African American Medical Group Calls for DietaryGuidelines to Include Lactose-free Dairy...

LAS VEGAS--(BUSINESS WIRE)--Aug. 12, 1999--

The National Medical Association (NMA) - the largest and oldest national organization of African American physicians - is urging the U.S. Department of Agriculture to promote lactose-free dairy foods in the Food Guide Pyramid and Dietary Guidelines

The announcement, made at the NMA's Annual Convention and Scientific Assembly this week, is in response to the large numbers of lactose intolerant African Americans who may be avoiding dairy products due to a fear of digestive discomfort. While not all African Americans have trouble digesting dairy, many have eliminated milk entirely and may be missing out on crucial nutrients their bodies need, especially calcium.

"The average black woman consumes only about half the calcium she needs. If she's cutting out dairy products because of lactose intolerance, it's unrealistic to think that she'll get enough calcium from other foods," said NMA's president Gary C. Dennis, M.D., who first proposed the new policy statement. "We think this is an easy solution to help address the calcium problem in the African American community. Unfortunately, many people just don't know about the lactose-free options."

Lactose intolerance results from the inability to properly digest the natural sugar or carbohydrate in milk called lactose. It is not an allergy, but the lack of a digestive enzyme called lactase that helps break down the sugar in your system. While it is estimated that about 25 percent of the U.S. population may have some trouble digesting lactose, the problem is particularly prevalent among African Americans, Asian Americans, Hispanic Americans and Native Americans.

A Simple Solution: Lactose-Free Milk

The National Medical Association is drawing attention to lactose-free milk as one easy solution to help all African Americans get the calcium they need. Dr. Dennis said the avoidance of dairy products reduces the intake of several key nutrients and virtually guarantees inadequate dietary intake of calcium. Three-fourths of the calcium in the U.S. diet comes from milk and milk products.

Lactose-free milk contains all the same nutrients, including calcium, of regular milk. It is simply milk that has been pre-treated with the lactase enzyme, which breaks down the lactose before you drink it. Widely found in supermarket dairy cases, these milk products now come in all the same varieties as regular milk, including lowfat and fat free options - only the lactose has been reduced (70 to 100 percent less lactose than regular milk). The milk may taste a little sweeter because lactose has been split into two smaller and sweeter sugars so it can be easily digested.

"While other foods supply some calcium, it's more difficult to eat the quantities necessary to meet current calcium recommendations without including dairy products, particularly for young children and adolescents," Dennis said. "We support the two to three servings of dairy foods recommended in the Food Guide Pyramid since dairy products are among the most convenient and concentrated sources of calcium available. We'd just like to see more emphasis on the lactose-free options to help meet the calcium needs of all African Americans."

In addition to lactose-free milk, recent studies show that regular milk can still be an option for lactose intolerant individuals. By drinking small amounts of milk at a time, or pairing it with other foods, people can easily enjoy milk without suffering discomfort. In fact, many African Americans find that such measures suffice. Aged cheeses and cultured dairy products like yogurt are also less likely to cause symptoms.

Research shows that drinking milk can improve the overall quality of the diet. It's not only an excellent source of calcium, but milk provides eight other essential nutrients, including protein, potassium and vitamins A and D.

Low Calcium Consequences

Helping African Americans increase their calcium intake is becoming a greater public health priority. Too little calcium in the diet can reduce bone growth, which can lead to osteoporosis later in life. While African Americans tend to have stronger, denser bones compared to Caucasians, they are not immune to osteoporosis.

In fact, a new study found that black women are much more at risk for osteoporosis than previously believed. Evidence from the National Osteoporosis Risk Assessment (NORA) program - released at the American Society for Bone and Mineral Research meeting earlier this year - found that more than one-third (38%) of African American women studied had low bone density and were at risk for fractures.

The National Osteoporosis Foundation estimates that 300,000 African American women currently have osteoporosis. Additionally, between 80 to 95 percent of fractures in African American women over age 64 are due to osteoporosis; and African American women are more likely than white women to die following a hip fracture.

African Americans also suffer from hypertension in greater numbers and develop the condition earlier in life with more dire medical complications. Results from the recent Dietary Approaches to Stop Hypertension (DASH) study - first published in the New England Journal of Medicine in 1997 - found that a lowfat dairy-rich diet that was high in calcium and rich in fruits and vegetables helped significantly lower blood pressure in nearly all people. However, the benefits were twice as great in African Americans. The DASH diet lowered the blood pressure of this group an average of 13 mm Hg, a similar response to that produced by medications. Not only did the African American subjects experience the blood pressure benefits, but they did so without symptoms of lactose intolerance.

LIVING WITH LACTOSE INTOLERANCE

Research Shows No Need to Drop Dairy

Lactose-free milk is one option to avoid symptoms of lactose intolerance, but there are several simple steps to help people comfortably consume regular dairy foods as well, according to Dennis Savaiano, Ph.D., dean of Purdue University's School of Consumer and Family Sciences and one of the country's leading lactose intolerance researchers.

"These approaches can improve lactose intolerance to the point that people can consume diets that are quite dairy-rich and, in turn, supply adequate amounts of calcium," he said. "For example, virtually everyone - even the most severely lactose-intolerant individual - can drink one cup of milk at a time if it's consumed with a meal and not on an empty stomach."

Savaiano suggests the following tips for tolerance:

-    Try small, frequent portions. "You may not even need lactose-free
     milk if you limit portions to one cup or less at a time."

-    Drink milk with meals, rather than on an empty stomach. "Solid
     foods slow the digestive process and allow the body more time to
     digest the lactose, which helps decrease or eliminate symptoms."

-    Enjoy cheese and yogurt. "When milk is processed into cheese,
     most of the lactose is removed. Yogurts with active cultures are
     well-tolerated because they actually contain the lactase enzyme
     to help you digest lactose."

-    If necessary, buy over-the-counter digestive aids. "Look for
     lactase enzyme caplets that you can take before eating dairy
     foods or buy lactase enzyme drops that you add to regular milk."

It's a Matter of Degree

Savaiano says lactose intolerance is not an "all-or-nothing" condition. Instead, it's a matter of degree. Lactase levels vary from person to person, but most degrees of lactose intolerance are quite manageable.

In fact, he asserts that the problem may actually be part of the solution. Lactose intolerant people should be drinking more milk to help them manage the condition. The exposure to lactose helps "train" your digestive tract to handle the lactose.

"Our studies have shown a really amazing adaptation of the bacteria in the digestive tract," he said. "By exposing the body to small amounts of milk over time, intestinal bacteria will start producing lactase to effectively digest lactose, making milk better tolerated."

When you remove the "fear factor" of lactose intolerance, the symptoms also seem to lessen, he said.

"We've found in our controlled double-blind trials, where people don't know what they are consuming, you can give subjects a glass of milk with breakfast and another with dinner and they exhibit almost no symptoms."

Savaiano has also studied the incidence of lactose intolerance in the African American community, and he said the results indicate that lactose intolerance should not be a restricting factor in developing adequate calcium diets for this population.

"In our study of African American adolescent girls who were part of a calcium diet study at Purdue, many complained about having to drink the milk on the first day. They said they didn't like the milk and they were intolerant," he said. "Although, when we tested them, they had only a very modest level of symptoms, almost incidental. Two weeks later, after they had been consuming a dairy-based, high-calcium diet, we tested them again. Every one of these girls had absolutely no symptoms."