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Lactose Intolerance | HealthLink BC

Topic Overview

What is lactose intolerance?

Lactose intolerance means the body cannot easily digest lactose, a type of natural sugar found in milk and dairy products. This is not the same thing as a food allergy to milk.

When lactose moves through the large intestine (colon) without being properly digested, it can cause uncomfortable symptoms such as gas, belly pain, and bloating. Some people who have lactose intolerance cannot digest any milk products. Others can eat or drink small amounts of milk products or certain types of milk products without problems.

Lactose intolerance is common in adults. It occurs more often in Indigenous peoples and people of Asian, African, and South American descent than among people of European descent.

A big challenge for people who are lactose-intolerant is learning how to eat to avoid discomfort and to get enough calcium for healthy bones.

What causes lactose intolerance?

Lactose intolerance occurs when the small intestine does not make enough of an enzyme called lactase. Your body needs lactase to break down, or digest, lactose.

Lactose intolerance most commonly runs in families, and symptoms usually develop during the teen or adult years. Most people with this type of lactose intolerance can eat some milk or dairy products without problems.

Sometimes the small intestine stops making lactase after a short-term illness such as the stomach flu or as part of a lifelong disease such as cystic fibrosis. Or the small intestine sometimes stops making lactase after surgery to remove a part of the small intestine. In these cases, the problem can be either permanent or temporary.

In rare cases, newborns are lactose-intolerant. A person born with lactose intolerance cannot eat or drink anything with lactose.

Some premature babies have temporary lactose intolerance because they are not yet able to make lactase. After a baby begins to make lactase, the condition typically goes away.

What are the symptoms?

Symptoms of lactose intolerance can be mild to severe, depending on how much lactase your body makes. Symptoms usually begin 30 minutes to 2 hours after you eat or drink milk products. If you have lactose intolerance, your symptoms may include:

  • Bloating.
  • Pain or cramps.
  • Gurgling or rumbling sounds in your belly.
  • Gas.
  • Loose stools or diarrhea.
  • Throwing up.

Many people who have gas, belly pain, bloating, and diarrhea suspect they may be lactose-intolerant. The best way to check this is to avoid eating all milk and dairy products to see if your symptoms go away. If they do, then you can try adding small amounts of milk products to see if your symptoms come back.

If you feel sick after drinking a glass of milk one time, you probably do not have lactose intolerance. But if you feel sick every time you have milk, ice cream, or another dairy product, you may have lactose intolerance.

Sometimes people who have never had problems with milk or dairy products suddenly have lactose intolerance. This is more common as you get older.

If you think you might have lactose intolerance, talk with your doctor. He or she can make sure that your symptoms are caused by lactose intolerance and not by another problem.

How is lactose intolerance diagnosed?

A doctor can usually tell whether you have lactose intolerance by asking questions about your symptoms. He or she may also ask that you avoid dairy products for a short time to see if your symptoms improve.

Sometimes doctors order a hydrogen breath test or a blood sugar test to confirm the diagnosis. These simple tests check to see if you are digesting lactose normally.

How is it treated?

There is no cure for lactose intolerance. But you can treat your symptoms by limiting or avoiding milk products. Some people use milk with reduced lactose, or they substitute soy beverage and soy cheese for milk and milk products. Some people who are lactose-intolerant can eat yogurt without problems, especially yogurt with live cultures. You can also take dietary supplements called lactase products that help digest lactose. In time, most people who have lactose intolerance get to know their bodies well enough to avoid symptoms.

One of the biggest concerns for people who are lactose-intolerant is making sure they get enough of the nutrients found in milk products, especially calcium. Calcium is most important for children, teens, pregnant women, and women after menopause. There are many non-dairy foods that contain calcium, including:

    • Broccoli, okra, kale, collards, and turnip greens.
    • Fish canned with bones (examples: sardines and salmon).
    • Calcium-fortified juices and cereals.
    • Calcium-fortified soy products such as soy beverage and tofu.
    • Almonds.

