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Q And A Clearinghouse
1st Quarter, 1999

Updated April 1, 1999

This page answers the questions that arrived in the first quarter of 1999.

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. a) Do eggs contain lactose?

b) When I drink beer, I have some of the same symptoms as when I drink milk. Is there some sort of dairy product in beer?

    a) For some reason, probably since eggs are so often found in the "dairy" case in supermarkets, many people believe that eggs are dairy products and need to be avoided. This is completely false. Eggs come from chickens, not cows. They contain absolutely no lactose. (This is true of most mayonnaise as well.)

    b) Most beer does not contains lactose. But Drew Kissinger writes me to say:

      I have a friend who is a great brewer of beer, and he tells me that any beer with the word "Cream" in it such as "cream stout" actually has lactose in it. He knows, he adds the lactose himself to his "cream" beers! The milk sugar is added to the mix b/c it gives some sort of special twist to the flavor and fermentation. Is their any left over when you drink it? I don't know, but I suspect yes.
    Nevertheless, it's just as likely that it's the alcohol that's affecting you, since alcohol is definitely a known cause of all sorts of problems in all sorts of people. If it bothers you enough, stop drinking beer.
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Q. I have heard that black males experience LI at a much higher rate than white males. Is this true, and if so why?

    This is a yes and no thing. In general, the only peoples in the world who are _not_ lactose intolerance are northern Europeans (or descended from people originally from northern Europe). All others are.

    The brief explanation is that the first farmers to arrive in northern Europe about 10,000 years ago lacked a good way of getting and processing calcium in their bodies. Those who could drink milk had a slight reproductive advantage over those who couldn't. (Women were more likely to survive childbirth, men were more likely to be healthy enough to father healthy babies.) The northern Europeans happened to be the ones who colonized America, so most people grew up thinking that the ability to drink milk was normal. Africans, as well as Asians and Native Americans, either had other sources of calcium, or could use the abundant sunlight to manufacture vitamin D in their bodies to help them process the calcium, so they didn't need to adapt to milk drinking.

    The situation is far more complicated than I can describe here, of course. There are African peoples who because of local conditions had the same dilemma as the Scandinavians and solved it the same way, by natural selection favoring those who drink milk. There is nothing about skin color that inherently determines whether you are LI or not. It's all a function of what your ancestors ate 10,000 years ago.

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Q. Have you heard of a dairy allergy with no other symptoms at all, except a badly upset stomach?

    Yes. There are two types of allergy. A "true" allergy is mediated by one particular antibody. All the others, or hypersensitivities, are mediated by other antibodies. Hypersensitivities to milk in children are likely to manifest themselves as gastrointestinal problems rather than as classic respiratory and skin problems. So it could be a reaction to the dairy protein rather than to the milk sugar. Your doctor should be able to test for this.
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Q. Can wheezing and a stubborn dry cough be a symptom of lactose intolerance?

    Not a chance. It's barely possible that the wheezing could be due to a dairy allergy (some people beleive that a dairy allergy can cause _any_ symptom), but that would really be reaching. Sometimes a cough is just a cough. If it lasts and lasts, see your doctor.
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Q. What is whey? I heard it was the byproduct or waste water from cottage cheese. I've noticed that cookies or items with whey seem to bother me more than others.

    Milk separates into lactose (milk sugar), whey proteins, casein proteins, water, fat, and a few vitamins and minerals. Most cheeses, not just cottage and other soft cheeses, are predominantly hardened casein. The remaining liquid is known as whey. It has some of the milk's proteins and almost all of the sugar. Commercial bakers love whey because it is indeed a cheap waste product, but one that gives a product many of the same nutritional and taste benefits of whole milk. Most commercial whey is dried, meaning that it is roughly 50-75% pure lactose and the rest mostly whey protein. If you are lactose intolerant, whey is one of the worst ingredients to encounter on a label. Most allergies seem to be to casein, but many people are allergic to the whey proteins as well. And of course, since the majority of the world's population is LI, by sheer chance many of them have protein allergies as well. It's not clear which is your problem, but you should avoid whey on a package label. See my SuperGuide to Dairy Products for more info on dairy.
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Q. If my wife is pregnant with a child with lactose intolerance, how dangerous can it be?

    For your wife, not at all. There is absolutely no danger to the pregnant mother at any time, in any way.

    As for the child, the only possible problem would be in the extremely rare case that the baby could not digest milk at all. Those babies will not thrive, and must be put onto a soy (or other non-dairy) formula immediately after birth to prevent starvation and dehydration. This is so incredibly rare, however, that most doctors have never seen a case. For all other babies, absolutely nothing would happen. All humans, just like all mammals, are genetically programmed to be able to drink their mother's milk. Human milk happens to be highest in lactose of all milks, about 7%. But all babies, even those who will become LI later in life, can drink it just fine.

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Q. Why does the lactase that is in me when I am born, decrease when I grow older?

    Here's what one researcher had to say:

    "Speculation as to why the lactose gene 'turns off' is a fascinating topic. One theory suggests that lactase deficiency evolved early in mammalian history, perhaps 75 million years ago, as a means to facilitate weaning and shorten the dependence of the child on the parent for lactation. The gas and diarrhea produced by lactose malabsorption would stimulate the child to become weaned. One competing theory suggests that lactose malabsorption in adults prevents competition of adults with infants for food (who can only digest milk early in life), and another theory proposes that lactose intolerance evolved as a defense mechanism against intestinal infections."

    In other words, nobody knows for sure.

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Q. My 80-year-old mother has been diagnosed as being LI. I've heard that it was unusual to have this happen so late in life. What do you know about this?

    It is unusual, but hardly unknown. Different people are genetically programmed to lose their ability to make lactase at different ages, that's all. (Unless she had some sort of intestinal disease or surgery that might have damaged her intestines. That can cause LI at any age.)
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