I was at a friend’s 30th birthday pool party last weekend, when something odd happened. As the afternoon progressed, despite most of us being close to or over the ripe old age of 30, everyone seemed to morph into an under five.

By sundown we had a full on Canadian vs. American gymnastics competition underway, overseen by some neutral but somewhat legless British and Bermudian judges.

Of course it would be easy to blame it all on the beer, but it seems there was another factor at play — the birthday cake, a gigantic Heineken bottle (ah so still beer-related after all). No doubt about it, the cake was a work of art, but just think how much food colouring it takes to turn icing into the perfect shade of green. The result? Lots of adults with Shrek-green tongues and some form of hyperactivity disorder. Fortunately, or unfortunately (not quite sure which) I missed out — as I have a lactose and wheat intolerance that sidelines most treats. I could eat them, but it’s just not worth it — the aftermath is painful and not very glamorous! So you see, I’m not so virtuous after all — a lot of my healthy choices are enforced rather than willingly made.

The upside to a largely cakeless life however, is that I’m a pro when it comes to lactose intolerance. Good news for our cheese addict in Warwick.

Question of the week: I have recently learned that I’m lactose intolerant. A sad day as I love so many wonderful yummy cheeses. My question is, what is lactose intolerance, what causes it, and why do I suffer while other cheese lovers around me can indulge and not clear a room the next day? — Lusting for brie, Warwick <$>

First off, lactose is otherwise known as “milk sugar”. It’s found in the vast majority of products made from dairy milk (cow’s, goat’s or sheep’s), including: milk, milk powder, butter, butterfat, buttermilk, yoghurt, fromage frais, cheese, cr|0xe8|me fraiche, cream, sour cream and ice cream. Sounds fairly simple I know, but lactose and its many guises are also commonly found in potato chip flavourings, sauces, stock cubes, deli meats, dressings, margarines and medications, so it’s easy to make a mistake. Lactose intolerance is a more mild form of an allergy. Its symptoms may not feel mild — they can include diarrhoea, stomach cramps, fainting, hot flushes, gas, headaches, nausea and fatigue — but intolerance is in an entirely different league to the anaphylactic shock associated with severe allergy.

When you have lactose intolerance, it means simply that your digestive system is “intolerant” to lactose. You don’t have a severe, life-threatening reaction, but you still have a negative reaction.

There are several key causes of lactose intolerance. These include:

* For over 99 percent of our evolutionary history, we have been hunter-gatherers. We didn’t harvest grain and we certainly didn’t stop a buffalo in the middle of the plains, milk it and then send it on its way. Gluten, wheat and dairy are therefore fairly new to the human diet and our digestive systems haven’t adapted all that well. In addition to these being “new” foods, they are prevalent in our diets. Think about how often the average person eats dairy: milk on cereal and in coffee, muffin (made with butter/marg or milk), sandwich with cheese, milk chocolate bar, pasta with a creamy sauce— it’s easy to have a dairy product at every single stage of the day. Many people are simply incapable of digesting that much lactose in one day — this can be entirely random, genetic or be influenced by medical conditions or ethnicity.

For example, Asian, East-European and African Americans are more pre-disposed to lactose intolerance than others.

* Further, it’s worth noting that as humans we were never meant to have milk in our diets for long. As hunter-gatherers, the only milk we had was breast milk, and so as we aged the need for producing lactase — the enzyme that digests lactose — became redundant. As a result, many people stop producing lactase as they grow older, or don’t produce very much. This explains why some people develop lactose intolerance in their teenage years.

* “Intestinal permeability” otherwise known as “leaky gut syndrome” can also cause lactose intolerance.

This digestive disorder can result from repetitive inflammation of the digestive tract (triggers include frequent infections, yeast overgrowth and prolonged use of some medications), causing the digestive lining to become excessively porous. When this occurs, lactose can leak into the bloodstream before it has been digested, triggering an allergic response.

* Some parasitic infections such as giardia and dysentery can trigger lactose intolerance. This may be because the infections and the strong antibiotics used to treat them can set off intestinal permeability.

But why you and not others? As I’ve mentioned, there may be a genetic, ethnic or medical influence at play here.

However, if none of these seem relevant to you, bear this in mind. Most people have a weak spot somewhere in their system — some people get frequent headaches, some have joint problems, some have skin problems and some just have a weak digestive tract. This can mean that while others can survive the points above and happily wolf down a pint of Ben & Jerry’s without batting an eyelid, you react more sensitively. Unfair, I know.

However, as usual, all is not lost.

When dealing with lactose intolerance, bear the following in mind:

* You may be able to tolerate a little lactose, just not a lot. If you really miss those yummy cheeses, try seeing if you can tolerate a little every three or four days. However if your symptoms are really unpleasant, you’ll need to choose the times you experiment wisely — i.e. not right before a big day at work or a night out!

* Some people find that taking lactase enzymes when they eat dairy, overrides the problem. You can buy lactase from both Down to Earth and Rock On. The Lactaid products (which incorporate lactase enzymes) may also be a good option.

* Although goat’s milk contains lactose, it contains less, so you may be ok with goat’s milk and cheeses. Test carefully and note that food intolerance reactions can take up to 72 hours to manifest. Keep a food/symptom diary.

* Although casein and whey are dairy products, they are lactose free, so if you are just lactose intolerant (rather than dairy intolerant) you will probably not have a reaction. Most “vege” or lactose-free cheeses contain one or both of these ingredients. Some taste like rubber, others are great! Down to Earth has a good selection.

* Soy products often make a great alternative to dairy. Silk soymilk is really very good and Toffuti cream cheese tastes great, although I would limit the Toffuti products as they tend to have a high hydrogenated fat content.

* If you like to make creamy sauces or curries try cooking with coconut milk as it’s entirely dairy free. Careful of coconut cream though, as this can sometimes include lactose, check labels carefully.

IMPORTANT: Whilst lactose intolerance is not life threatening, anaphylaxis is. Anaphylaxis is commonly associated with peanut allergy but can be triggered by other foods too, including dairy products. Therefore, before you start experimenting with lactose, confirm with your doctor that you do just have intolerance, not anaphylaxis. Symptoms of anaphylactic shock include (but are not limited to): respiratory distress, low blood pressure, fainting, unconsciousness, hives, vomiting, abdominal pain and an impending sense of doom.>The advice given in this article is not intended to replace medical advice, but to complement it. Always consult your GP if you have any health concerns. Catherine Burns is a fully qualified Nutritional Therapist. She can be contacted on 291-4725 or clinicalnutrition[AT]gmail.com. Course details: www.nutrifitbermuda.bm.