Thursday, April 19, 2007

No thanks for the mammary

WHEN personal medical history is plied out to kindle earnest conversation or friendly banter strays into citing an array of exotic ills, allergies or hypochondriac infirmities one’s body wears like a swathe of military service decorations, such talk might be fashionable confession. Or much of it is bellyaching in lieu of breast-beating, maybe lavish indulgence to solicit sympathies or draw attention.

New York-based science fiction and fantasy writer Steve Carper plunged himself into earnest research after learning in 1978 that milk, dairy products and milk-laced food wouldn’t agree with his tummy. He learned a lot more about the quaint condition he suffers from. By 1996, he had turned up a volume, a 330-page straight-teller called Milk is Not for Everybody (Living with Lactose Intolerance) that is a joy to read.

Lactose intolerance isn’t a unique fad he picked up from any of about 3 billion people in the world that are lactose intolerant—virtual sitting ducks caught in the crossfire of a multi-million dollar advertising battle as two multinationals seek to corner a $100-million market in products for the lactose intolerant.

So there’s much lucre to be made from lactose intolerance which, as Carper had it worded "is not a disease, not a syndrome, not a disorder. It is the normal state of humanity and always has been throughout history."

Normal it is for one’s innards suddenly turning into a catastrophe zone: "Rumblings, gases, noises, explosions, rushing water and general commotion—a bout of lactose intolerance makes my insides feel like Tokyo in the midst of an attack by Godzilla. Amazingly, all that sound and fury comes not from a 100-foot-tall monster, but from a mere fraction of an ounce of (milk) sugar hidden in a delicious and nutritious meal."

Now, that makes sense with a sense of humor shining through.

Milk sugar-induced agony seems nothing to carp about: "You can define lactose intolerance simply as letting your lactose intake exceed the production of an enzyme called lactase, but that’s like dismissing the national deficit as nothing more than letting spending exceed taxes. It’s true as far as it goes, but if you want to do anything about the deficit it helps to know some basics about economics, party politics and what a trillion is. Digestion, fortunately is somewhat simpler to explain."

Carper lets out punch lines at himself and the whacked-out state of national affairs. But to even out, he takes a dig at doctors predisposed to brewing names in medical journals to latch a tab on what they thought to be a disease.

For convenience, he settles for "lactose intolerance" since no such "popular equivalent name exists for the ability to digest lactose, just as there is no term for the state of having a broken leg."

Water, vitamins and minerals are tolerable goodies directly absorbed in the digestive tracts— but other food molecules are too large and too complex in their biochemistry to be similarly processed. The body produces specialized proteins called enzymes to render molecules of protein, fat and carbohydrates into less complicated basic components—amino acids, fatty acids and simple sugars that can now be sifted into the bloodstream. This is what digestion boils down to.

Milk is water-doused sugar technically called lactose, thanks to mom’s mammary, we’re all born with a sweet tooth. Each molecule of lactose in milk is a fusion of two simple sugars glucose and galactose. Lactase is the digestive enzyme assigned the task of tearing down lactose into tenable bits fit for absorption into the bloodstream. If lactase isn’t there or its production has been stopped in the digestive tract, milk intake spells tummy trouble.

As last and weakest among intestinal enzymes, lactase is also the first to go: "The lactase-making ability of a few may diminish in their first year of life. Many more will keep their lactase high enough through age five and only then see a drop. And many more people simply keep producing sufficient lactase and never have lactose intolerance at any time in their lives."

About one fifth to one in every three people with lactose intolerance wreak havoc on their alimentary by taking a full glass of milk—and two glasses a day, as a TV ad prescribes will trigger a riot of sorts in tummies of nine among 10 lactose intolerance sufferers.

That doesn’t mean sufferers have to avoid milk and milk-based products like the plague. Say, butter is almost entirely milk fat—and is likely to inflict greater horrors on the circulatory system. Cheese is from milk protein and sheds off lactose remains via processing and aging—it takes two kilos of milk or cheese to equal the lactose content in two glasses of milk, a famished gourmand might as well eat a horse than dump two kilos of butter or cheese down his gullet.

And there are traditional sour milk preparations—yogurt, kumiss, kefir and acidophilus milk—with beneficial bacterial colonies swimming in them and churning out lactase of their own to break down up to 40% of milk’s lactose content.

Milk squeezed out of a cow’s teats is a niggardly 5% lactose, mom’s is 7% but dried milk products pack up to 80% that the sufferer need not inflict on his insides.

Despite those ads that bombard the sound bite "You never outgrow your need for milk," the hankering for milk can be outgrown and serious thought should give way to a craving for teats. Thus, Carper lets out a caveat: "If you believe everything you read, lactose intolerance may be the most widespread medical condition in the U.S."

He cites a veteran in gastrointestinal research who dismisses the hype about lactose intolerance: "Marketers are overdoing the severity of the problem."

The woes can be downright alimentary but there’s mounds of monies that can be realized from lactose intolerance— sales of lactase enzyme pills, reduced-lactose milk products and nondairy milk alternatives now exceed a fat $200 million a year in the U.S. alone.

Lactose intolerance can spawn such social gaffes as farting in sweet sorrow or too many a visit to the comfort room but, as Carper asserts, "adults do not die from lactose intolerance, nor do they need extensive testing, prescription drugs, or hospitalization.

"From a doctor’s point of view, lactose intolerance is hardly a sexy issue (nor a very profitable one, if you want to be cynical). Doctors can’t fairly be blamed for fir considering lactose intolerance to be a relatively minor concern."

And in the Philippines in which one of every five Filipinos make do with less than P50 a day for three square meals, pay for the semblance of a roof over his head and a quilt work of rags to clothe himself, lactose intolerance might be taken for a luxury food item that only the moneyed can enjoy.

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