Learn strategies to control lactose intolerance

Lactose intolerance is the inability to digest milk sugar. If you don't have enough enzyme to handle the lactose in the food you eat, you can experience a variety of unpleasant symptoms. We'll teach you more about the condition.

• Lactose is the natural sugar found in milk and milk products. It has to be broken down by an enzyme called lactase into glucose and galactose before it can be absorbed and used by the body.
• Unabsorbed lactose passes into the colon, where it's consumed by bacteria. The by-products of this bacterial activity are gases like hydrogen and methane, which are responsible for the discomfort, cramps, and gas that often plagues sufferers of lactose intolerance.
• The condition can be diagnosed by measuring the amount of hydrogen exhaled before and after ingesting lactose.
• Adults who can digest milk are a minority in the world population: 70 percent of people of African and Asian descent are partly or entirely lactose-intolerant after four years of age. In contrast, 90 percent of people of Northern ­Euro­pean descent continue to produce lactase. This genetic trait probably enabled their forebears to absorb extra calcium in a habitat where there was little sunlight available to develop vitamin D in the skin.
• Transient or permanent lactose intolerance may follow an illness that injures the intestinal lining such as gastrointestinal illness, celiac disease, or inflammatory bowel disease. It can also follow treatment with antibiotics or anti-inflammatory drugs.
• In some cases the intolerance is temporary and will disappear when bowel health returns to normal. In other cases, lactose intolerance is a "threshold intolerance," which means that you can handle small amounts of lactose but increasing doses cause a problem.

• Lactose is found in dairy products including milk, yogurt, and cheese. It can also be found as an ingredient or component of various food products such as cookies, breads, processed meats, hot dogs, some artificial sweeteners, and even some medications.
• Read labels carefully and look for milk, milk solids, cream, whey, cheese flavours, curds, and non-fat milk powder.
• Eat small amounts of dairy products. Most lactose-intolerant people can consume some milk without much discomfort. They can also safely eat cultured dairy products such as yogurt, because the bacteria used in fermentation use up most of the lactose for fuel. For people with a more severe intolerance who still want dairy products, many grocery stores sell lactose-reduced varieties.
• Pharmacies carry enzyme drops that can be added to milk, as well as enzyme tablets that can be taken before eating dishes containing dairy products.
• Don't confuse lactose intolerance with milk allergy, which is hypersensitivity to the proteins in dairy products. If you're allergic to milk, consuming a lactose-reduced product will not prevent a reaction.
• Even if you are lactose intolerant, you can include milk products as part of your diet if you follow these 5 guidelines:

1. Start very slowly. Try 50 millilitres (1/4 cup) of milk and gradually work your way up. You'll find that your tolerance will increase over time. The more that you avoid dairy, the more intolerant you'll become.
2. Drink milk with meals, rather than on an empty stomach.
3. Enjoy yogurt. The active cultures in yogurt make it highly digestible.
4. Eat hard cheeses containing only negligible amounts of lactose like cheddar, Edam and Gouda.
5. Drink lactose-reduced milk.

Lactose intolerance can be a big problem and severely restrict your dietary options. Use this guide to choose appropriate substitutes and manage the condition properly.