If consuming dairy products makes your digestive system sensitive and you suspect you have an intolerance to them, then you’ve come to the right place. Allergist Madeleine Epstein guides us on how to better identify lactose intolerance, and more importantly, distinguish it from other similar intolerances.
Differentiating allergy from intolerance
Lactose intolerance is not an allergy! The allergy is instantaneous, and manifests itself (unlike digestive disorders caused by intolerance) by skin rashes, such as redness or eczema on the skin; or even breathing difficulties. “It is much easier to identify an allergic origin than an intolerance”, since the allergic reaction occurs quickly after ingestion of the food. Conversely, the signs of an intolerance appear within two to three hours after a meal (“it can also happen more quickly”), the time for digestion. It is therefore, in this case, less easy to identify which food among those that we have eaten is the cause of bloating and stomach aches.
Identifying lactose intolerance
Being lactose intolerant involves stomach aches, bloating, and even diarrhea. However, “having digestive problems does not prove that lactose is the cause.” To understand everything, the majority of food intolerances give these same types of symptoms, like gluten intolerance. There is therefore nothing specific that allows us to distinguish lactose intolerance from another. It is ultimately only when we realize that eating dairy products causes us undesirable effects that we can think about this possibility.
Signs of lactose intolerance are not specific
To be sure, you will need to adapt your diet by stopping foods containing lactose (and observe if the symptoms persist), otherwise, “everything is case by case, everyone tolerates lactose differently”. If in doubt, talk to your doctor or consult an allergist.
Why am I sensitive to lactose?
“Lactose is the sugar naturally present in milk. In the body, it is digested by a specific enzyme called “lactase”. At birth, each individual naturally has it. This allows them to digest milk, the main food for infants. After “weaning”, as they grow up, each person has more or less lactase in their body, depending on whether they grew up with the habit of consuming dairy products. Those with less lactase are therefore more likely to be sensitive to lactose, since the body, in the absence of this enzyme, cannot digest it.
Not digesting milk is a normal phenomenon
“80% to 85% of the world’s population is losing its lactase,” since milk consumption, no longer so present, is decreasing drastically. In short, “the people most likely to be lactose intolerant are not those who are not used to consuming it, but those who, over time, have lost this habit.”
Lactose Tolerance Levels
There are varying degrees of lactose tolerance. “The less lactase your body contains, the less lactose you will tolerate.” It’s up to you to identify your “degree of tolerance” to lactose by finding your “comfort zone.” So adapt the quantities of dairy products to your ability to tolerate it, and you will know whether you should completely stop or just slow down your lactose consumption. “To identify your degree of lactose intolerance, look for the maximum dose that you tolerate: “can I tolerate a piece of cheese, a glass or rather half a glass of milk?”
Do not confuse lactose intolerance with cow’s milk protein intolerance.
If you cannot digest any dairy products, especially “fermented cheeses, then it is no longer lactose intolerance, but more likely an intolerance to cow’s milk proteins. Whereas if you can tolerate some dairy products, then you are lactose intolerant.” The reason? It all depends on the lactose content of the dairy products. “Fermented cheeses are more bearable because the lactose is completely metabolized in them. The milk is transformed, which reduces their lactose content.”
The more fermented the cheese, the less lactose it contains, and therefore the less risk there is of being intolerant to it.
As a practical example, if you cannot tolerate milk, whipped cream or yogurts (which have a very high lactose content since these products are little or not processed at all), but you can tolerate butter, brie, Roquefort or mozzarella (fermented products), then you are lactose intolerant.
Can lactose intolerance be relieved or treated?
Lactose intolerance is physiological, there is no treatment other than stopping or adapting consumption to your level of tolerance.
“If you no longer produce enzymes (lactase), you no longer produce enzymes. The only way to end lactose intolerance is to no longer drink milk.” Today, manufacturers have managed to create lactose-free milk, and even market lactase. A way to “consume it at the same time as a dairy product and thus optimize your tolerance.” A false good solution, however, which is expensive, while it is entirely possible to opt for plant-based alternatives (almond “milk”, soy yogurt and cream, plant-based cheese, etc.).
