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Managing lactose intolerance

different types of cheeses, butter and milk


Do you get gas, bloating, cramps or diarrhea when you eat dairy products? You may have lactose intolerance. Read on to learn how to manage your symptoms and find foods you can eat.

What is lactose intolerance? 

Lactose intolerance is when your body has trouble digesting lactose - a sugar naturally found in milk and dairy products. This is because you do not have enough of an enzyme called lactase to break down lactose. As a result, undigested lactose sits in your large intestine (colon) and gets fermented by bacteria. This may cause gas, bloating, cramps, diarrhea and nausea. Lactose intolerance is different from a milk allergy. A milk allergy is when your body is allergic to a protein in milk.
 
If you think you have lactose intolerance, speak to your health care provider to get tested.

What foods have lactose? 

Lactose is found mainly in milk and dairy products such as cow’s milk, goat’s milk, yogurt, cheese, kefir and ice cream. It can also be an ingredient in foods and beverages like bread, cereal, lunchmeats, salad dressings, chocolate and mixes for baked goods. Read labels and look for ingredients such as:

  • Milk

  • Cheese

  • Yogurt or kefir

  • Milk solids or milk powder

  • Malted milk

  • Cream

  • Buttermilk

  • Curds

  • Lactose

  • Whey

Foods that contain lactic acid, lactalbumin, lactate and casein do not contain lactose.

Can I still eat foods with lactose? 

Most people with lactose intolerance can tolerate some lactose in their diet. This is because they still produce some lactase enzyme but not enough to digest large amounts. Foods like hard cheeses (cheddar, mozzarella, Swiss) and yogurt have lower amounts of lactose compared to milk and may be better tolerated. Having other foods when eating foods with lactose may also help. Start by eating a small amount and see how you feel. Keeping a food diary after eating foods with lactose to record your symptoms after can be helpful.

What foods are lactose free? 

Fruits, vegetables, grains and meats are lactose free naturally. These foods may contain lactose if processed and prepared with milk-based ingredients (like smoothies, cream sauces, cheese sauces, breads made with milk, breaded and battered meats, etc.). Most grocery stores now carry lactose-free milk, yogurt and cheese.  

Can I still get enough calcium if I have lactose intolerance? 

Yes. There is lactose-free milk, yogurt and cheese available that have the same amount of calcium as the regular products. Choose these to get enough calcium. The following  foods and beverages are also sources of calcium:

  • Plant-based beverages fortified with calcium like soy, almond, oat, nut and rice beverages

  • Vegetables such as bok choy, broccoli, rapini, collards and kale

  • Canned fish with bones such as salmon, sardines and anchovies

  • Soybean-based foods such as edamame, soy nuts and tofu

  • Beans like chickpeas, kidney beans, white, navy and pinto beans

  • Nuts and seeds like almonds and sesame seeds

  • Blackstrap molasses 

Find more food sources of calcium here.
 
If your child has lactose intolerance, speak to a dietitian to make sure your child is getting enough essential nutrients to grow and be healthy. 

What about calcium supplements?

Speak to your health care provider or dietitian about calcium supplements if you think you are not getting enough calcium from food.

Are there medications that can help lactose intolerance? 

Lactase pills can be taken before eating meals containing lactose so you are less likely to get symptoms. There are also lactase drops that can be added to liquids like milk and cream. Speak to your dietitian or health care provider  about the forms of lactase that are available. 

How can a dietitian help?

A dietitian will work with you to help reduce symptoms of lactose intolerance, while making sure you are getting enough essential nutrients, like calcium. They will help you identify lactose-containing foods and suggest alternatives that take into consideration your preferences, culture and medical history. Connect with a dietitian today!

Bottom line

Lactose is a sugar found in dairy products. Lactose intolerance is when you have difficulty digesting lactose, causing uncomfortable symptoms like gas and bloating. If you have lactose intolerance, you should avoid food with lactose or eat less of them to help manage symptoms. It is important to make sure you are still getting enough calcium in your diet.

You may also be interested in: 

What You Need to Know About Calcium
Food Allergies & Intolerances
Nutritional Content of Plant-Based Beverages
Lower Your Risk of Osteoporosis
Cookspiration – Recipe and Meal Ideas by Dietitians of Canada
 
This article was written and reviewed by dietitians from Dietitians of Canada. The advice in this article is intended as general information and should not replace advice given by your dietitian or healthcare provider.

 

Last Update – March 1, 2023

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