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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.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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 3. 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.
- If you experience lactose intolerance, determining how much you can actually tolerate can be a challenge.
- Follow a lactose-free diet for two weeks and then gradually reintroduce foods with lactose.
Foods to Avoid
Colitis Diet 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.
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:
- are lower in lactose
Give them a trial for tolerance.
- To replace lactose-containing foods in your diet, experiment with different foods and flavors.
- Instead of yogurt or cheese made with milk, select soy yogurt or almond-based cheese.
Important Nutrients to Consider
Diabetic Diet Food List
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 2.
- 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.
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- 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
- US National Library of Medicine. Lactose intolerance. Medline Plus. 2019.
- National Institutes of Health. Lactose Intolerance. Genetics Home Reference. 2019.
- Borghini R, Donato G, Alvaro D, Picarelli A. New insights in IBS-like disorders: Pandora's box has been opened; a review. Gastroenterol Hepatol Bed Bench. 2017;10(2):79-89.
- Szilagyi A, Ishayek N. Lactose intolerance, dairy avoidance, and treatment options. Nutrients. 2018;10(12). doi:10.3390/nu10121994
- Johns Hopkins Medicine. Lactose intolerance.
- KidsHealth from Nemours. Lactose intolerance. 2015.
- UW Integrative Health. The elimination diet. School of Medicine and Public Health University of Wisconsin Madison.
- Dekker PJT, Koenders D, Bruins MJ. Lactose-free dairy products: Market developments, production, nutrition and health benefits. Nutrients. 2019;11(3). doi:10.3390/nu11030551
- Cleveland Clinic. Gas: management and treatment. 2016.
- Ferreira-lazarte A, Moreno FJ, Villamiel M. Application of a commercial digestive supplement formulated with enzymes and probiotics in lactase non-persistence management. Food Funct. 2018;9(9):4642-4650. doi:10.1039/c8fo01091a
- Ferreira-Lazarte A , Moreno FJ , Villamiel M .Application of a commercial digestive supplement formulated with enzymes and probiotics in lactase non-persistence management.Food Funct. 2018 Sep 19;9(9):4642-4650. doi: 10.1039/c8fo01091a.
- Varjú P, Gede N, Szakács Z, Hegyi P, Cazacu IM, Pécsi D et al. Lactose intolerance but not lactose maldigestion is more frequent in patients with irritable bowel syndrome than in healthy controls: A meta-analysis.Neurogastroenterol Motil. 2019 May;31(5):e13527. doi: 10.1111/nmo.13527. Epub 2018 Dec 17.
Stacey Phillips is a registered dietitian and nutrition writer. She has had articles and patient information handouts published in the "Renal Nutrition Forum" and the "Journal of Renal Nutrition." She holds a Bachelor's degree from the University of Illinois in Champaign-Urbana and a Masters degree at Central Michigan University.