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“Whether it’s lactose, fructose, gluten or histamine – you always have to see for yourself what you can tolerate“

Topic of the Month January: Nutrition as Therapy


“Whether it’s lactose, fructose, gluten or histamine – you always have to see for yourself what you can tolerate“

Photo: Professor Christine Behr-Völtzer

Professor Christine Behr-Völtzer;
© HAW Hamburg

Professor Christine Behr-Völtzer works at the Hamburg University of Applied Sciences, Faculty of Life Sciences at the Department of Ecotrophology. spoke with her about appropriate substitute products, eliminating certain foods and eating fresh foods.

 Professor Behr-Völtzer, as children we were already told how good milk is for our bones and health. But milk products can also be bad for our bodies if we suffer from lactose intolerance. What does this mean for our organism?

Christine Behr-Völtzer: Lactose intolerance is caused by an enzyme deficiency. Our bodies can only poorly or not at all break down lactose (milk sugar) which is attributed to a lack of the digestive enzyme lactase. This type of intolerance becomes apparent through symptoms like diarrhea, flatulence, bloating, nausea and burping. Can this type of intolerance be well treated?

Behr-Völtzer: The most obvious solution is an elimination diet. This means the patients eliminate the lactose-containing fresh milk products they don’t tolerate from their diet. Nowadays this can be done fairly well, since there are numerous lactose-free products on the market. In addition, many people for instance tolerate non-heated yoghurt. Hard cheese, sliced cheese, soft cheese and curdled milk cheese are usually well tolerated. In these cases the lactose has been broken down to a large extent during cheese maturation. Apart from that, another possibility would be to take a lactase enzyme supplement. Aside from lactose intolerance, fructose intolerance is also very prevalent.

Behr-Völtzer: Yes that’s correct. However, fructose intolerance depicts a so-called malabsorption. In this instance the Glucose 5 transporter is malregulated and the intake capacity for fructose is limited. The symptoms correspond to those of lactose intolerance. A detailed dietary protocol and plan helps to reach a diagnosis.

Photo: Banana tree

Some fruits, like bananas e.g.,
contain only little amounts of
fructose; ©
TongRoASIA Lewis Lee Do you then have to completely eliminate fruit as a treatment measure?

Behr-Völtzer: Not necessarily. There are some low-fructose fruits, such as bananas, strawberries, raspberries, papayas or redcurrants for instance. You could sweetens these with glucose, because if fructose and glucose are absorbed in roughly the same amounts, the intake capacity changes. Fructose-intolerant people generally often have issues with their intestinal tract. Whole foods and a balanced diet are recommended here as well as eliminating the foods that are known to cause bloating. But you should by no means generally eliminate everything! Gluten intolerance is an affection of the mucous membrane of the small intestine due to intolerance to properties of gluten, namely the gluten that can be found in many types of grains. What do you have to pay attention to in this case?

Behr-Völtzer: When you suffer from gluten intolerance it is essential to absolutely stay away from foods containing gluten! The so-called celiac disease is often very prominent in children and is accompanied by many symptoms. Some of them are for instance acute diarrhea, a bloated stomach, occasional vomiting, fatigue, dry skin, but also particularly stunted growth and so-called failure to thrive in children. In this case a biopsy is the most reliable diagnostic test, all others just provide indications. And what happens if you get a positive diagnosis?

Behr-Völtzer: At the moment a lifelong gluten-free diet is the only possible treatment. The intestinal mucosa can recover this way and the risks of long-term consequences also decrease.

Photo: Symbol for gluten-free food

With the crossed out ear gluten-free
food is labeled in Germany; © DZG So you only have to avoid grains high in gluten content, like for example wheat, barley and rye?

Behr-Völtzer: Unfortunately, it’s not quite that simple. Gluten is often used as an emulsifying agent. That’s why you implicitly need to pay attention to processed foods and convenience products and make sure that no gluten-containing ingredients have been used. The German Celiac Society (Deutsche Zöliakiegesellschaft e. V., DZG) provides detailed information on this issue. Histamine intolerance is often reported to mostly occur in middle-aged women. Is that true?

Behr-Völtzer: You cannot over-simplify it like that. All of us react to high histamine levels in foods. This intolerance depicts an absorption disorder of histamines absorbed with foods. It can be described as a discrepancy between histamine and the enzyme diamine oxidase that breaks down histamine. Histamine intolerance is shown in symptoms like hives, asthma, palpitations, headaches and turning red in the face. How can this intolerance be treated?

Behr-Völtzer: In this case it’s also important to avoid certain foods. To eliminate potential sources of histamine, you should resort to foods that are as fresh as possible and you should also prepare them yourself. This is the closest way to err on the side of caution.
Whether it’s lactose, fructose, gluten or histamine – you always have to see for yourself and carefully try out what you can tolerate and what you cannot.

The interview was conducted by Nadine Lormis and translated by Elena O'Meara.


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