The view that prolonged abstinence from lactose minimizes the ability to produce lactase and thus digest lactose was a common view until recently. However, recent research into lactase activity casts doubt on this doctrine and opens up new avenues in the treatment of lactose intolerance. What is it? I took a closer look.
Eating lactose does not alter enzyme production
Studies show that the intake of lactose does not affect the activity of the enzyme lactase in the body. This means that people who produce little or no lactase do not experience any improvement in their enzyme activity through the consumption of lactose. The data suggest that the regulation of lactase activity is genetically determined. The problem is that these findings come from studies that usually only had a small number of participants.
Other studies have mainly been carried out on people who genetically produce little or no lactase. It would be interesting to extend these studies to people with different genetic backgrounds in order to obtain a broader range of results. In addition, the age at which people no longer tolerate lactose varies greatly between different population groups. It would therefore be interesting to investigate the genetic and epigenetic factors that trigger these changes.
Bacteria help with lactose intolerance
There are bacteria that live by eating lactose. We find them mainly as yogurt cultures. They produce a different lactase than we do, the so-called β-galactosidase. Yes, bacteria have a different lactase to us mammals! Incidentally, this is also the type of lactase that we find in the enzyme products . But why does this help us? It’s all about the so-called β-galactosidase activity. Certain bacterial species and strains have a higher β-galactosidase activity than others. The more bacteria we have with a higher activity, the better for us lactose intolerant people. However, if we eat a lactose-free diet for a longer period of time, these bacteria starve. And that is bad for us. If we eat a little lactose despite being lactose intolerant, we feed these bacteria, which in turn is good for us because we can tolerate more lactose and have other health benefits. However, this theory has not yet been fully clarified and requires further research. Sorry.
What does this mean for us?
Avoiding foods containing lactose is the most important therapeutic measure for people with lactose intolerance. In addition, taking lactase as an enzymatic food supplement and special probiotic strains with β-galactosidase activity can improve lactose tolerance and quality of life.
Anyway, I will continue to use lactase tablets when I go out or eat a slice of cake with cream. And I will continue to eat fiber in the form of legumes to feed my intestinal flora. And I will continue to consume smaller amounts of lactose. Especially after meals. And especially through non-lactose-free yogurt. Because that contains a little lactose and exactly the bacteria that have this kind of β-galactosidase activity.
Literature
- R. A. Forsgård, “Lactose digestion in humans: intestinal lactase appears to be constitu tive whereas the colonic microbiome is adaptable”, Am. J. Clin. Nutr. , vol. 110, no. 2, pp. 273-279, Aug. 2019, doi: 10.1093/ajcn/nqz104.
- A. Szilagyi, “Adult Lactose Digestion Status and Effects on Disease”, Can. J. Gastroenterol. Hepatol. , vol. 29, no. 3, pp. 149-156, 2015.
- F. Fassio, M. S. Facioni, and F. Guagnini, “Lactose Maldigestion, Malabsorption, and Intolerance: A Comprehensive Review with a Focus on Current Management and Future Perspectives,” Nutrients, vol. 10, no. 11, p. 1599, Nov. 2018.
