Are you tired of not being able to drink milk, enjoy your favorite ice cream or put cheese on any of your favorite foods? Do they leave you gassy and feeling bloated? Well you are not alone. There may be over 30-50 million adults in the US affected by this same problem. This is known as lactose intolerance, a term closely related to lactose malabsorption. Lactose is the sugar found in milk. Let's explore what all this means and how you might be able to include dairy products in your diet.

Lactose malabsorption is a gradual reduction in the activity of lactase, the enzyme necessary to digest lactose in the gastrointestinal (GI) tract. Lactose malabsorption affects us more as we get older. This decline can also depend on an individual's genetic background. There may be no symptoms with lactose malabsorption, but there is a concern because lactase deficiency can lead to lactose intolerance.

Lactose intolerance can cause GI symptoms associated with the incomplete digestion of lactose. Not all individuals with lactose malabsorption develop these GI symptoms. Lactose intolerance means that you cannot completely digest foods with lactose in them. After eating foods with lactose in them, you may experience symptoms of diarrhea, swelling in the stomach, stomach pain, and gas.

Lactose intolerance is more common in Mexican-Americans, Native Americans, African-Americans and Asian Americans. The best way to find out whether you are lactose intolerant is to let your doctor know if you experience any GI symptoms after consuming milk products. Your doctor may do a blood, breath or stool test to find out if your GI problems are due to lactose intolerance. Lactose intolerance is not life threating, but depending on the severity of the symptoms, it can affect a person's quality of life.

Even though the body's ability to tolerate lactose cannot be changed, the symptoms can be managed. Studies show that there are different ways to treat lactose intolerance. One way would be to completely stay away from milk products. Eating less food with lactose may help, but keep in mind that you may not be getting the appropriate amount of calcium and vitamin D. Using medication may help digest lactose-containing foods. According to the 2010 Dietary Guidelines, if you are not eating at least three servings of milk products per day, you may need to consider taking a calcium supplement, since milk and foods made with milk are the most common source of calcium.

There are many choices on grocery shelves that can make it difficult to know which one you should buy. Lactose-free milk is basically regular cow's milk minus the lactose, the natural sugar in milk. It provides all of the same healthful nutrients (protein, calcium and vitamin D), just not the sugar that can cause digestive problems. Soymilk is a non-dairy option that is fortified with calcium and vitamin D, but research shows that people like lactose-free milk better than non-dairy alternatives. If you chose to continue drinking cow's milk, consider the following information.

-The 2010 Dietary Guidelines for Americans recommends 3 cups daily of low-fat or fat-free milk and milk products for those ages 9 and older, 2.5 cups for children ages 4 to 8 years, and 2 cups for children ages 2 to 3 years.

-Whole milk delivers 150 calories and 8 grams of fat (5 grams of saturated fat) per cup. A better choice would be Low-fat (1%) milk (100 calories, 2.5 grams fat) or nonfat milk (80 calories, 0.5 grams fat) to limit the intake of the saturated fats that can increase risk of heart disease.

-Reduced-fat (2%) milk is not a low-fat food. One cup has 5 grams total fat, of which 3 grams are saturated fat.

-You won't miss out on milk's nutritional benefits if you choose low-fat or nonfat milk (skim). All varieties have one third of the recommended daily value for calcium per serving.

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There are practical solutions that can help you enjoy your three servings of milk products per day. You can gradually reintroduce milk back into your diet by drinking smaller amounts of milk at a time. Drink low lactose or lactose-free milk products. Include them as a beverage at meals, or use them to prepare oatmeal and hot cereals. Yogurt with live and active cultures can also be more tolerable and may help the body digest lactose. You can make a dip for fruits or vegetables or make fruit smoothies from yogurt. Eat natural cheeses, which generally are low in lactose. One ways to include cheese in your diet is to top casseroles, soups, stews, or vegetables with shredded reduced fat cheese.

Bottom line: Before you completely give up on milk products make sure to consult your doctor with your concerns. Excluding all milk products from your diet can lead to other health concerns. Milk and other milk products are important sources of calcium and vitamin D, which are needed for growth and bone health at all ages. A decrease in calcium in your diet can lead to weakened bones and osteoporosis. With a balanced mix of carbs and protein and a rich supply of calcium and other bone-strengthening nutrients, three servings of milk per day certainly will do the body good.

1LT Bell is a Dietetic Intern here at WRNMMC in her second phase of the Army Graduate Program in Nutrition.