Episode Transcript
[00:00:00] Hi, everyone. I'm Courtney. I'm your dietitian with E2M.
[00:00:04] In today's video, I wanted to talk on lactose intolerance.
[00:00:08] Now, this is something that a lot of us may be experiencing or may have experienced.
[00:00:13] And I think it's a really important thing to kind of know about because some of your symptoms could be explained just by saying lactose intolerance or trying to eliminate lactose from your diet.
[00:00:25] So if you're not familiar with lactose intolerance, it is a GI disorder or where we tend to have stomach discomfort, GI discomfort when we consume foods or beverages that contain lactose.
[00:00:40] Lactose is a natural sugar found in milk or dairy products, and it requires an enzyme called lactase to break it down.
[00:00:50] Lactase is produced in the small intestines.
[00:00:53] Usually at birth. We tend to have a good amount of lactase enzyme production because breast milk and infant formula both have lactose in it. It's naturally occurring in them. And then as we age, we tend to see a decrease in lactase production for a lot of people.
[00:01:14] So what this means is we may need to consider reducing lactose intake. And I'm going to go over that in a bit.
[00:01:23] So when the body is not producing enough of the lactase enzyme to break down the lactose we are consuming, we're going to have symptoms. A lot of us have symptoms. The those symptoms could be gas and bloating or stomach, abdominal discomfort, cramping. Some people may have diarrhea, others may have vomiting after having items containing lactose.
[00:01:47] Now, I really want people to understand lactose intolerance is not a dairy allergy. Those are two separate things.
[00:01:55] A dairy allergy is usually an allergy or an immune response to consuming dairy proteins. And those are going to be your whey and casein protein. Usually with allergies, we see swelling, we see rash, we see difficulty breathing, or anaphylaxis versus GI discomfort with lactose intolerance.
[00:02:18] Now, majority of the world is actually lactose intolerant. About 65 to 70% of the world's population is considered lactose intolerant.
[00:02:29] That prevalence tends to be higher in East Asian, East Asian populations. Excuse me, Native Americans, African population as well as men, believe it or not, and then Hispanics and Latino populations. So we tend to see, like I said, the lactose intolerance in those cultures.
[00:02:52] Now, how do we diagnose lactose intolerance? It's always recommended that you go see your doctor if you're having these symptoms.
[00:03:02] Excuse me, because lactose intolerance could be a little more.
[00:03:08] We don't know for sure if you're having lactose intolerance without a surefast test.
[00:03:12] Now, some of the testing can be stool testing, others could require a breath test, just depending on what your facility, what your doctor recommends.
[00:03:22] For individuals who don't go to the doctor, you could potentially do a really simple elimination test. So just eliminating lactose from your diet. Diet for a bit, see how your body tolerates. And then when you add lactose back into your diet, then you have a pretty sure answer as to whether or not you possibly have lactose intolerance.
[00:03:44] Now, again, I strongly encourage you to go to your doctor if you are having symptoms and are concerned you have lactose intolerance, because that's the best way to find out and that's also the best way to get treatment. If you require treatment, just because you have lactose intolerance, does that mean you have to give up dairy? Absolutely not.
[00:04:06] So most people can tolerate a small amount of lactose.
[00:04:10] Usually we see about a cup to a cup and a half of milk is tolerated by individuals with lactose intolerant. Now that number can vary depending on the person. Obviously not everybody is the same.
[00:04:23] So if you are that person who absolutely has to have milk or, or absolutely has to have some ice cream, I do recommend trialing and see where you sit, like how much you can have before you start having symptoms.
[00:04:38] Rule of thumb is to always start small and then work up. So maybe we do a quarter cup of milk one day, then the next day we follow it up with a half a cup of milk and then the next day we follow it up with a whole cup of milk and see how your body does with that amount.
[00:04:54] If you have symptoms, say after drinking your whole cup of milk, that tells you that's kind of your limit, that's your stopping point.
[00:05:03] Now, I know E2M is not a heavy dairy diet, but as a dietitian, I do work with some of our E2M clients outside of the diet who do want to include dairy.