Symptoms

Symptoms of lactose intolerance can be mild or severe, depending on how much lactase your body makes. Symptoms usually begin 30 minutes to 2 hours after eating or drinking milk or milk products. If you have lactose intolerance, your symptoms may include:

  • Bloating.
  • Pain or cramps in the lower belly.
  • Gurgling or rumbling sounds in the lower belly.
  • Gas.
  • Loose stools or diarrhea. Sometimes the stools are foamy.
  • Throwing up.

Many people think they are lactose-intolerant, because the symptoms of lactose intolerance are very common symptoms. If you feel sick after drinking a glass of milk one time, you probably do not have lactose intolerance. But if you feel sick every time you have milk, ice cream, or another dairy product, you may have lactose intolerance.

Sometimes people who have never had problems with milk or dairy products suddenly have lactose intolerance. This is more common as you get older.

Symptoms of the most common type of lactose intolerance—adult lactose intolerance—often start during the teen or adult years and continue for life. Symptoms of acquired lactose intolerance last as long as the small intestine does not make lactase.

In rare cases, newborns are lactose-intolerant. Symptoms in newborns include severe foamy diarrhea, diaper rash, vomiting, dehydration, weakness and irritability, and slow weight gain.

Lactose intolerance is not the same thing as a food allergy to milk. Symptoms of a milk allergy are usually more severe than those from lactose intolerance. People who have a milk allergy cannot eat or drink any milk products. For more information, see the topic Food Allergies.

If you think you might have lactose intolerance, talk it over with your doctor. Your doctor can make sure that your symptoms are caused by lactose intolerance and not by another problem. Other conditions can cause symptoms similar to those of lactose intolerance, including irritable bowel syndrome, inflammatory bowel disease, overuse of laxatives, and problems digesting foods that contain fructose and sorbitol.

Examinations and Tests

If your doctor thinks you have lactose intolerance, he or she will ask questions about your medical history and do a physical examination. Before making a diagnosis, your doctor may ask that you avoid dairy products for a short time to see if your symptoms improve. You may also be asked to bring in a sample of your stool. The stool of a person who has lactose intolerance is usually loose or watery. It also can be foamy.

To confirm a diagnosis, your doctor may order a:

  • Hydrogen breath test. This is the most accurate lactose intolerance test. Before the test, you need to avoid certain foods and medicines and cigarettes. On the day of the test, you will drink a liquid that contains lactose and then breathe into a machine several times over a couple of hours. If the hydrogen levels in your breath are high, you may have lactose intolerance. This test is not usually done on babies and very young children, because it can cause severe diarrhea.
  • Lactose tolerance test. This test measures your blood sugar after you eat or drink lactose. After midnight on the night before the test, you should not eat or drink anything. On the day of your test, you will drink a liquid that contains lactose, which may cause gas or pain in your belly. Then your blood will be tested every 30 minutes for 2 hours. If your blood sugar levels do not rise, you may be lactose-intolerant. This test is not done on people who have diabetes. And it is usually not done on babies and very young children.

Treatment Overview

If you think you have lactose intolerance, it is a good idea to talk it over with your doctor. Your doctor can make sure that your symptoms are caused by lactose intolerance and not by another problem such as irritable bowel syndrome, inflammatory bowel disease, overuse of laxatives, or problems digesting foods that contain fructose or sorbitol. Your doctor can also make sure that your lactose intolerance is not related to another health problem.

After being diagnosed with lactose intolerance, you may feel relieved to find out what has been causing your symptoms. You may also feel frustrated by having to deal with this condition for the rest of your life. You may find it reassuring to know that there are many people who have lactose intolerance. Most can avoid discomfort and still eat or drink some milk products throughout the day.

There are different ways to live with lactose intolerance. What works for one person may not work for another. Because there is no cure for lactose intolerance, controlling your symptoms is mostly up to you. The following tips can help you prevent symptoms of lactose intolerance.

