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LACTOSE INTOLERANCE
MALLORY SALVI
DIETETIC INTERN
COMMUNITY ROTATION
 WHAT IS LACTOSE INTOLERANCE?

LACTOSE INTOLERANCE IS AN ABSENCE OF THE ENZYME LACTASE, WHICH IS RESPONSIBLE FOR

THE DIGESTION OF MILK SUGAR.

DIFFERS FROM A MILK ALLERGY WHICH IS CAUSED BY AN IMMUNE REACTION TO THE PROTEIN
IN MILK (CASEIN OR WHEY)

ABOUT 30 TO 5O MILLION PEOPLE IN THE UNITED STATES ARE LACTOSE INTOLERANT

 CAUSES

DEFICIENT OF LACTASE, WHICH IS THE ENZYME THAT DIGESTS SUGAR IN MILK

AFTER AGE 3, LACTASE PRODUCTION STARTS TO DECREASE DRAMATICALLY AND BY TEEN
YEARS WE ARE LEFT WITH ABOUT 5 TO 10 PERCENT OF LACTASE ACTIVITY
ONLY A SMALL PERCENTAGE OF PEOPLE IN THE WORLD RETAIN ENOUGH LACTASE TO DIGEST
& ABSORB LACTOSE EFFICIENTLY
NOT EVERYONE IS LACTOSE INTOLERANT
 METABOLIC PATHWAY
LACTOSE TOLERANT
LACTOSE NORMALLY GET HYDROLYZED INTO GLUCOSE
AND GALACTOSE IN THE SMALL INTESTINE BY THE
ENZYME LACTASE
LACTOSE INTOLERANT
LACTOSE IS NOT BROKEN DOWN OR ABSORBED INTO
THE SMALL INTESTINE IF THERE IS NOT ENOUGH LACTASE
CAUSING IT TO REACH THE LARGE INTESTINE
LACTOSE IS FERMENTED BY BACTERIA TO ACIDS & GASES
CAUSING GI ISSUES
 SYMPTOMS
ABDOMINAL PAIN
GAS
CRAMPS
BLOATING
DIARRHEA
NAUSEA
VOMITING
 MEDICAL NUTRITION THERAPY
LACTOSE INTOLERANCE IS NOT CURABLE BUT IT IS MANAGEABLE
DIETARY CHANGE
REDUCE CONSUMPTION OF LACTOSE CONTAINING FOODS
CONSUME LACTAID WHICH HAS BEEN TREATED WITH AN ENZYME THAT BREAKS DOWN THE
LACTOSE

ENZYME TABLETS WITH MEALS OR ADD ENZYME DROPS TO MILK

ENZYME HYDROLYZES THE LACTOSE TO GALACTOSE AND GLUCOSE

TOLERABLE INTAKE OF FOODS NEEDS TO INDIVIDUALIZED WITH EACH PATIENT

EACH PATIENT IS DIFFERENT, SOME MAY BE MORE SENSITIVE THAN OTHERS
STRICTER DIET
 MEDICAL NUTRITION THERAPY
STRICT LACTOSE-FREE DIETERS SHOULD BE AWARE OF THE FOLLOWING:
BREADS
CEREALS
BREAKFAST DRINKS
SALAD DRESSING
CAKE MIXES
CANDIES
CERTAIN MEDICATIONS & SUPPLEMENTS
INDIVIDUALS WHO AVOID DAIRY PRODUCTS MAY NEED A CALCIUM AND VITAMIN D
SUPPLEMENTATION IF NOT GETTING NONDAIRY SOURCES OF THESE NUTRIENTS
 DIET
HIGH LACTOSE / POORLY TOLERATED
MILK (NONFAT, 1%, 2% WHOLE)
BUTTERMILK
EVAPORATED MILK
NONFAT DRY MILK POWDER
SWEETENED CONDENSED MILK, UNDILUTED
YOGURT
ICE CREAM
SOUR CREAM
 DIET
LOW OR NO LACTOSE / WELL TOLERATED
CHEESE (CHEDDAR, SHARP, AMERICAN, SWISS, PARMESAN AND BLEU CHEESE)
CULTURED DAIRY PRODUCTS
BUTTER
WHOLE-WHEAT BREAD
COTTAGE CHEESE
CREAM CHEESE
SHERBET
 DIET

MILK ALTERNATIVES TO CONSUME IF LACTOSE INTOLERANT

SOY MILK
ALMOND MILK
CASHEW MILK
RICE MILK
LACTAID MILK
 REFERENCES

BOYLE, M. A., & HOLBEN, D. H. (2013). COMMUNITY NUTRITION IN ACTION: AN

ENTREPRENURIAL APPROACH ( 6TH ED.) BELMONT. CA:WADSWORTH
BYRD-BREDNENNER, C., MOE, G., BESHGETOOR, D., BERNING, J. (2013). WARDLAWS
PERSPECTIVES IN NUTRITION (9TH ED.) NEW YORK, NY: MCGRAW-HILL.
ROLFES, S. R., & WHITNEY, E. (2011). UNDERSTANDING NUTRITION (12TH ED.) BELMONT. CA:
WADSWORTH.
VANDENPLAS, Y. (2015). LACTOSE INTOLERANCE. ASIA PACIFIC JOURNAL OF CLINICAL
NUTRITION, 24 SUPPL 1S9-S13. DOI:10.6133/APJCN.2015.24.S1.02
QUESTIONS?