Dear Stabby: Advice for the lactose-intolerant cheese lover

BRATTLEBORO — Last month I decided to change the format of the Cheese Log to better incorporate the numerous cheese questions I field almost daily. I invented an alter ego for myself: “Dear Stabby.”

Why “Stabby”?

I'm not a violent person, but I am skilled with a knife after many years of cheesemongering. Plus, it's fun to have an alias, even if you're not running from the law. And “Abby” is taken.

So far, response has been good. I want to send a big “thank you” to everyone who wrote with cheese questions. As per my request, I even got a few photographs, but I think something got lost in translation. To the gentleman who sent the picture of himself in hot pants, that was very cute, but I am looking for pictures of cheese, not cheesecake.

So, keep those questions coming, folks! And the photographs of cheese, too. But please keep them G-rated. We're very delicate here in The Commons offices.

This month's big winner is a question many cheesemongers field numerous times each day, and according to statistics, there's a good reason why: it's about a condition many of us share.

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Dear Stabby: I'm afraid I might be lactose-intolerant. What should I do? Can I never eat cheese again? -Sad in Somerset

Dear Sad: The best way to find out if you are lactose-intolerant is to talk to your doctor. There are some symptoms that might clue you in, though. About a half hour to two hours after eating or drinking dairy foods, you experience what we politely call a “gastric disturbance.” You feel bloated, your stomach makes weird noises, you feel nauseous. For some, it gets worse.

This is happening because your body is having a hard time digesting lactose, the naturally occurring sugar found in milk.

Lactase, an enzyme produced in the lining of your small intestine, breaks down lactose. Most of us make enough lactase when we are babies to allow us to survive on milk, both from our mothers and from other animals. But as we get older, lactase production wanes, and we find ourselves very uncomfortable.

If you are lactose-intolerant, you are not alone.

According to the Genetics Home Reference website, published by the United States Department of Health and Human Services, “Approximately 65 percent of the human population has a reduced ability to digest lactose after infancy. Lactose intolerance in adulthood is most prevalent in people of East Asian descent, affecting more than 90 percent of adults in some of these communities. Lactose intolerance is also very common in people of West African, Arab, Jewish, Greek, and Italian descent.”

People of Northern European extraction are the least likely to have a problem with lactose; estimates point to only 5 percent. Because of their traditional diet relying on unfermented milk products as a major dietary source, they are genetically predisposed toward producing sufficient lactase as adults.

If you suspect you are lactose intolerant, it's a good idea to get checked. On rare occasions, lactose intolerance is a symptom of something else, such as Crohn's Disease or Celiac Disease.

Meanwhile, if you cannot digest lactose, what do you eat and what do you avoid?

And do you have to throw away all of your cheese?

Because lactose intolerance varies by person - and sometimes by meal - experimentation is key. For some, a small amount of dairy causes no discomfort. For others, it's not so much the dairy alone as it is the other foods it's combined with. As you begin to pay attention, you will learn what works for you.

Most people have a harder time with liquid milk, fresh cheese, and ice cream than they do with aged cheeses. This provides us with a good clue regarding the composition of these items: some have no lactose in them.

We have fermentation to thank for that.

Most people think of sauerkraut, kimchi, and kombucha when they think of fermented foods. They often forget that aged cheese is also fermented.

Fermentation takes place when a beneficial bacterium converts carbohydrates into alcohol. In making cheese, some common bacteria used to convert the lactose (milk sugar) into lactic acid are Lactococcus thermophilus, Lactobacillus bulgaricus, Lactococcus lactis, and Lactococcus cremoris.

Lactic acid is not the same thing as lactose; thus, it will not upset the stomach of a person with lactose intolerance.

In cheesemaking, fermentation happens toward the beginning of the process, when the bacterial starter culture is added to the fresh, heated milk, converting the milk sugar into lactic acid.

Later, rennet is added to separate the curds from the whey, and the whey draining removes even more lactose.

Fresh cheeses have more lactose than aged cheeses for one reason: they are younger. There is less time for the lactose to convert to lactic acid, and their softness - indicating a higher moisture content - means the liquid, the whey, has not had time to drain away.

As the cheese ages, more whey is drained, and it takes away whatever lactose remains.

This is why, for example, Cabot can boast its Monterey Jack and Mild Cheddar, which are only aged a month or two, contain no lactose. Those are fairly young cheeses in the “aged cheese” category.

Beyond that, nearly all aged cheeses are safe for most lactose intolerant people, including most blues, nearly all goat cheeses, more mature cheddars, gouda, aged sheep cheese, and Parmigiano-Reggiano, to name just a few.

It's far easier to list the commonly found cheeses one should approach carefully if lactose intolerance is an issue: fresh mozzarella, cream cheese, and fresh ricotta. Of course, this does not mean one should avoid them completely.

The best course of action is to eat these cheeses in smaller quantities, or combine them with certain foods, until you figure out the boundaries of your comfort level.

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