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Lactose Intolerance Test



How to Manage Lactose Intolerance

Although the body's ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes. Most people with lactose intolerance can tolerate some amount of lactose in their diet. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by taking them with meals.

The amount of change needed in the diet depends on how much lactose a person can consume without symptoms. For example, one person may have severe symptoms after drinking a small glass of milk, while another can drink a large glass without symptoms. Others can easily consume yogurt and hard cheeses such as cheddar and Swiss but not milk or other milk products.

The Dietary Guidelines for Americans 2005 recommend that people with lactose intolerance choose milk products with lower levels of lactose than regular milk, such as yogurt and hard cheese.

Lactose-free and lactose-reduced milk and milk products, available at most supermarkets, are identical to regular milk except that the lactase enzyme has been added. Lactose-free milk remains fresh for about the same length of time or longer than regular milk if it is ultra-pasteurized. Lactose-free milk may have a slightly sweeter taste than regular milk. Soy milk and other products may be recommended by a health professional.

People who still experience symptoms after dietary changes can take over-the-counter lactase enzyme drops or tablets. Taking the tablets or a few drops of the liquid enzyme when consuming milk or milk products may make these foods more tolerable for people with lactose intolerance.

Parents and caregivers of a child with lactose intolerance should follow the nutrition plan recommended by the child’s doctor or dietitian.

Lactose Intolerance and Calcium Intake

Milk and milk products are a major source of calcium and other nutrients. Calcium is essential for the growth and repair of bones at all ages. A shortage of calcium intake in children and adults may lead to fragile bones that can easily fracture later in life, a condition called osteoporosis.

The amount of calcium a person needs to maintain good health varies by age. Recommendations are shown in Table 1.

Table 1. Recommended calcium intake by age group

Age group Amount of calcium to consume daily, Age group in milligrams (mg)
0–6 months 210 mg
7–12 months 270 mg
1–3 years 500 mg
4–8 years 800 mg
9–18 years 1,300 mg
19–50 years 1,000 mg
51–70+ years 1,200 mg
Source: Adapted from Dietary Reference Intakes, 2004, Institute of Medicine, National Academy of Sciences.

Women who are pregnant or breast-feeding need between 1,000 and 1,300 mg of calcium daily.

Getting enough calcium is important for people with lactose intolerance when the intake of milk and milk products is limited. Many foods can provide calcium and other nutrients the body needs. Non-milk products that are high in calcium include fish with soft bones such as salmon and sardines and dark green vegetables such as spinach.

Table 2 lists foods that are good sources of dietary calcium.

Table 2. Calcium content in common foods

Non-milk Products Calcium Content
Rhubarb, frozen, cooked, 1 cup 348 mg
Sardines, with bone, 3 oz 325 mg
Spinach, frozen, cooked, 1 cup 291 mg
Salmon, canned, with bone, 3 oz 181 mg
Soy milk, unfortified, 1 cup 61 mg
Orange, 1 medium 52 mg
Broccoli, raw, 1 cup 41 mg
Pinto beans, cooked, 1/2 cup 40 mg
Lettuce greens, 1 cup 20 mg
Tuna, white, canned, 3 oz.. 12 mg
Milk and Milk Products
Yogurt, with active and live cultures, plain, low-fat, vitamin D-fortified, 1 cup 415 mg
Milk, reduced fat, vitamin D-fortified, 1 cup 285 mg
Swiss cheese, 1 oz.. 224 mg
Cottage cheese, 1/2 cup 87 mg
Ice cream, 1/2 cup 84 mg
Source: Adapted from U.S. Department of Agriculture, Agricultural Research Service. 2008. USDA National Nutrient Database for Standard Reference, Release 21.

Yogurt made with active and live bacterial cultures is a good source of calcium for many people with lactose intolerance. When this type of yogurt enters the intestine, the bacterial cultures convert lactose to lactic acid, so the yogurt may be well-tolerated due to a lower lactose content than yogurt without live cultures. Frozen yogurt does not contain bacterial cultures, so it may not be well-tolerated.

Calcium is absorbed and used in the body only when enough vitamin D is present. Some people with lactose intolerance may not be getting enough vitamin D. Vitamin D comes from food sources such as eggs, liver, and vitamin D-fortified milk and yogurt. Regular exposure to sunlight also helps the body naturally absorb vitamin D. Talking with a doctor or registered dietitian may be helpful in planning a balanced diet that provides an adequate amount of nutrients—including calcium and vitamin D—and minimizes discomfort. A health professional can determine whether calcium and other dietary supplements are needed.


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