THINGS THAT MATTER

I have been asked by several people recently to explain the lactose/lactase story, and why some of us can’t drink milk without bloating or diarrhoea. So here again is the full explanation, and cudos to Pine Hill Dairy for bringing us lactose free milk.

 

Like the legendary phantom of the comics, I’m a milk drinker. Sadly, I have the gene for lactose intolerance, became intolerant about 20 years ago, and spent a fortune on lactase tablets. But finally, with Pine Hill Dairy’s new Lactose Free Milk introduced a couple of years ago, I could drink my favourite drink again, by the muscle-building glassful! So let me explain about lactose intolerance, and why so many of us have it. 

 

Lactose is the sugar contained in milk … cow’s milk, goat’s milk and human milk. It comprises just under five per cent of milk. It’s a large sugar, or a “disaccharide”, twice the size of glucose, which is the sugar “currency” of the body – the “simple sugar”. Even cane sugar, sucrose, which is a bigger sugar, like lactose, has to be broken down in the gut into glucose, so it can be absorbed into the blood, while lactose must be broken down in to glucose and galactose.

 

The problem is that the enzyme that breaks down lactose, called lactase, is in plentiful supply in infants and children, but its production falls rapidly in some populations by adulthood. And if you don’t have the gene for continuous production of lactase, you will be intolerant of lactose, and milk will upset you – because if the lactose isn’t broken down, it will produce gaseousness (no rude words here!) and it absorbs water into the gut, causing diarrhoea.

 

Who suffers from lactose intolerance? Well, most of us in Barbados do! Northern Europeans, Laps and Russians, who use a lot of milk, are well adapted, and only about five per cent of them are intolerant. Most Europeans, Caucasians or “whitish” people are about ten per cent intolerant, but it rises rapidly in us older folk. And Asians and Africans are most commonly lactose intolerant… up to 80 or 90 per cent of the adults of most African and Asian populations are lactose intolerant, perhaps only partially so as children and adolescents, but increasingly so with age and most commonly by adulthood.

 

So of course, in Barbados, where people who are “black” or brown often have European ancestors as well, and people who are “whitish” often have African ancestors too, it means that the great majority of us are affected. It’s such a common problem, that most of us over 50, raised on terribly sweet condensed milk, never had the wherewithal to drink copious milk until Pine Hill Dairy started – and most of us then suffered bloating, flatulence and diarrhoea, and the word went around “That milk no good!” No one understood the problem, and no one explained it. Even some doctors would tell mothers not to give the children milk, because “they must be allergic to it”. And yet the solution was so simple – Pine Hill merely had to produce milk free of lactose, and hey presto – like magic – we can all drink milk like the phantom!

 

My mother only became intolerant in her 60s, when her favourite food, ice cream, started to cause her problems. I became intolerant at 50, and had to cut back on ice cream, spend a fortune on lactase tablets and nag Pine Hill! And of course ice cream is made with ordinary milk. On the plus side, less ice cream, less sugar, and so less obesity! Yoghurt and cheese, however, have much less lactose, and many partly intolerant people can eat yoghurt and cheese in modest amounts.

 

One of the problems of lactose intolerance is that other milk substitutes are promoted, one of which, almond “milk” is absolutely nothing like milk. It’s “white water” with a few additives and whitened to look like milk, and one gram of protein per standard glass compared to nine grams of protein in milk! So the nutritional value is practically zero. It 

might be considered libellous to call it a scam, so I won’t, but you see the point.

 

So – my biggest bouquet of the year goes once again to Pine Hill Dairy and Banks! Well done, folks, you have made the biggest contribution to the health of Barbadians than any one or any group has done for some time. Let’s hope that our medical colleagues, our nutritionists and dieticians and nurses (potentially the most powerful health educators) will all help to get the message across that this is the milk we can all drink now… and not almond “milk” and not all those high sugar drinks!

Postscript: And speaking of drinks, as I have said elsewhere, we in the health care field all congratulated the Minister of Finance for the tax on sugar laden beverages, but as I said then, and elsewhere and again last week in the Golden Jubilee lecture on Health Care, ten per cent on something assumed as essential, or compulsive, or addictive or necessary, is just a token, and taken in stride. It needs to be at least 30 per cent to make a difference and it WILL make a difference to our people’s health.

Professor Fraser is past Dean of Medical Sciences, UWI and Professor Emeritus of Medicine. Website: profhenry fraser.com