Limit the amount of milk and milk products in your diet. Most people can have about 10 g of lactose each day. This can be a glass of whole, low-fat, or skim milk, for example. All milk contains the same amount of lactose. Other milk products contain different amounts of lactose:

Approximate lactose and calcium in some foodsfootnote 1

Food

Serving size

Lactose (g)

Calcium (mg)

 

Milk, skim

 

1 cup (250 mL)

 

12.5

 

300

 

Cheddar cheese

 

1 oz (30 g)

 

0.05

 

204

 

Cottage cheese, 2% milk fat

 

0.5 cup (125 mL)

 

4.62

 

138.75

 

Cream cheese

 

1 oz (30 g)

 

0.96

 

28

Foods with less lactose, such as Swiss or cheddar cheese, may not cause problems. If you are not sure whether a milk product causes symptoms, try a small amount and wait to see how you feel before you eat or drink more.

Eat or drink milk and milk products along with other foods. For some people, combining a solid food (like cereal) with a dairy product (like milk) may reduce or eliminate symptoms.

Spread milk or milk products throughout the day. Many people who are lactose-intolerant find it helpful to eat small amounts of lactose-containing products throughout the day instead of larger amounts all at one time.

Eat or drink milk and milk products that have reduced lactose. In most grocery stores, you can buy milk with reduced lactose. Some people like buying this kind of milk and find that it helps control their symptoms. Others find that it tastes too sweet or is too expensive. People who have diabetes may find that lactose-reduced milk raises their blood sugar levels higher than normal.

Eat or drink other foods instead of milk and milk products. You can substitute soy beverage and soy cheese for milk and milk products. You can also use non-dairy creamers in your coffee. But keep in mind that non-dairy creamers do not contain the same vitamins and minerals as milk, and they may contain more fat than milk contains.

Use lactase products. Lactase products are dietary supplements that help you digest lactose. There are many different brands of lactase products. Some are pills that you chew (such as Lactaid) before you eat or drink milk products. Others are liquids that you can add to milk 24 hours before you drink it. Some foods have extra lactase added to them. Because products and brands are different, you may want to try a few to see which ones work best for you.

Eat yogurt with live bacterial cultures. Some people who are lactose-intolerant can eat yogurt without having problems, especially yogurt that contains live cultures. This type of yogurt can help people digest lactose. All yogurts are made with live cultures, but many yogurts go through a process called “heat treatment” that kills the bacteria. If you want to be sure you are buying yogurt that still contains live cultures, check the label. It will say that it contains live and active cultures. It’s best to try a small amount of different brands of yogurt to see which ones work best for you.

If you have severe lactose intolerance, you may need to avoid lactose completely. Some medicines and many prepared foods contain lactose. Examples of prepared foods with lactose include breads and baked goods; breakfast cereals and instant breakfast drinks; instant potatoes and instant soups; pancake, cookie, and biscuit mixes; margarine and salad dressings; candies, milk chocolate, and other snacks. Be sure to read labels for lactose and for lactose’s “hidden” names, such as:

  • Dry milk solids.
  • Whey.
  • Curds.
  • Milk by-products.
  • Non-fat dry milk powder.

One of the biggest concerns for people who are lactose-intolerant is making sure they get enough of the nutrients found in milk products, especially calcium. Calcium is especially important for women, because it keeps bones strong and reduces the risk of osteoporosis. There are many non-dairy foods that contain calcium, including:

  • Broccoli, okra, kale, collards, and turnip greens.
  • Fish canned with bones (examples: sardines and salmon).
  • Calcium-fortified juices and cereals.
  • Calcium-fortified soy products such as soy beverage and tofu.
  • Almonds.

To absorb calcium, your body needs vitamin D. Vitamin D is also found in fortified orange juice, fortified soy beverage, oily fish (such as salmon), egg yolks, and liver.

If you don’t know whether you are getting enough calcium, vitamin D, and other important nutrients found in milk products, such as magnesium, potassium, protein, and riboflavin, talk to your doctor. He or she may recommend that you take a calcium supplement or meet with a registered dietitian to make sure you are getting enough of certain vitamins and minerals.

You should also talk with your doctor if your symptoms do not go away with treatment, if they get worse, or if you have other symptoms, such as a fever, chills, or severe belly pain or vomiting.

What to think about

Lactose intolerance in newborns of normal birth weight and in babies is rare. But if your child has symptoms of lactose intolerance, see your doctor right away. Diarrhea is very dangerous because it can lead to dehydration, a serious problem that requires immediate attention.

