Lactose intolerance may not mean the end of dairy consumption

A Professional Dairy Producers of Wisconsin webinar illuminated the condition and how we can work around it.

At 18 I gave up dairy and gluten to serve my digestive health. My doctor told me both foods exacerbated the gastrointestinal irritation I’d been experiencing. Going cold turkey helped for a while — the gurgling that had once plagued every meal quieted, and I regained control over the way my body felt day-to-day. However, a few years later, a lab test revealed I was deficient in vitamins B12, A, and D and minerals magnesium and potassium. My body wasn’t getting the nutrients it needed, and while over-the-counter supplements provided a retroactive solution, I longed for a concrete fix: a definitive equation to my years-long gut health proof. 

Around the same time as I learned of my malnutrition, I’d started working part-time at Hoard’s Dairyman, learning all kinds of interesting and illuminating details about what goes into American dairy farming, both as a practice and as a production leader for one of our basic food groups. One thing led to another, and I began to wonder about reintroducing milk products back into my diet. 

I began with what was literally right in front of me: Hoard’s Dairy Farm Creamery’s gouda cheese. I took my own triangle home and ate a small amount each day — wholly astounded by its quality — and began to realize it didn’t bother my stomach. I then purchased organic grass-fed whole milk at a local co-op and began putting it in my morning coffee. This proved to still adversely affect my digestion, and I became discouraged once again. I didn’t know what to do — should I continue purposefully irritating my gut in order to obtain nutrients I need or stick to my prior restrictions and find those nutrients elsewhere? 

Cue Professional Dairy Producers of Wisconsin’s webinar, “Understanding lactose intolerance.”

“If you cut anything out completely, you cut out all the nutritional value that goes along with that food group, and you could become deficient in those nutrients,” said Center for Dairy Research outreach program manager Andrea Miller during her presentation. 

Had this webinar not been made for me? 

There is a difference between an intolerance and an allergy, Miller emphasized. An intolerance is when something gets in the way of digestion and absorption, causing gastrointestinal upset (for example, our friend lactose intolerance), whereas an allergy triggers an immune response and can be life-threatening (for example, a peanut allergy). An intolerance may not require elimination of the food in its entirety, while an allergy mandates you do just that, so your first step should be determining if what you have is an allergy or an intolerance. Then, you can move forward with smart dietary decisions.

If what you suffer from is in fact an intolerance, note that reactions are highly variable. There are a number of factors that can contribute to the severity of a reaction, such as time of day, age, stress, pace of eating, accompanying foods, hormones, and quality of chewing. In this way, it can be difficult to pinpoint causes of symptoms, because a food may have one effect one time and a different effect at another time. This can make it incredibly frustrating to address food intolerances.  

But there is hope! First, let’s break down some of the science behind what goes on when we lactose intolerant sufferers consume milk. 

What’s really going on?

In order for lactose, a disaccharide (two-sugar molecule), to enter the bloodstream and be used for its intended purpose, it has to be broken down by an enzyme called lactase. Lactase breaks down the two-sugar disaccharide into two monosaccharaides (separate sugar molecules): galactose and glucose. These are then absorbed into the bloodstream as energy. 

Without lactase, lactose goes through the digestive system without being broken down; thus, it is undigested and unabsorbed, resulting in the gas and bloating that lactose intolerant individuals are familiar with. This also means it isn’t turned into the energy it is intended to be. If your lactase enzyme is underperforming or if you were born without one (both common conditions), you are almost guaranteed to experience discomfort when consuming dairy. 

The problem is: milk is a nutrient-dense food, containing the complete proteins found in animal products, rich levels of vitamins and minerals, and healthy, full fats. Basically, milk is pretty great. But who wants to be in chronic pain? If your body rejects it, what then? 

In her presentation, Miller outlined some ways to work around this. 

Wait, I can shop in the dairy aisle?

Eating cultured dairy products is one way to mitigate lactose intolerant symptoms. Cultured foods are foods that are strained, removing whey from their final form. Whey is the water-protein liquid left behind, and it is where most of the lactose lies. So, when whey is filtered out, lactose is filtered out, too, resulting in less disaccharides needing breaking down by our systems. 

Given that this filtration is a part of the cheesemaking process, cheese is perhaps the most tolerable form of dairy for lactose intolerant individuals. Other cultured products include Greek yogurt, kefir, crème freche, sour cream, and ultra-filtered milk (milk that has been strained and condensed). 

The bottom line: Cultured products contains less lactose in their final form and are more tolerable to consume. 

Another solution is to look for “lactose-free” milk, which contains an added lactase enzyme, or to take an over-the-counter lactase supplement to aid in the lactose-breakdown process. 

The end of the tunnel

For six years, I watched in envy as my lactose tolerant friends enjoyed cheeses and frappes and custards without a thought to their digestive tract. My intestines were an adversary to be conquered: a dragon guarding the castle of taste, a troll under the bridge to nutrients. I stewed in front of the milk alternative case, visions of dairy dancing in my head. 

Now, I am equipped with an educated lens through which I can approach my dairy consumption. My doctor was right in trying to help me find a way to ease my symptoms, but I wish someone had told me about the science behind my condition and ways to work around it when I was first navigating gut health. For those who identify with this struggle, I hope you find a path forward, too. 

Now, for my gluten intolerance… If someone has that figured out, you know where to find me.