Research suggests that people who are lactose intolerant can still consume a 12-gram dose of lactose — about equal to the amount that’s in a cup of milk — and experience few or no symptoms. The best way to manage your lactose intolerance is to maintain a lactose-free diet or keep your periodic consumption of lactose below the 12-gram limit.
Lactose-Containing Foods
Aside from milk (including evaporated and condensed), there are many other foods that commonly contain lactose, such as:
Ice creamSherbetYogurt and kefirButterHeavy, light, whipping, and sour creamsWheyCheese
The amount of lactose varies between products, making some products safer to eat than others. For example, cheddar cheese has far less lactose than feta cheese. In addition to these milk-based products, many processed foods have lactose added to them, according to the Food and Drug Administration (FDA). These sometimes include:
Non-kosher lunch meats"Instant" products, such as soups and potatoesPowdered meal replacementsCerealsMixes for pancakes, biscuits, cakes, and cookiesBaked goodsBreadsDressings and creamy saucesFrozen dinnersSnack food, including candyMargarine
You can generally tell if a product contains lactose by looking at its ingredient list. It likely has lactose if it contains milk, cream, butter, margarine, cheese, whey, or curds. Some “non-dairy” products may also contain milk derivatives, such as sodium caseinate, which may have low levels of lactose. Carefully review the ingredients of products with “hidden” lactose, such as: Also, so called “non-dairy” products such as powdered coffee creamers and whipped toppings may also contain dairy proteins and lactose.
The Lactose Intolerance Diet
In the past, it’s been standard practice for people with lactose intolerance to avoid all dairy products. But experts now recommend that you keep some cheese, yogurt, and even milk in your diet. If you do consume a dairy product, try to do so with other foods, as this helps to slow down digestion, giving your body more time to break down the lactose. It’s also very important to make sure you maintain a nutritionally well-balanced diet. Milk contains numerous vital nutrients, including calcium, protein, and vitamins A, B12, and D. Therefore, you should make sure to supplement your diet with foods enriched with these nutrients — especially calcium and vitamin D — if you’re on a lactose free-diet. Without enough calcium or vitamin D, you may develop osteoporosis late in life, a medical condition in which your bones become brittle and fragile. To maintain healthy bones, children and adults require 1000 to 1300 milligrams of calcium and 600 to 800 international units of vitamin D each day, depending on age and sex. There are several “lactose-free” products that are sources of calcium and/or vitamin D:
Soy, almond, rice, and coconut milkSardinesSalmonCollard greensKaleBroccoliSpinachFatty fish (tuna, mackerel, and salmon)Fish liver oilCalcium-fortified orange juiceAlmonds
Vitamin D can also be obtained through sun exposure. 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. Dietary supplements can also help you obtain the recommended amount of nutrients you may be missing while on a lactose-free diet. 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. These strategies can help you manage dairy in your diet:
Try dividing your daily lactose intake into four-ounce to eight-ounce servings and spacing them out during the day.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.Lactase tablets help digest lactose and are available over-the-counter. You can also opt to drink a brand of milk that contains pre-digested lactose, such as Lactaid.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.
The more dairy protein you eliminate, the more you need to add in dairy-free foods that are rich in calcium and other nutrients.
Other Lactose Intolerance Treatments
Though there is no cure for lactose intolerance, various treatments may help you safely consume milk products. Dietary supplements containing lactase may help you digest lactose if you take the tablets immediately after consuming dairy. Some research suggests these tablets can help eliminate your lactose intolerance symptoms if you’re consuming up to 20 grams of lactose at a time. However, the pills don’t appear to be effective for larger amounts (50 grams or more) of lactose, according to a 2010 report produced by the Agency for Healthcare Research and Quality, which also notes that studies investigating the efficacy of lactase supplements generally have small numbers of participants. Another option for dealing with lactose intolerance is to drink hydrolyzed milk, or lactose-reduced milk, which is produced by adding lactase to the milk hours before consuming it. But research on this milk alternative shows inconsistent results, the report notes. Ingesting probiotics (beneficial bacteria), eating yogurt containing live bacteria, and incrementally adding more lactose to your diet may also be effective. But, again, the research on these treatments has yielded mixed results. However, these treatment options don’t have any major side effects, so they’re safe to try.