Intolerância à Lactose Não é Alergia

Lactose Intolerance is Not Allergy

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Lactose-free products are increasingly common in the market, but do you know what Lactose Intolerance really is and its causes? Come and I explain it easy for you!.(Photo: Kt Rb / Unsplash)

In recent years we have increasingly heard of restrictive diets and the best known pair is: gluten-free and lactose-free. And they can come together with different terms, in this case, Lactose Intolerance.

However, in the vast majority of the discussion is the bias of fitness, it is in that realm of miraculous ideas of weight loss (spoiler: there is no miracle) and with somewhat misinformation.

Let's look at the pot of truth: what is lactose? what is Lactose Intolerance?

As always, in the end has the summary with the Very Long; No Li.

Is Lactose intolerance allergy?

Not a big go. No. Intolerance and allergy are totally different things. The functions of the body involved in each are not the same. Keeping the proper proportions, allergy is an exaggerated response while intolerance is the lack of a response.

And yes, what can happen is allergy to the proteins in milk, usually casein. But again, it is a picture that has nothing to do with lactose intolerance. Are we agreed? Then I can move on!

David Tennat: Oh, yes!

What is Lactose ?

FoodLab: Lactose

A type of sugar (carbohydrate).

It consists of two simpler sugars: galactose and glucose. It is classified as a disaccharide : di two, sacid ? relating to sugar/carbohydrate. And chic name is: ?-D-galactopyrateose-(1?4)-D-glycopyranosis.

Within the same category we have sucrose (table sugar, glucose and fructose) and maltose (glucose and glucose), for example.

The main source is milk, the amount varies according to the species of animal (mammal). In the cow it is around 5% and in the human being 6.8%. In the biological context, it is the main sugar in the nutrition of puppies.

What is Lactose Intolerance?

Lactose intolerance refers to syndrome with one or more symptoms arising from the consumption of lactose and/or foods containing sugar. The most common are abdominal pain, diarrhea, nausea, gas and bloating. These happen when lactose digestion is not possible.

This condition is caused due to the absence and/or insufficient amount of lactase, an enzyme responsible for breaking down the lactose molecule. It is produced by the cells of the small intestine and located on the surface of it.

It can also be seen as the malabsorption of lactose that triggers intolerance. An imbalance between the amount of lactose consumed and the capacity of the enzyme.

Intolerance can be classified as:

  • Primary lactase deficiency: it is the complete or relative lack of lactase that can develop at different ages, usually in childhood and adolescence. It is the main cause in the population and the focus of the text.
  • Secondary lactase deficiency: it was caused by some injury to the small intestine, such as: acute inflation, persistent diarrhea, chemotherapy or any other cause that has hurt the organ. It can happen at any age.
  • Congenital lactase deficiency: the rarest of all in which the genes responsible for lactose production are not expressed (read: do not stay active) from birth. The baby may not consume breast milk or any other food that has lactose.

Causes and Reasons

In a generic way, the production of lactase begins to decay in mammals from weaning and the introduction of other foods. During adulthood, there is no longer consumption of milk. Except for the human being. In time: there should probably be some other rare animal that drinks milk during the mature phase, but to simplify we will disregard it.

The decrease in the production of lactase is technically expected and programmed by genetics. If you will not have the consumption, you do not need to expend energy to produce the enzyme. However, nothing is that simple when we have humans in the equation.

In many people, the signs of intolerance happen between adolescence (15-17 years) and young adult (21-25 years). Who doesn’t remember to take that milk cup with chocolate in childhood and have nothing, right?

So it is considered that a good part of the population is intolerant, more than 70%. But the level of intolerance varies among people. Some are more or less than others. No feeling sorry for themselves.

General symptoms

The most common diarrhea and gas occur because of the characteristics of lactose. Sugars in general have the ability to attract water (beyond the osmotic pressure), this happens in the intestine causing diarrhea.

And the gases are produced due to fermentation of it by the bacteria that inhabit the intestine. Yes, my friends inside your gut have a microbiota of pet microorganisms that help us.

As the severity of intolerance is variable and the other symptoms can happen. But it depends on each one, the food and the amount ingested.

Galactosemia

A deficiency of very rare genetic origin in the metabolism of galactose present in milk and/or after lactose has been broken down into glucose and galactose. It also happens because of lack of enzymes necessary for this task. It is a more serious condition due to the accumulation of galactose and the production of toxic substances that compromise the liver, kidneys and other organs.

Mutants: Lactase Persistent

I said it wasn't simple. In spite of all this, there is another situation. People in which the lactase gene remains active, hence the ability to digest lactose persists during adulthood. This characteristic is due to the mutation of the gene.

At some point in human history during the domestication of animals that produced milk, the mutation came on the scene and was passed on to future generations. (Genetics: is an autosomal dominant characteristic, while intolerance is autosomal recessive).

