Got trouble with milk? Try these proven tips for managing lactose intolerance

Does managing lactose intolerance keep you from enjoying the foods you love? Fortunately, there are many easy strategies for dealing with high-lactose foods without sacrificing the best of both worlds.

What is lactose intolerance, and can managing it solve my problem?

Lactose is a natural sugar found in milk. It is made of connected glucose and galactose molecules and requires the enzyme lactase to be broken down. Lactose intolerance means you don’t make enough of this enzyme, and the undigested sugar reaches your large intestine, where the gut bacteria happily ferments it to use it as fuel, resulting in gas formation and bloating. Undigested lactose also draws excess fluid into the intestine, resulting in loose stools or diarrhea. These symptoms can range from mild to very uncomfortable.

If you can’t handle lactose, you are in good company. About two-thirds of the world’s population cannot digest lactose properly after infancy. Lactose intolerance is more common among older adults and those of African-American, Hispanic, and Asian descent.

Genetics are the most common reason for lactose intolerance. However, damage to the intestinal tract after illness or infection or digestive conditions such as untreated celiac disease can also cause problems digesting lactose. But there are ways for managing lactose intolerance better that make living with it, well, tolerable.

How do I know I have lactose intolerance?

Although breath testing is available, most people determine a lactose intolerance based on their symptoms. For example, increased bloating or diarrhea soon after eating high-lactose foods is a common symptom. Finding relief from these symptoms after a trial of limiting lactose is also a good indicator of lactose intolerance.

Try these strategies for managing lactose intolerance

Choose low-lactose dairy foods

Such hard cheeses as cheddar and parmesan naturally contain minimal lactose due to the removal of lactose during production. Butter and cream are low in lactose because they are primarily fat. Yogurt and kefir contain less lactose than milk since lactose breaks down during fermentation. Greek and other strained yogurts tend to be lower in lactose because it's removed during straining.

Limit portions of lactose-containing foods

You may not need to completely avoid lactose-containing foods. Perhaps you can tolerate a splash of milk added in cooking, but not a full-blown cow's milk latte. Consuming lactose-containing foods as part of a meal instead of by themselves may also increase tolerance.

Use lactase: The enzyme that breaks down lactose

Lactase enzymes, such as Lactaid pills, are available to help make up for the enzyme you may lack. Take them with the first bite of a lactose-containing food. Lactaid milk and other dairy products pre-treated with a lactase enzyme are another option.

Non-dairy options

You'll find an abundance of dairy-free alternatives to help avoid lactose. Consider calcium- and vitamin D-fortified oat, almond, soy, or coconut-based products.

What foods have lactose?

Lactose occurs naturally in milk products and occasionally as an additive in foods and medications. The lactose content in dairy foods ranges widely, as shown in the table below.

Food	Portion	Lactose (grams)
Cow’s milk	1 cup	12
Goat’s milk	1 cup	11
Yogurt	¾ cup	5.7
Greek yogurt	¾ cup	4.6
Cottage cheese	½ cup	4.4
Ice cream	½ cup	2.9
Cheddar cheese	1 oz. (28 g)	0.1
Half and half	1 tbsp.	0.6
Heavy cream	1 tbsp.	0.4
Butter	1 tbsp.	0.1

What is the difference between lactose intolerance and a milk allergy?

Milk allergy and lactose intolerance are often confused and are quite different conditions. Milk allergy is an immune response to milk proteins and should be diagnosed by a medical professional. Milk allergy symptoms can range from mild to severe and can include itching, rashes, vomiting, and difficulty breathing. Milk allergy often requires avoidance of all milk products and ingredients. Lactose intolerance does not involve the immune system. Although lactose ingestion can cause unpleasant side effects for people with lactose intolerance, it does not pose a health risk.

Monitor lactose with MyNetDiary

Good news—you will soon be able to track lactose intake with MyNetDiary as one of more than 100 nutrients available for tracking. You can also use the Notes section of the app to record your symptoms and explore connections to your food choices. Note: Lactose content is not required on food labels; so you may notice missing data. Choose Staples or generic food items for more detailed nutrient data.

Tip: If a dairy product contains no or minimal sugar, it will likewise be lactose-free or very low in lactose.

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Foods & Recipes->Dairy Foods Other Health Issues->Gastrointestinal (Gut)