Everything You Need To Know About Lactose Intolerance

For about half of my life, I spent most of my waking hours in a toilet. The hours after lunch, breakfast and dinner were spent curled over in pain in the ladies room, as my body heartily rejected the food on offer. The odd thing is it never occurred to me that this wasn’t normal—I just merrily carried on, chugging back full cream milk, coating my meals in melted cheese, licking the bowl after baking, and eating my own weight in ice cream.

It wasn’t until my body started to alert everyone else in the room about my digestive issues—in the form of noxious, revolting farts—that I realised I had to take action. After a couple of months of trial and error (eliminating foods that could be causing the problem, and experimenting with eating them in different amounts) I admitted defeat. Dairy was not the friend that those “Got Milk” ads would have me believe. I am one of the unlucky 75 percent of the population that is lactose intolerant.

What is lactose intolerance?

Lactose intolerance is when your body stops making lactase, the enzyme your body uses to break down lactose, one of the main sugars in milk. Every baby mammal needs lactase to help digest breast milk, but the ability to produce lactase stops after breastfeeding in every single mammal but humans.

Without lactase to metabolise milk sugars, lactose hangs around to cause a range of uncomfortable (and often embarrassing) symptoms, which range in severity depending on how much lactase your body can still produce. If you have hit the dairy and you are mildly lactose intolerant, you can expect to be hit with toxic gas, a rumbling tummy, painful cramps, and/or bloating. If you are severely lactose intolerant, make sure you know where the closest bathroom is, because you’re in for some sexy diarrhoea, or a sensual vomiting session.

The 25 percent of you who can drink milk with impunity for your lifetime have an evolutionary quirk to thank for your superpowers—the ability to keep drinking milk with impunity is actually a genetic mutation, and is more common in societies where milk is a staple food source. Lactose intolerance varies by ethnicity: Northern Europeans like the Brits have a mere 5 percent of their population running to the bathroom after dairy, whereas more than 90 percent of people in Asian and African countries have difficulty digesting milk.

The unlucky 75 percent of us vary in how much dairy we can have. Some of us can have up to two cups of milk a day with no ill-effects. Lactose intolerance tends to get worse as you get older, but as we’ll see, there are some things you can do to try and keep your body producing some lactase.

Not all dairy is off the table.

Rejoice, fellow sufferers! You don’t have to forgo all dairy—the amount of lactose varies between dairy products. Cream, milk and soft cheeses are all high in lactase (boo), but hard cheeses (think Edam and gouda) and yoghurt are usually safe to eat. Yoghurt contains bacteria that naturally produces lactase and it’s mega good for your gut, so it’s a good one to keep in your diet. Check out this website to see the lactose content of your favourite foods.

Try to keep some dairy in your diet—but don’t go overboard.

There’s some evidence that keeping a bit of dairy in your diet can help your body to keep producing lactase. Don’t go crazy though—while you may be able to tolerate a bit of dairy, it’s in no one’s best interest for your experiment to end up down the toilet.

Your tolerance to lactose can also change over time. Some people develop lactose intolerance after a gut infection, and their tolerance to milk comes back after a while. That’s why it’s a good idea to test your lactose intolerance every now and then, by indulging in a bit of delicious, delicious dairy.

You can still have milk in your tea.

Don’t worry, your tea can still taste delicious. Most grocery stores now have lactose-free milk—it tastes slightly sweeter than milk because all of the lactose has been replaced with sugar, but that’s the only difference. There are also heaps of milk substitutes you can test out. Initially they might taste a bit strange, but the good news is that your taste buds do adjust to them. Of all the substitutes, soy milk tastes the most like milk. It’s a healthy choice, too, since it’s usually fortified with calcium and vitamins, but try to buy locally made or organic brands, as it’s bad news for the environment. Almond milk tastes more bitter than milk, but is usually produced more sustainably. Rice milk is good if you have a sweet tooth—but make sure you’re getting calcium from somewhere else, as it has little nutritional value.

Make sure you get your daily calcium by stocking up on leafy greens.

Your mother was right—you need to eat your greens. If you have been relying on milk and dairy to get your daily calcium, then you will need to start eating a little differently to get the calcium your body needs to keep your bones healthy. Dark green vegetables like broccoli, kale, collard greens and bok choy are all packed full of calcium—a cup of cooked collard greens has more than 350 mg. of calcium. Almonds are also a great source of calcium (but don’t go too crazy—they are also quite high in fat). For more tips on getting enough calcium when you’re lactose intolerant, click here.

Tips for eating out: Asian restaurants and sorbets are your new best friends.

Since more than 90 percent of Asian people are lactose intolerant, most of their foods aren’t heavy on the dairy. So rejoice: Chinese, Indian, Malaysian are all still on the table. If your dinner companions aren’t  keen on Asian foods, you can still usually find things that you can eat without turning into a human gas-bag. Read the menu carefully, and don’t be afraid to ask for changes, such as not having your tomato pasta covered in cheese.

For desserts, your options are more restricted—fruit salads, sorbets and anything vegan is right up your alley. If there isn’t anything dairy-free on the menu, ask the waiter for an alternative, or consider sharing something dairy-heavy with a friend (or two!).

If you have a sweet tooth, vegan recipes are the best.

The hardest thing about giving up dairy is that you have to wave goodbye to all the things that are good and delicious in life—ice cream, cheesecakes, dairy chocolate, fuhgeddaboutit. But don’t despair just yet my darlings, because vegans have been creating delicious substitutes for decades. I’ve had delicious “ice creams” made from bananas, “cream” made from pureed cashews, and delectable chocolate cheesecakes made from whipped tofu. And chocolate lovers should be relieved to hear that all dark chocolates are deliciously dairy-free, not to mention much better for you. Our resident vegan Amy recommends Oh She Glows and Holy Cow! for recipe ideas.

When you’re cooking, simple substitutes like oil or margarine in place of butter mean that you don’t have to throw out your favourite recipes. Sure, some things won’t taste exactly the same, but you also won’t be treating your family and friends to your digestive system’s musical toots.

Take lactase pills when you have to eat dairy.

If you have a special occasion coming up, then you should keep some lacteeze pills on hand. The instructions say to take one to two tablets just before you eat dairy, but since the level of lactose tolerance varies from person to person, you’ll need to experiment to figure out your ideal dose. The tablets taste like minty chalk, so only use when the dairy treats you have in mind are extra delicious!

Use probiotics and yoghurt to build up your lactose tolerance.

There’s some evidence that taking probiotics and yoghurt daily can help your body build up some resistance to lactose. The bacteria in probiotics and yoghurt can alleviate some of your symptoms by changing the bacteria that lives in your intestines. Look for yoghurts that say that they have an active probiotic in them, and if you’re taking supplements, try bifidobacterium longum, since this little guy actively metabolises lactose. Remember to start slow—if your body goes into freakout-mode with any dairy, start with probiotic supplements, and then gradually introduce yoghurt into your diet.

If dairy is a healthy part of your diet, consider getting tested to check that you are actually lactose intolerant.

Dairy is a great source of calcium and vitamin D, not to mention delicious, so consider getting yourself properly tested before you swear off it.
Your doctor can test you, or you can test yourself at home by fasting overnight, drinking a cup of milk for breakfast, and then waiting three to five hours without food to see if the magic happens. If you get symptoms in that time period—welcome to the lactose intolerant club! If your tests are normal, the most common reason is that your body is having trouble processing the fat in the dairy products you have been consuming.

For more information on lactose intolerance, check out the U.S. Department of Health and Human Service’s website.