Probiotics and its Health Benefits
Wіth аll thе hype аbоut hоw probiotics аrе thе “new health miracle”, уоu mіght bе wondering іf it’s nоthіng mоrе thаn а Nеw Age gimmick, but dіd уоu knоw thаt thе word “probiotic” асtuаllу means “for life” аnd thеѕе lіttlе microorganisms саn bе powerful еnоugh tо knock thе socks оff оf ѕоmе ѕеrіоuѕ ailments? Nоt оnlу dо probiotics hеlр tо prevent disease, but thеу offer а multitude оf health benefits аѕ well.Read More about Probiotics
Irritable Bowel Syndrome has a negative impact on overall quality of life.
Those who suffer under perform in life including:
- Career Progression
- Relations and Sex Life
An estimated 10-20% of the world population are affected by IBS, so if you DO suffer from IBS- You are not alone.
Here’s what you need to know at a quick glance!Read More about IBS- What You Should Know
Welcome to-The Cost of Common Constipation
Constipation is common and affects male and female of all ages.
A regular bowel pattern can vary massively between individuals, anything from three times a day to every three days can be regarded as normal.
A change in bowel habit, hard pellet like stools and difficulty or straining can be suggestive of constipation.
This can be a short lived episode which resolves or for some people a chronic condition that affects quality of life.
Its estimated that 1 in 7 adults are constipated at anyone time in the UK at a cost of £101million in prescriptions per year(coloplast.co.uk).
Although this figure does not take into account the cost of over the counter laxatives which would easily exceed the prescription cost.
Its difficult to imagine exactly how much the cost of common constipation actually amounts too.Read More about The Cost of Common Constipation
Welcome to Understanding Irritable Bowel Syndrome
You are reading this because you have IBS or you know someone that does!
If your asking yourself “Do I know someone with IBS” the answer is most likely “Yes”.
With almost 1 in 5 people suffering from IBS its likely that some of your close family or friends do!
Once you’ve had a camera up your bottom and various blood tests it can come as a relief that your diagnosis isn’t something more life threatening.
Anxious,Overwhelmed, Confused and Worried are common terms expressed by some of my patients.
You’re likely to have a lot of questions that your tapping into search engines.
- What actually is IBS?
- How do I manage IBS?
- What do I eat?
The additional anxiety and worry is unlikely to make your symptoms any better!
Understanding Irritable Bowel Syndrome does exactly what it says on the tin.
This post will help you understand IBS and hopefully answer some of those burning questions.
What is IBS?
“Irritable Bowel Syndrome is a gastrointestinal disorder characterised by altered bowel habits in association with abdominal discomfort or pain in the absence of detectable structural and biochemical abnormalities”.(1)
Irritable Bowel Syndrome can be characterised by the presence of the following symptoms:
- Alternating bowel habit
- Abdominal discomfort
- Bloating and distension
- Urgency to visit the loo
- Faecal Incontinence
Symptoms range from diarrhoea to constipation, a combination or the two along with abdominal pain and discomfort existing alongside abdominal distension(2).
IBS is sub grouped into predominant bowel pattern –
|IBS with constipation-hard or lumpy stools > 25% and loos or watery stools < 25% of bowel movements|
|IBS with diarrhea-loos or watery stools > 25% and hard or lumpy stools stools < 25% of bowel movements|
|Mixed IBS-loos or watery stools > 25% and hard or lumpy stools stools > 25% of bowel movements|
|Unsubtyped IBS-insufficient abnormality of stool consistency to meet criteria for IBS-C,D or M|
The degree of symptoms along with variety and frequency varies immensely between individuals.
Some may suffer excruciating chronic pain whilst others have intervals which can last from weeks to months(3).
For example episodes of constipation followed by urgent, explosive diarrhoea.
There is currently no biochemical, histological or radiological diagnosis of IBS, while the diagnosis of IBS being based mainly on symptom assessment(2).
Rome IV Criteria.
