Lactose Intolerance

Definition, Diagnosis and Diet

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Lactose intolerance often is misunderstood and is commonly confused with a milk allergy. It’s estimated that 10 percent of Americans are lactose intolerant, but because this condition is often self-diagnosed, the true prevalence is likely lower. Inaccurate self-diagnosis or misinformation may cause people to unnecessarily eliminate dairy from their diet and miss out on its key nutrients. Let’s break down the truth about lactose intolerance.

Lactose is the natural sugar found in milk. Lactose intolerance is defined as a gastrointestinal disturbance following the consumption of an amount of lactose greater than can be digested and absorbed by the body. It is not a milk allergy. Symptoms of lactose intolerance range from mild to severe and occur about 30 minutes to two hours after eating or drinking foods containing lactose. These symptoms include nausea, cramps, bloating, gas and diarrhea.

Diagnosis of lactose intolerance is difficult based on symptoms alone because other conditions, such as irritable bowel syndrome (IBS) and celiac disease, cause similar symptoms. Adults tend to have lactose intolerance more than children, since our bodies may make less of the enzyme needed to digest lactose as we get older. If you suspect you or your child has lactose intolerance, it is best to talk with your doctor and be tested.

Even if you are lactose intolerant, this doesn’t mean you need to abstain from dairy foods. Luckily, there are a host of solutions to keep dairy foods in the diet, so you still receive the associated health benefits and enjoy their great taste. A cup of milk contains about 12 grams of lactose. Lactose-free milk is one of your best options — it’s real milk, just with the lactose removed! In fact, people like the taste of lactose-free milk better than some of the non-dairy alternatives.1 Some dairy foods also are naturally lower in lactose:

  • A half cup of low-fat cottage cheese only contains 3 grams of lactose while cheddar, Swiss and mozzarella cheeses contain less than 1 gram.
  • Yogurt contains about 13 grams of lactose per serving, but its live and active cultures help digest the lactose for you, meaning many individuals with lactose intolerance are able to enjoy yogurt without discomfort.
  • A serving of Greek-style yogurt has 4 grams of lactose.
  • There’s even lactose-free ice cream! And because tolerance for lactose varies from person to person, lactose intolerance is a highly individualized condition.

Talk with your doctor or a registered dietitian about a management approach that best suits you or your child.

Enjoy this Rice Pudding with Praline Topping for a lactose free treat.

Strategies to Enjoy Dairy Foods

Levels of lactose intolerance vary. Some foods are more easily tolerated by the body and would be a good choice for many individuals.

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We suggest these tips to gradually bring dairy back into the diet:

  • Sip It. Start with a small amount of milk daily and increase slowly over several days or weeks to tolerance.
  • Stir It. Mix milk with other foods, such as smoothies, soups or sauces, or pair it with meals. This helps give your body more time to digest it.
  • Slice It. Top sandwiches or crackers with natural cheeses such as Cheddar, Colby, Monterey Jack, Mozzarella and Swiss. These cheeses are low in lactose.
  • Shred It. Shred your favorite natural cheese onto soups, pastas and salads. It’s an easy way to incorporate a serving of dairy that is low in lactose.
  • Spoon It. Enjoy easy-to-digest yogurt. The live and active cultures in yogurt help to digest lactose.

1Moskowitz HR, et al. J Sensory Studies. 2009; 24:731-748