So if you can drink milk without getting sick… my congratulations, you are a mutant!

FoodLab: Prof. X

Food without Lactose

In recent years the supply of lactose-free products only increases. In part for the niche market of people who actually have a serious intolerance as for the fashion of diets and nutritional terrorism (Read: What is Gluten?).

A business opportunity has been detected and is being filled gradually. It is well that the motives are more economical, which in the capitalist market has nothing wrong. However, exploitation ends up using questionable marketing tactics. Also for gluten, foods that have never had lactose are now promoted.

Another factor contributing to the increase was cheapening the technology to produce these foods. In general, synthetic lactase (from fungal origin) is used in milk to break down lactose. Therefore, some low lactose milks are sweeter.

For the meaning of the “lactose-free” is correct, but it is worth not pointing out that: lactose is not removed in the sense of it took it from one place and put it in another. But it was broken due to the inclusion of synthetic lactase.

Perhaps only Finnish products that the sense of removal will make sense. In the country there is a brand that has developed a process that removes lactose from milk. Whoever is nerdy food, she uses chromatographic separation (column 10m by 3m width).

In January (2017) the Law 13.305/2016 that regulates the labeling of products that have lactose entered into force. And the current legislation (RDC 135 and 136 of 2017) classifies the products into 3 categories and their lactose limits:

  • Below 100mg for every 100g (or mL) of product: Zero Lactose, Lactose-eated, 0% Lactose-free, Lactose-free or No Lactose
  • From 100mg up to 1g for every 100g (or mL) of product: Low Lactose or Lactose-Lactose
  • Equal to or above 100mg per 100g (or mL) of product: Contains Lactose (this is for products in general)

The amount 100mg is the same as 0.1g: milligram is smaller than grass, they are different units of measurement. So 0.1g is very little, but I mean, very much.

In the past, there was only special foods legislation with restriction of monosaccharides and/or disaccharides in which the maximum content was 0.5% lactose in food.

Derivatives of Milk

  • Fermented derivatives can be an alternative, like yogurt. Although yogurt has a high amount of lactose (4%), the bacteria and bacterial lactase present in the product help in digestion. In addition to the part that is fermented and transformed into lactic acid. For some people this step is enough to minimize the symptoms of intolerance.
  • The fats like butter (80% fat) the amount is minimal, about 0.4%. While, cream (36% fat) can have 3.6% lactose. These variations are due to the physicochemical characteristics, it has a preference for water (hydrophilic) and not for fat (hydrophobic).
  • And in mature cheeses, such as parmesan and pecorino, practically every whey is removed and along with the lactose. If something still remains, the ageing time and the action of microorganisms degrade it. Thus, consumption may not have symptoms. But it will depend on the degree of intolerance of each one.

The Lactose-free diet

Also the gluten-free diet, many people claim benefits of not consuming lactose. But again, the exchange of food will influence in the short term, but it is not necessarily related to lactose itself.

If your intolerance is imperceptible or absent: do not worry don’t. (Read: Why I Stopped Drinking Almond Milk & Went Back to Regular Milk Instead)

If the reason not to consume lactose is only to lose weight, calorie reduction… I feel informing, it will not make so much difference. As stated before, lactose has not been removed, but rather broken. That is, the product still has sugars being glucose and galactose.

As much as the supply of products has gotten higher, the price is still a big obstacle. The liter of low-grade milk is not cheap. Don’t get carried away by fashion and nutritional terrorism if you are not intolerant.

In my specific case, she is moderate. You get used to it and adapt it, but if you were to choose it, of course, you would prefer not to have to plan how and where to eat. If you understand me… (read: piriri alert).

FoodLab: Cápsula de Lactase

Controlled consumption of foods that have milk/lactose is still easier to avoid symptoms. However, access to lactase capsules is easier. Whether bought ready or manipulated, talk to your doctor.

If you are sick to consuming milk and suspect that you are intolerant, then talk to your doctor. There are specific tests for this, in addition to clinical evaluation.

I'm Vitor and… Intolerant to Lactose

Unlike the article about gluten in which I could not give a closer perspective because it is not celiac. In this, perhaps, I can. You may already know (or not), because I am shooting a self-in-law once in a while: I am lactose intolerant. And yes, I make lots of recipes that go milk and dairy products. ?teamButter4Life!

Although my intolerance is moderate, it causes discomfort. But since you are human beings, you adapt and get used to it. And also as I always say when they discover: between “going evil” and not eating, I choose to go bad. Refusing food doesn't make much of my temper. Of course, it depends on the food, the occasion and so many other factors. For example, I'm not having a glass of normal milk… so happy. I already know the taste, I already know what it is and its characteristics.

