Health Experts
Nutritionist
Q&As with our online nutritionist
Dr Pamela Mason advises online readers how to cope with lactose intolerance, avoiding uric acid build up and the use of soya during menopause
Lactose intolerance
Q: Please could you advise what my husband can take after eating or drinking anything which contains lactose without him realising it. He is very lactose intolerant and suffers greatly for 12 to 24 hours.
A: I assume that your husband has had a lactose tolerance test? It is important to be certain of the cause of his symptoms. It is also important to get advice from a registered dietician or nutritionist as excluding a whole food group like milk can increase the risk of nutritional deficiency, in this case calcium.
Lactose intolerance is the inability to digest lactose, the predominant sugar in milk. This occurs because of a deficiency of the enzyme lactase, which digests lactose. Though other dairy products such as yogurt, fromage frais, creme fraiche, cream and cheese, contain less lactose than milk, some people seem to be intolerant to even small amounts of lactose. Lactose, as you know, is also found in many processed foods, so it is important to check labels for ingredients such as milk, milk solids, non-fat milk solids, milk protein, skimmed milk, skimmed milk powder, casein, caseinates, whey, whey solids, buttermilk, lactose, milk sugar, whey sugar and whey syrup.
If symptoms of lactose intolerance are experienced after consuming it unknowingly, this is certainly unpleasant but is not dangerous, provided it occurs only occasionally. However, there are various lactase products available in liquid and tablet form which reduce the symptoms of lactose intolerance for some people. The liquid can be added to milk to reduce its lactose content. A more recent development is lactase tablets which can be taken before each meal or snack. They may not digest any lactose completely so they should not be used to enable you to drink milk. However, if your husband is say, going out for a meal where it is difficult to check the lactose content of the food, lactase tablets may be worth a try. If they don’t work for him, then at least you have tried.
Preventing uric acid stones
Q: Can you recommend a diet which would increase the alkaline in my body so that uric acid stones do not develop? I take Effercitrate and Allopurinol.
A: Evidence from scientific studies of benefit from a so-called “alkaline diet” in uric acid crystal formation is not powerful. However, in general an alkaline diet means emphasising fresh vegetables (raw or lightly cooked), nuts, seeds and grains (eg, almonds, pumpkin, sesame, sunflower, flax, lentils, sprouted seeds) and two to three litres of fluid a day; ionised water is sometimes suggested, as well as herbal tea, lemon juice, vegetable juice, non-sweetened soya milk. According to this concept, grapefruit, lemon, lime, tomato and rhubarb are also alkaline. Foods which are “acidic” include meat, dairy produce, bread, fizzy drinks, tea, coffee, beer, fruit juice, sweets, chocolates, processed food products and fruit other than that mentioned above.
However, this is a very restrictive diet and is not nutritionally sound. For example, meat and dairy produce are good sources of many nutrients (eg, protein, calcium, iron and zinc) while bread is a good source of fibre, B vitamins and some minerals. To follow this diet is likely to result in nutritional deficiency and I would not recommend it without medical advice and/or the guidance of a registered dietitian or nutritionist.
Soya for menopause
Q: I am menopausal, suffering the usual hot flushes. An assistant in a health food store said that I should try eating a spoonful of pure soya every day. This product she recommended is frozen isoflavenoles. Is this is the best way of taking soya, as it is not easy to obtain the frozen soya locally?
A: Soya contains isoflavones and other phytochemicals which mimic oestrogen. This is why it is thought to help symptoms such as hot flushes. However, I should emphasise that high quality scientific trials and meta-analyses (scientific reviews) of these trials have not shown much benefit, if any. However, as an individual, soya might help you so it is worth a try. Soya is a healthy food and available as tofu, tempeh, TVP, miso and soya alternatives to dairy milk and yogurt. Frozen soya beans are also available in supermarkets. Alternatively you could try an isoflavone supplement (50mg twice a day). I know of no particular benefit of frozen soya.
Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.