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with ≥2 of the following:
- Related to defecation
- Associated with change in stool frequency
- Associated with change in stool form (appearance)
Criteria should be fulfilled for at least 3 months with symptoms onset ≥6 months prior to diagnosis.
Upon presenting these symptoms, your Gastroenterologist may want to investigate further if you have any of the following red flag indications.
- Weight Loss
- Rectal Bleeding
- Inflammatory markers
The above symptoms are NOT suggestive of IBS and must be investigated further by your Specialist Gastroenterologist.
A routine assessment can include a Colonoscopy, stool tests and blood tests which identify whether there is any inflammation.
Hopefully these investigations will rule out more serious conditions including:
- Inflammatory Bowel Disease
- Coeliac Disease
Following these investigations, your consultant may come to the conclusion that there is no structural abnormalities to identify your symptoms.
This is likely to come as a sigh of relief when you’re told that your diagnosis is IBS and not life threatening.
It’s only weeks later when your symptoms return and you think of all the questions that you should have asked your consultant.
Who does IBS effect?
Irritable Bowel Syndrome is one of the most common gastrointestinal disorders. The percentage of patients seeking health care related to IBS approaches 12% in primary care practices and is by far the largest subgroup seen in gastroenterology clinics.
This is a lifelong condition that can appear out of nowhere with no clues to what initially caused your symptoms.
An estimated 5%-20% of the world population suffer from IBS, almost 1 in every 5.
More than twice as many women than men are affected by IBS although this prevalence could be down to women generally reporting more symptoms to their Doctor than their male counterparts.
“Although a minority (10%-50%) of IBS patients seek healthcare, they generate a substantial workload in both primary and secondary care”. COST OF IBS IN UK(REF).
Although age is not a contributing factor toward IBS, most presenting complains are between the age of 20-30 years.
Why Do I Have IBS?
This is a difficult question to answer.
No one actually knows exactly what causes IBS, however we do know that some factors can trigger or worsen symptoms.
- Gastrointestinal infection
- Increased sensitivity/ Visceral hypersensitivity
- Altered gastrointestinal motility
- Brain-Gut Interactions
- Gut Flora Alterations
- Intestinal Inflammation
Gastrointestinal Infection or Post Infective IBS is thought to affect 3-17% who have undergone an episode of gastroenteritis(5).
Most cases resolve after 6 months, however approximately 10% report persistent symptoms over this time(4).
Clinical features of Post Infective IBS include bloating, loose watery stools and urgency to defecate.
Psychological– Anxiety and anger can induce small bowel transit enhancing stool frequency.
Whereas depression and fear have the opposite effect and is more likely to delay colonic transit.
The “Brain-Gut Axis” refers to the interaction between the brain (central nervous system) and the intestinal tract.
Stress, emotions, and psychological problems can affect gut sensation, motility, and secretion.
Sensations within the gut can also affect the central nervous system leading to pain or to changes in mood or behaviour.
Abusive history, exaggerated consciousness, perfectionism and neuroticism is commonly reflected in personal features(5).
Visceral Hypersensitivity is the increased sensitivity of pain within internal organs.
This means that any changes in the gut including the buildup of gas or a large bowel motion can cause increased pain.
Diet and lifestyle
I don’t mean to disappoint , but diet is NOT the cause of IBS.
Lets say for example, we had two people living in the same house, working at the same job, eating the same, one of those people could easily have IBS with the other having no problems at all.
So what is causing IBS? No one really knows and therefore we can’t give you a definitive answer.
What we do know is that there are a group of contributing factors, when managed can help symptoms and improve quality of life.
Diet manipulation can significantly improve symptoms and advised by NICE as first line management of IBS.
Adopting a balanced diet with regular meals and structure would be this first thing to implement.
Over eating with large portions can result in stretching of the intestine causing pain, bloating as does going long periods without eating.
Diet and nutrition should be assessed for people with IBS and the following general advice given.
