It's easy to get answers about health and nutrition! Just send your question by email to [email protected] and Dr. Harlan will respond to selected questions of general interest. Answers will be posted in the Ask Dr. Gourmet newsletter (sign up now!) and archived in the Ask Dr. Gourmet section of the website.
Many of your recipes indicate, "Those who are lactose intolerant should avoid it." I am lactose intolerant, however, I don't avoid dairy but rather take a lactase enzyme supplement when consuming dairy. Often that mean taking the enzyme once or twice a day. Is it safe to use the enzyme so often? It works well for me.
We are very strict about labeling the recipes on the Dr. Gourmet web site regarding health issues. With lactose that means that if the recipe contains any lactose it is marked with the statement, "Those who are lactose intolerant should avoid it." Because some people who are lactose intolerant can tolerate some cheeses, when a recipe contains cheese (as opposed to liquid milk or other dairy), we mark it "This recipe contains cheese and some of those who are lactose intolerant may be able to tolerate it."
Interestingly, lactose intolerance is an issue of how much lactose is in a particular dish. Lactose is the main sugar found in milk and is made up of two sugar molecules bound together. The body can't absorb lactose and it must be broken down into the separate molecules glucose and galactose. Many people lack the enzyme lactase that the body uses to break down lactose, so the "milk sugar" is not absorbed and passes from the small intestine to the colon.
The problem is that the bacteria living in your large intestine love lactose and break it down, causing many unpleasant effects. We think of these bacteria as the "good guys" (and they are), but in the process of using the lactose they create lactic acid and other chemicals. Those substances are what causes abdominal discomfort and gas.
There has been good research to show that even those people who are lactose intolerant can usually tolerate some degree of lactose. At the same time Lactaid™ tablets are effective at providing the lactase enzyme and are recommended to be taken with each meal that contains dairy. Using the supplement at more than one meal per day is safe and you needn't be concerned, especially if it works well for you.
Thanks for writing,
Timothy S. Harlan, MD, FACP, CCMS