Babies who are only fed breast milk do not develop lactose intolerance, because breast milk contains lactase, the enzyme that helps digest milk sugar. If your baby is formula-fed and develops lactose intolerance, you can switch to a formula made without lactose. In rare cases, a baby may have a reaction to the proteins in milk, which is a different condition called sensitivity to milk protein.

References

Citations

  1. U.S. Department of Agriculture, Agricultural Research Service (2012). Nutrient data laboratory. USDA National Nutrient Database for Standard Reference, Release 25. Available online: http://ndb.nal.usda.gov.

Other Works Consulted

  • American Academy of Pediatrics (2014). Carbohydrate and dietary fiber. In Pediatric Nutrition, 7th ed., pp. 387–406. Elk Grove Village, IL: American Academy of Pediatrics.
  • Hogenauer C, Hammer HF (2010). Maldigestion and malabsorption. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 1735–1767. Philadelphia: Saunders.
  • Whitney E, Rolfes SR (2011). Digestion and absorption of carbohydrates section of The carbohydrates: Sugars, starches, and fibers. In Understanding Nutrition, 12th ed., pp. 105–107. Belmont, CA: Wadsworth.

Credits

Adaptation Date: 3/1/2021

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Lactose Intolerance – Cause, Symptoms, Diagnosis, Treatment

Millions of Americans can’t digest a certain sugar in milk and milk products called lactose. If you’re one of them, you have lactose intolerance.

The condition isn’t harmful, but it can be uncomfortable and may be embarrassing. There’s no cure, but you can manage it by watching how much milk or milk products you drink or eat.

Being lactose intolerant is not the same as being allergic to milk.

What Is Lactose?

Lactose is the sugar that’s in milk.

Our bodies use an enzyme called lactase to break down that sugar so we can absorb it into our bodies. But people with lactose intolerance don’t have enough lactase. It’s produced in the small intestine.

Even with low levels of lactase, some people can digest milk products just fine. For people who are lactose intolerant, their low lactase levels gives them symptoms after they eat dairy.

What Happens In My Body If I’m Lactose Intolerant?

When we drink milk or have a milk-based product, lactase in our small intestines breaks down the milk sugar. It then gets absorbed into the body through the small intestines.

But people who are lactose intolerant don’t have it so easy. In them, the lactose doesn’t get broken down. Instead, it goes on to the colon, where it mixes with normal bacteria and ferments. It can cause things like gas, bloating and diarrhea.

The symptoms are no fun, but they’re not dangerous. Most people can manage their symptoms by changing their diet and limiting the amount of lactose they consume. Some people do better by cutting lactose out of their diet altogether.

Your body may be able to handle some lactose without symptoms. Experiment to find out the types and amounts of products with lactose you can eat and drink.

There are some steps you can take to test yourself:

  1. Go without milk or milk products for a couple of weeks.
  2. If your symptoms disappear, bring dairy products back into your diet a little at a time to take note of how you react.
  3. If your symptoms continue after cutting out the dairy — or if they return — see your doctor to find out what’s going on.

Who Develops It?

Believe it or not, most adults around the world can’t digest milk — 40% of humans stop producing enough lactase to digest milk between the ages of 2 and 5.

In the United States, it’s estimated that just over one-third of people are lactose intolerant. It is most common among:

  • Asian Americans
  • African Americans
  • Mexican Americans
  • Native Americans

It can also be inherited or associated with other specific diseases.

How Do I Know If I’m Lactose Intolerant?

Our bodies react to milk in ways that are easily measured. Two common tests for adults are:

  • Breath test. This will show if you have high levels of hydrogen when you exhale. If you do, you might be lactose intolerant. That’s because hydrogen is given off when lactose is broken down in the colon. The hydrogen gets taken by the blood up to your lungs, and then you exhale it.
  • Blood test. This can show how your body reacts after you drink something with a lot of lactose. However, this test is usually not done.

Doctors can also take a stool sample from babies and young children.

What If I Have It?

