Remember the milk campaign of 1994? Milk industry advocates noted sagging sales and developed an advertising campaign with athletes and movie stars wearing white mustaches. Over the 20-year duration of the campaign, they promoted the wholesomeness and nutritious properties of milk and milk products. Unfortunately, although it’s true that milk is a good source of calcium and protein, it’s poorly tolerated by most adults and not necessary for our health.
Roughly two-thirds of the world’s adult population can’t digest milk products. Milk contains a complex protein called lactose that requires a specific enzyme, lactase, to break it apart. While present in most children, as we age, most humans lose this enzyme. When someone without lactase consumes milk products, they may notice nausea, bloating, diarrhea, flatulence and abdominal cramping. Symptoms typically begin within an hour and depend on the amount of milk product consumed.
One of the defining features of mammals is feeding their offspring mother’s milk. All mammals lose the ability to digest this milk while quite young, promoting weaning. Humans are an exception as over the centuries, we’ve evolved to tolerate milk as adults by incorporating milk products into our diets. Milk is species dependent, and infants given cows’ milk may develop anemia.
The diagnosis of lactose intolerance is mostly by clinical history. That is, if the person has stomach issues whenever he or she consumes a milk product, lactose intolerance is likely to blame. Specific tests include a hydrogen breath test and stool acidity test, but they usually aren’t necessary to make the diagnosis. Certain conditions predispose someone to lactose intolerance, such as celiac disease or inflammatory bowel disease. Any recent diarrhea will damage the tips of the villi in the small bowel where the lactase lives, so drinking milk within 24 hours of diarrhea may perpetuate those symptoms. Fortunately, even during an episode of diarrhea in response to lactose intolerance, there’s no harm done to the body.
Calcium is essential in our diets to build and keep our teeth and bones strong. Everyone should be consuming around 1000 milligrams of calcium daily — 1300 milligrams for teenagers. It’s true that milk, cheese and yogurt are all excellent sources of calcium, with a cup of whole milk providing around 350 milligrams. Fortunately, for those with lactose intolerance there are plenty of other sources of this essential mineral.
The intensity of symptoms varies among individuals, and most adults can tolerate a single cup of milk or slice of cheese on occasion. Levels of lactose intolerance vary in people of different heritages, with those of European descent faring better than Asian or African. For those who are lactose intolerant, lactase pills can be obtained at your local pharmacy or health food store. Preferably taken before consuming milk products, they also work if taken soon after the meal.
While milk products offer an excellent source of calcium and protein, the majority of adults are unable to digest them due to lactose intolerance. If you notice bloating and diarrhea after eating your pizza, consider next time ordering it without cheese.
NON-MILK SOURCES OF CALCIUM
- Milk substitutes, such as soy and almond
- Other fortified drinks, like orange juice
- Seeds such as poppy, sesame, and celery
- Canned seafood, especially sardines and salmon
- Beans and lentils
- Almonds
- Dark leafy greens including collard, kale and spinach
- Rhubarb and figs
- Fortified cereals
- Edamame and tofu
Dr. Philip L. Levin is a retired emergency medicine specialist in Gulfport. Learn more or contact him at www.Doctors-Dreams.com.
