Lactose is the naturally occurring sugar found in milk . People with lactose intolerance do not produce enough lactase to adequately breakdown lactose , which can result in gastrointestinal symptoms like bloating , pain and diarrhoea after consuming milk and other lactose containing dairy products .
Even people with lactose intolerance can usually tolerate a level of lactose ( around 12g per day or 1 cup of milk ), as they may still produce some lactase . This may be better tolerated if spread across the day . For those who are lactase deficient , regular consumption of lactose containing foods may promote colonic adaptation . This means there may be an increase in lactose digesting bacteria in the colon , which may result in reduced intolerance symptoms .
Although it is commonly assumed that gastrointestinal symptoms experienced after consuming regular milk is due to lactose intolerance , lactose might not be the cause of some people ’ s digestive discomfort . It ’ s important to talk to your doctor and dietitian to help determine if you have a true lactose intolerance .
Milk from dairy cows contains different proteins , including casein and whey . Approximately one-third of the protein in regular cow ’ s milk is beta-casein , of which there are two types - A1 and A2 . There is a slight difference in the way the A1 and A2 beta-casein proteins are digested in the body – the A2 beta-casein protein is easier on digestion . Some studies have shown that the A1 beta-casein protein may be a contributor to gastrointestinal symptoms following milk ingestion for some people who have difficulty digesting milk .
Some dairy foods contain less lactose than others and may be better tolerated . For example , a serve of hard cheese or yoghurt contains less lactose than a glass of milk .
With a little planning , dairy foods can usually be included in the diet of a person with lactose intolerance . See below some common foods and their lactose content .
Cheddar cheese 0.1g lactose per 100g
Natural yoghurt , regular ( 3 %) fat 5.1g lactose per 100g
Feta cheese 0.4g lactose per 100g
Skim milk 5.5g lactose per 100g
Ricotta cheese 2.7g lactose per 100g
Full cream milk 6.1g lactose per 100g
Symptoms of milk intolerance , but maybe it ’ s not lactose ? The first step when trialling milk with only the A2 protein should be a dairy elimination diet to resolve symptoms . Then , follow 4 simple steps :
Start with a small portion of milk containing only the A2 protein in tea , coffee , on cereal and in recipes
DAY 1
2 tbsp
Gradually increase over a week to a full of milk containing only the A2 protein
DAY 4
3 / 4 cup
DAY 2
4 tbsp
DAY 5
1 cup
Avoid other regular dairy foods during this reintroduction phase
DAY 3
1 / 2 cup
If no symptoms arise during the reintroduction phase , milk containing only the A2 protein could be the answer for your patient or client
Supported by The a2 Milk Company , February 2022 , v1
Grains contain three distinct layers :
Whole wheat cereal flakes 4.7g fibre per 40g serve 17 % daily fibre needs
Wheat bran flakes 5.4g fibre per cup 20 % daily fibre needs
Natural muesli 7g fibre per ½ cup 25 % daily fibre needs
Fibre is a health hero for your gut . It ’ s the indigestible component of plant foods that passes through your digestive system – and provides a raft of health benefits along the way ! Not only does fibre keep you regular , it can also support a healthy ticker by lowering cholesterol levels and help to keep you feeling energised by balancing your blood sugars . What ’ s more , fibre has a fullness factor , so if you eat a lot of it , it ’ ll keep pesky hunger pangs at bay . You ’ ll find fibre in plant foods like Adults need grains , fruit , vegetables , legumes , nuts and seeds .
25-30g fibre per day
Breakfast Cereal
Puffed rice cereal 0.9g fibre per cup 3 % daily fibre needs
Mixed grain breakfast flakes 1.2g fibre per cup 4 % daily fibre needs
Rice crackers 0.3g fibre per 10 crackers 1 % daily fibre needs
White bread 1g fibre per slice 4 % daily fibre needs
The inner core called the germ . This is rich in essential micronutrients , like iron for oxygen transport and Vitamin E for a healthy heart .
The middle layer called the endosperm . This is rich in carbohydrates .
Gluten free mixed grain bread * 2.4g fibre per serve 9 % daily fibre
Wholegrain crispbreads 2.5g fibre per 3 crispbreads 9 % daily fibre needs
Brown grainy bread 3.4g fibre per slice 12 % daily fibre needs
The outer layer called the bran . This is rich in fibre .
Bread / Crackers
Grains
White rice * 0.8g fibre per ½ cup cooked 3 % daily fibre needs
Cous cous 1.5g fibre per ½ cup cooked 5 % daily fibre needs
Brown rice * 1.4g fibre per ½ cup cooked 5 % daily fibre needs
Quinoa * 2.8g fibre per ½ cup 10 % daily fibre needs
Rolled oats 3.9g fibre per ½ cup 14 % daily fibre needs
Whole grains , like rolled oats and brown rice , contain all three layers of the grain . Refined grains like white bread and white rice , on the other hand , only contain the endosperm .
