Can lactose-free milk cause diarrhea?
By
Dr Rafael Frascino Cassaro (PhD)
| Reviewed by
Dr Anny Manrich (PhD)
The contents of this article are fact-based except otherwise stated within the article.
Author bio
Dr Rafael Frascino Cassaro PhD is a Chemist with expertise in Food Technology, extraction of essential oils from food sources, organocatalysis, extraction by supercritical CO2 and organic chemistry. He writes and reviews content on these topics.
Dr Rafael Frascino Cassaro’s Highlights:
- PIPE-FAPESP Project Coordinator for the company Bioativos Naturais Ltda involving the extraction of essential oils from food sources, with supercritical CO2.
- PhD in Chemistry with research in supercritical fluid reactivity.
- Bachelor of Environmental Chemistry at University of São Paulo State (UNESP)/Brazil
Professional Experience:
Dr Rafael Frascino Cassaro’s Experience:
Dr Rafael coordinated a PIPE-FAPESP Project (Company Research and Innovation Project) for the company Bioativos Naturais Ltda, involving the extraction of essential oils with supercritical CO2 from food sources such as turmeric, ginger, hops, orange bagasse, pepper rose, cupuaçu pie, among others.
Dr Rafael has worked on a project, involving studies of the influence of pre-treatment on the recovery of crude food extracts by extraction with supercritical CO2 (Supercritical Fluid Extraction or SFE) and with pressurized liquids (ethanol and water) for food sources, aimed at obtaining oleoresins; determination of global yield and chemical composition of crude extracts. As a postdoctoral fellow for the Food Engineering department at the University of Campinas/Brazil
Dr Rafael Frascino Cassaro has worked as a substitute Professor at the University of São Paulo State (UNESP) on General Chemistry and Thermodynamics II disciplines for the Food Engineering course.
Education:
- 2009 Bachelor in Environmental Chemistry at the State University of São Paulo, Brazil
- 2015 PhD in Chemistry with research in supercritical fluid reactivity University of São Paulo, Brazil
- 2017 Post Doctoral in Food Engineering Research: Influence of Biomass Pre-Treatment on Supercritical CO2 Extraction: Preservation of High Added Value Assets and Reduction of Process Costs at the State University of Campinas, Brazil
The main publications of Dr Rafael Frascino Cassaro are:
RC Bazito, RF CASSARO, LC OLIVEIRA, RA Gariani, CAO Nascimento. (2013). Proline derivatives as organocatalysts for the aldol reaction in conventional and non-conventional reaction media. Green Processing and Synthesis 2, 43-50
TS Bastos, SB Rodriguez Reartes, MS Zabaloy, RF Cassaro, RC Bazito. (2019).Phase Behavior for the System Carbon Dioxide plus p-Nitrobenzaldehyde: Experimental and Modeling JOURNAL OF CHEMICAL AND ENGINEERING DATA 64 (5), 2116-2125
GH Sakae, LM Takata, AS Paulino, RC Bazito, RF Cassaro, C Princival, .(2013). A high enantioselective Proline-based helical polymer catalyst for aldol type reaction. Blucher Chemistry Proceedings 1 (2), 214-214
You can view some of Dr Rafael’s work below and links to his professional profile.
Research Gate: https://www.researchgate.net/profile/Rafael-Cassaro-2
Fapesp: https://bv.fapesp.br/pt/pesquisador/680718/rafael-frascino-cassaro/
Google Scholar: https://scholar.google.com/citations?user=ToO7HIcAAAAJ&hl=en
Linkedin: https://www.linkedin.com/in/rafael-frascino-cassaro-4a156a37/?originalSubdomain=br
ORCID: https://orcid.org/0000-0002-3729-2858
Reviewer bio
Dr Anny Manrich PhD is a food Engineer with expertise in Food Technology, Natural Polymers, Edible Films, Enzymes, and Nanotechnology. She writes and reviews content on these topics.
Dr Anny Manrich’s Highlights:
- Research and Technology at the Brazilian Agricultural Research Corporation
- PhD in Chemical Engineering with a focus on Biochemistry at the Federal University of Sao Carlos/ Brazil and a one-year scholarship at the Technical University of Munich/ Germany
- Bachelor of Food Engineering at the University of Campinas/ Brazil and a one-year scholarship at the Technical University of Munich/ Germany
“To solve a problem, global vision and multifactorial understanding are necessary. Therefore, in addition to expertise, one should seek multidisciplinary thinking connected with science and reality” – Dr Anny Manrich, PhD.
