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Lactose is primary carbohydrate in milk. Cow’s milk contains 4-5% lactose, whereas human milk contains almost twice that amount. Lactose provides 30-50% of energy in milk, depending on fat content (skim vs. homogenized). A number of individuals are affected by lactose in diet, but there is a difference between intolerance and maldigestion.
Lactose maldigestion is "a disorder characterized by reduced digestion of lactose due to low availability of enzyme lactase." Lactose intolerance is "the term for gastointestinal symptoms (flatulence, bloating, abdominal pain, diarrhea, and 'rumbling in bowel') resulting from consumption of more lactose than can be digested with available lactase." In other words, intolerance refers to symptoms of maldigestive disorder caused by an insufficient enzyme required to hydrolyze lactose to galactose and glucose.
Genetic defects often cause a deficiency of lactase, as well as injuries to mucosa lining of intestines or with age (as we age our enzyme levels decrease). When lactose molecules remain in intestine undigested, they absorb water and this can cause bloating, discomfort, cramping, diarrhea, and nausea. Bacterial fermentation along intestinal tract that produces lactic acid and gas is also a characteristic of lactose intolerance.
It is estimated that one in three adults suffer from lactose maldigestion and it appears to be inherited in about 80% of world’s population, including most Greeks, Asians, and Africans. Those who suffer from any discomfort after eating or drinking milk products can consume foods labeled lactose free or take an enzyme preparation such as Lact-Aid to aid digestion. Do note, however, that lactose intolerance varies and amount of lactose allowed in a diet depends on an individual’s tolerance. Some people cannot tolerate milk, ice cream, or creamed foods, but they can eat aged cheeses and yogurt (some brands are better tolerated than others) without difficulty. Lactose products include:
