Lactose Intolerance - Is it Real?

Updated: Jan 27



Dairy free diets are growing in popularity. Are they another fad or are they the real deal? Is lactose intolerance even a real thing?


Yes, it is!


Lactose intolerance is when someone produces too little of the enzyme lactase. Lactase is a digestive enzyme that breaks down the milk sugar lactose in dairy products such as milk, cheese, yoghurt and ice cream. This food intolerance is very common in some populations such as the Asian population for example.


Lactose intolerance usually results in digestive issues such as bloating, cramping, excess gas and diarrhoea. However, anecdotal evidence has also suggested that intolerance can also manifest itself in other ways such as acne breakouts, skin disorders, overproduction of mucous and headaches.


There are different degrees of lactose intolerance with sufferers being able to tolerate varying amounts. Most people can tolerate a small amount of dairy, especially hard cheeses, as these are very low in lactose. There’s now also many lactose free products available. This is where commonly consumed dairy foods such a milk, yoghurt and desserts have the lactase enzyme added into them, meaning the lactose is already broken down. It’s also possible to buy the lactase enzyme in a supplement form in pharmacies or health food shops.


Is it the lactose? Or is it something else?


Lactose is a common intolerance but there are lots of ways that people who are sensitive to it can still include it in their diet. However, some people still get issues even when trying lactose free food products, using the lactase enzyme and with foods that are very low in lactose such as fermented cheeses. It’s possible that for these people lactose isn’t the issue, something else in dairy is.


Casein is a slow release protein found in dairy products. Some people have trouble breaking down casein, which manifests itself into similar symptoms as lactose intolerance, making it difficult to differentiate between the two intolerances. Unfortunately, there aren’t any casein free products available in supermarkets or digestive enzymes to break it down. In this case, sufferers will most likely have to avoid most dairy.


So what do you do if you can’t tolerate dairy? Or what about if you’re reducing your animal product consumption for environmental or ethical reasons?


There’s no denying that dairy products can be a really nutritious addition to diets as it provides essential nutrients such as calcium, phosphorous, potassium and vitamin D. Items like natural yoghurt, kefir and fermented cheeses are rich sources of probiotics - Live bacteria that are beneficial for our gut microbiome.


However, a diet doesn’t necessarily need dairy to be healthy. Though some careful planning is needed to ensure all nutritional requirements are met.


Dairy is possible the best known source of calcium. Calcium is needed for healthy bones and preventing conditions such as osteoporosis, a disease of brittle bones. As milk is a rich source, if you’re using a dairy free alternative, it’s important to use one that’s fortified with calcium. There are so many milk alternatives on the market these days including almond, oat, rice and soya milk. Many brands now offer fortified versions that are enriched with minerals usually found in milk such as calcium, B12 and vitamin D. Look for a milk alternative with 120mg of calcium per 100mls.


Calcium is naturally occurring in other foods such as almonds, sesame seeds, the bones of tinned fish, soya beans, tofu and green vegetables including kale, broccoli and cabbage. Including a range of these foods will help you ensure that you’re getting enough calcium, but that you’re also getting a wide range of other vitamins and minerals too.


Vitamin D is a really important vitamin pretty much everyone should be supplementing with, whether they have dairy in their diet or not. It’s known as the sunshine vitamin, given its main source is sunlight. Foods like milk and cheese also provide some vitamin D. During the winter months, it’s important to supplement with 1000-4000IU of vitamin D3, especially if you’re not including vitamin D rich foods such as dairy in your diet.


What should I do if I think I’m lactose intolerant?


If you think you might be lactose intolerant, it’s important to see your doctor, a dietitian or nutritionist. While it might be quite possible that you are lactose intolerant, it’s also possible that there are other dietary and lifestyle triggers that are contributing to any issues you’re experiencing. This is why we recommend seeing a professional to chat through your symptoms and rule out any other causes.


One method of diagnosing lactose intolerance is a hydrogen breath test but the most commonly used and more accurate approach is a food and symptom diary approach. This applies for any suspected food sensitivities. It involves the person keeping note of everything they’re eating and drinking alongside any digestive issues they experience. This can require some detective work, but it’s a great way to find out what’s causing any issues.


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