What Is Lactose Intolerance, and How Does It Affect Your Body?

Lactose intolerance a condition prevalent across various age groups and demographics, impacts a significant portion of the global population. Understanding lactose intolerance is not just about identifying a list of foods to avoid; it's about comprehending a bodily reaction, adapting lifestyles, and maintaining nutritional balance.

At its core, lactose intolerance is a digestive issue linked to lactose, a sugar found in milk and dairy products. Unlike allergies or severe intolerances to certain foods, lactose intolerance generally doesn’t pose severe health risks. However, it can cause discomfort and inconvenience, affecting the quality of life. This article aims to demystify lactose intolerance, shedding light on its causes, symptoms, and management strategies.

As we explore this condition, we'll look into the role of lactose in our diet, how the body reacts when it struggles to process this sugar, and practical ways to manage the condition for those affected.

Understanding Lactose and Its Role in the Body

Lactose is a type of sugar predominantly found in milk and dairy products. It's a disaccharide, meaning it's made up of two simpler sugars, glucose and galactose. When we consume dairy products, lactose is typically broken down by an enzyme called lactase, which is produced in the small intestine. This process is essential for the digestion and absorption of lactose, allowing our bodies to utilize it as a source of energy.

The nutritional role of lactose goes beyond just providing energy. It aids in the absorption of essential minerals, particularly calcium and magnesium, which are vital for bone health. This is why milk and dairy products are often recommended as part of a balanced diet, especially for children and adolescents who are in their peak bone-building years.

Lactose is found in a variety of dietary sources, not just in obvious products like milk, cheese, and yogurt. It's also present in lesser-known sources such as baked goods, processed breakfast cereals, and even some medications. People with lactose intolerance need to be aware of these hidden sources to manage their condition effectively.

In summary, lactose plays a significant role in nutrition, primarily as a source of energy and as a facilitator for the absorption of key minerals. Its digestion is reliant on the enzyme lactase, the production of which varies greatly among individuals and populations, leading to varying degrees of lactose tolerance. Understanding these aspects is important for managing lactose intolerance and maintaining a healthy, balanced diet.

What Is Lactose Intolerance?

Lactose intolerance is a common digestive condition characterized by the body's inability to digest lactose, a type of sugar found primarily in milk and dairy products. Unlike a food allergy, which involves the immune system, lactose intolerance is related to the digestive system and its inability to break down lactose.

Understanding Lactose Digestion

To digest lactose properly, the small intestine needs to produce an enzyme called lactase. This enzyme breaks down lactose into two simpler sugars, glucose and galactose, which are then absorbed into the bloodstream. In people with lactose intolerance, the production of lactase is insufficient, leading to incomplete digestion of lactose.

Forms of Lactose Intolerance

There are three main types of lactose intolerance, each with a different cause:

• Primary Lactose Intolerance: The most common form, usually developing in adulthood. It is caused by a gradual decrease in lactase production as part of the natural aging process.

• Secondary Lactose Intolerance: This occurs when the small intestine decreases lactase production after an illness, surgery, or injury to the small intestine. Conditions like celiac disease or Crohn's disease can also lead to secondary lactose intolerance.

• Congenital or Developmental Lactose Intolerance: A rare form where infants are born with little or no lactase enzyme. This condition is inherited and is more common in certain populations.

Distinguishing Lactose Intolerance from Milk Allergy

It's important to differentiate lactose intolerance from a milk allergy. While lactose intolerance is a digestive issue, a milk allergy involves the immune system reacting to the proteins in milk, which can lead to more severe reactions, including anaphylaxis. 

Understanding lactose intolerance is the first step towards managing its symptoms and maintaining a comfortable and healthy lifestyle. This condition, though not curable, can be effectively managed with diet and lifestyle modifications.

Causes of Lactose Intolerance

Lactose intolerance is a common digestive issue that arises from the body's inability to fully digest lactose, the sugar found in milk and dairy products. Understanding the causes of lactose intolerance is essential for managing this condition. This section delves into the primary factors contributing to the development of lactose intolerance.

Genetic Factors

• Primary Lactose Intolerance: This is the most common type of lactose intolerance and is largely determined by genetics. In this form, the body's production of lactase, the enzyme that breaks down lactose, decreases with age, particularly after childhood. This decline in lactase is normal and varies among populations, being particularly prevalent in people of East Asian, West African, Arab, Jewish, Greek, and Italian descent.

• Inherited Lactase Deficiency: In rare cases, some people may inherit a disorder known as congenital lactase deficiency. This condition, resulting from a mutation in the gene responsible for lactase production, is present from birth and leads to severe lactose intolerance.

Age-Related Changes

• Decrease in Lactase Production: As people age, their bodies naturally produce less lactase. This reduction often begins after the age of two when the need for lactase naturally decreases. The degree and rate of decrease can vary greatly, influencing the severity and onset of lactose intolerance symptoms.

Certain Medical Conditions and Treatments

• Secondary Lactose Intolerance: This form of lactose intolerance is often the result of illnesses or injuries affecting the small intestine, where lactase is produced. Conditions such as Crohn's disease, celiac disease, bacterial overgrowth, and certain gastrointestinal infections can temporarily reduce lactase production. Treatments such as chemotherapy or radiation therapy that impact the small intestine can also lead to secondary lactose intolerance.

• Intestinal Surgery: Surgical procedures that remove a part of the small intestine or alter its functioning can reduce lactase production, leading to lactose intolerance.