- Have regular meals and take time to eat.
- Avoid missing meals or leaving long gaps between eating.
- Drink at least 8 cups of fluid per day, especially water or other non caffeinated drinks, for example herbal teas.
- Restrict tea and coffee to 3 cups per day.
- Reduce intake of alcohol and fizzy drinks.
- It may be helpful to limit intake of high fibre food (such as wholemeal or high fibre flour and breads, cereals high in bran, and whole grains such as brown rice).
- Reduce intake of ‘resistant starch’ (starch that resists digestion in the small intestine and reaches the colon intact), which is often found in processed or re cooked foods.
- Limit fresh fruit to 3 portions per day (a portion should be approximately 80 g).
- People with diarrhoea should avoid sorbitol, an artificial sweetener found in sugar free sweets (including chewing gum) and drinks, and in some diabetic and slimming products.
- People with wind and bloating may find it helpful to eat oats (such as oat based breakfast cereal or porridge) and linseeds (up to 1 tablespoon per day). [NICE,2008]
How Do I Manage my Symptoms?
That all very much depends of YOUR symptoms.
The free diet and symptom diary along with the symptom severity tool will help you identify the following:
- Identifying your symptoms
- Frequency of your symptoms
- Severity of your symptoms
- Trend in your symptoms
There is no “one size fits all” approach towards managing IBS, therefore self-management should be encouraged.
Once you have identified your symptoms, you may want to steer your approach towards managing constipation which could include eating more fibre and drinking more fluids.
Alternatively if constipation were an issue, the approach may be towards eating less fibre or less insoluble fibre and remain drinking fluids to minimise dehydration.
Caffeine, milk products, wheat and various fruits can be known to worsen some symptoms.
A Registered Dietitian can help go over your diet in more detail, increasing or decreasing fibre as well as caffeine, fatty foods and alcohol.
Some people may require simple alterations to their diet whilst others may benefit from a more exclusive diet such as the low FODMAP diet.
The low FODMAP diet is an exclusion diet designed by Monash University in Australia.
IBS sufferers are advised to make simple (first line) dietary changes which before considering the FODMAP diet.
The FODMAP diet can be challenging as it excludes variety of foods and can be more costly when doing the weekly shop.
Despite this, the FODMAP diet boasts a 76% improvement in overall symptoms, the FODMAP diet should be carried out alongside a Registered Dietitian.
Your Dietitian will help you adhere to the low FODMAP diet to ensure the best outcome whilst remaining nutritionally adequate.
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Welcome to – Are You Getting Enough Vitamin D?
I decided to cover this topic for two reasons.
Reason 1- Vitamin D is essential for Calcium absorption.
Reason 2- Vitamin D deficiency is a global problem.
Reason 3- If you’re avoiding dairy in your diet, you may be deficient in Calcium.
I decided to cover this topic because vitamin D is essential for Calcium absorption, Calcium being another Micronutrient deficiency is a global he
Over a billion people worldwide are vitamin D deficient or insufficient
Vitamin D is an extremely important vitamin for your skin and beauty, bones and strength, and overall health and immunity.
WHAT IS VITAMIN D?
Vitamin D is a fat-soluble vitamin, meaning it can travel into your blood circulation and be stored in your body’s tissues.
It is the only vitamin that can be produced in the body on its own, making it more of a hormone than a vitamin.
It does so when your skin has direct sun exposure, and it can also be found in some food sources as well as Vitamin D supplementation.
Vitamin D, also described as “the Sun Vitamin” is a steroid with hormone like activity.
It regulates the functions of over 200 genes and is essential for growth and development. There are two forms of vitamin D.
Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol).(2)
Vitamin D status depends on the production of vitamin D 3 in the skin under the influence of ultraviolet radiation from sun and vitamin D intake through diet or vitamin D supplements.
Usually 50 to 90% of vitamin D is produced by sunshine exposure of skin and the remainder comes from the diet.
Natural diet, most human consume, contain little vitamin D.
