Lactose intolerant? ...All is not lost


Lactose intolerant? ...All is not lost

Dr Gabriella Diaz

Sunday, September 20, 2020

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YOU'VE been craving a milkshake treat after a long, productive week however, you do not want the side effects of bloating, cramping and diarrhoea.

You may not be alone, as lactose intolerance is a common phenomenon.

What is lactose intolerance?

Your intestinal cells produce an enzyme called lactase. Lactase is responsible for digesting lactose into glucose and galactose. Lactase activity is the highest immediately after birth, and declines thereafter.

About 30 per cent of people retain enough lactase to digest lactose efficiently throughout adult life. When more lactose is consumed than the available lactase can handle, the undigested lactose molecules remain in the gut attracting water. This results in the characteristic symptoms of bloating, gas, abdominal discomfort, and diarrhoea.

Lactase deficiency may also develop when the intestinal villi (tiny projections that line the inside of the small intestine which absorb nutrients) are damaged by disease such as celiac/gluten sensitive enteropathy, some antibiotic medications, prolonged diarrhoea, or malnutrition. This can lead to temporary or permanent lactose malabsorption.

Lactose intolerance vs milk allergy

Lactose intolerance is not the same as a milk allergy. A milk allergy results in the body's abnormal adverse immune reaction to the protein in milk and can be deadly.


People's tolerance to lactose varies widely.

The total elimination of milk products is not necessary. Excluding all milk products from the diet can lead to nutrient deficiencies. Some may try to restrict milk and dairy products, which may compromise the dietary calcium intake, especially if there are no other calcium-rich foods or a suitable calcium supplement consumed.

Of particular concern are children, teenagers, pregnant women, and those with a family history of osteoporosis. A diet for lactose intolerance is not the same as a milk-free diet, which is required for milk protein allergy. Regular and gradual consumption of milk by lactase-deficient individuals may improve tolerance.

Most can tolerate cup of milk with a meal over time, if not immediately, and gradually increase with time.

Include milk with other foods in meals and spread its intake throughout the day.

Whole milk may be better tolerated than skimmed milk, because of the delay in gastric emptying.

Choose lactose-free products, like lactose-free milk.

Fermented products like yogurt with active cultures, hard and cottage cheeses, and sour cream are better tolerated. Frozen yogurt has little or no lactase activity.

Lactase supplements which are available in Jamaica can be utilised. For some it may cause a strain on the budget.

Pay attention to the food labels as non-dairy foods may also contain culprits in the ingredients. Lactose may be used in some medications as a filler. Some of the words to look out for include milk powder/protein/solids, whey solids/proteins.

Dr Gabriella Diaz is a medical aesthetics doctor and registered dietitian who is the director at Finesse Nutrition and Esthetics (FINE) at 129 Pro, 129 Old Hope Road, Kingston 6. Check out 876FINE on Facebook or contact her via e-mail at and 876-522-8297.

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