What's the Difference Between Allergy and Intolerance?

The difference lies in how your body handles the offending food. A food allergy affects the body’s immune system; a food intolerance generally affects the body’s metabolism. In other words, the body cannot properly digest a food or food substance, resulting in “intestinal chaos”—a.k.a. the gurgles.

What’s Lactose Intolerance All About?

If you can’t stomach milk and you experience bloating, nausea, cramping, excessive gas, or a bad case of the runs after eating a dairy food, you are not alone. In fact, an estimated 30 to 50 million Americans suffer from some degree of lactose intolerance, which is the inability to digest the milk sugar lactose. In fact, I once had a client tell me he visited so many restrooms while touring through Europe he was ready to write The Complete Idiot’s Guide to European Bathrooms.

Why can’t some people tolerate dairy foods? People who are lactose intolerant are unable to produce enough of the enzyme lactase, which is responsible for the digestion of lactose. Just imagine trying to tear down a skyscraper without a bulldozer; it’s not gonna happen! Just like the bulldozer, lactase must break down, digest, and absorb lactose in the blood-stream. What’s more, this type of intolerance affects people at different levels. Whereas one person might dash for the bathroom after just one sip of milk, others can tolerate small amounts of dairy without any problem.

Who generally tends to have a problem digesting milk?

• Up to 70 percent of the entire world’s population does not produce enough of the enzyme lactase and therefore has some degree of lactose intolerance.
• In the United States alone, the following groups experience some or all symptoms of lactose intolerance:
• More than 80 percent of Asian Americans
• 79 percent of Native Americans
• 75 percent of African Americans
• 51 percent of Hispanic Americans
• 21 percent of Caucasian Americans
• In rare cases, some people are born unable to produce the enzyme lactase due to a congenital defect.
• Following gastric surgery, people taking chronic antibiotics or anti-inflammatory drugs might also lose their ability (both short-term and long-term) to digest lactose.
• People might develop a temporary lactose intolerance during or following a bout of the flu, a stomach virus, or irritable bowel (spastic colon). During these instances, your doctor will probably tell you to avoid all milk and dairy because the enzyme lactase is easily destroyed with any stomach irritation. In these cases, when you recover, so does your ability to produce lactase.

Living with a Lactose Intolerance

The following tips are helpful for people who have difficulty digesting lactose. As mentioned earlier, the degree of lactose intolerance can vary from person to person; therefore, not everyone will be able to handle all of the suggestions. Give them each a shot, but be sure that you’re in a comfortable place if some seem a bit risky. Keep in mind that lactose-containing foods are generally your best sources for the mineral calcium, so children and women with increased calcium requirements should load up on the nondairy sources and speak with a registered dietitian about the possibility of calcium supplementation.

• Carefully look through the list of food ingredients and check for obvious and disguised lactose, including milk, cheese, cream, margarine, sour cream, milk solids, milk chocolate, whey, curds, malted milk, and skim-milk solids. Remember that people with severe lactose problems might not be able to tolerate even the small amounts in pancakes, biscuits, cookies, cakes, instant potatoes, salad dressings, sauces, gravies, lunch meats, soups, powdered coffee creamers, and whipped toppings.
• Be aware that a lot of over-the-counter medications have added lactose. Speak with your pharmacist if you’re not completely sure.
• Although most lactose-intolerant people can’t gulp down a straight glass of milk, some can tolerate smaller amounts of dairy combined with other foods. For instance, try a bowl of cereal with fruit and milk, or a slice of pizza with a lot of veggies (easy on the cheese), or a ham sandwich with one slice of cheese.
• Some people with lactose intolerance can tolerate yogurt because the bacteria in the yogurt actually metabolizes the milk sugar lactose for you.
• Also try cultured buttermilk and sweet acidophilus milk. Some folks find them easier to digest than regular milk.
• When real ice cream is a lethal poison, try a nondairy substitute such as Toffuti or Rice Dream.
• Stock up on special lactose-reduced products, including Dairy Ease and Lactaid milk, cottage cheese, yogurts, cream cheese, and ice cream.
• Try the special tablets and drops that you can add to regular milk; they will almost completely break down the lactose after about 24 hours in the fridge.
• Also look for the special lactase enzyme pills in your pharmacy that you can swallow before eating or drinking a dairy product. This comes in handy when you think you might encounter a difficult situation.
• Try taking probiotic supplements. The term probiotic refers to several active cultures that may help promote healthy digestion.
• In severe cases, even the lactose-reduced products might not be tolerated. But don’t cheat your body of calcium just because you can’t stomach the dairy. Buy calcium-fortified juice, calcium-fortified soymilk, and any other calcium-fortified food products you can get. Note: definitely speak with your physician or a registered dietitian about calcium supplementation.

Excerpted from The Complete Idiot's Guide to Total Nutrition © 2005 by Joy Bauer. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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