Traditionally the human vitamin D system begins in the skin, not in the mouth as Dietary sources of Vitamin D are limited.
However, important sources of vitamin D are egg yolk, fatty fish, fortified dairy products and beef liver.(3)
Foods fortified with vitamin D are the main sources of dietary vitamin D in some industrialized countries but such programs are practically nonexistent in most low- and middle-income countries.
In the absence of food fortification programs, a majority of the populations in the world solely depends on the sun for their vitamin D nutriture.
However, sunlight alone is not considered a reliable or adequate source as production of vitamin D in the skin minimizes in winters.
In the UK there is not enough ambient sunlight between the months of October- April for the skin to synthesise vitamin D.
Dark skin color exacerbates the problem of low endogenous vitamin D production.
Religious body-covering habits, staying indoors for the majority of daytime (particularly children, women, and the elderly), and lack of open spaces and direct access to sunlight in high human density habitations have resulted in the high prevalence of vitamin D deficiency, even in countries close to the equator where sunshine is abundant.
With this background, vitamin D can easily be classified as a “problem nutrient” with the potential of high risk of its deficiency in a large proportion of the human population.
Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neuro-degenerative diseases including Alzheimer’s disease.
Vitamin D deficiency may even contribute to the development of cancers, especially breast, prostate, and colon cancers.
Vitamin D3 is believed to play a role in controlling the immune system (possibly reducing one’s risk of cancers and autoimmune diseases), increasing neuromuscular function and improving mood, protecting the brain against toxic chemicals, and potentially reducing pain.(5)
Exposure to sunshine each day helps human body to manufacture the required amount of vitamin D.
However, due to fear of developing skin cancer most people avoid the sun exposure.
To prevent vitamin D deficiency, one should spend 15 to 20 minutes daily in the sunshine with 40% of the skin surface exposed.
High concentration of melanin in the skin slows the production of vitamin D; similarly aging greatly reduces skin production of vitamin D.
Use of sunblock, common window glass in homes or cars and clothing, all effectively block UVB radiation – even in the summer.
People who work indoors, wear extensive clothing, regularly use sunblock, are dark skinned, obese, aged or consciously avoid the sun, are at risk of vitamin D deficiency.
Despite the abundance of sunshine in the Middle East allowing vitamin D synthesis all year round, the region registers some of the lowest levels of vitamin D and the highest rates of hypovitaminosis D worldwide.
This major public health problem affects individuals across all life stages, especially pregnant women, neonates, infants, children and the elderly.
Furthermore, while rickets is almost eradicated from developed countries, it is still reported in several Middle East countries.
These observations can be explained by limited sun exposure due to cultural practices, dark skin color, and very hot climate in several countries in the gulf area, along with prolonged breast feeding without vitamin D supplementation, limited outdoor activities, obesity, and lack of government regulation for vitamin D fortification of food, in several if not in all countries.(7)
Risk Groups (NICE, 2014)
- Infants and Children under 5 years
- Pregnant and breastfeeding women, particularly teenagers and young women
- People who have low or no exposure to sun, for example, those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods
- People of darker skin, for example, people of African, African-Caribbean or South Asian family origin
Suitable supplements should be available for people with particular dietary needs (for example, people who avoid nuts, are vegan, or have a halal or kosher diet).
Identify Your IBS Subtype
Irritable Bowel Syndrome is a Functional Bowel Disorder meaning there is no diagnostic test.
Blood tests, stool samples and radiological scans may have been arranged by your Doctor although these are to rule out other conditions such as Coeliac, Crohns, Colitis and Cancer.
Diagnosing IBS is dependent on the profile of presenting symptoms. For example – bloating / constipation / diarrhoea / pain.
With no way of diagnosing IBS, assessing symptoms can be vague when a patient complains of bloating or diarrhoea.
Fortunately a diagnostic criteria exists for Irritable Bowel Syndrome, another reason to thank the Romans.
