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My daughter can sit and complain about another kid who has some habits that annoy her and then turn around and clamor for us to take said kid on our next vacation. It made me laugh when she did this the other day and it made me wonder if I had similar push-pull feelings about a bad boyfriend or troublesome friend when I was already an adult.  When you’re older, you probably judge more and put up with less or perhaps are quicker to question your commitment to keeping them in the picture. I don’t have an easy relationship with certain dairy products either. It could be classified as one of those dynamics of ‘I love it, but it doesn’t love me’ though over time I’ve developed some workarounds that keep us together.

I’ve never officially been diagnosed as lactose intolerant but I was bright enough to figure it out after being laid low by a big soft serve ice cream cone almost 20 years ago on a Montana road trip, on the way up to Flathead Lake. My gut hurt, I was uncomfortable and gassy. It was awkward, having to stop every half hour to find a gas station or someplace where I could use a bathroom. Not a pretty picture, I know. I was also miserable at the thought that I’d have to give up ice cream for life. Ice cream! That just didn’t seem negotiable. Still, after a few other attempts to try ice cream while safely at home left me with bad nights – bad sleep because of the pain and cramping. Enough of that did take the shine off ice cream for sure but then I was able to  determine that it was just the rich ‘premium’ ice creams like Haagen Dazs or Ben and Jerry’s that seemed to cause the problem and I cut back on them for a while. Then the problem just seemed to go away.

That just doesn’t happen, said the doctor I met and chatted with at a party. I shrugged my shoulders. It had, in my case. Since it has reappeared in the last few years, I take Lactaid pills in my purse when I can remember to, especially if we are on vacation and eating in a lot of restaurants or when I’m on the hunt for a great dessert. (You take a couple of pills with the first bite of the dairy dish. It provides the lactase that your system doesn’t produce enough of and helps your digestive system break down lactose.) Sour cream based dishes like beef stroganoff or chicken paprikash also require me to take a pill or two. According to the articles I consulted in researching this post, I learned that it is quite typical to become lactose intolerant as one ages. African Americans, Hispanics, Asians and Jews are ethnic groups that are cited as being at an increased risk for lactose intolerance. In my corner of California, that accounts for a significant proportion of my neighbors.

Some people would make the natural choice to stop having milk products if intestinal pain was going to keep them up in the middle of the night. But not me. Give up tortellini alla panna? ice cream with hot fudge sauce? An intolerable thought. I don’t eat these things a lot, but I am not ready to cut them out of my repertoire just yet. Let me be sure to point out that a person can be lactose intolerant without being allergic to milk. If you don’t have an actual allergy to dairy products (an allergy being an immune response with a wider range of symptoms potentially including disruptions in the upper-respiratory, cardio-vascular systems or rashes) then having Lactaid milk or lactaid pills around can enable you to keep eating dairy products, within reason, if you enjoy them and want to get your calcium and protein that way.

What is Lactose?

Lactose is a naturally occurring sugar found in milk. A person who is lactose intolerant doesn’t make enough of the enzyme lactase to break down the lactose and so it hangs out in your intestines making trouble. Some people can’t tolerate even a little milk, while some will hit a maximum of dairy intake, then having hit their limit they will start showing symptoms. I seem to fall into that latter variety, and I expect my tolerance for dairy products to decline as I age.

How can I tell if I am Lactose Intolerant?

Lactaid’s website has a simple, two day trial and error test found here. They recommend beginning the test, on Day One, by drinking a big old glass of milk and checking to see if you go through agony. Then trying their milk the next day to see if you don’t go through agony. I am not so puritanical, or so scientific, as to put myself through this. I just switched to Lactaid and said “phew, that’s better.”  I’m no doctor, but I think it’s common sense to consider that if you habitually have gastric pain, terrible gas and diarrhea as a result of drinking milk then you may want to think about testing yourself or checking out milk alternatives or switching to milk with supplemental lactase. Some people are happy to give up milk altogether. We are not necessarily designed to keep drinking it through adulthood, or even past the age of two, but while there is my sister-in-law’s chicken pot pie and Lark Creek’s butterscotch pudding, to paraphrase Tom Joad the hero of Steinbeck’s The Grapes of Wrath, I’ll be there too. So I am grateful for my little Lactaid on-the-go pills.

Our patriotic duty to eat pie on the 4th of July was fulfilled at the Creamery in Palo Alto, CA. Note the bottle of digestive aid pills I brought along to help me in my mission.

What should I eat/avoid if I am Lactose Intolerant?

Yogurt with active cultures is no problem, because the live bacteria eats up the problematic sugars in the gut. Harder cheeses like cheddar, parmesan, pecorino romano, don’t contain a lot of lactose. Lactose dwells in the watery parts of the cheese and is concentrated in the byproducts like whey, so softer cheeses will be harder to digest.

The Lactaid folks want to point out that milk products are a good way to get calcium and they are happy to sell you their brand of yogurt and ice cream too. (I personally don’t find soy products that easy to digest, so did not investigate that alternative.) One more word about Lactaid style milk – it will taste a little sweeter than regular milk. If you do bake with it, you may want to decrease the sugar in the recipe a little bit.

By all means avoid raw, unpasteurized milk and whey protein concentrate, which is the prime ingredient in a lot of body building powders. This stuff is murder on the intestines because it is like lactose concentrate, and is added to certain products to make them seem richer and creamier – like soft serv ice cream. The discomfort level for people starting out with these body building products, even for those who have never had lactose intolerance issues, is well documented.

What are the stats on Lactose Intolerance?  

Here is a handy chart of Lactose Intolerant Statistics from the statisticbrain.com website. Source: National Digestive Diseases Information, USA Today (Date Verified: 3.7.2012)

Total percentage of people who are lactose intolerant: 33%
Total percentage of adults that have a decrease in lactase activity: 75%
Total percentage of people who maintain ability to digest lactose after childhood: 40%
Total number of Americans who are lactose intolerant: 40 million
Total percent of all African-American, Jewish, Mexican-American, and Native American Adults who are lactose intolerant: 75%
Total percent of Asian-Americans that are lactose intolerant: 90%
Average amount of time it takes for side effects of lactose intolerance to occur after intake: 30 min

More sufferers than you’d think, eh? I know. I’m reminded of those celebrity couples that you hear about who live in separate town houses to make their relationships work. (I think being a celebrity means never having to give up your quirks.) In the same vein, I can make adjustments for the special, very dairy treats that enrich my life even if they do drive my intestines a little nuts. Love and synthetic lactase conquers all.