Nutrient Considerations in Lactose Intolerance

Ingestion of a large, single dose of lactose by lactose maldigesters commonly results in diarrhea, bloating, and flatulence. However, multiple factors affect the ability of lactose to induce perceptible symptoms. These factors include residual lactase activity, gastrointestinal transit time, lactose consumed with other foods, lactose load, and colonic fermentation. This chapter reviews the pathophysiology of lactose maldigestion, attempts to correct common misconceptions concerning the frequency and severity of lactose intolerance symptoms, and provides dietary strategies to minimize symptoms of intolerance. In addition to food sources of lactose, small amounts of lactose are found in a wide variety of medications due to the excellent tablet-forming properties of lactose. Avoidance of milk and milk products is unnecessary since moderate lactose consumption does not produce a symptomatic response in maldigesters. Additionally, various dietary strategies effectively manage lactose intolerance by reducing or eliminating gastrointestinal symptoms. Dairy food consumption is possible for individuals who are lactose intolerant if simple dietary management strategies are incorporated into daily living.