tough news.

Hard To Swallow

Is Milk Bad For Some People--or Is It Getting A Bad Rap?

November 28, 2000|By Lisa Skolnik. Special to the Tribune.

You've seen the ads. Celebrities, including Britney Spears, Tyra Banks, Sarah Michelle Gellar, Spike Lee and Serena and Venus Williams, show off their creamy mustaches and ask if you've "got milk?"

Your first reaction probably is to go get a glass of the stuff yourself. After all, it's great for you, right? Not necessarily, especially if you're a minority.

"Approximately 90 percent of Asian-Americans, 70 percent of African-Americans and Native Americans and 50 percent of Hispanics are lactose intolerant," says Milton Mills, a Washington, D.C.-based doctor who specializes in nutrition. That means they're unable to digest lactose, a form of sugar in milk and dairy products, because they either lack the enzyme lactase or don't make enough of it. This can cause stomachaches, gas, bloating, cramps and diarrhea.

"Minorities lack the ability to digest lactose because they come from areas of the world where they didn't have lots of dairy products in their diets for generations, so over time their lactase enzymes [the enzymes that deal with lactose in the body] became deactivated," explains Natalie Webb, a dietitian in Rockville, Md., who is a consultant to the National Dairy Council, one of the groups that funds the milk mustache ads.

The abundance of diets around the world that are low in dairy products means lactose intolerance is widespread.

"About 75 percent of the world's population, and 25 percent of Americans, lose their lactase enzymes after weaning," points out Amy Lanou, nutrition director for the Physicians Committee for Responsible Medicine. (Mills also belongs to this national group.)

So should you skip milk and dairy products if you're a minority or think you have symptoms of lactose intolerance? It's a hard question, and it depends on your body chemistry, preferences and willingness to monitor your diet. Here's what you and your parents need to know (and talk to your doctor about) before you decide what to do:

First, keep in mind why milk and dairy products are so important.

"They provide us with 75 percent of the calcium in our food supply, which is one of the nutrients most likely to be lacking in our diets," Webb explains. "And adolescents ages 9 to 18 need 1,300 milligrams of calcium a day to reach peak bone density. That amounts to four to five servings of dairy products a day.

Recent studies also show that increased calcium intake can lower blood pressure and cholesterol and prevent colon cancer, especially among African-Americans, Webb says. And "milk provides us with eight other nutrients besides calcium that are critical to our health: protein, potassium, phosphorus, riboflavin, niacin and vitamins A, B12 and D."

According to Greg Miller, vice president of nutrition research for the National Dairy Council, "Most degrees of lactose intolerance are easy to manage. For instance, almost anyone can tolerate the amount of lactose in a glass of milk as long as you don't drink it on an empty stomach." The council puts out a pamphlet, "The Lowdown on Lactose Intolerance," that gives tips for building up your tolerance (call 800-949-6455 or check to get one).

But keep in mind some of dairy products' other downsides.

Besides being difficult or impossible to digest if you're lactose intolerant, they "can be high in fat and calories," and "studies show they can cause other chronic diseases," Mills says. These include diabetes, obesity and heart disease.

Also, since most infants and kids can digest milk, Lanou thinks that lactose intolerance is a protective mechanism. "It's basically our bodies telling us we don't need milk anymore and should be looking to other sources for its nutrients. There are plenty of calcium-rich foods we can eat instead that are healthier for us, like calcium-fortified cereals and orange juice, or green leafy vegetables and beans," she says.

There is a simple breath test doctors can administer to figure out if you're lactose intolerant. You should get one before eliminating dairy from your diet, "since dairy products are a complete package, thanks to their other nutrients, and accessible, portable and tasty," says Jeanette Newton Keith, a doctor at the University of Chicago.

You can also "manage your lactose intolerance," Webb says. You need to incorporate dairy products into your diet slowly and in small amounts (like a half glass of milk at a time) to activate your lactase enzyme again and build up your tolerance to lactose. Also eat dairy products with meals (not on an empty stomach) and eat dairy foods with lower levels of lactose but high amounts of calcium, like aged cheeses (cheddar or Swiss), yogurt (its live cultures help break down lactose) or lactose-free milk.