For most people, consuming lactose, the sugar found in milk, causes no problems. But for as many as 50 million Americans, lactose sparks gastrointestinal symptoms such as gas, bloating and diarrhea. Asian-Americans, African-Americans and Native Americans suffer the most from lactose intolerance, but anyone can be affected. Milk and its byproducts are an ingredient in a lot of products, not just dairy--so those with lactose intolerance must be vigilant in reading food labels.
Why Avoid Lactose
Lactose intolerance occurs when a person lacks the enzyme lactase that helps digest the (lactose) sugars in milk. Severity of symptoms vary, but usually appear within 30 minutes to an hour of consuming products containing lactose. Some people who are lactose intolerance can tolerate a small amount of milk products--perhaps a cup of milk or an ounce of cheese--but for people with severe symptoms, it is best to avoid all foods containing lactose. If you suspect lactose is the culprit for your gut issues, try cutting out all lactose for a few weeks to see if your symptoms subside.
Milk and milk-based products obviously contain lactose. The amount of lactose in each product varies, so you might be able to tolerate small amounts. Remember, these include yogurt, all cheese, kefir, sour cream, milkshakes and some smoothies, ice cream, sherbet, butter and whipping cream. Use common sense--cream sauces and soups made with milk or cream will also contain lactose. Lactose-reduced milk still contains some lactose, though not as much as regular milk, so beware if you are particularly sensitive. Non-dairy creamer does not contain lactose, but does contain sodium caseinate, a derivative of the milk protein casein.
Less Obvious Sources
A lot of prepackaged foods contain milk or milk products as an ingredient. Every brand is different, but be especially careful when buying instant mashed potatoes, salad dressings, mayonnaise, cake, biscuit and pancake mixes, chocolate (especially milk chocolate), hot cocoa, snack cakes and cookies, breads, breakfast cereals and peanut butter. Read food labels and become alert to the allergen statement, "contains milk ingredients." Sometimes, a label may fail to warn you of milk, so always scan ingredient lists for any of the following words that indicate lactose may be an ingredient: whey, nonfat milk solids, buttermilk, malted milk, margarine and sour cream. Many whey protein supplements declare they are completely lactose free. The truth is that they are mostly lactose free and may affect very sensitive people.
About 20 percent of prescription medications contain lactose. Birth control pills often contain lactose, and several over-the-counter medications do as well. Although most people who are lactose intolerant are not affected by the amount of lactose in medications, it would be worth asking your pharmacist or health care provider if you suspect a problem.
How to Avoid the Symptoms
Supplements, in pill or liquid form, that contain the lactase enzyme may be taken orally right before or during the consumption of dairy products. These supplements help mitigate the effects of lactose on the gastrointestinal system, but they do not work for all people. Keeping a food diary and carefully noting how you feel when consuming certain products might help you pinpoint your lactose-containing triggers. The best way to prevent the discomfort associated with the consumption of lactose is to avoid it altogether.