Long-Term Care Survey Alert

Resident got milk issues? Help him avoid GI distress.

Lactose intolerance can be a big problem for residents who love dairy foods or need to consume them to boost calcium and caloric intake.

The good news is that a few dietary changes can help prevent "lactose maldigesters" from suffering gastrointestinal symptoms, says Dennis Savaiano, PhD, a nutritional and food scientist and dean of Purdue University's School of Consumer and Family Sciences.

Key example: Drinking an eight-ounce glass of milk with a meal almost never causes a problem, whereas a couple of glasses on an empty stomach is more likely to lead to a problem, Savaiano tells Eli. Also, keep in mind that not all dairy products are created equal lactose-wise. Hard cheese contains almost no lactose, he says. People with problems digesting lactose may also tolerate ice cream which has a lower level of lactose and more solids to dilute the lactose, Savaiano adds.

For most people, simply including milk or dairy foods with meals will prevent symptoms, Savaiano says. If that doesn't work, the next step is to add a lactase enzyme preparation to milk, or the resident can take it orally.

The resident should try the enzyme when consuming small amounts of lactose-containing foods or beverages at first, suggests Becky Dorner, RD, LD, president of Becky Dorner & Associates Inc. in Akron, OH. Or you could give the person a small amount of lactose-reduced milk, she adds. Then gradually increase the amount of lactose foods and assess how the person tolerates them, she advises.

More is better: Repeated consumption of dairy foods induces or trains the colon to digest lactose more effectively, Savaiano counsels. Thus, lactose maldigesters who never consume milk will be more likely to experience GI symptoms than maldigesters who consume milk and dairy foods multiple times a day.

Good idea: Include some dairy foods with each meal, he suggests. "The goal is to provide three to four servings a day" to ensure the resident receives calcium, protein and the B vitamins. "For the elderly, providing adequate protein is important, and dairy is a very good protein source."