IBS is not a new disorder affecting people today with busy lifestyles and convenience foods.
It’s highly likely that people have been suffering from IBS for centuries.
In 1989 a group of Physicians got together in Italy and decided to lay down some criteria for diagnosing IBS- the Rome Criteria was born.
The Rome Criteria outlines the frequency, and duration of specific symptoms aiding in the diagnosis if IBS.
Over the years the criteria has been adapted with a total of 4 being published.
Rome I Criteria- 1989
Rome II Criteria- 1999
Rome III Criteria- 2006
The most recent version being Rome VI Criteria May 2016.
Don’t worry if you were diagnosed before the new criteria were published.
Rome criteria are used globally to diagnose IBS and little is changed other than the wording in the latest revision.
The recent update is more accommodating to terminology rather than symptoms.
Diagnostic Criteria for Irritable Bowel Syndrome
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria:
1. Related to defecation
2. Associated with change in frequency of stool
3. Associated with change in form (appearance) of stool.
Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.
The criteria states symptoms must be persistent at least 1 day per week within the last 3 months and over 6 months since onset.
Short lived symptoms of travel diarrhoea or food poisoning would not fit the Rome Criteria.
The symptom profile of IBS can vary between individual. The prominence of IBS symptoms can categorise sufferers into 1 of the three main subgroups including:
1. Diarrhoea Predominant (IBS-D)
2. Constipation Predominant (IBS-C)
3. Mixed Predominance (IBS-M)
IBS with predominant constipation: More than onefourth (25%) of bowel movements with Bristol stool form types 1 or 2 and less than one-fourth (25%) of bowel movements with Bristol stool form types 6 or 7. Alternative for epidemiology or clinical practice: Patient reports that abnormal bowel movements are usually constipation (like type 1 or 2 in the picture of Bristol Stool Form Scale (BSFS), see Figure 2A).
IBS with predominant diarrhea (IBS-D): more than onefourth (25%) of bowel movements with Bristol stool form types 6 or 7 and less than one-fourth (25%) of bowel movements with Bristol stool form types 1 or 2. Alternative for epidemiology or clinical practice: Patient reports that abnormal bowel movements are usually diarrhea (like type 6 or 7 in the picture of BSFS, see Figure 2A).
IBS with mixed bowel habits (IBS-M): more than on fourth (25%) of bowel movements with Bristol stool form types 1 or 2 and more than one-fourth (25%) of bowel movements with Bristol stool form types 6 or 7. Alternative for epidemiology or clinical practice: Patient reports that abnormal bowel movements are usually both constipation and diarrhea (more than one-fourth of all the abnormal bowel movements were constipation and more than one-fourth were diarrhea, using picture of BSFS, see Figure 2A).
IBS unclassified (IBS-U): Patients who meet diagnostic criteria for IBS but whose bowel habits cannot be accurately categorized into 1 of the 3 groups above should be categorized as having IBS unclassified. For clinical trials, subtyping based on at least 2 weeks of daily diary data is recommended, using the “25% rule.” a IBS subtypes related to bowel habit abnormalities (IBSC, IBS-D, and IBS-M) can only be confidently established when the patient is evaluated off medications used to treat bowel habit abnormalities.
Welcome to the ultimate guide to lactose intolerance.
As a Registered Dietitian, I have a responsibility to provide informed evidence based advice to my patients.
I frequently see people who have introduced various restrictions within their diet and completely understand why they are looking for a solution.
The concern I have is when people exclude foods with very little knowledge of why!
More recently I had a middle aged guy tell me, “ I stopped all milk because a work colleague mentioned it causes bloating”.
When we discussed this a little further it turns out this gentleman had not only excluded milk for 2 months, he had been avoiding cheese, yogurts too!
When asked if he had any improvements in his symptoms, he couldn’t recall.
Here was a guy who had completely eliminated dairy without trying any dairy alternatives.
Not only did he have a miserable time doing this, he had no improvements in his symptoms and was inadequate of dietary Calcium.