You may still be able to eat or drink small amounts of milk. Some people do better if they have their dairy with a meal. And, some dairy products, like hard cheese or yogurt, may be easier to digest.

Also, there are lots of lactose-free dairy products at the supermarket. Or you can take commonly found over-the-counter supplements (like Lactaid) to break down the milk sugars if you still want the real thing.

Talk to your doctor about a liquid lactase replacement. These are over-the-counter drops that you add to milk.

But if you give up milk completely, you can still get plenty of calcium, vitamin D and other nutrients in a healthy diet.

Instead of milk, you can substitute these foods:

  • Almonds
  • Dried beans
  • Tofu
  • Collards
  • Kale
  • Calcium-fortified orange juice and soy milk
  • Fatty fish, like salmon, tuna and mackerel
  • Egg yolks
  • Beef liver

Watch for Hidden Lactose

Always read labels. Many foods have lactose, including snack foods, bakery products, candy, dry mixes, dried vegetables, and infant formulas.

Many medicines also have lactose, which is used as a filler, especially in white tablets. Many birth control pills and medications used to treat gas and stomach acid contain lactose. Your doctor or pharmacist can let you know if any prescription medications you take contain lactose.

Some high-lactose foods to watch out for:

  • Milk and heavy cream
  • Condensed and evaporated milk
  • Ice cream
  • Cottage cheese
  • Ricotta cheese
  • Sour cream
  • Cheese spreads

Some milk substitutes you could try:

If you have symptoms of lactose intolerance, see your doctor. And if you’re diagnosed with it, talk with them about how to be sure you’re eating right.

Lactose Intolerance Symptoms | Everyday Health

Dairy products are an important part of a balanced diet, providing the body with calcium, protein, and various vitamins, including A, B12, and D.

If you swear off dairy but don’t supplement your diet with foods containing these essential minerals and vitamins, you may experience complications, including a low bone-mineral density condition called osteopenia, which can lead to osteoporosis, a thin-bone disorder that increases your risks of fractures, according to Harvard Health Publishing.

Talk to your doctor or dietitian about whether you’re getting the nutrients you need.

Lactose Intolerance Tests

A simple method to see if you might be lactose intolerant is the so-called milk challenge.

Drink a glass of milk after not consuming any dairy products for several days; if you experience the hallmark symptoms of lactose intolerance listed above, you likely have the condition.

Your doctor also has a number of tests to see if you are lactose intolerant, including:

  • Hydrogen breath test
  • Lactose intolerance blood test
  • Intestinal biopsy
  • Stool acidity test

The hydrogen breath test is a simple and generally accurate technique to diagnose lactose intolerance.

Your doctor will ask you to drink a liquid with a known amount of lactose in it, and then later have you breathe into a device that measures the amount of hydrogen in your breath.

If you’re lactose intolerant, the bacteria in your intestines will digest the sugar and release the hydrogen and methane that the device can detect.

Alternatively, your doctor may perform a type of blood test called the lactose tolerance test. This test is rarely used today, according to Harvard Health Publishing.

Two hours after you drink a lactose solution, your doctor will draw and test your blood for glucose, a sugar produced when lactase breaks down lactose.

If your glucose levels didn’t rise or raised little, it means your body isn’t digesting the lactose.

An invasive intestinal biopsy is also available to diagnose lactose intolerance. This test is also rarely used today, according to the National Health Service.

A gastroenterologist will use a long, thin surgical tool called an endoscope to take a sample of the lining of your small intestine. The sample will then be tested for lactase activity.

A stool acidity test is available for infants and children who cannot undergo other tests, according to Stanford Children’s Health.

This test detects lactose intolerance by looking for a rise in stool acidity or pH, caused by bacteria fermenting lactose in the colon.

Additional reporting by Ashley Welch.

What it is and 8 signs of lactose intolerance

If you’ve ever had an upset stomach after eating cheese or ice cream, you may be intolerant to lactose. It’s is a sugar found in milk and other dairy products. The FDA estimates that 30 to 50 million people in the United States can’t properly digest it. Here’s what that means for you.

What is lactose?

