Lactose intolerance requires a diet excluding or limiting lactose or including supplemental lactase. Anyone following a lactose-intolerant diet should continue to consume a balanced diet that includes essential macro and micronutrients. Lactose intolerance results from lack of the enzyme lactase, which breaks up the lactose into simple sugars, making them easy to digest.
Determine and Increase Tolerance
The lactase enzyme diminishes as we grow older; therefore, everyone has varying lactose tolerance levels. While one option is to avoid lactose-containing products, another is to select products with active cultures, such as yogurts, buttermilk and kefir, as the cultures may assist in the digestion of lactose and make these products more tolerable. Additionally, lactase enzymes can be purchased over the counter and taken immediately before ingesting lactose, and liquid drops can be added to lactose-containing liquids. Lactose-free milk is also available.
What Not to Eat
For those severely intolerant to lactose, it is essential to avoid lactose-containing items such as milk, yogurt, cheese, butter, sour cream, ice cream, whey, curds, milk byproducts, dry milk powder or solids. Those with severe lactose intolerance must carefully read labels to identify the presence of hidden sources of lactose. These hidden sources include lactose in products such as baked goods, breads, meats, dressings, baking mixes, protein supplements, instant and processed foods like soup and potato chips, candy, cereals, nondairy creamers and medications.
Getting Calcium and Vitamin D
Calcium and vitamin D are important for bone health, and you can easily fail to meet your daily requirements if you eat few or no foods that contain lactose without properly substituting in nutrient-rich dietary sources of these vitamins and minerals.
Dietary recommendations for young adults age 9 to 18 years is 1,300 milligrams of calcium daily. Men and women age 19 to 50 require 1,000 milligrams of calcium daily; and adults over 51 years of age need 1,200 milligrams of calcium daily.
Vitamin D recommendations for all ages is 15 micrograms daily.
Substitutions for Lactose Foods
Rather than lactose-containing cow's milk, try oat, nut or soy milk. Soy milk has 299 milligrams of calcium and 2.7 micrograms of vitamin D per 8-ounce serving. If you want to replace your morning glass of lactose-containing milk, swap in calcium-fortified orange juice, which contains 348 milligrams of calcium and 3.4 micrograms of vitamin D per 8-ounce serving.
- National Digestive Diseases Information Clearinghouse: Lactose Intolerance
- Academy of Nutrition and Dietetics: Lactose: Tips for Tolerance
- Office of Dietary Supplements: Calcium
- USDA: Dietary Guidelines for Americans 2010
- International Foundation for Functional Gastrointestinal Disorders: Lactose Intolerance
- USDA National Nutrient Database: Broccoli, Raw