With good health in mind , it ’ s wise to choose whole grains most of the time . Not only do they contain more fibre than their refined grain equivalents , they ’ re also more nutritious and there ’ s a raft of scientific evidence proving just how good for you they are . Research has shown that eating at least three serves of wholegrains a day has been linked to reduced risk of heart disease and diabetes . What ’ s more , grain fibre works differently to other types of fibre , and has unique health perks . For example , studies have shown that grain fibre is protective against bowel cancer .
Pasta / Noodles
Vermicelli noodles 0.6g fibre per ½ cup 2 % daily fibre needs
Soba noodles 1g fibre per ½ cup cooked 4 % daily fibre needs
Instant noodles 1.5g fibre per ½ cup cooked 5 % daily fibre needs
White pasta 1.6g fibre per ½ cup cooked 6 % daily fibre needs
Wholemeal pasta 4.4g fibre per ½ cup cooked 16 % daily fibre needs
Gluten is the natural protein found in wheat , rye , barley and oats . Some people are sensitive or intolerant to gluten and as result , they need to avoid it in their diet . The good news is , if you do need to avoid gluten , there are plenty of high fibre foods you can still pop on your plate like fruit , vegetables , legumes , nuts and seeds , as well as gluten free grains , indicated by an asterix (*) on the table beside .
Supported by The Arnott ’ s Group . February 2022 , v1
There are many types of fibre . Insoluble fibre adds bulk to your stool and keeps you regular – without enough insoluble fibre , you may become constipated . Soluble fibre , on the other hand , absorbs water . It also adds bulk to your stool , which helps to keep things moving . New research has linked prebiotic fibre to improving constipation .
Wholegrains and legumes are gut-loving superstars . To boost your wholegrain intake , opt for rolled oats , brown rice and wholemeal pasta over their refined white counterparts , like white rice and pasta . To eat more legumes , try baked beans for breakfast , a chickpea salad for lunch or dhal made from lentils for dinner .
Fruit and vegetables are particularly rich in fibre , especially the skins – so throw away your veggie peeler ! Your target is a rainbow of at least two fruits and five veg a day .
You may be constipated if you don ’ t drink enough water , even if your diet is high in fibre . Fibre draws water into your digestive tract and softens the stool . Without enough water , your stool will be hard and difficult to move along your digestive tract .
Exercise strengthens the muscles of your digestive system and gets them working , speeding up the transit time of the contents in your bowel .
Some pre- and probiotics have been linked to reducing constipation . In particular , the prebiotic Galacto-oligosaccharides ( GOS ), which is found in beans , chickpeas , lentils , cashews and pistachios , ( along with GOS-enriched foods like milk ) has the potential to nourish helpful microbes , like bifidobacteria , that play a key role in digestive health . There are also specific strains of probiotics , such as B . lactis ( BB-12 ® ), that can be added to food products , like yoghurt and kefir , which have the potential to support regularity of bowel movements . Your dietitian can help you identify foods that have the relevant probiotic strains in a dose that is suitable for your condition .
Please note this information is not intended to be a substitute for professional advice , which should be tailored to your individual circumstances . Supported by The Culture Co and Dairy Farmers Gut Active . February 2022
Worrying excessively can upset your gut in several ways . It can cause inflammation and lead to constipation and / or diarrhoea .
This can cause constipation as the stool will lose moisture , which makes it harder to pass .
A shift in your usual routine – like going on holidays or doing shift work – can lead to constipation .
As a rule of thumb , that ’ s 30mL of water per kilogram of your body weight each day . If you weigh 80kg , for
BB-12 ® is a trademark of Chr . Hansen ( A / S )
Drinking tea and coffee count towards your water target .
Your target is 30 minutes every single day . The more , the better .
PHGG is a natural , prebiotic dietary fibre produced from plant seeds called guar beans . It is taste-free , odourless and completely dissolves in liquid 1 . When added to foods and drinks like smoothies , bliss balls and homemade muffins , PHGG supports digestive health by :
Improving stool bulk 2 Helping to normalise stool consistency 2 Supporting regular bowel movements 2
Helping to manage flatulence , bloating and abdominal discomfort in people with irritable bowel syndrome 3
References : 1 . Yoon SJ et al . J Clin Biochem Nutr 2008 ; 42 ( 1 ): 1-7 . 2 . Rao TP , Quartarone G . Nutrition 2019 ; 59:158-169 . 3 . Giaccari S et al , Clin Ter 2001 ; 152 ( 1 ); 21-5 . Please note this information is not intended to be a substitute for professional advice , which should be tailored to your individual circumstances . Supported by Nestlé Health Science . February 2022
Supporting resources
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Patient resources for you to share with your clients
What is lactose and lactose intolerance ?