Lactose is a large milk sugar molecule found in dairy products. It makes up 2% to 8% of milk—and is even found in some medications. Lactose is a disaccharide (double sugar) that the body breaks down into the simple sugars glucose and galactose. The body can use the energy from these sugars for many things like repairing cells, building muscles, and fueling everyday activities. 

What is lactose intolerance?

Lactose intolerance (also called lactose malabsorption) is the inability to digest lactose. People with lactose intolerance don’t have enough lactase enzyme in their body, which is what’s needed to digest lactose. Without lactase, lactose can’t break down into its smaller units, which means the body can’t access those important sugar molecules.   

This digestive disorder affects about 36% of the U.S. population. Risk factors for developing lactose intolerance include being of African American, American Indian, Asian, or Hispanic descent; being older; or being born prematurely.  

It’s a chronic condition that currently has no cure. It’s possible to become lactose intolerant all of a sudden if another medical condition—such as gastroenteritis—or prolonged abstinence from dairy triggers the body. It is normal to lose tolerance for lactose as you age. 

Causes of lactose intolerance

There are two types of lactose intolerance that scientists recognize: primary and secondary lactose intolerance. Primary lactose intolerance is caused by either a deficiency of lactase or decreased lactase production that becomes more prevalent with age. 

Problems in the small intestine, resulting in decreased production of lactase, cause secondary lactose intolerance. Illness, injury, infection, or celiac disease can cause these problems. 

Both types of intolerance have to do with an inability to digest lactose due to low lactase levels. Primary lactose intolerance is much more common than secondary lactose intolerance. In North America, 79% of Native Americans, 75% of African Americans, 51% of Hispanics, and 21% of Caucasians have primary lactose intolerance.   

Acquired lactase deficiency is also possible. In these cases, individuals acquire lactose intolerance as they age.

Symptoms of lactose intolerance

Lactose intolerance causes some easily recognizable symptoms. If you’ve just eaten dairy products and have any of the following symptoms within 30 minutes to two hours after eating, you may be lactose intolerant.    

  1. Bloating
  2. Flatulence
  3. Diarrhea 
  4. Nausea
  5. Vomiting  
  6. Abdominal cramping
  7. Indigestion
  8. Belching 

These symptoms all happen because the small intestine can’t properly digest the sugar in dairy products. As a result, bacteria in the colon ferment the undigested lactose, causing a buildup of gas and water. Adults and children will experience many of the same symptoms if they’re lactose intolerant. It’s very uncommon but still possible for infants to have lactose intolerance. 

For infants and children, both breast milk and milk-based formulas contain lactose. If parents believe an infant might have a lactose intolerance, they should consult their pediatrician and consider eliminating dairy from diet (if breastfeeding) or switching to non-dairy infant formula. Parents should discuss their concerns with their pediatrician before eliminating foods from their children’s diet to ensure adequate nutrition and growth.

Sometimes lactose intolerance is confused for a milk allergy in young children, but being allergic to milk is a very different thing. Children with milk allergies may develop hives, wheezing, a runny nose, diarrhea, or abdominal cramping.  

How is lactose intolerance diagnosed?

Lactose intolerance is usually self-diagnosable, but many of the symptoms of lactose intolerance are the same as irritable bowel syndrome and a milk allergy. So if you suspect you are intolerant, it is important to discuss it with your primary care provider to make sure there are no other medical or nutritional concerns. 

Some medical tests can help accurately diagnose the condition so that people can treat their symptoms appropriately. A hydrogen breath test, which is administered by a gastroenterology specialist, measures how much hydrogen is in the breath after consuming dairy products. It tests for hydrogen because the body turns undigested lactose into hydrogen gas.  

Blood tests are another type of laboratory test that can help diagnose lactose intolerance. A blood test looks for elevated blood glucose levels after the patient consumes a standard amount of lactose. If blood glucose levels don’t go up, this means the body isn’t breaking lactose down into glucose. 

If someone has genetic lactose intolerance, they’ll continue to have symptoms unless they stay away from dairy products. Secondary lactose intolerance may go away after the intestinal tract heals and begins to function normally again, which could take weeks or months.  However, once lactose is eliminated from a diet, the body’s ability to produce the lactase enzyme decreases, resulting in less ability to digest lactose.

