2023-06-28 05:49:00
Biologically, lactose intolerance occurs due to a relative lack of the enzyme lactase, which is supposed to break down the lactose sugar and is located at the end of the lining cells of the small intestine. After infancy, the amount of lactase decreases in all of us, but in disease states in the small intestine (such as intestinal infections, untreated celiac disease, Crohn’s disease, etc.), the decrease is more significant.
Some people find it difficult to digest a large amount of dairy products or specific products, even without organic underlying diseases. In general, if we eat more lactose than the ability of our lactase to break it down, excess lactose will be created in the intestinal cavity that will be broken down by the intestinal bacteria, which will trigger unpleasant symptoms such as gas, bloating, abdominal pain, nausea, soft stools and diarrhea. The threshold and sensitivity to these symptoms also vary greatly from person to person. People with sensitive intestines will suffer much more due to significant lactose consumption. Here are 5 things you should know about the phenomenon.
Milk allergy and lactose intolerance? Not the same at all
Unlike an allergy to dairy products, lactose intolerance is a phenomenon that does not require a break in the consumption of dairy products, but requires choosing them carefully – that is, the type of products and their quantity.
A milk allergy, on the other hand, is an allergic reaction of the immune system to milk protein that occurs mainly in babies and small children. The symptoms of this condition can manifest in stomach pains, rashes and even more severe reactions with shortness of breath. It is important to note that those who are diagnosed with a milk protein allergy must not eat milk and its products at all, although these childhood allergies sometimes pass over the years.
This is a common phenomenon – really
Many are surprised to learn that lactose intolerance is a phenomenon that bothers 50-70% of adults to varying degrees. These rates vary between geographic regions of the world and are more common among Asians. Genetic factors are involved in our ability to break down lactose, but not only them – the microbiome (intestinal bacteria composition) is also important for the breaking down process and its products. Lactose intolerance, therefore, is a “developmental” condition and is not a disease. Its severity may change throughout the life cycle.
Each dairy product contains a different amount of lactose
In fact, the more solid the dairy product, the less lactose it contains. Therefore, solid dairy products such as hard cheeses have less lactose. Products containing “bio” bacteria are also easier to digest since they break down some of the lactose in the product. Also, dairy products from goats and sheep often contain less lactose compared to products from cattle. On the other hand, skimmed milk, ice creams, sweet cream – all these will contain a larger amount of lactose. Dairy products that are from small dairies are usually of higher quality and better for the gut since they are less industrialized and processed. A reasonable amount of dairy products may benefit the body, due to their nutritional benefits including: calcium, vitamins and protein. Many studies attribute the health value of quality dairy products to development Normalization of children, prevention of obesity, prevention of decrease in bone density and fractures; it is even possible that some of them reduce the chance of certain types of cancer such as colon cancer.
It’s not all genetics
In the past it was believed that food intolerance was highly dependent on the genetic background. But new studies show that lactose intolerance is also related to the composition of the microbiome, which is, as mentioned, the composition of our intestinal bacteria. It is an ecological community of microorganisms that mostly include bacteria but also viruses, parasites, fungi and more. The main factors that affect the health of the microbiome are our diet and its quality, the medications we take (with an emphasis on antibiotics), as well as smoking and alcohol consumption and even various additives. Today we know that the microbiome and its composition also affects our ability to break down lactose. A varied, unprocessed diet, rich in fruits and vegetables, containing a reasonable amount of dairy and fish products and a little meat and sweets – contributes to a healthy and balanced microbiome that aids in the digestive process. By the way, in case you were wondering, there are no specific probiotic preparations that will necessarily help break down the milk, but you can purchase food supplements that contain the lactase enzyme that helps break down.
The firmer the cheese – the less likely it is to contain lactose Photo: shutterstock De baibaz
Lactose intolerance can change throughout life
As mentioned, there are quite a few people who have been diagnosed at some point in their lives with lactose intolerance, but this does not mean that it is a permanent condition. Hormonal problems and changes, infections and stress – all of these, for example, can affect the digestion of milk and the changing personal experience. Diagnosing the inability to break down lactose is done by a breath test with labeled lactose and testing the composition of the exhaled air. People with a positive test do not always have to completely avoid all dairy products.
The authors are: Prof. Roital Krib – chief gastroenterologist at Maccabi Health Services and Michal Sukman, district dietitian of the central district in Maccabi
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