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Q And A Clearinghouse
1st Quarter, 1998

Updated March 19, 1998
This page answers the questions that arrived in the first quarter of 1998.

Send your questions to me, Steve Carper, at SteveCarper@CS.com.

Remember, I personally answer all questions that you send me, no matter what. The ones that are of sufficiently general interest get posted here, where I hope they can do the most good.

If you don't spot your question here, be sure to check my Q and A Quick Finder Index.


    


Q. I am interested in calcium supplementation and read labels. Many of these labels list a calcium lactate. Should someone with LI be concerned about lactates or just lactose.

    Just lactose.

    None of the sound-like-milks (lactates, lactylates, lactic acid, etc.) should be a problem to anyone who is LI.

    One word of warning: Occasionally, these products are made from other products that originate from milk. That still shouldn't be any problem at all for the LI, but people with severe milk allergies should avoid such products. It can be extremely difficult to tell the origins of any additives, however. You have to call the manufacturer and ask about each product individually.

    I have an extended discussion of this issue in my Dairy or Nondairy? The Experts Speak page.

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Q. If there is lactose-free milk, then why isn't there lactose-free ice cream?

    Because it doesn't sell, is my guess. Various companies have put out lactose-reduced ice creams in the past and most people, and I mean most LI people as well, never buy them.

    I have a list of all the ones I know of in my Product Clearinghouse. Look on the Reduced-Lactose products page.

    But what you should be doing is checking out the Frozen Desserts page in the Product Clearinghouse for listings of lots of completely milk-free alternatives.

    And don't forget that many people with LI can still eat frozen yogurt and that most true sorbets and ices are also milk-free.

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Q. I recently read in a nutrition book that soy products can cause gas, bloating, diarrhea etc. if eaten too often. Is this true?

    I don't think so. There is no reason to believe that any food that is not intrinsically harmful causes problems just from regular consumption. What the book might have been trying to say is that many people who are allergic to milk and turn to soy products as a substitute find that they are also allergic to soy protein. In that case, more is definitely less. And soybeans are a legume, like peas and beans, and legumes can produce gas in some people. Otherwise, if soy doesn't bother you now, eating more of it later shouldn't be any different. (Of course, if you eat too much of anything at one meal, you'll pay for it, but that's another issue.)
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Q. If one is lactose-intolerant, what effect, if any, does the presence of lactose in an injected medication have? How is it absorbed and metabolized? Is there an effect on delivery of the accompanying drug?

    Bearing in mind that I'm not a doctor or a biochemist, here goes.

    Lactose symptoms are caused solely by the presence of undigested lactose in the small and large intestines. I can think of no reason why lactose in the bloodstream should create any problems for anyone. I have read of only one, single, isolated case of an allergic reaction to lactose itself. Lactose is used in so many medications because it is basically as neutral an agent as possible, and it also has the nice property of not caking, another reason for its use. It's an interesting question, but I have never run across any reason to think that injected lactose would be a problem.

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Q. My intestinal distress increases with the fat content of the lactose carrier, particularly butter and cream. Yet your tables show that the lactose content actually decreases with fat content. Could something else be going on here?

    There is some slight evidence that a small number of people have milk fat intolerance. Unfortunately, the studies were never redone, so it's hard to know whether such a thing really exists.

    A somewhat different study found no difference in symptoms between people drinking high-fat milk and those drinking fat-free milk.

    But fat alone can create problems in some people. All I can give is the common sense advice to lay off high milkfat items for a while and see if your symptoms decrease.

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Q. I can purchase generic lactase tabs which identify the "units" of lactase. However, drops, which are the easiest to use to treat milk don't have a "unit" number - simply telling you to use 15 drops per quart for 100% lactose treatment. Is there a lactase unit number that is generally accepted as the amount needed per quart/gallon of milk?

    Sorry, there's a reason for the difference between the two. Lactase drops use a different form of lactase than the one used in lactase pills. They are not interchangeable. If you want to make reduced-lactose milk, buy the drops and follow the directions.
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Q. I'm planning on going to Samoa soon, and I need to know if there is lactose in coconut milk, as it is used in most Samoan dishes.

