Although milk is among the most consumed foods in the world, a significant portion of the population has some degree of intolerance to lactose, the natural sugar present in the food. In Brazil, it is estimated that 51% of people are prone to developing the condition, according to a study by the Genera genetics laboratory.

Lactose intolerance occurs when the body produces little or no lactase, the enzyme responsible for digesting lactose in the intestine and allowing its adequate absorption by the body. Without this enzyme in sufficient quantity, the sugar in milk is not processed correctly, which can lead to symptoms after consuming dairy products.

According to Dr. Renato Zorzo, doctor and professor of nutrition at Afya Ribeirão Preto, intolerance can appear at different stages of life. “Many people start to show symptoms in adolescence or adulthood because lactase production tends to naturally decrease over the years”, he explains.

Furthermore, the condition varies from person to person. “Lactose intolerance is the clinical expression of lactase insufficiency, and most people are somewhere between the extremes. There are those who tolerate small amounts of milk without symptoms and there are those who experience discomfort with much smaller doses”, points out the doctor.

Main symptoms of lactose intolerance

According to Dr. Renato Zorzo, babies, in general, do not present the condition, except in rare genetic cases. He explains that lactase production tends to decrease from the first years of life and can intensify with aging, which makes intolerance more common in the elderly and also influenced by genetic factors.

Among the most common symptoms of lactose intolerance are:

• Abdominal pain;
• Stuffing;
• Excess gases;
• Nausea;
• Diarrhea;
• Feeling of poor digestion.

Symptoms appear after consuming milk and dairy products, generally appearing shortly after ingestion. According to the doctor, intense abdominal distension, rapid increase in gas, cramps, intestinal noises, urgency to evacuate and, in some cases, malaise, sweating and significant discomfort may also occur.

Not everyone needs to give up dairy

Diego Righi, professor of Nutrition at Afya Centro Universitário Itaperuna, highlights that it is not always necessary to completely exclude dairy products from the diet, as lactose intolerance tends to be dose-dependent. He explains that each organism has its own tolerance level, which varies depending on the amount ingested, the type of food, the intestinal microbiota and even the form of consumption.

According to him, the current recommendation is to individualize diet and avoid excessive restrictions, adopting in practice an approach that involves reducing lactose, testing each person’s tolerance and preserving, whenever possible, important sources of calcium, protein, vitamins D and B12.

Lactose intolerance and milk allergy

Lactose intolerance was allergy to milk protein are different conditions. The first is related to the body’s difficulty in digesting lactose, the sugar present in milk. This is a dose-dependent condition, which does not involve the immune system and, in general, is not associated with serious reactions.

Milk allergy, on the other hand, is an immune response to milk proteins such as casein and whey proteins. In these cases, even small amounts can trigger reactions that affect the skin, intestine, respiratory system and circulation, such as itching, hives, swelling, vomiting, wheezing, shortness of breath, blood in the stool and, in more serious situations, anaphylaxis. More common in childhood, the condition requires the total exclusion of milk and its derivatives, including lactose-free versions.

“Intolerance is a reaction to milk sugar, while allergy involves an immune system response to dairy proteins. Therefore, the correct diagnosis is essential to define the appropriate treatment”, summarizes Diego Righi.

The nutrition professor warns that lactose-free products are not recommended for people with milk allergies, as they continue to be dairy derivatives and maintain the proteins responsible for allergic reactions. “Removing lactose does not eliminate milk proteins, which are precisely those responsible for allergywhich is why these products are not safe in these cases”, he explains.

Vegetable drinks for lactose intolerant

Vegetable drinks are a good alternative for people with lactose intolerance or milk allergies. In addition to expanding food options, they allow you to adapt your diet to individual needs, offering more variety and practicality in everyday life. Below, Diego Righi lists some options:

1. Unsweetened and fortified soy drink

It is the closest plant-based option to cow’s milk in protein content, offering around 7 to 8 g per glass when well formulated. It should be preferred in versions enriched with calcium, vitamin D and vitamin B12, being a good alternative for adults, the elderly, vegetarians and vegans. It is not recommended in cases of soy allergy.

2. Unsweetened and fortified pea drink

Good alternative for those who cannot tolerate soy. In general, it has a higher protein content than almond, rice, oat and coconut drinks, although this varies by brand. It is recommended to opt for versions with added calcium and vitamin D.

3. Unsweetened Fortified Oat Drink

It has good sensorial acceptance and works well in preparations such as coffee and vitamins. However, it contains more carbohydrates and less protein, which requires attention in cases of diabetes, insulin resistance, fatty liver or diets with glycemic control.

4. Unsweetened and fortified almond or nut drink

Recommended when there is an interest in lower caloric intake. It is versatile for drinks and recipes, but does not replace milk as a source of protein, as its protein content is usually low. Fortification with calcium and vitamin D is an important differentiator.

The nutritionist points out, however, that some vegetable drinks are less recommended as a main daily option, such as rice drinks, due to their low protein content and higher carbohydrate load, and coconut drinks, which also have little protein and may have a higher protein content. saturated fat in some versions.

He also warns against the frequent consumption of sweetened or flavored drinks, due to the excess added sugar. When choosing, Diego Righi recommends observing the label, prioritizing sugar-free versions, with around 240 to 300 mg of calcium per glass, fortified with vitamin D and vitamin B12, and which offer, when used as a substitute for milk, at least 6 to 8 g of protein per serving.

By Beatriz Felicio