Answers to Questions from Readers, part 3

Q. I am interested in calcium supplementation and read labels. Many of these labels list a calcium lactate. Should someone with LI be concerned about lactates or just lactose.

Just lactose.

None of the sound-like-milks (lactates, lactylates, lactic acid, etc.) should be a problem to anyone who is LI.

One word of warning: Occasionally, these products are made from other products that originate from milk. That still shouldn't be any problem at all for the LI, but people with severe milk allergies should avoid such products. It can be extremely difficult to tell the origins of any additives, however. You have to call the manufacturer and ask about each product individually.

I have an extended discussion of this issue in my Dairy or Nondairy? The Experts Speak page.

Q. If there is lactose-free milk, then why isn't there lactose-free ice cream?

Because it doesn't sell, is my guess. Various companies have put out lactose-reduced ice creams in the past and most people, and I mean most LI people as well, never buy them.

I have a list of all the ones I know of in my Product Clearinghouse. Look on the Reduced-Lactose Products page.

But what you should be doing is checking out the Frozen Desserts page in the Product Clearinghouse for listings of lots of completely milk-free alternatives.

And don't forget that many people with LI can still eat frozen yogurt and that most true sorbets and ices are also milk-free.

Q. I recently read in a nutrition book that soy products can cause gas, bloating, diarrhea etc. if eaten too often. Is this true?

I don't think so. There is no reason to believe that any food that is not intrinsically harmful causes problems just from regular consumption. What the book might have been trying to say is that many people who are allergic to milk and turn to soy products as a substitute find that they are also allergic to soy protein. In that case, more is definitely less. And soybeans are a legume, like peas and beans, and legumes can produce gas in some people. Otherwise, if soy doesn't bother you now, eating more of it later shouldn't be any different. (Of course, if you eat too much of anything at one meal, you'll pay for it, but that's another issue.)

Q. If one is lactose-intolerant, what effect, if any, does the presence of lactose in an injected medication have? How is it absorbed and metabolized? Is there an effect on delivery of the accompanying drug?

Bearing in mind that I'm not a doctor or a biochemist, here goes.

Lactose symptoms are caused solely by the presence of undigested lactose in the small and large intestines. I can think of no reason why lactose in the bloodstream should create any problems for anyone. I have read of only one, single, isolated case of an allergic reaction to lactose itself. Lactose is used in so many medications because it is basically as neutral an agent as possible, and it also has the nice property of not caking, another reason for its use. It's an interesting question, but I have never run across any reason to think that injected lactose would be a problem.

Q. My intestinal distress increases with the fat content of the lactose carrier, particularly butter and cream. Yet your tables show that the lactose content actually decreases with fat content. Could something else be going on here?

There is some slight evidence that a small number of people have milk fat intolerance. Unfortunately, the studies were never redone, so it's hard to know whether such a thing really exists.

A somewhat different study found no difference in symptoms between people drinking high-fat milk and those drinking fat-free milk.

But fat alone can create problems in some people. All I can give is the common sense advice to lay off high milkfat items for a while and see if your symptoms decrease.