Lactose is the sugar in milk which is made up of two larger sugars, galactose and glucose. The lactose must be split into these two sugars before it can be absorbed by the body in the small intestine. An enzyme called lactase is responsible for this split and is found in the lining of the small intestine. Deficiency of this enzyme can be caused by one of three reasons: secondary, congenital, or developmental. In this article we look at the symptoms and problems of lactose intolerance and the need for taking additional protein supplements as part of a healthy diet.
Congenital lactose intolerance is caused by lactase deficiency that is present at birth. This is a rare cause of deficiency and the symptoms are noted soon after birth. A secondary cause of the lactase deficiency results in the destruction of the lining of the small intestine which includes the enzyme lactase. A common cause of this is celiac sprue, which can cause a number of additional problems.
The most common cause of deficiency of lactase is a simple decrease in the amount of lactase that is produced by the body, which starts slowly in childhood and progresses into adulthood. It is almost 100% prevalent in the Asian community, 80% in the American Indian community and 70% in African Americans, while Caucasians only account for 20%. Symptoms can start at different ages among each population as well, with Asian children showing problems as young as five and other ethnicities showing symptoms at later ages (Source: Marks MD)
Symptoms of Lactose Intolerance
The most common symptoms are abdominal pain, diarrhea and flatulence. Other symptoms can include abdominal bloating, distention and nausea. However, these symptoms can be caused by other gastrointestinal conditions and may be largely dismissed, especially if they do not occur often, as in the case of a mild intolerance.
Symptoms can be nonexistent in some people while in others they may be problematic. It is estimated that up to 20% of the people who deem themselves lactose intolerant have never been tested. There are many people who think that they are lactose intolerant but are not, while there are a number of people who are intolerant but do not realize it.
Testing for Lactose Intolerance
There are several ways to test for lactose intolerance. First, there is the elimination diet, which has several drawbacks to consider. Other testing types include the milk challenge, breath test, blood glucose test and a stool acidity test. The most direct test is the intestinal biopsy which tests for the lactase deficiency directly. This can be done by endoscopy or by other means, however, it is not always possible to have this testing type done.
The Elimination Diet
For this testing method to be effective, all sources of milk and milk products must be eliminated from the diet, which is difficult. Milk is a common ingredient in so many foods that are found in the average diet, whether it is listed as such, that there is bound to be some that still gets in. It is necessary for the elimination diet to be started and monitored by a nutritionist or dietician so that all milk sources are eliminated. The average person may not realize that milk can be found in foods such as bread and baked goods, breakfast cereals, instant potatoes and soups, lunch meats, salad dressings and candies.
The Milk Challenge
The milk challenge is easier than trying the elimination diet and is done by fasting overnight, drinking a glass of milk and then having nothing else for up to five hours afterward. If you are in fact lactose intolerant, it is likely that milk will produce symptoms. If there are no symptoms, then it is likely that lactose intolerance is not the cause.
The testing must be done using the right amount of milk – if the person typically drinks milk or has large amounts of milk products, a large amount of milk should be used in the milk challenge. However, if the person does not typically drink milk or ingest large amounts of milk-containing food, a smaller amount can be used for the challenge.
The Breath Test
In this test, pure lactose is ingested with water after an overnight fast. (The amount of lactose used in the test is typically 25 grams, about the amount in 16 ounces of milk.) In the person who is lactose intolerant, hydrogen and methane will be absorbed from the colon, into the blood and then excreted into the breath. Breath samples are collected every ten or fifteen minutes for a period of three to five hours and analyzed for hydrogen and methane. The amount of these gases that is found in the breath is equal to the level of the deficiency. False positives can be had with this testing type, however, especially in those who have been treated with antibiotics.
The Blood Glucose Test
This is an older test but can have many problems. First, it requires several blood sticks and draws. There is also a problem with false positives, which is common with this type of testing. This test is not commonly used to test for lactose intolerance.
Stool Acidity Test
This test is used to test for deficiency in children and in infants. Lactose is given orally and then stool samples are analyzed. Lactose enters the colon and is then split into glucose and galactose, which is then split by bacteria into acids, including lactic acid. This acid is then released into the stools. It is not done frequently because the breath test is considered to be superior and can be used for children and infants as well as adults.
The Problem with Lactose Intolerance
One of the major problems with lactose intolerance is the possibility of calcium deficiency, which can lead to osteoporosis. Milk and milk products are among the best source of calcium in the diet, and the body uses this mineral to form strong bones and teeth. Without enough, the bones can become porous and brittle, increasing the risk for breaks, especially in those who have small, thin frames and certain ethnic groups. It is important that the person who is lactose intolerant supplement their calcium so that they do not increase their risk of osteoporosis. In some people, supplementing the enzyme lactase can be beneficial and allow the person to ingest some milk products without producing symptoms.
Making sure that you are eating a healthy and well-balanced diet can be tricky for those who are lactose intolerant. There are other foods that might be avoided as well. Adding a protein supplement might be a good idea, especially as a between-meal snack, however, it is important to note that many types of protein supplements can cause the same kinds of problems that milk can.
Whey protein, for instance, is derived from milk and is not appropriate for those who are lactose intolerant. A better option is using Profect or Proasis, from Protica. Profect is available in a number of flavors and can be consumed as is or mixed with other foods or beverages. Proasis is the first all-natural protein supplement and is free from lactose and other allergens as well. It is also available in a number of flavors and strengths. Each serving of Profect has a full 25 grams of protein and is only one hundred calories.
Protica Research (Protica, Inc.) specializes in the development of Capsulized Foods. Protica manufactures Profect, IsoMetric, Pediagro, Fruitasia and over 100 other brands, including Medicare-approved, whey protein shots for bariatric patients. You can learn more at Protica Research – Copyright