Novel Method to Mitigate Lactose IntoleranceNovember 2013
By William Lancaster
The majority of the world’s population—often starting before age five—experiences a decrease in the intestinal enzyme lactase, which creates digestive problems.
Left untreated, lactose intolerance—the inability to digest lactose—can lead to nutritional deficiencies.1,2
Milk products are found in a wide range of foods. People with lactose intolerance have to carefully avoid milk products to prevent diarrhea, gas, nausea, abdominal bloating, and cramps.
To mitigate this problem, researchers in Europe have developed an advanced lactase enzyme formulation that targets the underlying cause of the problem—and helps restore the ability to digest lactose!3,4
This novel enzyme, called neutral lactase, acts in the small intestine, instead of the stomach.5 This gives the digestive system much longer exposure to lactose-degrading molecules than conventional products!3
In this article, you’ll learn how neutral lactase breaks down more lactose, helping to prevent the painful and embarrassing digestive symptoms of lactose intolerance.4
Lactose Intolerance and Nutritional Deficiencies
All humans are born with the ability to drink and digest milk, which makes the abundant nutrition in milk readily available to newborns and young children.
But as we grow older, our levels of the digestive enzyme lactase decline. The result is that some of us lose our ability to break down lactose, the major sugar in milk.6 That makes sense, since in nature, milk consumption ends at weaning.
The only human populations that continue to consume liquid, unfermented milk in sizable quantities are those from Northern Europe and the northwestern territories of the Indian subcontinent.7 But even in those groups, and people descended from them, the prevalence of lactose intolerance hovers around 25%—and in other ethnic groups, can affect up to 90% of the adult population!6,7 That’s a huge number of people who suffer significant gastrointestinal upset from milk products!
In fact, lactose intolerance and the resulting avoidance of milk products is a known risk factor for osteopenia, the steady loss of bone mineral content that leads ultimately to osteoporosis.8,9 It is regrettable that doctors don’t better advise patients with lactose intolerance to supplement with bone-protecting nutrients such as vitamin D, calcium, magnesium, and vitamin K2.
How Lactose Intolerance Develops
The biology of lactose intolerance is simple. But it is devastating in its consequences.
Milk always contains a sugar called lactose.10 In fact, a liter of milk contains about 50 grams of lactose—that’s about 12 grams per cup.11 Lactose is composed of two simple sugars: glucose, the most common sugar in the world, and galactose, a sugar found primarily in milk products.12 Each lactose molecule consists of one molecule of glucose and one of galactose, bonded together.
Lactose by itself can’t be absorbed in the human small intestine. The two component molecules, glucose and galactose, must first be split by a special enzyme—lactase.6,10
Lactase is found in the tips of the cells lining the small intestine, which are directly in contact with intestinal contents.13 As lactase goes to work, glucose and galactose are separated from one another—and then each is separately absorbed (Figure 1).6,13
So the material that finally reaches the large intestine, or colon, is normally free of lactose, allowing colonic bacteria to live normally (Figure 2).
Newborns and toddlers have ample supplies of lactase in their intestines. That means they can readily digest lactose— along with the various other important nutrients contained in milk.6
But as they age, most children—and virtually all of those not from Northern European ancestry—lose much of their original lactase enzymes. By the time most of these children reach adulthood, lactase levels are very low.6
When a lactase-deficient person ingests lactose-containing milk products in quantities of more than about two cups per day, the small amount of lactase enzyme simply can’t deal with all of the lactose.14
And what happens next can be extremely distressing.
First, the undigested lactose in the small intestine draws water and electrolytes out of the bloodstream by osmosis. All that water dilates the small intestine, causing bloating.6
The dilated small intestine speeds up the rate of peristalsis—or wavelike contractions—of the small intestines, producing cramping. This faster rate of peristalsis means that undigested food moves more rapidly through the small intestine, further impeding normal nutrient absorption. This triggers still more fluid loss as well as bloating and cramping.6
Once this mass of undigested material reaches the large intestine, colonic bacteria attack the intact lactose and digest it themselves. That process generates odorous hydrogen, methane, and carbon dioxide, along with short-chain fatty acids (Figure 3).6,13 This causes more bloating and discomfort, accompanied by the release of these gases in the form of flatulence.15
Finally, all that excess water, gas, and undigested food produces the signature symptom of lactose intolerance: watery, often “explosive” diarrhea.16
Diagnosing Lactose Intolerance
The majority of people with lactose intolerance never undergo formal testing to make the diagnosis. Physicians typically think they recognize the symptoms and often recommend a “lactose-free” diet.13
Alternatively, since lactose intolerance runs in families, many people simply assume they have the condition because of a parent or relative.13
Several laboratory tests exist that can be used to diagnose lactose intolerance. A small intestinal biopsy can allow direct measurement of the enzyme, but this test is invasive, uncomfortable, and expensive—and may not be entirely reliable.13
The “hydrogen breath test” has been developed, which is relatively cheap and quite simple. After ingesting a known amount of lactose, a person simply breathes into a device that measures exhaled hydrogen, one of the byproducts of lactose malabsorption.17 The higher the hydrogen levels in the exhaled breath, the worse the lactose intolerance is.17
Hydrogen breath testing is now used in most studies of treatment of lactose intolerance to determine treatment effectiveness. It is the gold standard in clinical practice to diagnose patients with lactose
Let’s now look at standard treatment of lactose deficiency to understand what sufferers are up against.