Heithffitlless
•
OTO BY CRAI G TERKOW
The Myth
Cl.
It hits in the teen years. It can make
you miserable. But lactose intolerance
is a common human condition.
RUTHAN BRODSKY SPECIAL TO THE JEWISH NEWS
C
aryn Langbaum
watches what she
eats. But at 5 feet 4
and 120 pounds,
Caryn isn't counting
calories as she would
on a weight loss diet.
Nor does she follow a
low cholesterol diet, calculating
grams of fat. Instead, Caryn
worries about milk, cheese and
ice cream as well as less obvi-
ous foods that contain milk like
bread, cake and chocolate.
Like an estimated 50 million
Americans, Caryn, a 22-year
old law student, is lactose in-
tolerant. While there is no de-
mographic breakdown of that
figure for American Jews, Dr.
Jay Perman, director of pedi-
atric gastroenterology and nu-
trition at the Johns Hopkins
School of Medicine, estimates
that 70 percent of Jews world-
wide are lactose intolerant.
That may sound high but, ac-
cording to the experts, lactose
Ruffian Brodsky is a medical
writer in Bloomfield Hills.
intolerance isn't a "Jewish dis-
ease." In fact, it isn't a disease
at all but a condition that affects
most of the world's population.
Caryn, who was diagnosed
five years ago, takes lactose
tablets before eating certain
foods and drinks Lactaid milk
(a lactose-reduced product) in-
stead of regular or skim milk.
These restrictions don't both-
er her unless she forgets to take
her tablets when she goes out.
"Then I have to decide, do I eat
whatever and get a stomach-
ache and have to deal with it,
or don't I?" she said.
What causes lactose intoler-
ance? Lactose is a sugar that is
naturally found in most dairy
products. Normally, an enzyme
called lactase breaks down lac-
tose in the small intestine into
two component sugars, called
glucose and galactose. These
sugars are much easier for the
human body to digest.
Experts quoted in the Jour-
nal of Clinical Nutrition define
lactose intolerance, the inabili-
ty to digest lactose (a.k.a. milk
sugar), as resulting from a de-
ficiency of the lactase enzyme.
Eating foods containing lactose
causes symptoms of abdominal
cramps, diarrhea and gas.
If a person is lactose intoler-
ant, the condition often appears
in the teen-age and young adult
years, as Caryn's did.
Infants manufacture
lactase in order to digest
their mothers' milk. How-
ever, lactase levels start
declining between the ages
of 2 and 7. By the time
most of us hit puberty or
late adolescence, we make
about 10 percent less lac-
tase than we did as babies.
Thus, as we age our abili-
ty to digest lactose de-
clines.
But not everyone whose
lactase level declines de-
velops lactose intolerance.
What separates those who
get it from those who don't
is hereditary — a genetic
programming, say the ex-
perts. Those who don't get
it also have a reduced lev-
el of lactase, but their di-
gestive systems can
function without symp-
toms on this lesser
amount.
The good news is that
lactose intolerance doesn't
get progressively worse. The
bad news is that it's for life.
Dr. Robert Strauss, assistant
professor of medicine, division
of digestive diseases at Emory
University School of Medicine,
Atlanta, explained, "Lactose in-
tolerance does not go away as
we get older, nor does it get
worse with aging. Whatever the
level of lactose a person devel-
ops during childhood usually re-
mains with them as adults.
However, changes that do take
place with age, such as an in-
crease in irritable bowel syn-
drome, can worsen the
symptoms."
Why lactase production de-
clines is not known. But people
from northern Europe (and
their descendants), who have
historically depended on herd-
ing and dairy products, are re-
markably free of the condition.
Experts estimate that only
about 5 percent of this popula-
tion experiences lactose intol-
erance.
However, more than 90 per-
cent of the people (and their de-
scendants) from Asia, Africa
and the Mediterranean area are
lactose intolerant.
Dr. Ann Silverman, director
of gastroenterology and hepa-
tology research at Beaumont
Hospital in Royal Oak, says
that while there seems to be a
high proportion of lactose in-
tolerance among Jews, "it's not
because they're Jewish but be-
cause Jews can trace their an-
cestry to the Mediterranean
area where lactose intolerance
is typical. Being lactose intol-
erant doesn't make the Jewish
population unique except when
compared to people who trace
their ancestry to Northern Eu-
rope."
While the most common
cause of lactose intolerance is
genetics, there are other caus-
es. One is damage to the small
intestine's lining resulting from
a disease like inflammatory
bowel disease, Crohn's disease
or even the flu. This is often a
temporary condition; once the
damaged cells recover, they be-
gin producing lactase again.
According to Robert Trading,
director of pediatric gastroen-
terology, also at Beaumont Hos-
MYTH page 18
The Familiar & The Hidden
Familiar Foods With Lactose
• Milk (whole, low-fat, skim, buttermilk)
• Cream; dried or condensed milk; milkshakes
• Cocoa mixes
• Ice cream; ice milk
• Processed cheese; cottage cheese; low-fat
cheese
• Sour cream; yogurt
•Hidden Offenders
• Breads; baked goods
• Breakfast cereals containing milk solids;
breakfast drinks
• Mixes for pancakes, cookies, biscuits
• Instant potatoes; frozen vegetables with sauces
• Salad dressings
• Milk chocolate candies; butterscotch; toffee
• Pie filling; custard; frozen yogurt
• Artificial sweeteners; gravy; margarine; mo-
lasses; spice blends
• Dietetic and diabetic products
• Prescription and over-the-counter medications
such as oral contraceptives and antacids
Note: Check labels carefully to determine if prod-
ucts contain milk or milk byproducts like sodi-
um caseinate, whey, nonfat dry milk solids or
lactalbumin. ❑
Eli