Does Lactose Intolerance improve by refraining, then partaking of dairy products again?

Question

My neighbour has Lactose Intolerance which is a problem but a Nutritionist has advised that refraining from all dairy products for a while, then gradually returning to them, in measured amounts, can 're-balance' the system to tolerate dairy once again.

Is there documented evidence for this ?

I am also interested if intolerance is a feature only of 'free' lactose in food, as opposed to lactose that is associated with other components, such as 'bound' lactose which is intimately bound up with proteins.

Is there documented evidence for this also ?

My understanding is that primary (genetic) intolerance is not dependent on exposure (therefore, also, not affected by absence) and that secondary intolerance is reversible. But I would like to see confirmation of the combined effects.

Elimination of Lactose

Answer 1

Is there documented evidence for this ?

According to this paper consumption helps not absence of lactose from diet

However, in lactase-deficient individuals, lactose feeding supports the growth of lactose-digesting bacteria in the colon, which enhances colonic lactose processing and possibly results in the reduction of intolerance symptoms.

I think the nutritionist is advising to refrain to get sure your neighbour doesn’t have FODMAPs intolerance, lactose intolerance tends to be part of a wider intolerance to poorly absorbed, fermentable oligo-, di-, monosaccharides and polyols (FODMAPs),and gradual returning is consistent with the argument I mentioned above.

Yes lactose in free and bound form can affect the symptoms accordingly

Consuming lactose with meals, especially fat (in milk or otherwise), slows gastric emptying, reducing the quantity of lactose exposure to the small intestine per unit time [60,61]. On the other hand foods like coffee or hot peppers may increase intestinal transit delivering lactose to the lower intestine and increasing symptoms. Lactose in fermented dairy products contain quantitatively less lactose volume for volume.