[00:05:18] And we talk through safe ways to include dairy, especially if there is a concern for lactose intolerance.
[00:05:24] Now, there are some items that are lactose free. For instance, lactose free milk that is still cow's milk, that has been treated with lactase, that lactose enzyme, to make it lactose free.
[00:05:39] Other dairy products that are going to be lactose free would be certain cheeses.
[00:05:44] So cheddar, Swiss, mozzarella are a few that would be lactose free.
[00:05:49] Butter is lactose free sour cream is lactose free and then some yogurt. Yogurt is generally lact free as well. So there are lots of options for you to have if you are that person who wants to consume dairy.
[00:06:03] If however you don't want to consume dairy. So if you want to completely remove, excuse me, lactose and dairy from your diet, there are options.
[00:06:14] So alternative milk options would be oat milk or soy milk or pea protein milk or coconut milk, even almond milk and rice milk. All of these are options to have these. They make dairy free cheeses and dairy free yogurts as, as dairy substitutes as well.
[00:06:33] Now it's important to know these alternatives can be low in some key nutrients.
[00:06:39] So always, always, always remember that, you know, we're, we're swapping out one thing we could potentially lack in another.
[00:06:46] So a lot of times we see lower calcium, lower vitamin D and lower B12 intake with the swap to a dairy free item. So we want to make sure that we are taking in other items that are high in calcium, high in vitamin D and then high in B12 to ensure we're meeting our goals for the day.
[00:07:07] Excuse me again.
[00:07:09] So you could potentially take a supplement. I am a strong proponent to eat your nutrients.
[00:07:18] So we want to make sure we're doing high calcium foods. Those are going to be some of your greens.
[00:07:25] You get calcium in broccoli as well. You're going to get calcium, believe it or not, in some of your salmon and canned salmon products.
[00:07:32] Vitamin D. We want to make sure we're doing our egg yolks when we're eating eggs or mushrooms or some of our nuts.
[00:07:41] Also tofu for our plant based or vegan population. They make fortified tofu.
[00:07:47] B12 is in a lot of our animal products.
[00:07:51] So unless we are more so following a vegan type diet, your B12 should be okay. I say should.
[00:08:00] But if there's ever any concern, you can always talk with your physician about whether or not labs need to be checked and whether or not you need further supplementation for these nutrients.
[00:08:11] Now in my article for this video that matches this video, I do have the daily recommended intakes for calcium for vitamin D and for vitamin B12.
[00:08:27] Excuse me again.
[00:08:29] And these go from infancy to older adults. So it's something I would recommend to look through.
[00:08:35] I don't want you to feel like you have to count out the milligrams you're eating a day of these things. But it's also really important to look through and just kind of get an idea of okay, I am supposed to have a thousand milligrams of calcium a day if I'm not drinking a cup of milk. Where is this calcium coming from? What are some of the high, high calcium foods I'm going to eat?
[00:08:56] If that's the case, I usually do recommend, like, making sure you're getting in two to three high calcium foods a day or two to three high vitamin D foods a day to ensure we're meeting that number.
[00:09:09] Now, just to kind of like recap, to reiterate, lactose intolerant. Lactose intolerance is very common.
[00:09:18] More than half of the world has this disorder, this digestive disease.
[00:09:23] So what is the right approach? Everybody's a little different.
[00:09:27] Easiest approach would be to limit your lactose intake. You can still do dairy, but we just want to limit your lactose intake.
[00:09:35] However, they're all alternative options for those of you that do want to avoid dairy completely.
[00:09:41] And if that is you, we want to make sure we are consuming correct amounts, adequate amounts of some of our nutrients.
[00:09:49] So just looking overall for items that are going to be fortified, trying to make sure we're staying well with our whole food intake as opposed to processed food intake, to ensure we're meeting those numbers.
[00:10:04] And always talk with your medical team if there's any concerns for any nutrient deficiency.
[00:10:10] I can't stress that enough.
[00:10:13] So I hope everybody has a wonderful day and I will see you later. Bye.
