Every Monday, we find the nutrition chronicle of Dr. Binetou Cheikh Seck, dietician-nutritionist at the Nutridéal Dietetic Cabinet in Dakar, Senegal. Today, she explains to us what lactose intolerance is and how to get around it.
For starters, this deserves an explanation:
To understand lactose intolerance, you must first know what lactose is: it is the sugar found in dairy products. There are some in liquid milk, three times more in condensed milk, seven times more in powdered milk (which is consumed a lot in Africa), in cheeses (especially soft cheeses like Camembert), in sour milk and yoghurts. It is estimated that 70% of adults worldwide absorb lactose less well than children. However, one speaks of lactose intolerance only if lactose malabsorption causes the following symptoms within 15 to 30 minutes after ingestion lactose:
- the emission of odorous gases
- bloating
- abdominal pain
- diarrhea
- headaches.
This malabsorption of lactose, how to explain it?
Malabsorption is due to a lactase deficiency, the enzyme that breaks down lactose so it can be absorbed into the blood. So in case of lactase deficiency, lactose is poorly digested, it is rejected in the large intestine (or colon), where it ferments and produces gas.
Are there different degrees of lactose intolerance?
Absolutely. A 100% intolerance is rather rare. There remains, in general, a certain tolerance which will depend on the frequency of consumption of dairy product and the dose consumed.
When the intolerance is well and truly confirmed, should dairy products be eliminated?
No, except in cases of total intolerance. Studies show that in most cases, the complete elimination of dairy products leads to a calcium deficiency (which is important for the health of bones and teeth). Instead, you should adapt your consumption of dairy products to your tolerance threshold..
What does it actually mean to “adapt” one’s consumption when eating?
First, opt for dairy products that contain less lactose:
- liquid milk, instead of powdered milk
- semi-skimmed milk instead of skimmed
- hard cheese (like guyère) instead of soft cheese.
Then there are practices that reduce the symptoms of malabsorption:
- Combine milk with other foods (e.g. with cereals, degue)
- Incorporate milk into a recipe (e.g. mash)
- Consuming dairy products as part of a meal instead of on its own
If the symptoms persist, what should be done, what should be changed?
If symptoms persist, you should space out the frequency of consumption (for example: instead of every day, every other day). If it still does not go well, despite the spacing, I advise:
- hydrolyzed milk (lactose-free), if available
- Regularly consume non-dairy foods, but rich in calcium (such as canned sardines, monkey bread (1 tablespoon of powder / day), tiger nuts, oranges, etc.
- Consuming milk substitutes (for example, calcium-enriched soy juice)
- Take lactase tablets where available