Q. I'm a 64-year-old woman who is lactose intolerant. Do you think this will put me at risk for osteoporosis?

Between 30 and 50 million Americans are lactose intolerant, which means they have trouble digesting dairy products. Lactose intolerance usually is not dangerous.

Lactase is an enzyme made in the small intestine. You need lactase to digest lactose, the sugar in milk. People who are lactose intolerant don't make enough lactase; after consuming lactose, they suffer from bloating, nausea, stomach cramps and diarrhea. These symptoms usually begin a half-hour to two hours after ingesting lactose.

Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue. This condition creates an increased risk of fractures.

Osteoporosis is a major public health threat for 44 million Americans; about 68 percent of them are women. One out of every two women and one in four men over 50 will have an osteoporosis-related fracture in their lifetime.

A major risk factor for developing osteoporosis is insufficient calcium intake. Dairy products are significant sources of calcium. It's easy to assume that someone who is lactose intolerant might be more likely to suffer from osteoporosis. However, research into the influence of lactose intolerance upon osteoporosis has produced mixed findings.

People who are lactose intolerant just have to be especially vigilant about consuming enough calcium to maintain bone health. You can maintain a diet rich in calcium by eating broccoli, leafy greens, canned salmon, almonds, oranges, certain kinds of tofu and soy milk, and calcium-fortified breads and juices. In addition, there are supplements you can take to meet your daily requirements of calcium and other nutrients.

Those of us between the ages of 51 and 70 should take in 1,500 milligrams of calcium daily.

People of northern European descent are less likely to be lactose intolerant. However, about 75 percent of adult African-Americans and Native Americans are consider to be lactose intolerant. And, 90 percent of Asian-Americans are lactose intolerant.

There are three types of lactose intolerance:

Primary - This is caused by aging. The body produces large amounts of lactase during early childhood when milk is the primary source of nutrition. Usually, lactase production drops when you become less reliant on milk. This gradual decline may cause symptoms of lactose intolerance.

Secondary - This type occurs when lactase production decreases after an illness, surgery or injury to your small intestine. This form of the condition may last weeks and be completely reversible. However, long-term illness can make it permanent.

Congenital - You can be born with lactose intolerance, but it happens rarely. Infants with congenital lactose intolerance can't tolerate their mothers' breast milk.

Don't self-diagnose lactose intolerance. If you have symptoms, see a doctor. The symptoms could be caused by something else. There are tests to determine if you are lactose intolerant.

Most people with lactose intolerance can take some milk products. They may be able to increase their tolerance to dairy products by gradually introducing them into their diets.

However, most supermarkets carry lactose-reduced or lactose-free products.

You can manage your lactose intolerance with lactase enzyme tablets; you can take them just before you eat. These tablets help many people.

Probiotics are living organisms in your intestines that help maintain a healthy digestive system. Probiotics are available as active cultures in some yogurts and as supplements in capsule form. These may also help your body digest lactose.

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