Lactose Intolerance and 2010

Happy New Year, Everyone.

Today is January 1, 2010. Somewhere in the United States, some cable station is playing the movie 2010 right now. I know because I bumped into it while flipping channels a while ago. That movie was made back in 1984, when 2010 seemed like a future so distant that space travel seemed like the easiest prediction to make.

Nobody's that sure about the future today. (I mean, 2009? Even looking backward that year isn't the least bit plausible.) We can't even agree whether we're starting a new decade or not. (Yes, 2009 meant the end of the Aughts. But 2010 will be the end of the first decade of the 21st century. And every year is the end of some decade. Every minute. Every second. Of course, when something happens 31,536,000 times a calendar year, people get bored and latch on to fun stuff with more meaning, like having a zero at the end. You have to be very bored to read meaning into that, but it's all reruns on television this week, isn't it?)

So here's what I know for sure.

Lactose intolerance. It's a simple thing that we make very complicated. All mammals are genetically programmed to produce milk to feed their live young. And all mammals manufacture a unique sugar, lactose, to use as one of the energy sources in that milk. (Except for the monotremes, the most primitive mammals that evolved before lactose did, and the pinnipedia, sea mammals that use extra fat rather than lactose.) To digest lactose, that is, to break it down into simpler sugars so that it can be absorbed into the small intestine, all the lactose-producing mammals also manufacture an enzyme called lactase. Nobody really understands why the mammals went to the trouble of having to build up a complex sugar found nowhere else in nature just so that they would also have to make a special enzyme just to break it down. Somewhere along the line evolution thought this was a good idea. It works. Mammals are extremely successful animals.

It works, but it takes effort, in the form of extra energy to do this double manufacturing process. Mammals only do it for as long as is absolutely necessary, for the length of time they would normally be dependent on their mother's milk. At about the time of weaning, all mammals lose the ability to manufacture lactase. After that age, all mammals are lactose intolerant.

Humans are mammals. Humans have lactose in mother's milk, the most lactose of any species, about seven percent worth. All humans manufacture lactase, except for the tiniest handful who never do. These babies, who have what is called congenital lactose intolerance, used to die of starvation within a week of birth. They couldn't survive until nondairy milk substitutes were found early last century.

And all humans naturally stop manufacturing lactase at about the age of weaning, which is around three years. That means we are all naturally lactose intolerant.

Except some are not. Some humans are mutants. Well, all humans are mutants. Every single one of us have some mutations on some genes, which is why every one of us is different from all the others. One particular mutation, found on chromosome 2, either never sends out the signal that turns off lactase production or doesn't send it out until after the normal age of weaning. Around 30% of humanity has this mutation.

That's where it gets complicated. How do we define lactose intolerance? Is it by the form of the gene we have? Some people use this definition. That's how scientists estimate numbers and percentages like "Around 30% of humanity has this mutation."

The problem with that definition is that some people who currently manufacture lactase and who can drink milk just fine get classified as lactose intolerant. This confuses everyone. Wouldn't it be better to define lactose intolerance as those people who get symptoms from drinking milk (even if they don't have another disease or genetic condition)? That is better, and it's the definition that most researchers writing about the subject use. Unless they're genetic researchers who care more about genes than about symptoms.

I care about symptoms. That's because I'm lactose intolerant either way you define it. I'm pretty sure that most of you reading this care about symptoms too. Whatever's happening on my chromosome 2 is less interesting to me than what happens in my large intestine after drinking milk.

I can predict one piece of the future, therefore. For the rest of 2010 I'll be spending a lot of time writing about nondairy products, lactase pills, lactose-free cookbooks, and anything else that might help people who want to avoid the lactose in milk. I'll also write regularly about ways of avoiding milk altogether for those of you with dairy allergies or dietary needs that make you want to cut milk either temporarily or permanently out of your diet. And I'll spend the rest of my time correcting the misinformation on these subjects I find on the great unwashed intrawebs out there. It's all good.

Thank you for reading. Now, and in the future.

Lactaid's 25th (and 35th) Anniversaries

When I first learned I was lactose intolerant, in 1978, I had never heard the words before. Didn't know what lactose was. Milk, well, milk was supposed to sooth the stomach. The concept made no sense.

No books were available on lactose intolerance. Almost no articles could be dug up at the library. No web, of course. I poked here and there, doing my own research.

Who doesn't know about lactose intolerance (LI) today? The phrase is a standing joke. Just mention milk and somebody will throw out a reference to LI. People think they're LI even if they're not. Consume any dairy product, suffer any digestive complaint? Boom, you're LI. See lactones on a label? Lactylates? Lactates? Lactic acid? Lactacystin? Must cause lactose intolerance. Not one of them contain any lactose, and not one of them would have been noticeable or comprehensible on a label in 1978, but today the connection is automatic. Amazing.

There were no specialty foods aimed at the lactose intolerant in 1978. What few diary alternatives existed were created for the kosher market, as a way to get around the prohibition of eating milk with meat. Today, the corner supermarket will have shelves full of milk-alternatives of all types, varieties, and bases. Some are from international food conglomerates; many are made by small firms struggling to find a niche for their products.

