The Chocolate Milk Conspiracy

Does your kid love chocolate milk, but vow that “regular” milk makes her tummy hurt? When I told MY parents this, they laughed and assumed I was milking the system for more sweets. As I grew older, I realized that certain dairy products battled my GI tract, while others peacefully coexisted. Pizza was fine, but a milkshake? Not so much.

Well, guess what? That kid chugging chocolate milk and avoiding regular milk may simply be lactose intolerant. Hold on-doesn’t chocolate milk have the same amount of lactose as regular milk? Yes, but…

Lactose intolerance refers to the inability to digest lactose (the main milk sugar). Lactase- the enzyme that breaks down lactose- lives on the inside surface of our intestines. Symptoms typically appear 30 minutes to 2 hours after consuming a product that contains lactose. The degree of symptoms produced (abdominal bloating, cramping, gas and/or diarrhea) depends on several variables:

1. The AMOUNT of lactose consumed
2. The LEVEL of lactase enzyme present
3. The SPEED of gastric emptying- the FASTER the gut transit, the WORSE the symptoms

Higher fat content SLOWS gastric emptying, which reduces the symptoms, so voila! Your explanation for the chocolate milk: more fat content-> slower gut processing -> fewer symptoms. Of course, adding lactase in the form of a powder or capsule will also reduce the symptoms, so no, I’m not advocating adding chocolate to every glass of milk.

Who gets lactose intolerance? 80% of Blacks and Hispanics, nearly 100% of Native Americans and Asians, and roughly 15% of Caucasians develop it. Symptoms usually appear later in childhood or even as an adult. Also, everyone may transiently develop lactose intolerance after a serious bout of diarrhea, because that temporarily damages the lining of the gut (which houses the lactase enzyme). Avoiding dairy products for a few days while the gut lining recovers typically takes care of this type of intolerance.

The easiest way to tell if you have lactose intolerance is to temporarily ELIMINATE LACTOSE from your diet, and see if your abdominal complaints disappear. Remember, though, to read labels carefully, looking for “milk sugar, whey, or curd” as well as plain “milk”. Note, too, that many prescription and OTC medications also use lactose as a base. Typically, however, even a lactose intolerant person is fine with SOME lactose (roughly 12 g) so it is not necessary to eliminate lactose 100% to see results.

If it turns out you are indeed lactose intolerant, remember you will still need calcium to protect your bones, so talk with a registered dietician to be sure you are getting all you need.

BOTTOM LINE: Lactose intolerance is all about degrees, not simply “yes, you have it” or “no, you don’t”. If you’re having abdominal complaints, schedule an appointment to talk with your doctor, and meanwhile, consider giving up dairy/lactose for a few days to see if your symptoms improve .

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