually undergo testing before packaging to make sure they are at least 99% lactose-free. This means that the product is easily digested and absorbed by those who are lactose intolerant.
In general, people seem to have varying thresholds for lactose. Some people are able to get away with eating low lactose foods without cramping and bloating, while others can only tolerate a very small amount. If you are someone who can tolerate some lactose in your diet, read our post ‘Hold the Lactose!’ for some low lactose food suggestions!
Over the Counter Lactase Enzymes
You can also buy lactase enzyme tablets over the counter at your local pharmacy. The supplement is meant to be taken with the first bite of food containing lactose, so it can replace the missing enzymes from the body’s intestinal lining. These products can be found at most pharmacies and range in price from $15 to $25, so if you are using them regularly, it could get expensive.
Do Lactase Supplements Work?
After reviewing the best scientific evidence that we have to date, it appears that the effectiveness of lactase-containing products is very subjective. Researchers report inconsistent results in trials testing how well lactose-free dairy products and lactase enzyme supplements reduce digestive distress in lactose intolerant populations. Some participants had much fewer symptoms overall, while others didn’t notice that much of a difference. So what does this mean for you? If you are experiencing digestive distress after eating lactose containing foods, there is no harm in trying a lactose-free dairy product or talking to your local pharmacist about lactase supplementation. It may just work for you!
Do lactose-free dairy products or lactase tablets seem to curb your bloating and cramping? Leave us a comment below!
Wishing you good gut health and wellness,
Shaukat A, Levitt MD, Taylor BC, MacDonald R, Shamliyan TA, Kane RL, et al. Systematic review: effective management strategies for lactose intolerance. Annals of internal medicine. 2010;152(12):797.
Brown-Esters O, Mc Namara P, Savaiano D. Dietary and biological factors influencing lactose intolerance. International Dairy Journal. 2012;22(2):98-103.