• Medication Effects: Certain medications, especially those that affect the digestive system or the gut microbiome, can temporarily impair lactase production or function.

Symptoms and Diagnosis of Lactose Intolerance

Lactose intolerance primarily affects the digestive system, and its symptoms can vary in severity. Common symptoms include:

• Abdominal Pain and Cramps: Soon after consuming lactose-containing foods, you may experience stomach pain.

• Bloating: A feeling of fullness or swelling in the stomach area.

• Gas: Increased flatulence is common due to the fermentation of lactose in the intestines.

• Diarrhea: Lactose that isn’t absorbed in the intestine draws water into the bowel, leading to loose stools.

• Nausea and Vomiting: Less common but can occur, especially in severe cases.

Symptoms usually begin 30 minutes to 2 hours after consuming lactose-containing products. The severity depends on the amount of lactose ingested and the individual’s level of lactose intolerance.

Impact on the Body and Health

Short-term Effects on the Digestive System

Lactose intolerance primarily affects the digestive system. When an individual with lactose intolerance consumes lactose, their body is unable to break it down properly due to a deficiency or absence of the enzyme lactase. This unprocessed lactose moves into the colon, where it interacts with intestinal bacteria, leading to various digestive symptoms. The most common of these symptoms include:

• Bloating: This is a feeling of fullness or swelling in the abdomen, often uncomfortable and sometimes painful.

• Gas: The fermentation of lactose by bacteria in the colon produces gas, leading to flatulence and abdominal discomfort.

• Diarrhea: The presence of undigested lactose in the colon draws in water, leading to loose, watery stools.

• Abdominal Pain: Many people experience cramps or pain in the abdominal area, which can range from mild to severe.

These symptoms usually begin within a few hours of consuming lactose and can vary in intensity depending on the amount of lactose consumed and the individual's level of intolerance.

Potential Long-term Health Implications

While lactose intolerance is not dangerous, its mismanagement can lead to certain long-term health issues, primarily due to nutritional deficiencies:

• Calcium and Vitamin D Deficiency: Since dairy products are a primary source of calcium and vitamin D, people avoiding these foods might not get enough of these essential nutrients. This can lead to weakened bones and an increased risk of osteoporosis, particularly in older adults.

• Growth Issues in Children: In children, inadequate intake of nutrients due to restricted dairy consumption can impact growth and development.

• Digestive Health Concerns: Chronic digestive issues, if not managed properly, can affect overall gut health and may contribute to a disrupted gut microbiome.

Importance of Managing Lactose Intolerance

Effective management of lactose intolerance is essential for maintaining overall health and quality of life. It involves balancing the diet to avoid discomfort while ensuring that all nutritional needs are met. Ignoring or poorly managing lactose intolerance can lead to discomfort, social embarrassment, and potentially more serious health problems related to nutrient deficiencies. 

For many, managing lactose intolerance doesn’t mean cutting out dairy entirely. It can be about understanding one's own threshold for lactose and finding suitable alternatives or lactose-free versions of favorite dairy products. Moreover, incorporating non-dairy sources of essential nutrients like calcium and vitamin D into the diet is vital. These might include leafy green vegetables, fortified plant-based milks, and supplements, as advised by a healthcare provider.

Conclusion

Lactose intolerance is a common digestive issue caused by the body's inability to properly digest lactose, a sugar found in milk and dairy products. The symptoms, which include bloating, gas, and abdominal discomfort, can range from mild to severe and are triggered by the consumption of lactose-containing foods.

Understanding lactose intolerance is crucial, not just for managing its immediate symptoms, but also for maintaining overall health. Long-term, unmanaged lactose intolerance can lead to nutritional deficiencies, particularly in calcium and vitamin D, which are vital for bone health. However, with careful dietary management, the use of lactase supplements, and by finding suitable alternatives to lactose-containing foods, those affected can lead a healthy and comfortable life.

For anyone experiencing symptoms of lactose intolerance, the first step is to confirm the diagnosis. A healthcare provider can offer a proper diagnosis and tailored advice for managing the condition. It's important not to self-diagnose or eliminate dairy completely as dairy products are key sources of essential nutrients. Alternatively, you can also try at-home lactose intolerance test kits which are both accurate and convenient, such as those manufactured by Advance Food Intolerance Labs (AFIL).

Watch AFIL test kits testimonial videos click here

References 

1. Vesa, Tuula H., Philippe Marteau, and Riitta Korpela. "Lactose intolerance." Journal of the American College of Nutrition 19.sup2 (2000): 165S-175S.
2. Vandenplas, Yvan. "Lactose intolerance." Asia Pacific journal of clinical nutrition 24.Supplement (2015).
3. Lomer, Miranda CE, G. C. Parkes, and J. D. Sanderson. "lactose intolerance in clinical practice–myths and realities." Alimentary pharmacology & therapeutics 27.2 (2008): 93-103.
4. Swagerty Jr, Daniel L., Anne D. Walling, and Robert M. Klein. "Lactose intolerance." American family physician 65.9 (2002): 1845-1851.
5. Matthews, Stephanie B., et al. "Systemic lactose intolerance: a new perspective on an old problem." Postgraduate medical journal 81.953 (2005): 167-173.
6. Wilt, Timothy J., et al. "Lactose intolerance and health." Evidence report/technology assessment 192 (2010): 1-410.