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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.
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.
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.)
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.
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.
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.
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!)
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.
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.
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.
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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