Understanding Lactose Intolerance and Lactase Deficiency
Lactase is an enzyme produced in the small intestine that breaks down lactose, the sugar found in milk, into simpler sugars (glucose and galactose) for the body to absorb. The user query, "How to decrease lactase?", stems from a misconception about the underlying biology. For most people worldwide, the body's production of lactase naturally and genetically decreases after infancy, a condition known as lactase non-persistence. This is a normal process and not something that needs to be actively reduced. The discomfort of lactose intolerance—bloating, gas, and diarrhea—occurs when undigested lactose reaches the colon and is fermented by bacteria. The focus should therefore be on managing these symptoms, not trying to lower an already deficient enzyme level.
Types of Lactase Deficiency
- Primary Lactase Deficiency (Lactase Non-Persistence): This is the most common type, where lactase production declines with age after early childhood. The severity varies greatly among individuals.
- Secondary Lactase Deficiency: This can happen at any age due to an injury, illness, or surgery affecting the small intestine. Causes include celiac disease, Crohn's disease, or gastroenteritis. Treating the underlying condition can sometimes restore lactase levels.
- Congenital or Developmental Lactase Deficiency: A very rare genetic disorder where infants are born with no or very little lactase. Premature infants can also have temporary deficiency.
Practical Dietary Strategies for Managing Symptoms
Managing lactose intolerance effectively involves a combination of dietary control and supplementation. The key is to reduce the amount of undigested lactose that reaches the colon.
Reduce Overall Lactose Intake
One of the most effective ways to manage symptoms is to limit the amount of lactose-containing foods and drinks. This does not always mean complete elimination, as many people can tolerate small amounts. Keep a food diary to identify your personal tolerance level.
Choose Dairy Products with Lower Lactose
Not all dairy products contain the same amount of lactose. Fermentation and processing can significantly reduce the lactose content, making some options easier to digest.
- Hard and Aged Cheeses: Cheeses like cheddar, Parmesan, and Swiss have very little to no lactose.
- Cultured Dairy: Yogurt with live and active cultures contains bacteria that help break down lactose.
- Fermented Milk Products: Kefir, a fermented milk drink, is also often well-tolerated.
Use Lactose-Free Dairy Alternatives
Many dairy products are available in lactose-free versions, where lactase enzyme has been added to break down the lactose during processing.
- Lactose-Free Milk: A common and excellent alternative to regular milk.
- Plant-Based Milks: Alternatives like soy, almond, oat, and coconut milk are naturally lactose-free and often fortified with calcium.
Eat Dairy Products with Other Foods
Consuming lactose-containing foods as part of a larger meal can slow down the digestive process, giving your body's limited lactase more time to work. This can help reduce symptoms like bloating and diarrhea.
Tools and Supplements for Symptom Management
Lactase Enzyme Supplements
Over-the-counter lactase supplements, available in tablets or drops, contain the lactase enzyme that your body is lacking.
- Tablets/Capsules: Take these supplements right before or with your first bite of a dairy-containing meal.
- Drops: These can be added directly to a carton of milk and left to sit, allowing the enzyme to break down the lactose before you drink it.
The Role of Probiotics
Probiotics are live bacteria and yeasts that are beneficial for your digestive system. Consuming probiotics may help some people manage symptoms by contributing to lactose digestion in the gut. This is one reason why many people can tolerate yogurt with live cultures.
Comparison of Dairy Products
| Dairy Product | Typical Lactose Content | Tolerance Level (for intolerant individuals) |
|---|---|---|
| Milk (Cow's) | High (approx. 12g per cup) | Low |
| Hard Cheese (Cheddar, Parmesan) | Very Low to None | High |
| Yogurt (Live Cultures) | Lower than milk (bacteria aid digestion) | Variable, often high |
| Ice Cream | High (higher in lactose than milk) | Low |
| Lactose-Free Milk | Virtually None | High |
| Butter | Low (mostly milk fat) | Variable, often high |
| Cottage Cheese | Moderate | Variable, often low |
Conclusion: Managing, Not Decreasing, Lactase
In conclusion, attempting to decrease lactase is not the correct approach to addressing the symptoms of lactose intolerance, as the condition is caused by a natural or temporary decline in the enzyme's production. The focus should instead be on proactive symptom management. By understanding which dairy products are lower in lactose, using lactase enzyme supplements strategically, and incorporating probiotics, individuals can effectively manage their condition. Exploring the wide array of lactose-free and plant-based alternatives also provides a simple way to avoid symptoms while maintaining a balanced diet.
For more detailed information on dietary approaches, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) offers comprehensive resources. Lactose Intolerance - Eating, Diet, & Nutrition.
Disclaimer: Always consult a healthcare provider or a registered dietitian before making significant changes to your diet or starting new supplements, especially if you suspect an underlying medical condition.
