Ask the Doctor: Lactose Intolerance; Berries

Q. I’ve started drinking more almond milk because I seem to have become somewhat lactose intolerant as I’ve gotten older. Is almond milk just as nutritious as cow’s milk or soy milk?

A. Lactose intolerance is a fairly complex condition. Your body produces an enzyme called lactase, which helps break down lactose in dairy products. People with low lactase levels therefore have difficulties digesting even moderate amounts of milk and milk-based foods. Generally, a person’s lactase levels don’t change much with age. However, symptoms of lactose intolerance, including bloating, cramps, and diarrhea, can be attributed to more than just lactase levels. The speed with which your body digests all types of food can change over time. This, along with a growing sensitivity to other foods you consume in addition to dairy, can cause more digestive issues as you age.

There are some important distinctions you should understand about nutritional benefits of various milks. For example, almond milk contains no calcium naturally—but you can buy calcium-fortified almond milk to match or even exceed the calcium you would get in the same amount of cow’s milk. And almond milk doesn’t have the same amount of protein as cow’s milk, but it’s a great source of vitamins A and D, and contains no saturated fat or cholesterol. It’s also lower in calories than even skim milk—but watch out for almond milk flavored with added sweeteners.

Soy milk contains no cholesterol, and is lower in calories than skim milk, while containing about the same amount of protein. Soy milk is also a great source of vitamins A, D, B12, and potassium. Some research suggests that soy may interfere with the absorption of thyroid hormone replacement medication taken by people with hypothyroidism. If you have thyroid disease, talk with your doctor about how much soy is safe to consume.

Q. I hear a lot about the health benefits of strawberries and blueberries, but what about other berries, such as raspberries and blackberries?

A. Summer is definitely berry season, and you should feel good eating a wide variety of these healthy sweet treats. Strawberries and blueberries get a lot of attention for being excellent sources of vitamin C, fiber, and anthocyanins (chemical compounds associated with improved cardiovascular health), but other members of the berry family offer just as many benefits.

Blackberries are high in vitamin C and fiber, and their dark color means they are packed with antioxidants, which are associated with a lower risk of cancer, and better heart, brain, and oral health. Raspberries have similar qualities, and contain a phytochemical called ellagic acid, which is associated with reduced cancer risk, and the antioxidant quercetin, which may help improve cholesterol levels.

So take advantage of all types of fresh berries this summer—and after. Consume a wide range of fruits and vegetables of all colors to get the best mix of antioxidants and other health benefits. 

-ORLI R. ETINGIN, M.D., EDITOR-IN-CHIEF

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