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Many people avoid milk products because of misperceptions and myths about lactose intolerance. But long-term lactose restriction is a mistake and can result in low levels of calcium, vitamin D and other essential nutrients. The National Institutes of Health recently released a statement to reflect current findings on lactose intolerance. Among their findings is that it's generally not necessary to fully restrict lactose. Most people with lactose intolerance can adapt to lactose when it's given in small doses over time.
Lactose intolerance isn't a disease; it's a condition that's controlled by one's genes. The symptoms of lactose intolerance, such as diarrhea, abdominal pain, flatulence and bloating, are caused by the body's inability to digest lactose due to a deficiency in the levels of the enzyme lactase. Production of lactase is hardwired; drinking lots of milk can't stimulate it and eliminating milk won't reduce it. However, everyone has some level of lactase in their intestine, even if they are clinically lactose intolerant, and a certain amount of lactose can be tolerated. Colon bacteria also help the body digest lactose.
Pediatricians can help parents understand that even if their child is clinically lactose intolerant, their child can become tolerant by ingesting small amounts of milk with meals and slowly increasing the amount of milk up to eight ounces a day. Each patient will have a different threshold for ingesting lactose without symptoms. Have your patient take milk with meals and increase the amount of lactose until she experiences minimal symptoms. Once the limit is identified, she can ingest just below that amount so she gets adequate levels of dairy in her diet.
When lactose is removed from a diet, even for brief periods of time, efforts should be made to supplement with calcium, vitamin D and protein. Dairy products without lactose, including live culture yogurt, many hard cheeses and some ice creams, can be great sources. With the help of a nutritionist, patients can find a satisfactory diet that provides all the nutrients they needs from dairy food without uncomfortable gastrointestinal symptoms.
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