The Dairy-Free Diet
Are you one of the many Americans who are lactose intolerant? If so, you must avoid lactose—a naturally occurring sugar in cow's milk—to avoid unpleasant symptoms ranging from intestinal discomfort to nausea, diarrhea, gas, bloating, etc. It's no fun. But it's not particularly dangerous, either. Also called lactase deficiency, lactose intolerance is a condition that is actually more or less normal. In fact, people who can consume dairy products throughout life, with no problems, are the exception to the norm.
Lactose intolerance involves the inability to break down lactose, the primary sugar in cow's milk. When we're babies, we all possess an enzyme called lactase, which helps us digest lactose. Ordinarily, by about two years of age—when most babies have been weaned—the ability to produce this enzyme in the small intestine fades away. Among some people of Northern European heritage, though, a mutation occurred that allows people to continue producing lactase throughout life.
Other ethnicities are not so lucky. They never developed this mutation, so they're unable to handle milk sugar. The interaction between lactose and gut bacteria causes the uncomfortable symptoms experienced by people with lactose intolerance. People of Africa-American, Asian, Hispanic, and Native American heritage are among the most likely to be intolerant. Other things can also trigger lactose intolerance, including cancer chemotherapy, or intestinal disorders such as Crohn's disease and celiac disease.
The only way to address lactose intolerance at present is to alter your diet to avoid significant amounts of lactose. Some people with lactose intolerance can drink up to a cup of milk a day, but no more. Milk is an important source of calcium, and calcium is an essential nutrient. People with lactose intolerance need to increase their intake of calcium-rich foods, such as broccoli, salmon, pinto beans, and spinach, since they can't rely on dairy products for their daily calcium requirements. They also need to be sure they're getting enough vitamin D, since most dairy products are fortified with the sunshine vitamin, and studies show that many Americans do not get enough of this crucial vitamin. Consider daily supplementation with 2,000 IU vitamin D3, or more.
Not all dairy contains significant amounts of lactose. Yogurt, for example, has very little, and may be an acceptable alternative food. Hard cheeses also tend to have very low amounts of lactose, and may be entirely tolerable. Finally, learn to read food labels carefully. As with wheat, manufacturers are fond of sneaking milk products into places where you might not expect to find them. Look for words that hint at lactose, such as whey, milk byproducts, fat-free dry milk powder, and dry milk solids.