52. Causes Lactose intolerance happens when the small intestine does not make enough of the enzyme lactase. Babies' bodies make this enzyme so they can digest milk, including breast milk. Before humans became dairy farmers, most people did not continue to drink milk, so their bodies did not make lactase after early childhood. Lactose intolerance is more common in Asian, African, African-American, Native American, and Mediterranean populations than it is among northern and western Approximately 30 million American adults have some amount of lactose intolerance by age Not having enough lactase (lactase deficiency) may also occur as a result of intestinal diseases such as celiac sprue and gastroenteritis, or after bowel surgery. Temporary lactase deficiency can result from viral and bacterial infections, especially in children, when the cells lining the intestine are injured.
53. Tests & diagnosis *Enteroscopy *Lactose-hydrogen breath test *Lactose tolerance test *Test for stool-reducing substances
54. Prevention There is no known way to prevent lactose intolerance. If you have the condition, avoiding or restricting the amount of milk products in your diet can reduce or prevent symptoms.
55. Treatment *Buttermilk and cheeses (they have less lactose than milk *Fermented milk products, such as yogurt *Goat's milk (but drink it with meals, and make sure it is supplemented with essential amino acids and vitamins if you give it to children) *Ice cream, milkshakes, and aged or hard cheeses *Lactose-free milk and milk products *Lactase-treated cow's milk for older children and adults *Soy formulas for infants younger than 2 years *Soy or rice milk for toddlers *Take calcium supplements *Eat foods that have more calcium (leafy greens, oysters, sardines, canned salmon, shrimp, and broccoli) *Drink orange juice that contains added calcium
Exposure during childhood can affect our preferred level of sweetness. As we age, we can lose some of our sensitivity to sweet taste. Choosing too many high-sugar foods and beverages can compromise the nutritional quality of our diet by decreasing the intake of higher nutrient foods.
We use sugar as a preservative in jams and jellies – and it prolongs the shelf-life of many baked foods. Sugar is important for the volume and texture in baked goods and ice-cream, including helping yeast breads raise.
In addition to sugar, there are a number of sweeteners that are available, some that have calories, and some that do not. They’re often categorized based on whether or not they contain calories – nutritive contain calories; non-nutritive do not.
Many sugars can be identified by the fact that they end in “ose.” Sucrose and fructose are the primary sugars that are found naturally in the food supply or are added as sugars, in corn sweeteners, or in syrups. Glucose is the most simple form of sugar. Table sugar is known as sucrose that comes from beet or cane sugar. Fructose is found naturally in honey and fruit, but is also available commercially. Lactose is the sugar found in milk. Our bodies do not distinguish between energy from natural and refined sugars, therefore “natural” sugars are not nutritionally superior to “refined sugars.
Sugar alcohols, or polyols, are used to sweeten foods and to provide bulk. They are less sweet than sugar and are not completely digested. They usually have about half the calories of sugar. Sugar alcohols are found in many reduced-calorie or sugar-free products like sugar-free gum, cough drops, candy, and ice-cream. You should limit your use of foods containing sugar alcohols because they can have a laxative effect if you eat too much. Also, many of these reduced-calorie or sugar-free foods are not much lower in calories than the regular products they’re replacing. Although many of these sugar-alcohols are made commercially, some are found in foods naturally. For example, sorbitol is found naturally in prunes, apples and pears.
Sugar alcohols can be labeled “sugar-free” because they replace sugar sweeteners and contain fewer calories. Because they are absorbed in the intestines more slowly than sugars, they can cause diarrhea in some people, especially when consuming more than a few servings/day.
One major advantage of sugar alcohols is that they are not digested in the mouth; therefore, they do not promote tooth decay. If you have diabetes, you may see less rise in blood sugar after eating something sweetened with sugar alcohols compared to a similar product that contains sugar. Keep in mind that many foods sweetened with sugar alcohols have other ingredients that increase the calories, fat, and carbohydrate. The major factor that limits the use of sugar alcohols is the laxative effect. It varies with individuals, the type of sugar alcohol, and the amount consumed.
The high intensity sweeteners are good because they do not contribute calories or increases in blood glucose. There are limitations for their use in cooking and baking. Some are more stable with heat (Splenda, Neotame, Sweet One) than others. Aspartame especially becomes less sweet when it is heated in liquid for more than 15 minutes. It can also lose sweetness when it is stored for extended periods in a hot environment. For example, you may notice that soft drinks sweetened with Aspartame may seem less sweet in the hot weather. This is because the soft drinks may be stored in a hot warehouse for an extended period of time before they are sold.
Many foods sweetened with sugar substitutes have calories from other ingredients and may be contain a significant number of calories, carbohydrate, or fat such as sugar-free or reduced-sugar pie, cake, ice-cream, and chocolates. If you are watching your calories or you have diabetes, you should limit these foods that have more than 20 calories or 5 grams of carbohydrate per serving.
Sugar substitutes or high-intensity sweeteners offer a way to enjoy the taste of sweetness with little or no calories and no effect on blood sugar. However, they are often blended with other nutritive or nonnutritive sweeteners to improve the stability or taste. The FDA has approved 5 sugar substitutes in regard to their safety. Neotame is the newest sweetener approved, although it is initially being marketed to the food industry for use in processed foods, and is not in the form of a table top sweetener as yet.
You can use a high-intensity sweetener if sugar is only used for flavoring as in beverages, pie fillings, cheesecakes, sweet sauces, marinades, no-bake cookies without adversely affecting the food quality. Be sure to check the label on your sweetener as some lose their sweetness (Equal) or become bitter at high temperatures (saccharin). Some (Equal or NutraSweet) may work best added at the end of cooking.
Generally the quality of baked goods like cakes and some cookies suffer when sugar is reduced or replaced by a high-intensity sweetener. If you want to be sure a baked good will turn out well using a high-intensity sweetener, visit a sweetener company’s web site for recipes that they have tested or buy a special diabetes cookbook using the sweeteners with recipes you like. Yeast will not grow well if sugar is totally removed from bread recipes. A cake may end up flat, rubbery, and dry without much browning unless other ingredients are added to give bulk, texture, and color that sugar normally provides. Non-fat dry milk might be used to increase volume and baking soda to help it raise more. Cocoa or molasses might be used to give it color. The baking time is usually less.
We often think of adding sugar simply for the sweet taste, but sugar goes through certain chemical changes during baking that some foods require to result in an acceptable product. Sugar provides structure, volume and texture to recipes. It also add browning, helps retain moisture and provides tenderness to baked goods.
A small amounts of sugar eaten in the context of a healthy diet does not usually present a problem, even in people with diabetes. But when high sugar foods take the place of more nutritious foods, it can become a health issue. As we age, we tend to require fewer calories and our appetites decrease. If high-sugar foods or beverages make up a significant part of your calorie intake, you are limiting the amount of nutrients you get that are important for your health. They also may be contributing to your weight or diabetes control.
If you find you’re consuming too much sugar, cut back by using less in your coffee or tea, on your cereal and in many recipes. You can choose a high-intensity sweetener for many foods. You can use fruit packed in juice instead of heavy syrup.
If you drink regular sodas or tea sweetened with sugar, the calories can really add up. Even smaller drinks from fast food restaurants give you over 200 calories each. One 12-ounce can of soda contains 9-10 teaspoons of sugar.
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