Milk is good for you, right? Not always.

For nearly 50 million U.S. adults suffering from lactose intolerance, drinking milk or eating dairy products may result in bloating, cramps, diarrhea, and gas.

But the story doesn't miserably end there. With careful diet planning, the effects of lactose intolerance can be minimized.

"Lactose intolerance is your body's inability to digest lactose, the natural sugar found only in dairy products," says Warren Bishop, M.D., UI Health Care pediatric gastroenterologist. "It is caused by a shortage of the lactase enzyme that normally breaks down this sugar into simpler forms."

Lactose intolerance is not the same as an allergy to milk. People with milk allergies have symptoms caused by milk proteins as opposed to milk sugar. Symptoms of milk allergy include respiratory problems, diarrhea, vomiting, and rashes.

Because most mammals do not drink milk after weaning, they are programmed to lose the ability to digest lactose. This is true in many humans as well. However, Bishop says, adults of Northern European ancestry are more likely to digest milk well because of the importance dairy products played in survival in early Europe.

People from other parts of the world have more trouble digesting lactose as adults. An estimated 75 percent of African Americans, Jewish, Native Americans, and Mexican Americans, and 90 percent of Asian Americans experience lactose intolerance, whereas only five percent of Danish adults have symptoms.

"Adult lactose intolerance is normal and cannot be reversed," Bishop says. "The symptoms can be controlled through wise diet choices&emdash;avoiding too much milk and cheese and choosing yogurt as a source of dairy protein and calcium."

Over-the-counter lactase drops and over-the-counter lactase supplements can also help digestion.

If you eliminate milk and dairy products from your diet, you must supplement your diet to replace the missing nutrients, especially calcium if you are a child or woman. Many non-dairy foods are high in calcium including:

• Green vegetables like broccoli and kale
• Fish like sardines, salmon, tuna
• Pinto beans
• Calcium fortified juices

In most cases, yogurt with active cultures can be a good source of calcium. The bacterial cultures used in making yogurt produce some of the lactase enzyme needed for digestion.

If you really crave cheese, Swiss cheese has only one gram of lactose per ounce. As cheese ages, the lactose is gradually eliminated by natural bacteria.

There are no hard and fast rules about lactose intolerance. What one person can tolerate, another may not. Check with a registered dietitian, your family physician, or call a UI Family Care physician to learn more about lactose intolerance and meal planning to fit your life.

Call UI Health Access at 800-777-8442 or 319-384-8442.

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Lactose is often added to prepared foods. You have to read food labels to protect yourself from additives that lead to the symptoms of lactose intolerance. Foods that may contain lactose include:

• Bread and other baked products
• Processed breakfast food
• Instant potatoes, soups, breakfast drinks
• Margarine
• Lunch meats (other than kosher)
• Dips and salad dressings
• Mixes for pancakes, biscuits, and cookies
• Soups and sauces
• Mousses and other desserts

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