Healthy Eating for Your Active Lifestyle

Have you found yourself in this situation or experiencing other uncomfortable symptoms after eating, such as cramping, diarrhea or bloating? If so, lactose intolerance (LI) has likely crossed your mind. Before committing yourself to a life of lactose avoidance, here are a few things you need to know to spare yourself from a misdiagnosis and/or limitations to foods you enjoy.

What’s going on in my gut?

We are all (except for rare cases) born able to digest lactose, the natural sugar found in milk and dairy products. As we age, lactase, the enzyme that digests lactose, decreases. This makes sense – infants rely solely on milk and need a lot of lactase, while children and adults eat a variety of foods.

Many of us still have enough lactase to enjoy lactose-containing foods as part of a well-rounded diet. However, some people don’t have enough lactase. Instead of lactose being digested in the small intestine, it draws water into the gut (enter diarrhea and discomfort) and travels on to the colon where gut bacteria ferment it and produce uncomfortable gases. While no damage is done to the gut, it can certainly be unpleasant!

Isn’t the solution simple? Not exactly…

While the solution to this discomfort may seem as simple as avoiding lactose, there are a couple complicating factors:

1 - Many food sensitivities and gut disorders have similar symptoms. If you avoid lactose and your symptoms become marginally, but not completely, better, where do you go from there? Do you continue restricting more and more foods? There are many conditions that cause gut discomfort and misdiagnosing yourself with LI may not get to the root of the issue.

2 - Avoiding lactose removes nutrient-rich foods from your diet, such as milk, yogurt, kefir and cheese. This is particularly a problem for adolescents, who need such nutrients for growth, and for women and the elderly because of the higher risk for osteoporosis and bone breakdown.

What do I do instead?

Get tested. LI is commonly self-diagnosed or diagnosed by a doctor or alternative health practitioner without proper testing. If you suspect LI, ask your doctor for a hydrogen breath test. This simple test will tell you if you have trouble digesting lactose. If you digest lactose properly, it’s time to explore your symptoms further to get to the root of the issue.

What if it is LI?

If a hydrogen breath test reveals LI, it’s time for modifications with the goal of determining how much lactose you can have without discomfort. Here are some ideas:

-       Consume lactose with meals instead of by itself.

-       Have small amounts of lactose throughout the day. For example, try ¼–½ cup of milk at a time.

-       Choose low-lactose foods:

o  yogurt and kefir contain live bacteria that break down the lactose;

o  mozzarella and aged cheeses, such as cheddar, Swiss, blue and brie, contain almost no lactose as a result of the fermentation process.

-       Try lactose-free milk, whichhas the same amount of protein and nutrients as regular milk.

-       Use “lactase” tablets or drops, which are enzymes that work to break down the lactose for you.

If you are still experiencing symptoms after trying these strategies, consult a registered dietitian for further advice.


Gut discomfort is real and uncomfortable

Your symptoms are real and we want you to get to the bottom of them! For LI, this starts with proper testing and then the least restrictive solutions that make it easy to eat a variety of nutritious foods. If gut discomfort is an issue for you, consider seeing aregistered dietitian[ that specializes in gut health to help you get to the bottom of your symptoms while maintaining a nutritious diet.

This infographic from the World Gastroenterology Organization is a great summary of LI and has some additional information about the benefits of yogurt!


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Kristina Isaac, RD.

Registered Dietitian

Kristina (BSc, RD) is a registered dietitian and blogger for Nourish Move Thrive. She enjoys finding creative, fun and simple ways to communicate the science of nutrition.

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