Lactose Intolerance: Symptoms, Causes and Dietary Alternatives
Lactose intolerance is a common condition that causes troublesome digestive symptoms when drinking milk. We look at its causes, symptoms, alternatives for calcium and protein, and the best plant-based milks for health.
What Is Lactose Intolerance?
Lactose intolerance is the digestive system's inability to digest lactose, the sugar found in milk and dairy products, because of a lack or absence of the enzyme lactase in the small intestine. It is not a serious illness, but it causes a range of digestive discomforts.
The most common symptoms:
- Nausea (and sometimes vomiting)
- Bloating and gas
- Diarrhoea or loose stools
- Abdominal pain or cramps
Do Yoghurt and Cheese Have a Different Effect from Milk?
Yes. Yoghurt, especially types containing live bacteria, is digested more easily by the body, and these bacteria also help break down part of the lactose. In addition, hard and aged cheeses such as cheddar and parmesan contain much less lactose than milk. By contrast, liquid milk usually remains the hardest to digest for people with lactose intolerance.
What About Goat's Milk and Other Animal Milks?
Goat's or sheep's milk also contains lactose, and although its level is sometimes slightly lower than cow's milk, some people find it easier to digest. However, this milk is not a guaranteed solution for everyone. On the other hand, if the cause is an allergy to milk protein rather than just lactose, the problem continues with all types of animal milk.
Safe Dietary Alternatives for Calcium and Protein
Sources of calcium:
- Leafy vegetables such as kale and broccoli
- Sesame and tahini
- Almonds
- Dried figs
- Calcium-fortified products such as some breakfast cereals and plant-based milks
Sources of protein:
- Eggs, meat and fish (for non-vegetarians)
- Legumes such as lentils, chickpeas and beans
- Nuts and seeds
- Tofu and tempeh (from soya)
What Are the Most Nutritious Plant-Based Milks?
- Soya milk: the highest in protein (roughly similar to cow's milk), and often fortified with calcium and vitamins.
- Oat milk: rich in fibre and filling, but lower in protein than soya.
- Almond milk: low in calories but poor in protein.
- Coconut milk: rich in fat, but poor in protein and calcium.
The healthiest option is usually soya milk because it contains protein, and you can vary it with oat or almond milk, preferring types fortified with calcium and vitamin D.
A Debate: Are Cow's Milk Products Beneficial for Adults?
Some researchers believe that milk is not necessary after childhood, because people can get calcium and protein from other food sources. On the other hand, many studies confirm that dairy products, when eaten in moderate amounts, support bone and muscle health and help prevent some diseases.
Conclusion: milk is not essential for adults if the diet is balanced, but it is not harmful for those who can tolerate it.
General Tips for People with Lactose Intolerance
- Try the low-lactose or lactose-free products available in shops.
- Watch how you respond to cheese and yoghurt, as they may be easier to digest than milk.
- Spread your lactose intake across the day rather than having it all at once.
- Make sure you get calcium and vitamin D to keep your bones healthy.
- If you suspect you have a milk protein allergy (not just lactose intolerance), it is best to consult a specialist doctor.
If you have symptoms of lactose intolerance or digestive problems, you can book a consultation with Dr. Shereen Ali Omar, nutrition specialist at Al Nokhba Medical Center, for a dietary plan that suits your condition.
