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Lactose intolerance is a chronic problem that has to be dealt with for the rest of a person's life. What is lactose and why are some people intolerant of it? How can they change their diet to deal with this condition. Lactose is a natural sugar found in milk ( glucose and galactose bound together). In the small intestine, lactase, an enzyme, works to split the bond between the glucose and galactose. This is done to break apart all lactose molecules ingested in the milk. The intestinal walls can absorb glucose and galactose, but not lactose so it must be split apart.
If you have lactose intolerance what is really happening is you do not have the lactase, or the natural enzyme, to break apart the lactose so it can be digested. The lactose, in a person without the ability to break it down, will just sit in their stomach and get sour. Or in other words, bacterial fermentation will produce gas causing pressure on the intestinal wall. The intestine tries to get rid of the gas with contractioning and bringing in fluid. Painful, crampy diarrhea is the result. These symptoms usually show up within 24 hours of eating a food high in lactose.
During the fermentation of milk to make products such as yogurt, chesse, sour cream, buttermilk and cheese the bacteria or yeast in the fermentation produces enzymes that break down lactose. This would make these foods easily digested by people who are lactose intolerant because the lactose is already broken down. But today, with modern food engineering, dairy products are modified so much that they no longer use the fermentaion process and are no longer o.k. for a those who are lactose intolerant to eat. Often powdered milk is added to the already fermented product to thicken it. Read labels very carefully to ensure the product is designated as "cultured" or natural. Sweet creamery butter, made in the U.S., can also contain lactose, depending on the way it's made, but "European" or "cultured" butter is usually low in lactose because fermented cream is used in the process. Using margarine as a substitute for butter is probably the safest idea.
If you like buttermilk then cultured buttermilk is usually safe, however it's still good to check the label to make sure that it isn't just milk soured chemically with some acidic ingredient.
Cream cheese products are often high in lactose, but making safe cream cheese is easy.
Place a pint of "cultured" sour cream into a coffee filter and let it drip into a measuring cup for 18-24 hours or until it is firm. You need not refrigerate this while it's filtering.
Just cover it lightly with a paper towel to keep out the dirt. The bacterial action at room temperature will further decrease the lactose.
Processed cheeses are made by chemical coagulation and should be be avoided. Since most fast food restaurants use processed cheese, cheese burgers are out, unless they specifically say cheddar is used.
Most cheeses, like cheddar, are low in lactose because they are products of microbial fermentation, followed by some form of aging or curing. If in doubt about a cheese, look to see if it has holes in it or is flakey, because the microorganism produces gas during the fermentation process and this indicates that it is safe to eat.
Cottage cheese, theoretically, should be low in lactose since it's traditional preparation is heating fermented milk until the curds clump. However most cottage cheeses sold in the U.S. today are "creamed", meaning that cream, milk or milk solids are added to the cottage cheese. If you like cottage cheese use cultured dry cottage cheese that is quite safe to use as an ingredient in a lactose free diet.
Check with your doctor for further information. If you are lactose intolerant, you need to have professional diet counseling.
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