INTRODUCTION
Lactose is a sugar naturally found in milk and dairy products. Lactose needs to be broken down into glucose and galactose in the intestine by an enzyme called lactase. Approximately 65% of people across the globe are unable to digest lactose and categorized as lactose intolerant. It occurs due to insufficiency or absence of lactase enzyme to break down lactose in the gut. Consequently, the undigested lactose that passes through the colon may cause several symptoms such as bloating, abdominal pain, diarrhea and constipation which create discomfort to the body. There are several types of lactose intolerance:
| Primary lactose intolerant | Secondary lactose intolerance |
| Congenital -Present at birth and mostly a rare case | Damage/injury within the intestine due to gastroenteritis |
| Delayed (adult form) -Developed around the age of 20 years old | Bowel diseases such as celiac disease Bowel surgery |
Lactose intolerance is a common disorder and can be controlled by limiting food that contains lactose. The amount of lactose an individual can tolerate varies from person to person. Some might need to adjust the type, amount and timing of the food while some left with no option but to completely eliminate lactose in their dietary intake.
To highlight, most lactose-containing food such as cow’s milk and dairy products are the nutrient powerhouse to our bodies because they supply calcium, phosphorus, choline, vitamin B12 and high-quality protein. Avoidance of these food groups can lead to imbalanced nutrition intake and it is associated with poor bone health. Thus, dietary approach is the best way to counter nutritional deficiency caused by lactose intolerance.
DIETARY GUIDELINE
Choose lactose-free products
Lactose-free products are safe to consume as lactose is already pre-digested at the production level, thus it can provide an identical amount of nutrients as normal milk or dairy products. For example, lactose-free milk, cheese and yoghurt drink.
Additionally, lactose-free products are also available in formula milk to accommodate lactose intolerance among babies and toddlers.
Choose plant-based products
Milk alternatives from plant-based sources such as fortified soy milk, almond milk and oat milk can be the best substitute to cow’s milk. Plus, it is a healthier choice as well as plant-based foods are cholesterol-free!
Yoghurt
Most yogurts are considerably harmless to lactose intolerants. Few studies reported that despite their lactose content, yogurts contain live organisms (probiotics) such as β-galactosidase that are able to hydrolyze lactose and facilitate its absorption inside the intestine.
Check the food label
Lactose intolerants are advised to meticulously check food labels as some ingredients are hidden lactose which possibly causes unintended symptoms later. Baked goods, ice creams, cake mixes, butter, margarine, breakfast cereals and chocolates are typically lactose-based. Food ingredients that indicate lactose content are:
- Milk sugar
- Whey or whey protein concentrate
- Curds
- Cream
- Condensed milk
- Goats milk
- Butter
- Buttermilk
- Evaporated milk
- Malted milk
In addition, ingredient names that look alike to lactose such as lactic acid, lactate and lactalbumin are unrelated to lactose hence it is safe to consume.
BOTTOM LINE
All in all, people with lactose intolerants can enjoy vast sources of food as long as it is lactose-free or has reduced-lactose content. Adherence to this dietary guideline is highly recommended to prevent unwanted symptoms and to ensure balanced nutrition is well-supplied daily despite some food limitations.
REFERENCES
- Lactose intolerance. Retrieved from, http://www.myhealth.gov.my/en/lactose-intolerance/
- Facioni, M.S., Raspini, B., Pivari, F. et al. (2020). Nutritional management of lactose intolerance: the importance of diet and food labelling. J Transl Med 18, 260. https://doi.org/10.1186/s12967-020-02429-2
- Ajmera, R. (2023). Lactose-free diet: food to eat and avoid. Retrieved from, https://www.healthline.com/nutrition/lactose-free-diet
