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Why Are Some People Lactose Intolerant? Expert Shares Management Tips

Lactose intolerance, a condition affecting a significant portion of the population, presents a challenge in enjoying dairy products due to difficulties in digesting lactose, a sugar found in milk and various dairy items. The root cause lies in the deficiency or absence of lactase, an enzyme vital for lactose digestion, which is predominantly produced in the cells lining the small intestine. This deficiency can stem from both genetic and non-genetic factors.

We spoke to our expert Dr Shweta Jaiswal, Senior Dietician - Sharda Hospital to shed some light on why only a few individuals are lactose intolerant and what are its management strategies. Here is what she shared with us.

Congenital Lactase Deficiency

In some cases, such as congenital lactase deficiency or congenital alactasia, infants face a critical inability to break down lactose from breast milk or formula. This condition manifests severely with symptoms like persistent diarrhoea. Prompt attention and action are crucial in such cases to avoid dehydration and weight loss, often necessitating the use of lactose-free infant formulas.

Lactose Intolerance in Adulthood

Beyond infancy, lactose intolerance can also develop due to diminished lactase production. This condition, termed lactase nonpersistence, commonly surfaces in adulthood. Individuals experiencing lactose intolerance may encounter distressing symptoms like abdominal pain, bloating, flatulence, nausea, and diarrhoea within 30 minutes to two hours post-consumption of lactose-containing dairy products.

Also Read: Optimising Protein Intake: Expert Shares Tips on Healthy Food Combination

Management Strategies for Lactose Intolerance

While lactose intolerance may not be preventable or curable, effective management strategies exist to alleviate symptoms and enable individuals to continue enjoying dairy products:

1. Gradual Introduction

Introduce small amounts of dairy into your diet progressively to gauge your body's tolerance. This method allows your system to adapt gradually and may reduce the severity of symptoms.

2. Combination with Other Foods

Pairing dairy products with other foods can aid digestion. For instance, consuming milk with cereal or incorporating dairy into meals alongside other food items may ease discomfort.

Also Read: Oestrogen Detoxification: Expert Shares A Comprehensive Guide to Hormone Balance and Wellness

3. Opt for Low-Lactose Options

Choose dairy products with lower lactose content, such as hard cheeses like cheddar, swiss, or parmesan. Additionally, cultured milk products like yoghurt typically contain less lactose and are better tolerated by some individuals.

4. Lactose-Reduced or Lactose-Free Alternatives

Explore lactose-reduced or lactose-free milk options available in the market. Alternatively, consider dairy milk alternatives like almond, soy, or flaxseed milk for beverages or cereal. These alternatives offer a lactose-free option without compromising nutritional value.

5. Label Reading

Prioritise reading nutrition labels to identify dairy products and ascertain their lactose content. Familiarising yourself with ingredients can help you make informed choices and avoid triggering symptoms.

By adopting these management tips, individuals with lactose intolerance can navigate their dietary choices effectively, allowing them to enjoy dairy products while minimising discomfort. It's essential to tailor these strategies to suit individual tolerances and preferences, finding the balance that works best for you.

A Final Word

Lactose intolerance poses challenges in consuming dairy products due to difficulties in digesting lactose, primarily stemming from insufficient lactase production. However, with appropriate management strategies such as gradual introduction, pairing with other foods, opting for low-lactose alternatives, and label reading, individuals can mitigate symptoms and continue incorporating dairy into their diets. By understanding the causes and implementing effective management techniques, individuals can maintain a balanced and enjoyable diet despite lactose intolerance.

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Dairy Innovations: IFF Shares Strategies For Developing Lactose-free Products, Low-sugar Yogurts

"We really believe in the dairy industry. We [realize] that plant-based is growing, but dairy is very important for us. And we are developing new innovations to help the dairy producers to overcome the challenges .... North America is a market that [is] growing ... And we will be supporting customers there," said Rossana Rodriguez, global marketing director of cultures and food enzymes at IFF. 

IFF boosts dairy capabilities with DuPont merger, predicts strong dairy demand

IFF has a range of dairy enzymes and cultures and a full portfolio of ingredients, including texturants, emulsifiers, proteins, fibers, flavors, colors, and sweeteners, to help develop dairy products. In 2021, IFF merged with DuPont Nutrition & Bioscience​, further bolstering its dairy capabilities, Rodriguez explained. 

"Three years ago, IFF and DuPont Nutrition & Bioscience got together, and that brought to IFF really a lot of dairy knowledge, more than a 100 years. We really know the application. ... We understand the equipment that our customers are using, we understand the technical challenges that they are they are facing, and we help them to overcome those challenges," Rodriguez said. 

IFF also assists brands in finding new areas of innovation with its "proprietary trend and foresight capability called Panoptic," Rodriguez said. Panoptic shares a range of market trends and data on health, wellness, food, nutrition, sensorial experience, and sustainability. 

Despite challenges facing the dairy industry from lower US production to global uncertainty​, IFF still predicts strong dairy demand globally, said Morten Boesen, business unit leader of cultures and dairy enzymes. However, consumer dynamics around the globe are changing, providing opportunities for the overall dairy market to grow and expand with new offerings, he said. 

