Lactose is a type of carbohydrate found in milk and milk products. It is sometimes referred to as milk-sugar. Lactose is broken down in the small intestines by the enzyme lactase.
If you are lactose intolerant, your body is unable to digest large amounts of lactose. Consuming lactose may result in symptoms such as gas, bloating, cramping, and
diarrhea. Reducing the amount of lactose in your diet will prevent or reduce these symptoms.
usually occurs when there is a shortage of the lactase enzyme. It can also occur with diseases or injuries that affect the small intestines.
The goal of this diet is to reduce any lactose-induced symptoms to a point where they are not bothersome. The amount of lactose that is tolerated will vary from person to person. You may find it helpful to keep a log of the foods that you eat and any symptoms that you have.
Lactose is found in all dairy products. Some products contain more lactose than others. This carbohydrate can also be an ingredient in other types of food. To determine whether a food contains lactose, look for the following key words on the ingredient list: CreamDried milkLactoseMilkMilk solidsPowdered milkWhey
The following foods generally contain no lactose: Lactose-free milk like LactaidBroth-based soupsSoy, almond, and rice milkFish, beef, pork, lamb, and poultry prepared without dairy productsTofu and tofu products prepared without dairy productsBread, cereal, and crackers made without dairy productsSorbetGelatin
The following foods contain only small amounts of lactose (2 grams or less per serving) and can often be tolerated in small amounts: Aged cheese, like Swiss, Cheddar, or Parmesan—1-2 ouncesCream cheese—2 tablespoonsCottage cheese—one-half cupOrange sherbet—one-half cup
Before cutting dairy products out completely, try cutting back. Milk is usually better tolerated in small amounts (4 ounces or less at a time) and when consumed with food. Cultured dairy products, such as yogurt and kefir, are often well-tolerated because they contain bacteria that help break down the lactose. Aged cheeses, such as cheddar and Swiss, which contain low amounts of lactose, are also usually well-tolerated.
Alternatives to regular milk include lactose-reduced and lactose-free milk. Nondairy alternatives include soy milk and rice milk.
Lactase enzyme tablets can also be taken when milk and milk products are eaten. These over the counter tablets contain the enzyme needed to digest the lactose.
Dairy products are an excellent source of
calcium. Milk is also fortified with
vitamin D, which is necessary for your body to use calcium. If you cut back on or eliminate these products, be sure you are getting these nutrients elsewhere. Good sources of calcium include fortified orange juice, fortified breakfast cereals, canned fish with bones, and tofu. Good sources of vitamin D include salmon, mackerel, egg yolks, and sunlight.
Use a food log to pinpoint which foods are troublesome.Make gradual changes to your diet and note the effects.Try cutting down on portion sizes of lactose-containing foods.Consume lactose-containing foods with other foods.Read food labels for ingredients that may indicate the presence of lactose.Look for Kosher food products labeled “Pareve.” This means they contain no dairy.Try taking a lactase supplement before eating lactose-containing foods.Work with a registered dietitian to create a diet that works for you.
Dietary guidelines for Americans 2010. Department of Agriculture and US Department of Health and Human Services. Available at:
http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed November 17, 2014.
Lactose intolerance. American Gastroenterological Association website. Available at:
http://www.gastro.org/info_for_patients/2013/06/06/understanding-food-allergies-and-intolerances. Updated April 2008. Accessed November 17, 2014.
Lactose intolerance. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/lactose-intolerance/Pages/facts.aspx. Updated June 4, 2014. Accessed November 17, 2014.
Lactose intolerance in adults. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated March 4, 2012. Accessed November 17, 2014.
Last reviewed December 2015 by Dianne Scheinberg Rishikof MS, RD, LDN
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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