If you're lactose intolerant, reaching for lactose-free milk means the difference between enjoying dairy and suffering unwanted gastrointestinal discomfort. As with regular milk, you have options from full-fat to fat-free. Here's what to consider when choosing a dairy alternative.
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How Lactose-Free Milk Helps
Roughly two-thirds of the population struggle to digest lactose, the naturally occurring sugar in milk, according to the U.S. National Library of Medicine.
Lactose-free and lactose-reduced milk are boons for dairy lovers in that they're similar to regular milk except that troubling lactose has been neutralized. "Lactose-free milk is a great alternative for lactose-intolerant individuals because it has all the same nutrients as milk with the exception of lactose," says Cait Sheppard, a clinical nutritionist and WIC (Women, Infant and Children) nutrition coordinator with the Erlanger Health System in Chattanooga, Tennessee.
"The enzyme that breaks down lactose in the body, lactase, is added to the milk so that the lactose is broken down before you even drink it. If individuals are having gastrointestinal issues with cow's milk, then trying lactose-free milk is a great first step to deciphering if it's lactose intolerance or an allergy."
Keep in mind that, while some people with lactose intolerance have trouble consuming any dairy products, others may be able to enjoy regular ice cream, yogurt and cheese without feeling the digestive discomfort, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Lactose-Free Milk and Cholesterol
Your body needs cholesterol to run smoothly, but having too much in your bloodstream can lead to the development of cardiovascular disease.
According to the American Heart Association (AHA), there are two main types of cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is referred to as your bad cholesterol because it can create a buildup of plaque inside your arteries when too much is in the bloodstream. HDL is your good cholesterol because it helps to remove the bad cholesterol from your body.
Early research found that the saturated fats in foods, rather than their cholesterol content, seemed to raise bad cholesterol levels. Because of these findings, the AHA recommends that you consume no more than 5 to 6 percent of your total daily calories from saturated fat. However, research on the effects of full-fat dairy has led to contradictory findings over the years.
A study published in Advances in Nutrition in September 2019 points out that, based on the latest research, full-fat dairy doesn't necessarily have a negative effect on levels of blood fats like cholesterol (or, for that matter, blood pressure and insulin levels either). What's more, eating full-fat dairy doesn't raise your risk for heart and metabolic diseases and could actually offer some protection against them.
While research continues, talk to your doctor about whether restricting or eliminating full-fat dairy — lactose-free or not — from your diet is something you should or should not consider. If your doctor has advised you to lower your saturated fat intake in general and you're drinking lactose-free milk, you might ask if choosing fat-free or reduced options, such as 1 percent milk, should be part of your plan.
Lactose Intolerance vs. Dairy Allergy
As Sheppard points out, having a food intolerance is not the same as having a food allergy, and it's important to know the difference. Dealing with a dairy intolerance simply means that you have inadequate levels of lactase. According to the Mayo Clinic, with a dairy allergy, your immune system is having a negative response to milk protein and, while lactose intolerance symptoms can vary in terms of severity, milk allergies can be life-threatening.
Though some symptoms can be the same, an allergy often causes reactions like hives, swelling or itching of the lips and throat, and vomiting, states the Mayo Clinic. Lactose intolerance causes more GI-localized woes, like bloating and gas. No matter what your symptoms are, work with your doctor to get a definitive diagnosis so you can plan out your diet accordingly.
- U.S. National Library of Medicine: “Lactose Intolerance”
- National Institute of Diabetes and Digestive and Kidney Diseases: “Eating, Diet and Nutrition for Lactose Intolerance”
- Cait Sheppard, clinical nutritionist, WIC (Women, Infant and Children) nutrition coordinator, Erlanger Health System, Chattanooga, Tennessee
- American Heart Association: “Saturated Fat”
- American Heart Association: “HDL (Good), LDL (Bad) Cholesterol and Triglycerides”
- Advances in Nutrition: “Effects of Full-Fat and Fermented Dairy Products on Cardiometabolic Disease: Food Is More Than the Sum of Its Parts”
- Mayo Clinic: “Milk Allergy”