Dear Theresa: It may be beneficial for you to undergo testing for milk allergy, as it is distinct from lactose intolerance. Allergic reactions to the protein in milk, as opposed to an intolerance to lactose, can lead to severe responses even with minuscule doses of milk products. It is crucial to receive an accurate diagnosis.
Lisa, a reader of this column in the Lincoln Journal Star, suggests the need for a column discussing various intolerances, particularly fructose intolerance, which she personally experiences. She points out the abundance of articles on dairy and gluten intolerances, but the scarcity of information on fructose intolerance.
This is indeed a complex topic, Lisa. Fructose is a sugar found in fruits, honey, agave, certain vegetables, and foods with added sugars. It even occurs naturally in regular table sugar.
Some individuals lack the ability to digest fructose, and that’s where the complication arises.
According to the National Library of Medicine’s Medline Plus, there exist two types of fructose intolerance. One is a rare genetic disorder called hereditary fructose intolerance, which occurs when a person is born without the enzyme needed to break down fructose. It is primarily observed in infants and children and necessitates a strict fructose-free diet to prevent severe liver and kidney damage.
The more common type is fructose malabsorption (previously known as dietary fructose intolerance). This condition arises when the cells in the intestines cannot properly absorb fructose, leading to bloating, diarrhea or constipation, gas, and stomach pain. Its cause remains unknown, although our ability to digest fructose can be affected by other gastrointestinal conditions such as celiac or Crohn’s disease, stress, and chronic antibiotic use.
Living with fructose malabsorption is challenging and diagnosing it can be difficult (with a breath test considered the most accurate method). However, many individuals find relief by adhering to a low-fructose diet, such as the low FODMAP diet developed by Monash University in Australia (refer to www.monashfodmap.com).
Certain fruits, including apples, pears, mangoes, cherries, figs, pears, watermelon, and dried fruit, contain high levels of fructose. On the other hand, oranges, berries, bananas, and cantaloupe have lower fructose content.
Since fructose naturally occurs in plant-based foods, limiting these foods can lead to nutritional deficiencies. In such cases, it is advisable to seek an individualized diet plan from a registered dietitian nutritionist. To find one in your area, visit www.eatright.org.
(Barbara Intermill is a registered dietitian nutritionist and syndicated columnist. She is the author of “Quinn-Essential Nutrition: The Uncomplicated Science of Eating.” Contact her at [email protected].)
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