Lactose intolerance occurs when your small intestine lacks the enzyme lactase, which is necessary to digest the sugar lactose. You may experience symptoms of gas, bloating, diarrhea and stomach upset if you eat lactose-containing foods. Past treatment for lactose intolerance was to avoid these foods or to take a lactase supplement before eating. Current recommendations from the American Academy of Pediatrics suggest trying small amounts of foods with lactose for tolerance. Eating lactose-containing foods that your body tolerates better supports a healthy, balanced diet.
How Much Is Too Much
If you experience lactose intolerance, determining how much you can actually tolerate can be a challenge. The Cleveland Clinic recommends a trial-and-error diet to help see how much lactose you can include in your diet. Follow a lactose-free diet for two weeks and then gradually reintroduce foods with lactose. Many people can tolerate up to 12 grams of lactose at a time. Milk, yogurt and ice cream are high-lactose foods, with 5 to 8 grams per serving. Butter and processed and aged cheeses contain lower amounts of lactose per serving, with up to 2 grams.
Foods to Avoid
On a lactose-restricted diet, read the ingredients on food labels to verify if the item contains lactose. Avoid or monitor for tolerance any product containing milk, milk solids, milk powder, malted milk, cream, butter, whey, curds or margarine. Milk and dairy products are high sources of lactose; avoid them or eat them in limited amounts. Also check the ingredients on prepared breads, grains, meats, vegetables, fruits and desserts to ensure lactose wasn’t added during the preparation process.
Foods to Eat
To replace lactose-containing foods in your diet, experiment with different foods and flavors. Replace milk with lactose-free rice, soy or almond milk. Instead of yogurt or cheese made with milk, select soy yogurt or almond-based cheese. Certain cheeses, such as Swiss, cheddar, Parmesan, cream, ricotta and cottage, are lower in lactose. Give them a trial for tolerance. Grains, meat, fruit, vegetables and dessert such as fruit ice, sorbet or gelatin shouldn't cause any indigestion symptoms unless made with lactose-containing products.
Important Nutrients to Consider
Dairy products are an excellent source of calcium and vitamin D. The recommended dietary allowance for calcium ranges from 700 milligrams per day in very young children to 1,000 milligrams for most adults and 1,200 milligrams per day in women aged 51 and older. Pregnancy or lactation recommendations increase, with an RDA of 1,300 milligrams of calcium. The RDA for vitamin D for children and adults ranges between 600 and 800 international units per day. If you can't eat dairy products because of lactose intolerance, speak with your doctor or dietitian about the need to supplement calcium and vitamin D in your diet.
- American Dietetic Association: Nutrition Care Manual: Lactose-Controlled Nutrition Therapy
- Brigham and Women’s Hospital: Diet for Lactose Intolerance
- Cleveland Clinic: Diseases and Conditions: Lactose Intolerance
- Institute of Medicine of the National Academies: Dietary Reference Intakes for Calcium and Vitamin D