The Shavuot holiday, cheeses and stomach aches

Cheeses from cow’s milk, goat’s milk, sheep’s milk and even buffalo’s milk –Israel is abundant with various kinds of dairy products, and every deli and average supermarket provides a wide and delicious variety for the palette. “There are those who will say,” says Prof. Zvi Feirman, Director of the Gastroenterology Institute at the Hillel Yaffe Medical Center, “that dairy products are a part of our required diet, in childhood and adulthood. But the truth is that humans are different from other animals among the mammals in that they continue to consume milk after the nursing period, and it is not possible to say that these products are necessarily essential for our survival, this is in spite of the fact that they certainly have nutritional values that are for the most part positive.”

So it is true, dairy products contain nourishing and healthy nutritional supplements, but they also have one significant Achilles heel – lactose.

Milk allergy? It happens

There is a significant difference between two conditions:

milk allergy

lactose intolerance.

The term milk allergy refers to a condition in which a person is born allergic to milk proteins. This is a type of genetic mutation, like allergies to bee stings, peanut allergies and others. The same person, if exposed to milk protein, will suffer from the characteristic allergic responses such as rash, shortness of breath as well as a state of anaphylactic shock or even death. For those who are born allergic to milk - it is forbidden to consume any milk or dairy products.

In contrast, lactose intolerance refers to the milk sugar (lactose). There is an enzyme in the intestinal mucosa that is supposed to break down lactose. This enzyme is an enzyme that resides on the epithelial cells (mucosa cells) in the small intestine, and is responsible for the breakdown of lactose, which as mentioned exists in all animal dairy products that we consume.

As one matures, over one's lifetime, the amount of this enzyme decreases, therefore, the body cannot digest lactose. This can manifest as symptoms – in various levels of severity – such as stomach aches, gas, diarrhea and bloating whenever one eats dairy products. This phenomenon, of lactose intolerance, is common among 70% of the adult population in our country, regardless of ethnic origin.

“The severity of the decrease in the enzyme levels over the years is affected significantly by the amount of milk and dairy products one consumes,” points out Prof. Feirman, “in childhood years, intolerance is low, but as we grow older, whoever drinks and eats more dairy products, his/her body will react accordingly.”

It is worth mentioning that there are products which are relatively low in lactose, such as cottage cheese and yogurt.

To eat dairy products or not to eat dairy products – that is the question?

“Lactose intolerance is not dangerous to one’s health, in contrast to milk allergy,” explains Prof. Feirman, “it causes physical sensations that are potentially unpleasant. In other words, an effect on quality of life and that’s all.”

With that in mind, one should know that today lactose is contained in many products that do not contain milk – such as products in the food industry and pharmaceutical industry. Therefore, even if it is stated on the packaging (which is required by law) that the product contains lactose, we don’t always notice. “In truth they are relatively small amounts,” points out Prof. Feirman, “but one should definitely be made aware.”

So what do we do? There are a few ways to deal with it:

1.       Abstaining from excess consumption of dairy products.

2.       Consuming products that are low in lactose – products that are available today due to the increasing awareness of the issue of lactose intolerance. With relation to this, one should know that goat cheeses also contain lactose.

3.       For those with severe intolerance – ingesting the enzyme in its synthetic form before eating dairy products. These products are sold in pharmacy chains and health food stores and aid in digestion of dairy products.

In summary, know that milk is a source of calcium and protein, which are essential to our diet. That having been said, Prof. Feirman’s recommendation is to not get carried away with dairy consumption, and not just because of the unpleasant effects that are caused by reduced levels of the enzyme that breaks down lactose. In relation to the Shavuot holiday, on which, of course, completely avoiding dairy products is almost impossible, it is preferable, like any recommendation for a balanced diet, to eat in moderation. For those who are aware that they are lactose intolerant – it is recommended to take the pills that were mentioned earlier, or consume products that are low in lactose.