Professional Experience:
Dr Anny Manrich’s Experience Joining the Brazilian Agricultural Research Corporation, as soon as she completed her doctorate,
Dr Anny Manrich has worked on several projects, including the more than three-year partnership project with BRF, a major food producer in Brazil. As a postdoctoral fellow.
Dr Anny Manrich has also contributed to several business consultancies and research projects of the National Nanotechnology Laboratory System in areas such as food technology, fibres, films and coatings and Nanotechnology; in a very determined way, having a great team relationship, being creative and committed.
Growing concerns about the safe introduction of nanomaterials into today’s life emphasises the need to create regulatory documentation in front of characterising, using and testing them. Dr Anny Manrich worked for two years on a characterization project for nanoscale materials, with the aim of exploring their possible health effects.
Despite not having specific academic training in packaging or polymeric films, Dr Anny Manrich works at the Brazilian Agricultural Research Corporation in areas of edible and biodegradable films produced from agricultural waste and in the development of films with greater resistance to water, having articles published in renowned scientific journals, which demonstrates her multidisciplinary understanding and creativity.
In addition, she worked for four years as a consultant to a food company to develop a line of snacks that are healthy and that add functional ingredients, physiologically active compounds that bring health benefits, made from fruits and vegetables, enabling diet improvement, disease prevention and reduction of nutritional deficiencies.
Dr Anny Manrich participated as a member of the examination board for two Master’s exams and one PhD exam at the Department of Chemical Engineering of the Federal University of São Carlos.
Education:
- 2001 Bachelor in Food Engineering at the State University of Campinas, Brazil
- 1999 One year scholarship at the Technical University of Munich
- 2004 Master in Chemical Engineering at the Federal University of São Carlos, Brazil
- 2012 PhD in Chemical Engineering at the Federal University of São Carlos, Brazil
- 2010 One year scholarship at the Technical University of Munich
The main publications of Dr. Anny Manrich are:
Articles
Manrich, A., Moreira, F. K., Otoni, C. G., Lorevice, M. V., Martins, M. A., & Mattoso, L. H. (2017). Hydrophobic edible films made up of tomato cutin and pectin. Carbohydrate Polymers, 164, 83-91.
Mendes, J. F., Norcino, L. B., Martins, H. H. A., Manrich, A., Otoni, C. G., Carvalho, E. E. N., … & Mattoso, L. H. C. (2020). Correlating emulsion characteristics with the properties of active starch films loaded with lemongrass essential oil. Food Hydrocolloids, 100, 105428.
Norcino, L. B., Mendes, J. F., Natarelli, C. V. L., Manrich, A., Oliveira, J. E., & Mattoso, L. H. C. (2020). Pectin films loaded with copaiba oil nanoemulsions for potential use as bio-based active packaging. Food Hydrocolloids, 106, 105862.
Manrich, Anny, et al. Immobilization of trypsin on chitosan gels: Use of different activation protocols and comparison with other supports. International Journal of Biological Macromolecules 43.1 (2008): 54-61.
Manrich, Anny; Komesu, Andrea ; Adriano, Wellington Sabino; Tardioli, Paulo Waldir ; Giordano, Raquel Lima Camargo . Immobilization and Stabilization of Xylanase by Multipoint Covalent Attachment on Agarose and on Chitosan Supports. Applied Biochemistry and Biotechnology, v. 161, p. 455-467, 2010.
Mendes, J. F., Martins, J. T., Manrich, A., Neto, A. S., Pinheiro, A. C. M., Mattoso, L. H. C., & Martins, M. A. (2019). Development and physical-chemical properties of pectin film reinforced with spent coffee grounds by continuous casting. Carbohydrate polymers, 210, 92-99..
Milessi, T. S., Kopp, W., Rojas, M. J., Manrich, A., Baptista-Neto, A., Tardioli, P. W., … & Giordano, R. L. (2016). Immobilization and stabilization of an endoxylanase from Bacillus subtilis (XynA) for xylooligosaccharides (XOs) production. Catalysis Today, 259, 130-139.
Mendes, J. F., Norcino, L. B., Manrich, A., Pinheiro, A. C. M., Oliveira, J. E., & Mattoso, L. H. C. (2020). Development, physical‐chemical properties, and photodegradation of pectin film reinforced with malt bagasse fibers by continuous casting. Journal of Applied Polymer Science, 137(39), 49178.
