California dairy body provides guidance for lactose intolerant kids

The move by the Dairy Council of California comes a week after the American Academy of Pediatrics (AAP) announced that that lactose intolerance in children should be managed by adjusting dairy food choices and eating patterns, rather than eliminating dairy products from the diet.

Lactose is the primary naturally occurring carbohydrate found in cow's milk. Lactose intolerance manifests itself due to a relative or absolute absence of the enzyme lactase in the small intestine, which prevents metabolism of lactose.

It is a clinical syndrome with symptoms including abdominal pain, diarrhoea, nausea, flatulence, and/or bloating after ingesting lactose-containing substances. The condition should not be confused with milk allergies, which is an immune response.

Because the lactose is not absorbed in the gut, it can draw fluids into the intestine by osmosis, which produces softer stools (diarrhoea), and the carbohydrate can be metabolised by certain intestinal bacteria that produce carbon dioxide, methane and hydrogen as waste products, thereby leading to flatulence.

Such uncomfortable symptoms lead many to avoid dairy products, but this has a negative effect on the intake of calcium and vitamin D in children and adolescents that has serious implications for bone health.

According to AAP, avoidance of dairy products may lead to inadequate calcium intake and consequent suboptimal bone mineralization. It recommends the incorporation of dairy foods into the diet to ensure children do not miss out on these essential nutrients.

In response to the article published in the journal Pediatrics​, the Dairy Council of California this week provided suggestions on how to help lactose intolerant children increase their dairy intake to three servings a day, or four servings for adolescents.

These included consuming swiss or cheddar cheese slices with whole-grain crackers; combining plain yoghurt with dry soup mix as a dip; and consuming a yogurt-bran breakfast.

Research has shown that yoghurts containing live cultures are well tolerated by people with lactose intolerance because the bacteria partially digest the lactose into glucose and galactose before the yoghurt is consumed.

And aged cheeses such as swiss and cheddar are also known to have lower lactose contents than other cheeses.

"Dairy products remain principle sources of protein and other nutrients that are essential for growth in children,"​ wrote the AAP last week.

Lactose intolerance differs greatly between populations. In northern Europeans, for example, where dairy food consumption is common, as few as two per cent of the population can be lactose intolerant. In Asians, Hispanics and blacks, however, the prevalence is said to be 100, 65 and 70 per cent, respectively.