If it ’ s not lactose causing my discomfort , then what could it be ?
Lactose levels in foods
IS IT LACTOSE , OR SOMETHING ELSE ?
1
2 cup
3 4
Challenge accepted !
Soba noodle stir fry
Time : 30 minutes | Serves : 4
Ingredients
1 x 270g packet soba noodles , prepared according to packet instructions
3 tbsp EVOO 300g lean pork fillet , thinly sliced 2 cups broccoli head florets 2 medium carrots , julienned
1 small red capsicum , seeds removed and julienned
15 green beans , sliced 1 cup bean sprouts ½ cup coriander leaves 2 tsp black sesame seeds 2 tbsp sweet chilli sauce 2 tbsp lime juice
What is fibre ?
Why is grain fibre important ?
How much fibre is in different grain foods ? guthealthmonth . com
WHOLE GRAIN FIBRE : YOUR GUT-LOVING FRIEND
Method
LF
1 . Heat a large fry pan or wok to a high temperature . Add 1 tbsp of oil and stir fry half of the pork fillet for 3-4 minutes . Repeat with second half of pork . Remove from pan and set aside .
2 . Heat remaining oil , add broccoli , carrots , capsicum and beans and toss till just tender , another 3-4 minutes .
3 . Return pork to the pan with cooked noodles . Add sweet chilli sauce and lime juice . Toss to combine and heat through .
4 . Serve immediately garnished with bean sprouts , coriander leaves and black sesame seeds .
Gluten free swap !
Use rice noodles instead of soba noodles
And what if you ’ re on a gluten free diet ?
The happy gut guide | 19
GF *
PRACTICAL STRATEGIES TO BEAT CONSTIPATION
What is constipation ?
• Constipation is one of the most common medical complaints in Australia .
• If you struggle to empty your bowels completely or open your bowels infrequently , you may be constipated .
• Constipation can lead to stomach discomfort , nausea and fatigue .
Neglected gut ? An unhappy gut can be caused by a variety of factors , including ...
A lack of dietary fibre .
Five tips to get things moving
1
Choose minimally processed quality carbs .
Aim for colour and variety of veg .
2
Insufficient water intake .
Inactivity .
Drink enough water .
4
Stress .
Resisting the urge to have a bowel movement .
Changes to routine .
example , you should aim for 2.4L of water per day .
3
Move more .
Nourish your gut with pre- and probiotics .
5
What is fibre ?
PREBIOTIC FIBRE AND GUT HEALTH
• Fibre is the component of plant foods that cannot be digested . It is found in whole grains , fruit , vegetables , legumes , nuts and seeds . It is important to eat a variety of plant foods to get enough fibre in your diet .
• Consuming enough fibre is essential for digestive health . It keeps your bowels regular and can help manage constipation .
• High-fibre meals and snacks can help you feel full and satisfied .
• There are many different types of fibre , each of which offer different health benefits .
What is prebiotic fibre ?
Not all fibres are prebiotic . Prebiotics are a special type of fibre that act as food for the good bacteria called probiotics living in your gut . They are an essential component of a healthy diet .
Foods naturally high in prebiotics include :
Legumes , such as chickpeas , lentils , peas , black beans and baked beans Fruits including nectarines , white peaches , grapefruit and under-ripe bananas Vegetables including Jerusalem artichokes , chicory , brussels sprouts , garlic and onion Grain , such as barley , rye bread , pasta , couscous and oats
What is gut health ?
If you ’ re unable to consume enough prebiotic-rich foods , speak to your dietitian about using a prebiotic supplement .
• The gut plays an important role in breaking down food and absorbing nutrients , which helps your body function at its best .
• Your gut microbiome is comprised of trillions of bacteria and microorganisms living in your digestive system . A healthy microbiome is one that has many different kinds of bacteria and high levels of ‘ good ’ bacteria , like lactobacillus and bifidobacteria .
• The foundations of good gut health are : 1 . A healthy diet that includes plenty of plant foods and fibre
2 . An active lifestyle
• Gut health can be compromised by factors like poor eating habits , illness , certain medications or stress . Poor gut health may be characterised by digestive issues like abdominal pain , bloating , loose stools , constipation and diarrhoea .
Partially Hydrolysed Guar Gum ( PHGG )
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© Dietitian Connection 7 Infuse | February 2022