Limits my food options? To tell the truth, no. As consciously, that is, I know that the symptoms will appear. But if I will visit a restaurant I try to prevent the first dishes from having milk, because the dessert will probably have. So when piriri shows up I'll be homecasa. I did this a lot when I didn't take lactase capsules.

For me, the capsules worked well. But it goes from each one. See with your doctor if in your case it is valid to try. I have used man and bought ready.

Because of my case being moderate, it is quite circumventable and classic symptoms. But nothing so terrible. However, in the severe in which a small amount triggers extreme symptoms, the care in the diet should be seen carefully.

Very Long; Not Li

  • No, it's not an allergy. Come on, repeat with your uncle: it is not an allergy!
  • Lactose is a type of sugar formed by glucose and galactose.
  • It happens due to the insufficient amount of lactase, the enzyme responsible for the breakdown of lactose.
  • The decrease in the production of lactase is a natural physiological process (read: it is part of the body) that begins during weaning and the consumption of other foods. There are other causes, but this is the main one.
  • More than 70% of the population is intolerant to lactose, but the degree of intolerance varies from person to person. So without mercy.
  • Main symptoms: intestinal discomfort, diarrhea, gas and bloating. They may vary and exist others depending on the person.
  • The remaining 30% of the population have the mutant version of the gene being classified as persistent lactase, the production of the enzyme continues during adulthood.
  • And yes, there can be products with milk (and their derivatives) and be lactose-free, or in small amounts. With technological processes it is possible to remove or break down lactose.
  • If you are not lactose intolerant, don’t bother to take lactose out of your food.
  • Lactase capsules are with the easiest access, talk to your doctor!

Bibliography

  • BRAZIL, Health Surveillance Secretariat. The Ministry of Health. Ordinance no. 29. Technical regulation for identity and quality of food for special purposes. Official Gazette of the Union, Brasilia, 13 Jan. 1998.
  • BRASIL, LEI No. 13,305, DE 4 JULY 2016. Establishes basic food rules for labelling of foods containing lactose. Official Gazette of the Union, Brasilia, 5 jul. 2016.
  • BRAZIL, Health Surveillance Secretariat. The Ministry of Health. RDC No.135. Technical regulation concerning special purpose foods, to provide for foods for diets with restriction of lactose.. Official Gazette of the Union, Brasília, 9 Feb. 2017. 2017.
  • BRAZIL, Health Surveillance Secretariat. The Ministry of Health. RDC No. 136. Establishes requirements for declaration
    mandatory of the presence of lactose on food labels. Official Gazette of the Union, Brasília, 9 Feb. 2017. 2017.
  • CHANDAN, Ramesh C. and KILARA, Arun. Dairy Ingredients for Food Processing. Ames: Wiley-Blackwell, 2011.
  • FAEDO, R., Obtaining low lactose milk by membrane separation processes associated with enzymatic hydrolysis. CIATEC Magazine – UPF, vol.3 (1), p.p.44-54. University of Passo Fundo, 2013.
  • FENNEMA, Owen R. Food chemistry. 3rd ed. New York: Marcel Dekker, 1996. (English | English)
  • LEMBER, M. Hypolactasia: a common enzyme deficiency leading to lactose malabsorption and intolerance. Polskie Archiwum Medycyny Wewn?trznej, v. 122 Suppl 1, p. 60–64, 2012.
  • Heyman, M. B. B. Lactose Intolerance in Infants, children and adolescents. Pediatrics, v. 118, n. 3, p. 1279–1286, 1 Sep. 2006.
  • Lehninger, Albert L.; Nelson, David L.; COX, Michael M. Lehninger Principles of Biochemistry. New York: W.H. Freeman and Company, 2007.
  • McCRAY, S. Nutritional support in gastroenterology, series 2. Lactose intolerance: considerations for the clinician. (24, 28, 31, 36, 38-9). Practical Gasteroenterology, 2003; XXVII(2):21–2.
  • McGEE, Harold. On food and cooking: the science an lore of the kitchen. New York: Scribner, 2004. (English | English)
  • MILKPOINT. The supply of lactose-free products in Brazil, 2014 is growing.
  • MILKPOINT. Professor at UFMG explains about lactose-free milk production, intolerance and milk allergy, 2013.
  • PRENTICE, A. M. M. Dairy products in global public health. The American Journal of Clinical Nutrition, v. 99, n. 5, p. 1212S–1216S, 1 May 2014.
  • SAVIANO, D. A. Lactose digestion from yogurt: mechanism and relevance. The American Journal of Clinical Nutrition, v. 99, n. 5, p. 1251S–1255S, 1 May 2014.
  • SWALLOW, D. M. M. Genetics of lactase persistence and lactose intolerance. Annual Review of Genetics v37: 197–219, 2003.