What is lactose?
Having worked in the NHS with patients that suffer with inexplicable and frequent gastrointestinal complaints, a rising number of the problems were stemming from lactose.
Lactose is the natural sugar within milk and dairy products, whilst whey and casein is the protein. Lactose accounts for approximately 30% of the calories present in whole milk, but that’s only if you can digest it! Undigested lactose provides no calories, but will come with several unwanted side-effects! Some people have real difficulty digesting lactose, usually because they lack lactase, the enzyme required to break lactose down so it can be used for energy. Lactase is an integral component to lactose digestion and is normally made in the small intestine, but if lactase is missing then the lactose consumed passes through the intestine completely undigested.
Symptoms of lactose intolerance
Undigested lactose can cause bloating, pain or cramps, rumblings in your tummy, gas and distension, loose bowels (diarrhoea) and even nausea and vomiting. Most people will notice these symptoms within 30mins to 2 hours after eating or drinking foods containing lactose. The majority of these symptoms result from bacteria in your gut unsuccessfully trying to digest the lactose, a by- product of which is the persistent release of gas within the gut.
Is lactose present in all dairy products?
Short answer is no, take the Californian Seal Lion for example, the milk from this animal is completely lactose free. So strictly speaking, not all dairy contains lactose, plus cheese is considerably lower in lactose compared to milk.
Lactose in Milk
The lactose content of skimmed, semi-skimmed and full-fat cow’s milk is between 4- 5%, this is the same for the more novel milks including goat, sheep, buffaloes, camels and yaks. Santa is unlikely to have issues with lactose because the Reindeer milk is one of the lowest in lactose, containing just 2% lactose. Similarly low is the aforementioned Californian Sea Lion which is completely lactose free. Don’t forget you can get some cow’s milks that have had all of the lactose removed, and others which have lactase (the enzyme needed to digest lactose) added to aid in the digestion of lactose (Note that these don’t always work for lactose intolerance).
Lactose in Cheese
In just a few hours of processing, cheese is 15-20% lower in lactose because the majority of it has been converted to lactic acid and other non- lactose components. According to The American Journal of Clinical Nutrition, ripened cheeses such as Camembert and Limburger is known to only contain around 0.4% lactose, whilst grated parmesan is 2.9%.
Not all cheeses are lower in lactose, processed cheeses such as Swiss cheese and American Cheese (the yellow cheese you get in McDonalds burgers) have highly variable amounts of lactose ranging from trace levels to as much as 14%!
Lactose in butter and ice- cream
The lactose content of butter to milk is comparatively low containing approx. 0.8-1% lactose. Then you’ve got the summer favourite, ice- cream, which is actually quite high in lactose ranging from 3- 8% lactose, with higher fat options containing slightly lower total lactose.
Lactose heavyweights – Evaporated, condensed and dried milk powder
Condensed and evaporated milk are jam packed with lactose (hence their sweetness) containing anything from 11- 16% lactose. Although evaporated milk is high, these dairy products pale in significance compared to dried milk powder which can contain as much as 53% lactose, making these a no go area for anybody that struggles to digest lactose.
What to do if you think you might be lactose intolerant
If you suspect that you might be lactose intolerant then the first thing you should do is head to see your Doctor. The Doctor can either refer you to a Dietitian who can offer a dietary analysis and symptom assessment, then implement an empirical diet aka an exclusion diet and see if lactose is indeed the likely problem.
A definitive diagnosis must come from something called a hydrogen breath test which see’s you breath into a piece of apparatus and assesses the composition of your breath. If your breath contains higher than normal hydrogen levels, then there is a good chance you are lactose intolerant.
It’s at this point that you should stop consuming dairy… it’s as harsh but as simple as that. Of course the application of this is far less simple, especially when dairy is in a lot of the foods we commonly consume, but try to avoid dairy initially until a Dietitian can get you on a tailored diet plan to suit you.
Lactose free protein supplements
This is not a straight forward one and deserves considerable attention. If you have a lactose intolerance, then you only have to consume trace (very small) amounts of lactose to cause a reaction. Many supplement companies are unable/ unwilling to make outright claims, so you end up with very few truly lactose free products. Some of the few that are available to you are as follows:
NOTE: Reflex Nutrition Micro Whey is considered to be very low in lactose due to the high filtration process it undergoes, however it cannot be classified as completely lactose free.