    Coconut "milk" is just the white liquid found in a coconut. None of the nut "milks" or nut "butters" have any real dairy content.

    (A warning for non-travelers. In this country coconut milk is often processed with cow's milk. I doubt this is much of a problem in Samoa, but here it wouldn't hurt to doublecheck that you are getting pure coconut milk, not some canned processed variety.)

    For a big fun list of such similar sounding foods, none of which contain the slightest amount of lactose, go to my The Better Look Twice List of Supermarket Products That Appear To Contain Milk -- But Don't! page.

    (And then use the back button on your browser to return and read the rest of these questions!)

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Q. I have SLI (Secondary Lactose Intolerance) that I got from a really bad undiagnosed intestinal infection that left me severely intolerant two years ago. Yes, there are people like me out there who really can't tolerate anything more than one teaspoon of butter a day. We want to be acknowledged too!

    And here's your acknowledgment!

    It's true that I have my doubts that there are very many people out there with normal LI due to aging who cannot have even a speck of lactose. But here's a big BUT. But I've always made an exception for people with damage to their intestines; I know that their intolerance can be much worse than what happens with normal aging.

    Avoiding all dairy projects is a project. I know, I did it for years before lactase pills came along. It can be done, and there are many more products around now to help you. Check out my Product Clearinghouse for info on dozens of them.

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Q. Can you tell me what percentage of the population is Lactose Intolerant and if it is more prevalent in different ethnic groups?

    My book, Milk Is Not for Every Body, has a listing that runs a full 15 pages, summarizing the results of dozens of such studies from around the world.

    Very briefly, LI is most prevalent (up to near 100% levels) in East Asians, Native Americans and most Africans. It runs around 50% in people who live around the Mediterranean -- from Arabs and Jews to Romanians and Italians. The farther north one goes in Europe, the less likely you are to be LI. Scandinavians run no more than 5% LI.

    The same holds true for this country. If your ancestors come from northern Europe, you are unlikely to be LI. If your ancestors come from places where LI is universal, you are likely to become LI yourself.

    Nobody has ever done an LI survey of the entire U.S. population. (That 50,000,000 LI figure you see tossed around a lot is sheer meaningless extrapolation off of insufficient data.) But generally, the LI percentages for groups are similar to those of their ethnic ancestors.

    This is already changing, however. Intermixing of the population is rapidly blurring these distinctions in this country. In another few generations LI will be mostly a thing of the past in the U.S.

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Q. I have been reading that LI is mostly seen in certain regional areas and ethnic groups. Why this is so? Is it perhaps those individuals' diets do not consist of dairy products?

    I cover this in detail in my book, Milk Is Not for Every Body, but here is as brief as explanation as possible.

    In most places in the world, humans were able to get enough of certain important nutrients, especially calcium, without using dairy products. As people moved toward less hospitable climates, like northern Europe, those alternate sources were hard to come by. People who could have dairy products after the age of weaning had a reproductive advantage. Lactase persistence (LP), the ability to produce lactase as an adult, is a known dominant genetic mutation, so it would easily spread through a population.

    Those who had the mutation in places where it was not necessary to eat dairy products to survive had no reproductive advantage and LP remained rare.

    The oddest case is in Africa, where many tribes who live on the edges of the Sahara and other deserts survive for many months almost entirely on milk and nothing else. The almost total lack of other food generates as severe genetic pressure as one can imagine. These tribes are the only ones in Africa who are LP.

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Q. I am Chinese and in my family, we eat a lot of vegetables, fish, and rice--non-dairy products. And in the last few years I have developed Lactose Intolerance. Did I develop LI because I stopped eating foods with lactose thus, my lactase enzyme was depleted?

    Nope. The loss of lactase is genetically regulated only. Nothing that an individual does or doesn't do is known to change the rate of loss in any way.

    There is some evidence that a person can reduce the symptoms produced by LI, however. LI symptoms are produced by the gases created when the bacteria in your colon ferment the undigested lactose. Some bacteria do this more than others and it would seem to be possible to encourage more of the ones that don't by regularly eating certain dairy products, yogurt in particular. Your lactase levels remain as low as ever, even so.

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