Lactose intolerance can be managed through your diet by eliminating food containing lactose, primarily milk and dairy products. It’s important to note there is a distinction between lactose intolerance and an allergy to dairy. So, ask your dietitian to help you determine if you need to be on a low lactose or lactose free diet.
Most people with lactose intolerance can enjoy small amounts of milk products symptom-free. More specifically, people with an intolerance can have up to 12-15 grams of lactose per day without experiencing symptoms. To provide some perspective, 12 grams is the amount contained in 1 cup of cow’s milk. It’s possible to handle upwards of 15 grams if lactose consumption is spread throughout the day rather than in a single sitting.
In addition, not all dairy products contain identical amounts of lactose. Often, yogurt and kefir are tolerated because they include live bacterial cultures such as Lactobacilli that help break down and digest lactose. Hard cheeses, such as Swiss, Cheddar, or Parmesan contain less lactose than milk and are frequently tolerated, depending how much is consumed.
This table highlights the amount of lactose contained in various dairy products:
In my practice, I typically recommend that you experiment with dairy products to identify the ones that cause fewer symptoms. This will allow you to get adequate calcium and other essential nutrients. You may be able to increase your tolerance to dairy products by slowly reintroducing them into your diet. Under these circumstances, your dietitian can help you to transition safely.
How can I ensure adequate intake of essential nutrients if I follow a lactose free diet?
If you steer clear of milk and milk products, you’ll likely get less than an adequate amount of calcium (and vitamin D). Consequently, it is necessary to seek out appropriate calcium rich replacements to prevent calcium deficiency. A low lactose, calcium rich diet is achievable due to the wide assortment of lactose free dairy products available.
Selecting lactose free milk and yogurts, probiotic yogurts as well as naturally low lactose cheeses from the chart above will ensure you still get sufficient calcium in your diet.
Otherwise, dairy free substitutes such as brown rice milk, almond milk, soymilk, oat milk, brown rice milk, are found in most grocery stores. If you consume non-dairy, lactose free milks, choose a brand with added calcium, as these products contain little, calcium naturally. Preferably find a brand with 200-300mg of calcium per 250ml serving.
Lactase supplements are an option to be taken when eating or drinking foods that contain lactose. You can take tablets right before a meal or snack, or drops can be added to a jug/carton of milk. Yet, bear in mind that these products don't help everyone with lactose intolerance.
Consult your dietitian If you’re worried you may have insufficient amounts of calcium, vitamin D, and other essential nutrients found in dairy. Your dietitian will help you create a diet based on your degree of lactose intolerance and your dietary preferences. To avoid unpleasant symptoms, always speak with your dietitian before modifying your diet.
To book a one on one consult for a detailed, customized, nutrient rich, low-lactose diet plan, and to find out about the dosage and details of calcium and vitamin D supplements click here.