Can Lactose Intolerant Individuals Adapt to Enjoy Milk or Dairy Foods?

Including dairy products in the diet may result in colonic adaptation, allowing individuals to overcome symptoms of lactose intolerance.

It has been frequently observed that the symptoms of lactose intolerance disappear after prolonged periods of lactose intake in lactose intolerant people (1, 2, 3). Gilat et al. (4) reported on lactose intolerant individuals who consumed gradually increasing amounts of milk (up to 1 L/day) for one year as part of their usual diet. Some had symptoms initially, but all came to tolerate the milk without complaints. There was no increase in lactase activity, however, it has been suggested that prolonged consumption of lactose may favour colonic bacteria which don’t result in symptoms (5, 6). Thus, although the mechanism for this “colonic adaptation” to lactose has not been clearly demonstrated (5, 6), symptoms may be eliminated or reduced by eating small amounts of dairy foods each day (7, 8). Alternatively, individuals may be able to handle lactose containing foods, simply if they consume them with other foods (9).

References

1. Habte D., G. Sterky, B. Hjalmarsson.1973. Lactose malabsorption in Ethiopian children. Acta Paediatr. Scand.62:649–654.
2. Montgomery R.K., H A. Bueller, E.H.H.M. Rings, RJ. Grand.1991. Lactose intolerance and the genetic regulation of intestinal lactase-phlorizin hydrolase. FASEB J.5:2824–2832.
3. Reddy V.,J. Pershad.1972. Lactase deficiency in Indians. Am.J.Clin. Nutr. 25:114–119.
4. Gilat T., S. Russo, E. Gelman-Malachi, T.A.M. Aldor.1972. Lactase in man: a nonadaptable enzyme. Gastroenterology 62:1125–1127.
5. Arrigoni E., P. Pochart, B. Flourie, P. Marteau, C. Franchisseur, J.C. Rambaud.1992. Does a prolonged lactose ingestion induce clinical and colonic metabolism adaptations in lactose intolerant subjects? Gastroenterology 102:A197.
6. Hertzler S., D A. Savaiano.1993. Colonic metabolism and lactose tolerance. FASEB J.7 A583.
7. Savaiano D A.1994. Lactose intolerance:dietary management. In: Dairy Products in Human Health and Nutrition. M. Serrano Rios, A. Sastre, M.A. Perez Juez, A. Estrala, C. de Sebastian (eds.). Rotterdam, Netherlands: A.A. Balkema. pp.401–405.
8. Scrimshaw N.S., E.B. Murray.1988. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am. J. Clin. Nutr.48 (suppl.): 1083–1159.
9. Suchy FJ, Brannon PM, Carpenter TO< Fernandez JR, Gilsanz V, Gould JB, Hall K, Hui SL, Lupton J, Mennella J, Miller NJ, Osganian SK, Sellmeyer DE, Wolf MA. NIH Consensus Development Conference Statement: Lactose Intolerance and Health. NIH Consens State Sci Statements. 2010. Feb 22-24; 27(2): 1-27.