Lactose Intolerance: Did Holiday Foods Make You Sick?

If you’re like me, you’ve made and broken New Year’s resolutions your entire life. Frankly, I think they’re for young people who believe that willpower is the answer to many of our problems. I find that having more information provides me with more solutions than willpower.

Now, I think it’s time to look at the number-one reason for poor health: digestive problems. And to focus on an aspect of digestion that’s often ignored – lactose in tolerance. If you’re lactose intolerant, you may have had increased digestive disturbances during the holiday season.

Many of us tend to go off our dietary programs, at least to some degree, between Thanksgiving and New Year’s. If these changes have resulted in your eating more dairy – such as desserts, creamed soups, and pumpkin pie – you may have been more bloated. Or perhaps you had unexplained diarrhea or abdominal pain. If so, your increased dairy consumption could be to blame. Eating more dairy can lead to lactose intolerance.

What is lactose, and why does it bother us?
Lactose is a sugar found naturally in milk and other dairy products. To digest it, your body needs to make an enzyme called lactase. Lactase helps you digest lactose. But if you’re over the age of five, your body may be making very little lactase. Seventy-five percent of the world’s population stops producing lactase after being weaned. That’s almost everyone! This is nature’s way of telling us we don’t need to drink milk to be healthy. If you can’t digest lactose, you’re considered to be lactose intolerant. Lactose intolerance is an enzyme deficiency – not a true allergy. It increases as we age and our enzyme production decreases.

Basics of lactose intolerance
You need the enzyme lactase to digest the milk sugar lactose. If you don’t have enough lactase, lactose can’t be digested and get into your bloodstream. Instead, it remains in your intestines. The lactose in your intestines attracts water, which leads to bloating. When lactose makes its way into your large intestines (colon), intestinal bacteria eat this undigested sugar creating gas and acid. The gas and acid produce cramps, more gas, and, frequently, diarrhea.

If you get any of these symptoms, either immediately or for up to 12 hours after eating dairy, you may be lactose intolerant. Specific tests can confirm or rule out a lactose-digesting problem.

Testing for lactose intolerance
Lactose challenge test: Stop using all dairy except for butter for two weeks. Read the labels of all foods carefully. If any foods contain milk solids or are creamy, they may contain dairy. Some creamed soups available in health food stores contain no dairy. Otherwise, most creamed foods in supermarkets do. To test yourself for a lactose problem, remove dairy completely for two full weeks. If you are lactose intolerant, you should notice fewer digestive problems. At the end of two weeks, drink a little milk or eat some ice cream. Wait up to half a day and see what happens. If you have no digestive problems, try eating more dairy the following day. Still feel fine? Chances are you don’t have a problem with lactose. Feel more bloated? Dairy is likely the culprit.

Brenda Davis, RD, in her book Dairy-Free & Delicious, mentions other tests your doctor can do to determine lactose intolerance. These are helpful if you don’t have the willpower to stop eating all dairy for two weeks. Sometimes it’s easier to change your lifestyle when a laboratory test indicates there’s a problem.

Lactose tolerance test: Your doctor needs to administer this test. First, you fast overnight and in the morning before being tested. Your doctor will take a blood sample and then give you a drink with 50 grams of lactose (milk contains about 12 grams/glass). Two hours after you drink the lactose-laced beverage, your doctor will take another blood sample. If you are not lactose intolerant, your blood-sugar level will rise because your body is able to break down the sugar. If you are lactose intolerant, your blood sugar either won’t rise, or will not rise completely. If you have a lactose problem, you’re also likely to have bloating, cramps, and diarrhea.

Hydrogen breath test: For this test, you simply breathe into a bag to collect a sample of the gasses in your breath. Then you drink a solution containing a little lactose and breathe into another bag. These samples are sent to a laboratory where methane and hydrogen gasses are tested. Methane levels are usually zero to seven parts per million (ppm). If the level between your two samples is 12 ppm or more, you are lactose intolerant. Hydrogen is normally 10 ppm, but people who are lactose intolerant often have 20 ppm after ingesting dairy. Some hydrogen breath tests only measure hydrogen. But any undigested carbohydrates (either sugars or starches) will cause more hydrogen to be released. So if you’re using this test, be sure you’re being tested for both methane and hydrogen. Don’t do this test when you’re taking antibiotics, since antibiotics destroy the bacteria that help break down carbohydrates, and the test won’t be accurate.

Stool acidity test: When undigested lactose is broken down by intestinal bacteria, various acids – like lactic acid – are produced. So a high amount of acid in the stool is a good indication of potential lactose intolerance. While lactose tolerance and hydrogen breath tests are more accurate, they are not completely safe for children and infants. This test is. If you suspect a child has difficulty digesting milk sugars, you can simply get their stool examined for acidity or eliminate all dairy and see if their symptoms are reduced.