That's one major reason I maintain this blog, to help readers find the complete range of products and services available if you want to reduce or eliminate dairy in your life. I'm constantly passing along press releases about new foods, new companies, new cookbooks, new ways of dealing with the issue.

And by concentrating on the new, I suddenly realized how little attention I've given to the one constant in the LI world, the one that made lactose intolerance as well known as it's become, the one that everybody knows so well it's become almost the generic word. Lactaid.

I have in front of me a copy of a January 1984 news clipping announcing the introduction of LactAid brand lactose-reduced milk to Rochester. Yes, with a capital "A" in the middle. LactAid wasn't new even then. It had been introduced late in 1979. (Four years to get to Rochester. You'd think LactAid was high fashion.) New to Rochester meant new to me. No web, remember.

A quart of LactAid cost 89 cents in Wegman's then, which made it "roughly 20 to 30 cents higher than regular milk." In today's shopping trip I checked current prices. Fat-free regular milk cost 76 cents. Fat-free Lactaid was up to $2.19. We're still very much a niche market, and we continue to pay that price.

LactAid the firm had been around for a decade by then, although I didn't know that either. It's first product was a lactase powder that could be mixed with milk to remove most of the lactase. Alan Kligerman, the inventor of Sugar-Lo, an ice cream for diabetics and later Beano, introduced Lact-Aid powder in 1974, making this year Lactaid's 35th anniversary. Lactaid finally got its lactase pills on shelves in 1985.

In 1990 Dairy Ease, made by a division of a pharmaceutical giant, emerged as a competitor with its own line of milk and lactase. That energized Lactaid, which had been taken over by McNeil Consumer Products, a subsidiary of the equally gigantic Johnson & Johnson corporation. The two companies staged massive competing promotional campaigns in 1993. They have to be among the most successful ad campaigns in history. Lactose intolerance became a household word.

Lactaid eventually won out over Dairy Ease, which no longer makes lactase and whose milk is distributed by Land O'Lakes but is much harder to find. In fact, Lactaid has no real competitors in the LI market. It just keeps rolling along. While I've mentioned Lactaid products and promotions a few times in this blog, there's never been a reason for me to do a big intro to the firm. But anniversaries count, even if they're only meaningful to me.

The company's website, lactaid.com, unfortunately requires Adobe Flash Player to see all the contents, an annoyance that is increasingly common and worthwhile only to the graphics types in the marketing department, not actual consumers.

The products are only accessible through a lot of mousing and clicking, so I'll summarize them here:

Milk: fat free, low fat (1%), reduced fat (2%), whole, chocolate low fat (1%); all except the chocolate also available calcium-fortified
Organic Milk: fat free, reduced fat (2%)
Dietary Supplements [lactase]: original, fast act caplets, fast act chewables
Ice cream: chocolate, vanilla, cookies & cream, strawberries & cream, butter pecan
Cottage Cheese: low fat
Eggnog: Christmas holiday season availability only
Evaporated Milk: available only in Puerto Rico

None of the products are truly national. The Fast Act lactase is available in the largest number of states, but many of the products can be found in fewer than a half dozen.

That's too bad, but at least the lactase caplets and chewables are available online from anywhere in the country from such dealers as Amazon.

So happy 35th anniversary, Lactaid. Hope you stick around for another 35 years.

Another Helping of Goat Cheesy Ignorance

The folks at Montchevré Handcrafted Goat Cheese may make tasty cheese, but I'll never know because their science comes from the bottom of a dunghill.

Strong words? Well, read this and listen to your stomach curdle:

Q. Why is a lactose intolerant person able to have goat cheese products?

A. Most lactose intolerants who can't have cow's milk will be able to digest goat's milk and goat's milk products.

The fat particles in goat's milk are 1/3 the size of the fat particles in cow's milk, and in fact similar in size to those in mother's milk. Goat's milk products are said to be "naturally homogenized" and therefore easier to digest for lactose intolerants.

Lactose is sugar. It does not matter what package the lactose comes in. Homogenized, non-homogenized; fat-laden, fat-free; cow's milk cheese, goat's milk cheese. It doesn't matter. All lactose is identical. Your body treats it identically.

Your mind is a different creature. Treat it well. Don't fall for this self-serving ignorance.

LI Celebrity Alert: Dustin Lance Black

Ever since the film Milk opened, the headline punsters had been bombarding me with lactose puns. Yes, I take it personally. I have Google News set to dredge up every reference to lactose made by anyone in the inner solar system. When I have to wade through these jokes to get to the stuff worth sharing with you my annoyance level, normally at incendiary on a good day, goes past fission and into sun's core.

And yet, here's the extreme irony. Dustin Lance Black, the now-Oscar nominated screenwriter of Milk, has just revealed that he is, yes, lactose intolerant. He apparently made the comment at a screenwriters' panel at the Santa Barbara Film Festival.

At least, I think and hope he did. Scott Feinberg posted this bit on trivia on the Los Angeles Times blogs today, but they've already pulled the link. Does that mean Black was making a joke that Feinberg fell for and had to squelch?

Let's hope not. Good irony is hard to find. And I deserve some reward for my efforts.