Content of the material
To make cheese, typically an edible acid like rennet is added to milk, which forces the liquid to curdle and form curds. Whey is the liquid remaining after the milk has been curdled and strained. To make cheese, the curds are separated from the whey and then, depending on the variety of cheese, are ripened and aged. “Most of the lactose follows the whey,” explain the cheesemakers from Jarlsberg. “Very little lactose is left in the curd,” which, after ripening, becomes the final product available in stores.
The enzyme lactase in the small intestinal lining breaks down lactose to glucose and galactose, which are then absorbed . Most healthy people can absorb at least 50 grams of lactose (aka 1 liter of milk) in one sitting .
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Causes of lactose intolerance
There are two types of lactose intolerance that scientists recognize: primary and secondary lactose intolerance. Primary lactose intolerance is caused by either a deficiency of lactase or decreased lactase production that becomes more prevalent with age.
Problems in the small intestine, resulting in decreased production of lactase, cause secondary lactose intolerance. Illness, injury, infection, or celiac disease can cause these problems.
Both types of intolerance have to do with an inability to digest lactose due to low lactase levels. Primary lactose intolerance is much more common than secondary lactose intolerance. In North America, 79% of Native Americans, 75% of African Americans, 51% of Hispanics, and 21% of Caucasians have primary lactose intolerance.
Acquired lactase deficiency is also possible. In these cases, individuals acquire lactose intolerance as they age.
Lactose and Cooking
- Lactose is commercially available in the form of a powder and tablets.
- Lactose powder is a white crystalline substance without odor, about 20% as sweet as sucrose .
- Lactose solubility in water at 77 °F (25 °C) is 21.6 g/100 mL . Lactose solubility in 10% ethanol at 77 °F (25 °C) is 13 g/100 mL .
- Lactose is not a fermentable sugar: it is not fermented by baker’s yeast, so it can be used as a preservative and browning agent in baked goods ; it is also not fermented by brewer’s yeast, so it can be used as a thickener and sweetener in beer .
- Lactose melting point is 396-417 °F (202-214 °C) [56,59].
- Lactose decomposes to glucose and galactose at 220 °C (428 °F) , so it does not seem likely that any significant amount of lactose would be decomposed during usual milk boiling at 212 °F (100 °C).
- Caramelization of lactose starts at 302 °F (150 °C) and browning at 347 °F (175 °C).
- Lactose is a reducing sugar  so it takes part in the Maillard browning reaction with amino acids.
Processed American Cheese Lactose
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According to Beemster, a producer of Dutch Gouda, "during the maturation process, the lactose changes into lactic acid." Beemster claims their Classic Gouda (matured 18 months) and XO Gouda (matured 26 months) is lactose-free. However, some of their other varieties of Gouda that aren't aged as long do have traces of lactose. Cabot Creamery, a Cheddar producer, says, "Aged cheeses, such as Cabot's naturally aged cheddar contain 0 grams of lactose. In fact, unlike many other dairy products, cheese, in general, is very low in lactose. Most contain less than 1 gram per serving and should not cause any lactose intolerance related symptoms."
Other cheese types that are aged for long periods of time and are likely to have very small or non-measurable levels of lactose include:
- Parmigiano-Reggiano (typically aged 12 to 24 months)
- Grana Padano (typically aged 12 to 20 months)
- Mimolette (typically aged 22 months)
- Romano (typically aged 3 to 4 years)
How is lactose intolerance diagnosed?
Lactose intolerance is usually self-diagnosable, but many of the symptoms of lactose intolerance are the same as irritable bowel syndrome and a milk allergy. So if you suspect you are intolerant, it is important to discuss it with your primary care provider to make sure there are no other medical or nutritional concerns.
Some medical tests can help accurately diagnose the condition so that people can treat their symptoms appropriately. A hydrogen breath test, which is administered by a gastroenterology specialist, measures how much hydrogen is in the breath after consuming dairy products. It tests for hydrogen because the body turns undigested lactose into hydrogen gas.
Blood tests are another type of laboratory test that can help diagnose lactose intolerance. A blood test looks for elevated blood glucose levels after the patient consumes a standard amount of lactose. If blood glucose levels don’t go up, this means the body isn’t breaking lactose down into glucose.
If someone has genetic lactose intolerance, they’ll continue to have symptoms unless they stay away from dairy products. Secondary lactose intolerance may go away after the intestinal tract heals and begins to function normally again, which could take weeks or months. However, once lactose is eliminated from a diet, the body’s ability to produce the lactase enzyme decreases, resulting in less ability to digest lactose.
The simple fact that a particular cheese may be low in lactose (hello, dearest Gouda) doesn’t give you carte blanche to go on a cheese bender. Serving size matters. Depending on the level of sensitivity, most people with lactose intolerance can enjoy up to 2 percent lactose content. Also be mindful of combining forms of dairy. Milk is higher in lactose (up to 5 percent), and many recipes, like rich macaroni and cheese, rely on large amounts of both milk, heavy cream (4 percent lactose) and butter in the béchamel sauce. Certain crackers and baked goods, too, use milk and/or cheese powders that are significantly higher in lactose.
Fresh cheeses like mozzarella, ricotta and feta, which are not aged at all, should be avoided. Even American cheese and Velveeta, despite their reputations for being a heavily processed faux “cheese product,” contain anywhere from 9 to 14 percent lactose.
Author’s note: Upon researching this piece, the lactose-intolerant writer immediately procured an unnecessarily large wedge of imported Camembert. The results were thoroughly delicious and without gastrointestinal consequence.