This is not the first time nor the last that uninformed choices can have a negative outcome.
The Ultimate Guide to Lactose Intolerance will help you get it right.
As you know milk plays a big part in the western diet.
And it provides a good source of protein as well as micro-nutrients including calcium and phosphorus.
Which is essential for your bone health.
And it isn’t in short supply nor is it expensive.
But there is a reason why your local supermarkets shelves are saturated with alternatives.
Alternatives that are often double the price of regular cow’s milk.
You’ve probably seen these yourself…
Coconut milk, soy milk, almond milk and more.
And all of them more expensive than regular cows milk.
So what’s the deal:
Previous marketing campaigns have told us to drink cows milk, it’s good for us right?
So why quit drinking the white stuff?
Its natural, it must be healthy right?
Well it CAN be but not always depending on your tolerance to it.
As it turns out 70% of the world population are lactose intolerant.
Which means they have issues with dairy products causing symptoms including IBS.
And if you’re reading this then you probably suspect you do too.
Which is we you see so many milk alternatives on the supermarket shelves.
So here’s what I will do:
In this Ultimate Guide to Lactose Intolerance I will address every question you have about lactose intolerance.
And provide answers to the questions you haven’t yet thought of.
The aim of this article is to help you make educated choices with diet and health.
And help you understand lactose intolerance better .
So if you do have an intolerance you can seek to minimize the discomfort it causes you.
Or so you can rule out lactose intolerance completely.
Let’s do this…
What Is Lactose Intolerance?
Here’s the science part before we get to the plain English part:
Lactose is a disaccharide sugar found in milk.
Which basically means two sugar molecules that are joined together.
These two sugar molecules Glucose and Galactose are absorbed in the small intestine pretty easily on their own but not as a disaccharide.
So in order to break the disaccharide into simple monosaccharide’s for absorption, we need an enzyme.
The enzyme needed to “chop” the double sugar into two simple sugars is Lactase.
And this is where the problem occurs.
Mammals including Humans need milk initially as a sole source of nutrition,
But then after 6 months we begin weaning and trying out solids for the first time.
Lactase production in babies is normally high as milk is the primary source of nutrition.
Until after the age of 2 where we are consuming more solid food.
This trend continues as we age, meaning we become less tolerant of lactose as we get older.
So we begin to produce less of the Lactase enzyme.
If we continue to consume large amounts of lactose without enough Lactase, we are unable to break Lactose in half.
The double sugar molecule travels down the small intestine into the large intestine where gut bacteria ferment on the sugar producing symptoms.
Just so you know:
Lactose intolerance is not the same as a milk allergy and will not promote an immune response.
But symptoms of lactose malabsorbtion can be very uncomfortable still.
We will discuss these symptoms in more detail below.
That’s the science.
Here’s what this means in plan English:
- The small intestine does not absorb the natural sugar found in milk and dairy.
- The milk sugar (Lactose) travels through the small intestine and into the large intestine whilst retaining water.
- Bacteria within the large intestine ferments on the milk sugar and produces gas.
- Extra water retention and additional gas causes bloating and discomfort.
Why You Might Be Intolerant
Believe it or not:
Your ethnicity or race can play a major factor in your intolerance to lactose.
People of African, Asian, and Hispanic origin have a greater prevalence of lactose intolerance of 50-100%.
Whereas those of north European origin can be as little as 2%.
Lactose Intolerance In Terms Of Population Group
- South American, African 50%
- White American) 15%
- Black American 80%
- Scandinavian 2%
- Sicilian 70%
- Source: (BDA, 2015).
And here’s why this happens:
It is thought that milk and dairy remained a larger part of the northern European diet long past infancy.
As a result the small intestine has evolved over centuries to continue to provide Lactase.
The theory being Europeans have been consuming milk for a longer period of time that they have developed the capability to absorb Lactose.
So something as simple as your race can determine how likely you are to be intolerant.