Good-tasting dairy alternatives
Being lactose intolerant isn’t as bad as it may seem at first. In the past, it was difficult to find tasty substitutes for dairy. Now it just takes a little time and effort. Once you’ve found non-dairy foods you enjoy, it’s simple. After attending conferences on natural foods over the years and testing hundreds of samples on friends and patients, here are a few suggestions I’ve come up with. The products I’m listing here were those the majority of people liked.

Creme de la Soy is a non-dairy, lactose-free, creamer made by Westsoy, that may be used in coffee, tea, and other beverages. It contains no hydrogenated oils and comes in original, amaretto, and vanilla flavoring.

Imagine Foods has delicious creamy Portobello mushroom, squash, and broccoli soups (using soy milk) packaged in boxes. Stock up on a few and just heat, or use as a base for other soups. Or puree half of any soup you make for a thicker and creamier consistency. You can also blend in tofu or a can of drained, rinsed, navy beans, which increases the protein content and results in a thick, creamy soup.

While they’re not low in sugar or fat, delicious ice cream substitutes include Imagine Foods’ Rice Dream Supreme and Soy Dream frozen desserts. They taste like the real thing. Try other brands and see if there are other ice cream substitutes you like. And remember that sorbets contain no dairy.

For cereal or smoothies, you can choose between rice milk, soy milk, almond milk, and oat milk. All can be found in natural food stores and many supermarkets. Buy a small box of each one and see which you like best. My personal favorite is WestSoy Lite Vanilla. I use it in my morning tea, cereal, and smoothies.

Look in the frozen food section of major supermarkets and natural food stores for Amy’s brand non-dairy entrees. You can enjoy lasagna, pizza, Mexican dinners, and other foods that traditionally contain dairy made with soy cheese.

For non-dairy alternatives to Ensure and other high-calorie drinks, try WestSoy’s VigorAid (240 calories for eight ounces) and Imagine’s Power Dream (290 calories for 11 ounces). Unfortunately, many sick and frail people with poor digestion drink milk-and-sugar, high-calorie beverages that only add to their digestive problems. Since sugar feeds bad bacteria in the intestines, increasing intestinal discomfort, you may want to try Power Dream, which uses rice syrup instead. The rice syrup feeds beneficial bacteria.

If you’re looking for a dessert treat that’s quick to make, delicious, and dairy-free, Mori Nu, Inc. has recipes for pumpkin pie and creamy chocolate pie that will fool even the most discerning palate. Call 800-NOW TOFU (800-699-8638) for free recipes. Mori Nu also has packages of low-fat pudding mix (vanilla, chocolate, or lemon) that you blend in with a box of their tofu. I’ve made these desserts for finicky teenagers who were embarrassed to discover they actually liked something made with tofu!

Eating dairy safely
Not all dairy causes digestive problems in lactose-intolerant people. Butter, for instance, contains no lactose. It’s just a fat. Fermented dairy, like yogurt, uses up lactose during fermentation resulting in a low-lactose food you may be able to digest. Lactaid milk, which has had some of its milk sugar removed and is low in lactose, may not cause problems.

You can always take lactase pills with a meal that does contain dairy. Lactase is measured in FCC units (milligrams of lactase). You will probably need about 3,000 FCC lactase units or 200 mg of lactase for a meal with a little dairy. High-dairy meals may require more.

Acidophilus and lactose intolerance
As its name suggests, lacto (milk) bacillus (bacteria) acidophilus means that this friendly bacteria eats milk sugar (lactose). Acidophilus also makes the enzyme lactase. So taking acidophilus supplements could help improve mild lactose intolerance, especially over time.

With fermentation, the levels of friendly bacteria in dairy products increase. Although eating yogurt, even daily, won’t eliminate lactose intolerance, it can help improve your digestion.

What about calcium?
The most common misconception is that we need large quantities of calcium every day. Since dairy products are high in calcium, many people believe they will have porous, brittle bones unless they eat dairy or take high amounts of calcium supplements. This isn’t true. As I’ve said before, a healthy diet, including beans, whole grains, nuts, seeds, and green vegetables, is high in calcium. These foods are also high in magnesium, which you need to get calcium into your bones. Don’t worry about not getting enough calcium. Just stop eating dairy if it’s contributing to your digestive problems.

Davis, Brenda, RD. Dairy-Free & Delicious, Book Publishing Company, 2001.

Lipski, Elizabeth, MS, CCN. Digestive Wellness, Keats Publishing, 1996.

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Written by Nan Kathryn Fuchs PhD

Explore Wellness in 2021