"The dairy supply chain on a global level, I [see it] growing in the next many years, but you will see dynamics change," Boesen said. "In Europe, there's a lot of focus on having less animal production, including also less milk production in certain countries, so here you will probably see milk production going down in certain places, whereas in many emerging markets, it will still be growing because there is still a huge population that is not getting the amount of milk products they would actually like." 

Consumers seek out dairy products with 'an extra benefit'

As more consumers become knowledgeable of lactose intolerance, CPG brands can capitalize on the trend by creating innovative lactose-free products that go beyond milk offerings to include lactose-free ice creams and yogurts, Rodriguez said. The global lactose-free dairy market was valued at $11.45bn in 2021 and is expected to grow by an 8% CAGR from 2022 to 2031 to be worth $24.36bn, according to Allied Market Research​. 

"Globally, the market of lactose-free products has been growing very fast from 2016-2022, more or less," Rodriguez said. "Now, we see that it is stabilizing, so it is still growing but not as fast. ... [It] will continue growing because indeed it is still a small market, and we see that lactose intolerance worldwide is pretty high."

Additionally, consumers also want products that give "them an extra benefit" (i.E., functionality), she said. In 2021, IFF released Nurica​ in the US, a dairy enzyme that uses the lactose present in milk to create galacto-oligosaccharides (GOS) fibers, which reduces lactose and sugar levels. 

Addressing acidity challenges in creating a low-sugar yogurt 

CPG brands also can develop lower-sugar yogurts to tap into better-for-you demand, but will need to consider some key formulation considerations, Boesen said.  

"To have a well-tasting yogurt or fermented product, consumers typically do not like products that are too acidic, so a natural yogurt ... Can be quite tart and quite acidic. One of the ways you compensate for that is to add fruit and add a lot of sugar, honestly, because then you balance that acidity, and you make it nice and tasty. So, one of the problems of reducing sugar in that case is you get the acidity back," he added.   

Reducing sugar in yogurt applications comes with challenges to the mouthfeel and texture, which IFF can address with its portfolio of hydrocolloids and cellulosics​, Rodriguez noted. IFF can also "reduce sugar but keep the mouthfeel" in dairy applications by using dairy enzymes, like Nurica, Boesen said. 

CPG companies swapping out sugar with a non-caloric sweetener, such as stevia or monk fruit, might require additional flavors or flavor modulators to mask bitter off-notes, Rodriguez said.  

"We at IFF also have a lot of expertise on how to [mask these] off notes with our flavors portfolio and flavor modulators. We always say, 'Each challenge that the customer has, we have a toolbox of solutions,'" she said.  

Starbucks Intolerant Of Lactose Intolerance, $5m Lawsuit Alleges

Is charging extra for non-dairy milk an act of discrimination against people who are lactose intolerant?

This is the question three Starbucks customers are raising by filing a $5m class-action lawsuit against Starbucks for making customers who do not consume dairy pay more for their lattes and Frappuccinos.

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The three California customers – two from Los Angeles county, and one from Madera – are all lactose intolerant, and when they buy drinks at Starbucks, they are charged an extra fee of $0.50 to $0.80 per drink, according to a complaint filed in early March in a federal court in Fresno, California.

These menu surcharges violate the Americans with Disabilities Act, as well as a California civil rights law, the complaint alleges.

The coffee chain "created a separate, higher-priced menu, aimed at customers who cannot ingest milk", the lawsuit alleges, arguing that the extra cost of soy, oat, coconut or almond "milk" at Starbucks does not reflect substantially higher retail prices for the milk alternatives.

"Lactose intolerance is a protected disability under the ADA and state discrimination laws," Keith Gibson, an attorney for the plantiffs, said in a statement. "Millions of consumers are negatively impacted by Starbucks's illegal discrimination.

In a statement, a spokesperson for Starbucks said the company "cannot comment on pending litigation", but defended the company's current approach to charging for non-dairy milk.

"In US Starbucks stores, at no additional cost, customers can add up to four ounces of non-dairy milk to Hot or Iced Brewed Coffee or Tea, Cold Brew and Americano beverages," the company said in a statement. "Additionally, customers can choose to customize any beverage with a non-dairy milk on the menu for an additional charge; this is similar to other beverage customizations such as an additional espresso shot or syrup."

Several of the same attorneys in the Starbucks case previously filed similar class-action lawsuits against Dunkin' in December 2023, and against Starbucks in Florida in 2022. The Florida plaintiffs voluntarily dismissed their case against Starbucks early this March. The Los Angeles Times reported that one of their attorneys "would not say whether a settlement had been reached in that case".

Gibson said the attorneys had no comment on the Dunkin' and Florida Starbucks lawsuits.

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According to their complaint, the California customers suing Starbucks cannot ingest milk without suffering "stomach pain, digestive tract inflammation, bloating, bowel irregularities and vomiting". For them, "the use of these Non-Dairy Alternatives is not a choice."

The complaint argues that Starbucks offers low-fat, non-fat, and heavy cream dairy milk free of charge, and also modifies drinks free of charge if customers need less sugar or sugar-free beverages.

In response to the Dunkin lawsuit in December, Arlene Kanter, a leading expert in disability law at Syracuse University, told NBC News that its legal argument was a strong one.

"If a person qualifies as a person with a disability, and they're entitled to an accommodation or modification – which in this case looks pretty simple as non-dairy milk – they cannot be charged extra," Kanter said.

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