Are you lactose intolerant?

How often have you had a glass of milk or a bowl of cereal for breakfast? Have you ever thought about eating pizza without cheese? Paratha without curd? Now imagine if you couldn't do any of this. Imagine if your body couldn't digest milk or cheese or even dahi - a staple in every Indian home? This is a reality for me and many other Indians.

I recently underwent a DNA test to check for allergies, and my results showed that I was positive in lactose non-acceptance. In other words, I was lactose-intolerant. We've all heard of this condition, but it's surprising how few of us know what it actually means - especially given that a lot of Indians suffer from lactose intolerance.

The condition

So what exactly is lactose intolerance? Lactose is a type of complex sugar that is mainly found in milk and dairy products. The body digests lactose using an enzyme called lactase. People who are lactose intolerant don't produce enough lactase, resulting in improper digestion of dairy products.

Hence, common symptoms of the condition include abdominal discomfort, feeling bloated, passing gas or even diarrhoea within a couple of hours of consuming dairy products. However, basing a diagnosis on these symptoms alone may be misleading as they are common to other digestive disorders as well.

A quick and simple way for self-diagnose is the 'milk challenge'. Have a glass of milk or slice of cheese pizza after not consuming any dairy products for several days. If you experience the hallmark symptoms mentioned above, you should visit your doctor or nutritionist to get tested for lactose intolerance.

Diagnosis

Doctors commonly use one or a combination of the following three tests to measure how well a person digests lactose: lactose tolerance test, hydrogen breath test, and stool acidity test. The lactose tolerance test requires the patient to drink a liquid that contains high levels of lactose. A blood test is conducted two hours after drinking the liquid to measure the amount of glucose in the bloodstream. If the glucose level doesn't rise, it means that the body isn't digesting the lactose properly. The stool acidity test is mostly used for infants and children, as it's more difficult for them to undergo other tests.

A nutritionist will normally ask you to do a nutrigenomic test (gene test). This is normally the simplest and the most accurate way to detect lactose intolerance. It is done by a saliva sample and uses your DNA to process. If you don't have the gene that is able to produce the enzyme lactase, then you are lactose intolerant. You could be lactose intolerant even if you do not have any of the evident symptoms.

Treatment

There is currently no treatment to increase production of lactase in the body, but some dietary changes can help reduce the unpleasant symptoms of lactose intolerance. The most evident being moderating your intake of milk and other dairy products. However, a lot of packaged, canned and boxed foods also contain lactose that you may not be aware of. Milk and its by-products are used widely in baked goods, processed foods, and even salad dressings, so you may want to read the labels carefully next time you go grocery shopping.

Making changes to your diet may seem difficult at first. How are you supposed to control your dairy intake when it's in everything you eat? Trust me, I've been there. On learning I was lactose intolerant, I started my journey to ban milk and its derivate products from my life. I did this for a few months and noticed drastic changes to my health and blood profile. My sinuses cleared up and there were no signs of random headaches. But I missed my daily intake of milk, curd, and cheese.

Food options

Luckily, we're in an age where lactose intolerance has come to the forefront as a global digestive condition. People are more aware of it, are more vocal about it and more willing to adapt to changing their dietary lifestyle. Moreover, consumers, in general, have also started giving more importance to their health and the food they consume.

As a result, industry pioneers have started to fill the gap by catering to these markets. For example, I recently tried lactose-free artisanal curd for the first time in India. A paradigm shift has started where a niche set of dairy brands in India have recently introduced lactose-free alternatives for their consumers. Be this almond milk, soy cheese, sorbets or even artisanal curd.

(The author is a chief nutritionist, QUA Nutrition)