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Lactose intolerance can affect nutrient intake – here are some nutrition tips for those who can’t digest milk sugar.

Lactose intolerance is one of the most common digestive complaints among adults. If you know someone who seems to shy away from dairy products, lactose intolerance could be the reason.

What is Lactose Intolerance?

When someone is lactose intolerant, it means that they can’t digest lactose—a sugar that naturally occurs in fresh milk products. Lactose is a large molecule that the body can’t take up as it is. An enzyme called lactase is needed to break the lactose down into smaller sugar units that the body can absorb.

The body usually produces plenty of the lactase enzyme at birth, and for the first few years of life when cow’s milk is often a regular part of the diet. As milk consumption drops off with age, lactase production tends to drop off, too. This is why symptoms typically develop in the teen or adult years. There are varying degrees of lactose intolerance. Some people can’t handle any amount of lactose, while others can manage small amounts without having symptoms.

Lactose intolerance is more common in people of Asian, African, Native American or Mediterranean heritage. It’s much less common in Northern and Western European populations, where milk products are a regular part of the diet throughout life.

Lactose intolerance is not the same thing as a milk allergy. In that case, your body has a problem with the proteins in milk, not the sugar. It’s not generally considered a dangerous condition, but it can be uncomfortable. Since lactose intolerant individuals need to stay away from dairy products, it’s important that they find other ways to take in adequate amounts of some of the nutrients found in fresh milk products, notably calcium and vitamin D.

What Are the Symptoms of Lactose Intolerance?

The milk sugar lactose is made up of two sugar molecules—one called glucose and the other called galactose, which are tightly connected by a chemical bond. The body can’t absorb the lactose intact; the two sugars need to be split apart. The lactase enzyme, normally produced by the body in the digestive tract, breaks the chemical bond between the two sugars—so the body can absorb them through the wall of the small intestine.

without adequate lactase, the lactose sugar moves through the system intact and unabsorbed. As the lactose enters the lower part of the digestive tract, the bacteria that naturally reside there begin to break the sugar down, producing large amounts of gas in the process. This leads to the common symptoms of lactose intolerance—gas, bloating, cramps and diarrhea. This usually occur between 30 minutes to two hours after lactose is eaten.

Dietary Advice for Those With Lactose Intolerance

Those with lactose intolerance know to avoid fresh milk products. Milk, and any beverages made with milk, buttermilk, ice cream, sour cream and cottage cheese are the main sources of lactose in the diet. Some people find that they can handle small amounts of hard cheese and yogurt. That’s because some of the lactose is broken down as the cheese ages and the yogurt ferments.

Aside from dairy products, careful label reading is a must, because lactose can crop up in many foods. Lactose manages to find its way into breads and baked goods, cereals, soups, snack foods, processed meats, salad dressings, candies and even nondairy creamers and whipped toppings. Milk, milk solids, milk powder or whey on a label are good indications that there’s probably lactose. Also watch for the words buttermilk, milk by-products, nougat, caseinate and cheese flavor. All could indicate the presence of lactose.

For those who want to include cow’s milk products in their diet, lactose-free milk, yogurt and cottage cheese are available. Others with lactose intolerance turn to milk alternatives, like soy, rice, almond or hemp. One thing to note, though, is that these milks may not exactly match the protein, calcium and vitamin D content of cow’s milk.

Since dairy products are such a rich source of calcium and vitamin D, finding other sources of these nutrients is important. Leafy greens, broccoli, beans, tofu and some milk alternatives provide calcium, as well as certain calcium-fortified foods such as cereals or juices. Vitamin D is naturally found in fatty fish, eggs and liver, and some milk alternatives are fortified with Vitamin D, too. For those who have trouble meeting their needs, calcium and vitamin D supplements can help