Other reasons for intolerance include:
- Coeliac Disease
- Crohns Disease
- Long use of antibiotics
- Source: NHS,2016
And let’s look at what that means in terms of symptoms…
The Symptoms of Lactose Intolerance
Now if you suffer from lactose intolerance you’ll like be familiar with these symptoms.
But here’s a basic overview of the science before we cover the basic symptoms.
So you understand WHY these symptoms occur.
The bacteria ferment on the sugar and similar to brewing, produce a lot of gas.
The gas then causes your abdomen to stretch and distend.
This stretching can cause pain as well as flatulence in you.
Lactose also has an osmotic affect.
This basically means it draws fluid from your small intestine into the large bowel.
Too much water in your large bowel can cause further stretching of the bowel as well as diarrhea / liquid stool.
Now combine this extra fluid with the gas produced and it can be very messy indeed.
At a glance symptoms of lactose intolerance include:
- Abdominal pain
- Explosive diarrhea
These will be the symptoms you recognize, right?
And none of them are pleasant.
As a registered dietitian I deal with patients suffering from these symptoms day in day out.
And for some of them it controls their life.
How Lactose Intolerance Affects Your Health
Other than discomfort, flatulence, diarrhea and making you feel generally miserable, lactose intolerance itself won’t cause any harm to health.
However dietary restrictions imposed on you if you’re thought to have intolerance to lactose may have health implications.
Calcium is essential for your growth and maintenance.
Dairy is a rich source of calcium.
So excluding milk based products from your diet that is may lead to thinning of your bone, fractures and osteoporosis.
I will share below some alternatives to milk and lactose based products for you.
How To Find Out If You Are Lactose Intolerance
If you suspect that you may be intolerant to lactose, try excluding lactose from your diet for a couple weeks and take a note of your symptoms.
Do your symptoms lessen or disappear completely?
I have seen huge improvement in patients who suffer from lactose intolerance from trying this.
Milk exclusion is the simplest way of diagnosing whether you have lactose intolerance.
Switch up the milk in your cornflakes, tea and coffee for a cows milk alternative like Soy, Almond or Coconut milk.
Honestly I can say from personal experience they are delicious.
I will cover that in more detail below.
You can also speak to your health care provider and ask for a hydrogen breath test
Here’s the deal:
You would be asked to drink a lactose containing solution before breathing into an apparatus.
A health care provider then asks you to breathe into a balloon-type container that measures breath hydrogen level.
The test measures the amount of hydrogen you exhale when breathing.
Poor lactose absorption results in bacterial fermentation which produces hydrogen, an increase in hydrogen.
Hydrogen can then be calculated.
A high hydrogen output may suggest lactose intolerance.
A lactose tolerance test is similar to a blood sugar test.
Regular blood samples are taken following ingestion of lactose based drink.
Blood sugars can identify the absorption of lactose.
So if you suspect that you are lactose intolerant I suggest you speak to your health care provider.
Let’s look at how you can manage your intolerance…
How To Manage Your Lactose Intolerance
An estimated 75% of the world population are lactose intolerant although much fewer have any symptoms.
Simple changes to your diet to minimize consumption of lactose can help you manage it.
The severity and sensitivity of symptoms dictate how restrictive your diet should be.
You may wish to exclude lactose altogether, opting for lactose alternative products
I cover alternatives to lactose products below so keep reading.
Some people can have milk in cereal, cheese on their pizza and strawberries with cream, however a glass of milk may cause them problems.
It’s important to bear in mind that the amount of lactose consumed will have an effect on symptoms.
Smaller quantities likely won’t cause any symptoms in most people.
How To Know When You’re Consuming Too Much Lactose
This varies between individuals and depends on tolerance.
For example, you may have severe symptoms after drinking a small amount of milk, while another person can drink a large amount without having symptoms.
Other people can easily eat yogurt and hard cheeses such as cheddar and Swiss, while they are not able to eat or drink other milk products without having digestive symptoms.