Mendes, J. F., Martins, J. T., Manrich, A., Luchesi, B. R., Dantas, A. P. S., Vanderlei, R. M., … & Martins, M. A. (2021). Thermo-physical and mechanical characteristics of composites based on high-density polyethylene (HDPE) e spent coffee grounds (SCG). Journal of Polymers and the Environment, 29, 2888-2900..
Mendes, J. F., Norcino, L. B., Martins, H. H., Manrich, A., Otoni, C. G., Carvalho, E. E. N., … & Mattoso, L. H. C. (2021). Development of quaternary nanocomposites made up of cassava starch, cocoa butter, lemongrass essential oil nanoemulsion, and brewery spent grain fibers. Journal of Food Science, 86(5), 1979-1996.
Manrich, A., Martins, M. A., & Mattoso, L. H. C. (2021). Manufacture and performance of peanut skin cellulose nanocrystals. Scientia Agricola, 79.
Nascimento, V. M., Manrich, A., Tardioli, P. W., de Campos Giordano, R., de Moraes Rocha, G. J., & Giordano, R. D. L. C. (2016). Alkaline pretreatment for practicable production of ethanol and xylooligosaccharides. Bioethanol, 2(1)..
Manrich, Anny, de Oliveira, J. E., Martins, M. A., & Mattoso, L. H. C. Physicochemical and Thermal Characterization of the Spirulina platensis. J. Agric. Sci. Technol. B, v. 10, p. 298-307, 2020.
Book Chapter
Terra, I. A. A., Aoki, P. H., Delezuk, J. A. D. M., Martins, M. A., Manrich, A., Silva, M. J., … & Miranda, P. B. (2022). Técnicas de Caracterização de Polímeros. Nanotecnologia Aplicada a Polímeros, 614.
Conference Papers
Ferreira, L. F., Luvizaro, L. B., Manrich, A., Martins, M. A., Júnior, M. G., & Dias, M. V. (2017). Comparação da estabilidade de suspensões poliméricas de amido/tocoferol e quitosana/tocoferol. In: CONGRESSO BRASILEIRO DE POLÍMEROS, 14., 2017, Águas de Lindóia, SP.
Manrich, A., Hubinger, S. Z., & Paris, E. C. (2017). Citotoxicidade causada por nanomateriais: avaliação do micronúcleo. In: WORKSHOP DA REDE DE NANOTECNOLOGIA APLICADA AO AGRONEGÓCIO, 9., 2017, São Carlos. Anais… São Carlos: Embrapa Instrumentação, 2017. p. 655-658.
Manrich, Anny, et al. Immobilization and Stabilization of Xylanase by multipoint covalent attachment on Glyoxyl Agarose Support. The 31st Symposium on Biotechnology for Fuels and Chemicals. 2009.
Manrich, Anny, et al. Application of immobilized xylanase on hydrolysis of soluble wood hemicelluloses after using microwave and organosolv pre-treatments. The 32nd Symposium on Biotechnology for Fuels and Chemicals. 2010.
You can view some of Dr Anny’s work below and links to her professional profile.
Research Gate: https://www.researchgate.net/profile/Anny-Manrich-2
Scopus: https://www.scopus.com/authid/detail.uri?authorId=23103497100
Google Scholar: https://scholar.google.com/citations?hl=en&user=Ea9qpr0AAAAJ
Linkedin: https://br.linkedin.com/in/anny-manrich-20693129
In this short article, we will provide an answer to the question “can lactose-free milk cause diarrhea?” and the details about lactose intolerance.
Can lactose-free milk cause diarrhea?
Lactose-free milk is highly unlikely to cause diarrhea. Research indicates that consumption of lactose-free and lactose-hydrolyzed milk and dairy products tends to result in fewer to no gastrointestinal symptoms.
Symptoms such as bloating, flatulence, diarrhea, and abdominal pain, especially among lactose intolerant individuals were greatly diminished , in comparison to the consumption of lactose-containing milk and dairy products. (1)
The same isn’t true for people who have cow’s milk protein allergy (CMPA), as lactose-free milk still has these proteins and can cause the same symptoms such as abdominal pain, vomiting, and diarrhea. (2)
Is lactose-free milk nutritional value comparable to that of regular milk?
Despite containing lactase, which aids in the digestion of lactose, lactose-free milk maintains a nutritional profile that closely resembles that of regular milk.
This similarity makes lactose-free milk a valuable and nutritious beverage choice. It remains abundant in protein and calcium, both crucial for preventing osteoporosis and preserving muscle mass.
Additionally, lactose-free milk offers a diverse array of essential elements, such as riboflavin, phosphorus, vitamins A and B12, potassium, magnesium, and zinc. (2, 3)
What is lactose intolerance?
