Lactose Intolerance: Diet Options and Alternatives

Bloated right after drinking a glass of milk? You are not alone. About 70% of the world’s population just can’t drink milk or eat dairy products without getting an upset stomach. Lactose intolerance is genetic, and happens most often in people of African, Asian, and Mediterranean descent. Many people with lactose intolerance don’t even know they have the condition, while some may be misdiagnosed as having a serious bowel disease. Don’t believe you have a serious bowel disorder until you are sure milk is not the culprit.

How much upset milk can cause depends on the severity of your lactase deficiency. Many people with lactose intolerance can still drink a single glass of milk without distress, says researcher Dr. Dennis Savaiano of the University of Minnesota. Lactose intolerance is caused by a deficiency of the enzyme, lactase, needed to digest lactose (milk sugar). Undigested lactose lingers in the intestine and ferments – causing intestinal discomfort, including abdominal pain, bloating, gas and diarrhea.

Lactose Intolerance Diet Options

• Drink small quantities of milk at one time.
• Drink milk with meals.
• Take Lactaid pills, an enzyme to help digest lactose in dairy,  every time you eat dairy.
• Use special milk such as Lacteeze or other “Lactose-free milk” which have lactose reduced by 99%. Some “lactose-reduced” milk products have lactose only partially reduced – so be sure to read the labels.
• For infants with lactose intolerance, try lactose-free infant formulas.
• Try calcium-fortified soy milk or other non-dairy milk to ensure adequate calcium intake.
• Also try calcium-fortified orange juice if you are concerned about calcium.
• Stick to dairy products that are naturally low in lactose, such as Swiss cheese and cottage cheese.
• Watch out for hidden lactose in non-dairy commercial products. If the ingredient list includes any of the following ingredients, it has lactose or milk products in it.
  • whey
  • curds
  • milk by-products
  • dry milk solids
  • nonfat dry milk powder

Some Dairy Products Maybe OK

Yogurt

Yogurt may be safe. Some studies have shown that the active live bacterial cultures (also known as probiotics) found in yogurt help lactose digestion. However, frozen yogurt does not seem to have the same effect for many people, and may still cause stomach upset.

Other milk

Goat milk and cottage cheese are naturally lower in lactose. Goat’s milk, for instance, contains 10.9 grams of lactose per cup, while cow’s milk contains 12.3 grams. Some people with mild lactose intolerance may be able to consume that. On the other hand, buttermilk and acidophilus milk, although fermented, still cause as much distress in most people as plain milk. As everyone’s level of lactase deficiency is different, sometimes you really do not know whether you can tolerate a specific product until you try drinking it.

The Lactose Intolerance Test

How to tell if you are intolerant to cow’s milk?

If you suspect you may be lactose intolerant, stop drinking any milk or eating any dairy products for at least two weeks.

If you feel better – and the gastrointestinal symptoms have diminished – you can do a “challenge” or “reintroduction” test to try to determine how much of which dairy foods you need to avoid. Drink a little milk or eat a little cheese and wait for two or three days to see what happens. It may sometimes take that long for symptoms of lactose intolerance to show up, say experts.

Your physician can also give you more definitive tests to diagnose lactose intolerance, including blood tests and a simple breath-hydrogen test.

Gloria Tsang, RD

Alumni: University of British Columbia – Gloria Tsang is the author of 6 books and the founder of HealthCastle.com, the largest online nutrition network run by registered dietitians. Her work has appeared in major national publications, and she is a regularly featured nutrition expert for media outlets across the country. The Huffington Post named her one of its Top 20 Nutrition Experts on Twitter. Gloria’s articles have appeared on various media such as Reuters, NBC & ABC affiliates, The Chicago Sun-Times, Reader’s Digest Canada, iVillage and USA Today.