The good news:
Most people with lactose intolerance can tolerate some amount of lactose in their diet and do not need to avoid milk or milk products completely.
As avoiding milk and milk products altogether may cause people to take in less calcium and vitamin D than they need.
Lactose-free and lactose-reduced milk and milk products are available at most supermarkets.
And they are identical nutritionally to regular milk and milk products.
You’re wondering if they taste as good as regular milk, right?
From my personal experience many of them do.
Soy, almond or coconut milk are all delicious in my opinion.
And many of the clients I see as a dietitian after switching have said they wouldn’t go back to cows milk.
There’s also another option:
Lactase enzymes come in the form of tablets or drops.
Enzymes can be taken when eating or drinking a lactose rich meal.
Lactase enzymes are synthetic enzymes that do exactly the same as our natural enzymes would do.
Remember: Your symptoms are a result of not producing enough Lactase in the presence of a lactose rich meal or drink.
Lactose supplementation helps by breaking the disacharride into glucose and galactose.
Improving Lactose absorption and minimizing symptoms.
Some milks such as the one below is regular cows milk that has synthetic Lactase enzymes added to help with absorption.
This tastes just like cows milk and has the same nutritional values including Calcium and Protein.
How To Get Enough Lactose If You Are Intolerant
Although dairy produce is rich in calcium, those who who are lactose intolerant don’t necessarily have to consume milk and dairy products to get the calcium they need to maintain proper nutrition.
The following non-dairy foods are good sources of calcium and don’t contain lactose:
- Sardines, with edible bones
- Salmon, canned with edible bones
- Calcium-enriched fruit juice
- Soy milk
- Tofu (calcium-enriched)
Where Else To Find Lactose
Lactose is found mostly in dairy products including milk, yogurts cheese and ice cream.
However Lactase can also be found in cakes, biscuits and ready meals which is why I would suggest checking the labeling.
- Lactose Free
- Milk Free
- Dairy Free
Are a good give away that a product is Lactose free!
Another tip is using a little commonsense.
If a product does contain dairy, a good way of judging the concentration is the positioning on the label.
The higher the ingredient is on the list= the greater the concentration.
The same in reverse, the lower an ingredient is on the list =the lower the concentration.
The label above from a sponge cake has “milk emulsifier” and “whole milk powder”half way down the ingredients list.
If this was a label for ice cream, milk would likely be the first ingredient and therefore you may wish to choose a slice of cake over a serving of ice cream.
Depending on your level of sensitivity, you may want to pay extra attention to food labeling or reduce your portion sizes of certain foods.
A spot of milk in your tea or coffee is unlikely to cause any problems whereas a large glass of milk will.
Some medications can also contain lactose although very small amounts that are unlikely to cause issues. However if you have a severe intolerance to Lactose, you wish to discuss your medications with your Doctor.
Some medications that contain lactose:
- Anti anxiety medication
- Muscle relaxants,
- Pain relief,
- Anti inflammatoy drugs
- Source: Drugs.com
Wrapping This Up
Now you should have a good understanding of lactose intolerance, right?
If you takeaway anything from this article I hope it’s this:
Lactose intolerance doesn’t have to control your life.
You can manage your symptoms by reducing intake of milk and other dairy products.
Or replacing them with tasty and healthy alternatives.
Your options are still plentiful even if dairy is no longer a good option for you.
Lactose intolerance other than the discomfort it causes (which is not to be overlooked as it’s a real problem) isn’t likely to affect your health in any major way.
So please try not to get stressed about it.
As a registered Dietitian I’ve seen many of my clients who have been diagnosed as lactose intolerant manage their symptoms and live happy lives.
It’s about making a few small changes in your life that will make your life less stressful and happier.
So now you know just about everything there is to know about lactose intolerance.
Feel free to ask questions in the comments section below…
Hi, I’m Grame Syme, a registered Dietitian specialising in IBS, blah blah blah