Most tweens* and teens are not getting the recommended 1,300 mg of calcium a day they need to build strong bones—in fact, fewer than one in 10 girls and just more than one in four boys ages 9 to 13 are at or above their adequate intake of calcium.1 And adolescents who may be lactose intolerant are even less likely to get enough calcium.
As you know, pediatric bone development plays a considerable role in osteoporosis prevention. The tween and teen years are critical for bone development because most bone mass accumulates during this time. In fact, by the time teens finish their growth spurts around age 17, 90 percent of their adult bone mass is established.
As a health care provider, you can help your patients get the calcium they need by talking with them and their parents to determine if they have trouble digesting lactose and by providing guidance about how they can get enough calcium each day in spite of this condition.
Note: Tweens are kids ages 9 to 12.
Are there different types of lactose intolerance?
Individuals with lactose intolerance are unable to digest significant amounts of lactose due to an inadequate amount of the enzyme lactase.2
Research shows that lactase is high at birth in all infants regardless of race or ethnicity, but wanes by age 5 to 7 in non-Caucasians and other populations that don't traditionally include dairy products in their diets.3
There are three main types of lactose intolerance:
• Primarily lactose intolerance, in which individuals who were able to digest lactose previously begin experiencing symptoms of digestive discomfort with no history or signs of underlying intestinal disease, is the most common form of lactase deficiency.
• Secondary lactose intolerance is the result of a gastrointestinal disease, such as severe gastroenteritis.
• Congenital lactose intolerance, such as galactosemia, is a lifelong complete absence of lactase, and it is relatively rare. However, it is not uncommon for secondary lactose intolerance to be misdiagnosed during the newborn period as congenital lactose intolerance.
Clinical symptoms of lactose intolerance can include abdominal pain, diarrhea, flatulence, and bloating. The severity of symptoms differs, often depending on the amount of lactase remaining in the body and how much lactose has been consumed.
Individuals vary in their degree of lactose intolerance, but even children and teenagers with primary lactose intolerance can usually consume 8 to 12 ounces (1 to 1 1/2 cups) of milk without experiencing symptoms. Some patients with lactose intolerance may believe they are allergic to milk or milk products. A milk allergy, however, is related to the proteins in milk rather than the lactose.
How common is lactose intolerance?
An estimated 30 million to 50 million American adults are lactose intolerant.4 The pattern of primary lactose intolerance appears to have a genetic component, and specific populations show high levels of intolerance, including approximately: 95 percent of Asians, 60 percent to 80 percent of African Americans and Ashkenazi Jews, 80 percent to 100 percent of American Indians, and 50 percent to 80 percent of Hispanics. Lactose intolerance is least common among people of northern European origin, who have a lactose intolerance prevalence of only about 2 percent.5
Most people with lactose intolerance do not require a completely lactose-free diet.
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