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Lactose Intolerant after WLS? Why? What’s the Alternative?

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MILK

 
A fair number of bariatric patients end up with lactose intolerance after surgery. Lactose is the sugar found in milk. During the rapid weight loss phase, you do lose some muscle mass. The digestive system is a muscle. When the digestive system loses a little of its muscle mass, it loses the ability to digest lactose, because we quit producing lactase, the enzyme that breaks down lactose.

Lactose is the type of sugar found in milk. Fluid milk and foods made from this can contain lactose. Examples of these kinds of foods include ice cream, a glass of milk, instant hot cocoa and pudding.Yogurt and cheese go through a fermentation process that actually breaks down some of the lactose. That’s why people with lactose intolerance can eat some yogurt and cheese.

 

Lactose can also be found in milk based protein supplements whether it’s the ready to drink or the protein powders. Milk based protein supplements will have the words whey, casein or milk in the ingredient list. Some protein supplements will actually state “Lactose Free” on the label.

Lactose can also be found in a protein product when the milk-based protein is from a “concentrate” form of whey, casein or milk. The protein is the concentrated form of whey, casein or milk. However, the protein is not isolated from the lactose. For example, whey protein isolate may have up to 1 percent of its weight as lactose. Whey concentrate may have up to 52 percent of its weight as lactose.

You can look at the Nutrition Facts Label to see if the protein product you choose has any sugar in it. If a type of milk or milk protein is listed on the ingredients, it could mean there is some lactose. A product that has 2 grams of sugar or less per serving are often safe to drink. If you are lactose intolerance, you’ve now got information to start looking for lactose in all the right places.

 

 MILK AND ORANGE

 

Getting The Skinny On Milk Alternatives

Many pre-op, and most post-op bariatric eating regimes, encourage drinking low-fat milk for its nutritional benefits of good protein, high vitamin and valuable mineral content. However there are many in the general population, and within the bariatric community, that find this a tall order. Some have lactose intolerance or insufficient lactase (the enzyme that is required to digest lactose, the natural sugar found in regular milk and dairy products) and suffer with bloating, gas and changes in bowel habits.

Luckily there are a variety of delicious and nutrient-packed milk alternatives available for those with such intolerances or allergies. Take a look at the healthy and tasty options below but remember to choose and purchase the unsweetened variety to avoid excess sugar intake:

 

Soya Milk: This is made by soaking dry soya beans and grinding them with water and sometimes some sugar. It’s a good source of protein (about 7g per 7 fluid ounces) and heart-healthy omega-3’s. It is often also fortified with calcium and vitamin D so that it compares favourably with cow’s milk. You could opt for a light soya milk (with less fat and lower calorie count) but remember it will have less protein in it too.

Almond Milk: This is made from ground almonds and filtered water and, like soya milk, is fortified with calcium and vitamin D. It is a thin milk with a nutty taste and great rich vitamin E content. The regular variety contains less protein than other milk alternatives (only about 1 g per 7 fluid ounces) but there is a protein-fortified version available which has 5g per 7 fluid ounces which may make a better choice if protein is your priority.

Rice Milk: This is a mixture of partially milled rice and water. Again, like almond milk, it has a thinner texture than ordinary milk but also has a sweeter flavour. Lower in protein too at less than 1g per 7 fluid ounces, it’s a good choice for adding to breakfast cereals and in dessert recipes, providing you’re meeting your protein needs with other foods.

Oat Milk: Made from oats and water this milk has a sweet, earthy flavour. It’s a good source of protein (about 4g per 7 fluid ounces) and is offered fortified with calcium, vitamin A and vitamin D. Oat milk generally has a higher sugar profile than other milk alternatives due to its natural starch content.

Hemp Milk: This alternative is made from hemp seeds that have been soaked then ground with water to make a creamy milk with a nutty taste. It has a moderate amount of protein (about 2g per 7 fluid ounces) but is a great source of essential fatty acids and powerful antioxidants.

Coconut Milk: This is milk made from the grated meat of the coconut that is usually fortified with vitamin A and D. It only has 1g protein per 7 fluid ounces (unless enriched with more) and does have a higher saturated fat level than other milk alternatives. It does however have a good creamy texture but distinctive tropical flavour which works well with some recipes but not with all.

soy_milk

 

Some coverage courtesy of BariatricPal

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Comments

  1. Carol, wonderfully informative and helpful article, thank you! What is your view on lactase tablets?

  2. Hi Fiona, I have to be honest and say I don’t have much personal experience of them, only hearsay from others to go on. I haven’t been able to find much in the way of research either. Some take them as supplements to help before ingesting foods that are problematic to them and feel they help enormously and others have been fairly derisory so it’s a mixed bag. I think like pre and pro-biotics they may well have a place but the jury is still out. My only concern is that they may well encourage you to eat foods that may not be totally bariatric-friendly in abundance rather than in a controlled way (only my view and not verified) and ope the floodgates. Sorry I can’t be more helpful but I shall now ask around the bariatric community and some dieticians for some more guidelines and come back if I have any more constructive news. C x

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