Lactose intolerance, also known as lactase deficiency, is a common problem that occurs when the body cannot digest lactose, a natural sugar found in dairy products and milk. It’s so common, in fact, that it causes 25 to 50 million Americans to avoid milk altogether. Lactose intolerance is generally not dangerous, but it can cause unpleasant symptoms such as diarrhea, nausea, bloating, and gas. Lactose intolerance is more prevalent in adults than in children, as the body is less reliant on milk than it is during infancy, and therefore produces less lactase, the enzyme that breaks down lactose. In the past, it’s been standard practice for people with the condition to avoid all dairy products. But experts now recommend that you keep some cheese, yogurt, and even milk in your lactose-intolerance diet and treatment plan. Dairy products are excellent sources of calcium and vitamin D, which are essential for strong bones. Vitamin D is also important because it helps the body absorb calcium. Eliminating dairy products can cause nutritional problems if you don’t consume enough of both nutrients in other ways, which could lead to osteoporosis, a condition that weakens bones and can result in fractures. Read This Before You Eliminate All Dairy Being lactose intolerant is not the same as having milk allergy, which is a more serious problem affecting a much smaller portion of the population. According to experts, many people with lactose intolerance can handle varying levels of lactose. The American Academy of Pediatrics has long recommended that if you have children with mild lactose intolerance, you should try to keep some dairy products in their diet, particularly cheese and yogurt, which contain less lactose. Recent research has also shown that children and adults with lactose intolerance can build up tolerance over time by drinking small amounts of milk, which can slowly change their intestinal bacteria and make lactose easier to digest. The amount of lactose you can tolerate is often determined by trial and error, but almost everyone — regardless of whether or not they are lactose intolerant — needs to keep dairy proteins in check to avoid the uncomfortable and embarrassing symptoms of diarrhea, stomach cramps, and gas. These strategies can help you manage dairy in your diet:
Divide and conquer. Try dividing your daily lactose intake into 4-ounce to 8-ounce servings and spacing them out during the day.Make it part of a meal. Solid food slows down emptying of the stomach and allows extra time for lactase to break down lactose. For example, have a small glass of milk along with a full lunch.Take steps before you eat. Lactase tablets help digest lactose and are available over-the-counter. “Taking these pills approximately 30 minutes prior to ingesting dairy products should control most symptoms associated with lactose intolerance,” says gastroenterologist Paul Choi, MD, director of the Los Angeles Endoscopy Center and a member of the American Gastroenterological Association. You can also opt to drink a brand of milk that contains pre-digested lactose, such as Lactaid.Go for yogurt. Yogurt with live and active cultures is low in lactose and may not give you any problems. The bacterial cultures in yogurt pre-digest lactose, making it a suitable food for many people with lactose intolerance.
Get the Scoop on Calcium-Rich, Dairy-Free Foods Some people may still need to reduce or even eliminate dairy products to best manage symptoms of lactose intolerance. Planning a reduced-dairy diet for lactose intolerance is really a balancing act. The more dairy protein you eliminate, the more you need to add in dairy-free foods that are rich in calcium and other nutrients. Adult men and women should aim for around 1,000 mg of calcium per day, and women should get around 1,200 mg after menopause. Top picks include:
SpinachCanned salmon or sardines with bonesCalcium-fortified orange juiceRaw broccoliCanned white tunaCalcium-fortified soy milkDark green leafy vegetablesAlmonds
Still Hurting? Uncover Hidden Sources of Lactose Keep an eye out for foods containing “hidden” lactose as part of their overall ingredients, such as breads, baked goods, processed cereals, instant potatoes, soups, creamy sauces, non-kosher lunch meats, salad dressings, pancake and biscuit mixes, and powdered meal replacements. Also, don’t let the word “non-dairy” fool you. “Non-dairy” products such as powdered coffee creamers and whipped toppings may also contain dairy proteins and lactose. Because lactose lurks in foods you might not suspect, you’ll want to read food labels carefully to avoid these ingredients:
WheyCaseinCurdsMilk by-productsDry milk solidsNon-fat dry milk powder
And your diligence shouldn’t stop with food ingredients: “Certain medications, such as birth control pills, and vitamins contain lactose and may need to be avoided,” says Dr. Choi. Antacids and anti-gas preparations also contain lactose. You can do well by finding the right balance of dietary lactose. With proper diet and attention to food labels, you should be able to experience minimal or no symptoms. If you’re concerned you are not getting adequate amounts of calcium, vitamin D, and other essential nutrients found in dairy, talk to your doctor or work with a registered dietitian. Supplements may be a good option for you.