Lactose intolerance (LI) is a condition affecting the mucosa of the small intestine, hindering the digestion and absorption of lactose from the diet. This occurs either due to low activity or the absence of the lactase enzyme, β-D-Galactosidase, in the body.
Individuals with LI may experience various symptoms, including flatulence, abdominal discomfort, bloating, a feeling of swelling, nausea, borborygmus (stomach rumbling), vomiting, constipation, and watery diarrhea with acidic stools.
In severe cases, LI can lead to dehydration, metabolic acidosis, and potentially malnutrition. (2)
Why lactose intolerance causes diarrhea and gasses?
The occurrence of diarrhea in LI stems from the failure to absorb or utilize lactose in the small intestine. This results in increased local osmolarity, attracting water and electrolytes to the mucosa, leading to intestinal dilatation and accelerated transit, which exacerbates malabsorption.
Subsequently, lactose accumulates in the colon, where intestinal microbiota ferment it, producing short-chain organic acids like acetic, butyric, and propionic acids, along with gasses such as methane, carbon dioxide, and hydrogen.
These gasses contribute to flatulence, distension, and abdominal pain. The acidification of feces due to the formation of organic acids leads to liquid stools, causing further abdominal distension and perianal hyperemia. (2)
What is Cow’s milk protein allergy?
Cow’s milk protein allergy (CMPA) refers to an atypical immune response triggered by the proteins present in cow’s milk. This allergic reaction can be immediate and results from the interaction between various milk proteins and immune mechanisms.
Cow’s milk contains over 20 proteins that have the potential to induce allergic reactions, with casein and whey protein being the primary allergens.
Individuals who experience this allergy typically react to nearly all types of animal milk because some of these proteins are also present in milk from other mammalian species.
This cross-reactivity contributes to the allergic responses observed in people who are sensitive to animal milk proteins. (2)
What are Cow’s milk protein allergy symptoms?
The symptoms of CMPA can manifest either immediately or may appear after a few hours or days following the consumption of cow’s milk or infant formula. Gastrointestinal symptoms are the most common, occurring in 50 to 75% of cases, and typically include abdominal pain, vomiting, and diarrhea.
Around 50% of cases exhibit respiratory tract manifestations, such as runny nose, sneezing, coughing, or wheezing. Skin symptoms, including itching, edema, rash, or hives, are present in approximately 10 to 30% of individuals with CMPA.
Among the symptoms of CMPA, anaphylactic shock is the most severe and life-threatening. However, it is a relatively rare occurrence, affecting approximately 12% of cases, making it less common compared to other symptoms. (2)
How is lactose-free milk made?
The production of lactose-free milk involves the addition of lactase enzymes to regular milk, following a series of carefully orchestrated steps. Initially, the milk undergoes pasteurization and is cooled to a temperature of 5 °C.
Within a holding tank, enzymes are introduced to the milk, and it is left undisturbed overnight. The duration of this process varies, depending on the desired degree of lactose breakdown, usually aiming for 70% or complete hydrolysis.
Once the desired level is attained, the milk is subjected to a reheating process to deactivate the enzymes, known as ultra-pasteurization. Subsequently, the lactose-free milk is carefully packaged into retail containers.
The ultra-pasteurization step plays a crucial role in significantly prolonging the shelf life of lactose-free milk when compared to regular pasteurized milk. This ensures that consumers can enjoy lactose-free milk for an extended period without concerns about spoilage. (4)
Conclusion
In this short article, we provided an answer to the question “can lactose-free milk cause diarrhea?” and the details about lactose intolerance.
Reference
- Sharp, E. D’Cunha, N. M. Ranadheera, C. S., Vasiljevic, T., Panagiotakos, D. B., & Naumovski, N. Effects of lactose-free and low-lactose dairy on symptoms of gastrointestinal health: a systematic review. International Dairy Journal, 104936. 2020.
- Silva, A. R. A., Silva, M. M. N., & Ribeiro, B. D. Health Issues and Technological Aspects of Plant-based Alternative Milk. Food Research International, 108972. 2020.
- Pereira, P. C., & Vicente, F. Milk Nutritive Role and Potential Benefits in Human Health. Nutrients in Dairy and Their Implications on Health and Disease, 161–176. 2017.
- Mahoney, R. R. Enzymes Exogenous To Milk In Dairy Technology | Beta-d-Galactosidase. Encyclopedia of Dairy Sciences, 907–914. 2002.