Lactose intolerance treatments

Managing this intolerance is usually a matter of making diet changes, but some medications may be helpful.

Diet changes

Many doctors agree that the best way to treat an intolerance is to avoid consuming lactose to begin with. Lactose is in dairy products and non-dairy products, so reading food and medication labels is important.

Foods that are high in lactose include:

  • Cow’s milk
  • Goat’s milk
  • Breast milk and milk-based formula
  • Ice cream
  • Half and half 
  • Some yogurt (Greek yogurt has less lactose)
  • Dry milk powder, milk solids, and milk by-products
  • Cheese, especially soft cheeses (Parmesan, Swiss, and cheddar have less lactose)
  • Cream cheese
  • Cottage cheese
  • Heavy cream
  • Buttermilk 
  • Condensed milk
  • Sherbert
  • Coffee creamers 
  • Butter
  • Ghee
  • Whey 

Non-dairy sources of lactose:

  • Medications
  • Instant foods
  • Margarine
  • Salad dressings
  • Processed grains

Checking food labels is the best way to see whether or not a packaged food item or medication has lactose in it—the label will read “dairy-free” or “lactose-free.” Even small amounts can be difficult to digest, and some foods might cause more symptoms than others.  

Barry Sears, Ph.D., author of The Zone Diet series says some foods have less lactose in them than others. For people who can’t tolerate any lactose in their diet, Dr. Sears recommends lactose-free milk products as a source of high-quality protein. Health food stores will typically carry these types of foods, and regular grocery stores are starting to stock up on things like lactose-free milk as consumer demands go up. Substitutes have become quite trendy. In the milk aisle, you might find soy, rice, almond, coconut, macadamia, and oat milk alternatives.

If you’re concerned that taking dairy products out of your diet will mean you’re not getting enough vitamin D or calcium, you can try adding other foods into your diet. “Milk” isn’t necessary outside of infancy, so it’s very possible to supplement with other products. Fatty fishes, eggs, mushrooms, green leafy vegetables, and nuts are all great sources of calcium and vitamin D. 

“For some, eating yogurt is low enough in lactose not to cause problems,” Sears says. “Hard cheese is much lower in lactose, and lactose-free dairy products have no lactose at all.” The best way to determine which foods cause the most trouble for you is to eliminate all sources of lactose for a week or two, and then add them back in one at a time.  

Medications

Some medicines help the digestive system process lactose. Over-the-counter drops and tablets that contain the lactase can help with digestion. Adding drops of lactase to milk before drinking it, or taking a tablet before eating dairy products can make a big difference.  

Lactase is the active ingredient in products like Lactaid and Lac-Dose and their generics. It’s an enzyme supplement a patient with an intolerance should take before eating anything with lactose in it. This type of medication works well for some people, but it isn’t a cure.   

RELATED: What is Lactase? | What is Lactaid? 

Lactose intolerance will never completely go away for someone genetically predisposed to it. It’s possible to manage symptoms, and many people find that their symptoms go away within a couple of days after eliminating dairy products from their diet. The best way to learn more about lactose intolerance and how to treat it is to talk with your dietitian or healthcare provider.   

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Lactose Intolerance | Cedars-Sinai

Not what you’re looking for?

What is lactose intolerance?

Lactose intolerance is when your body can’t break down or digest lactose. Lactose
is a sugar found in milk and milk products.

Lactose intolerance happens when your small intestine does not make enough of a digestive
enzyme called lactase. Lactase breaks down the lactose in food so your body can absorb
it. People who are lactose intolerant have unpleasant symptoms after eating or drinking
milk or milk products. These symptoms include bloating, diarrhea, and gas.

Lactose intolerance is not the same thing as having a food allergy to milk.

Lactose intolerance is most common in Asian Americans, African Americans, Mexican
Americans, and Native Americans.

What causes lactose intolerance?

Both children and adults can get lactose intolerance. Here are some common causes
of this condition:

  • Lactose intolerance often runs in families (hereditary). In these cases, over time
    a person’s body may make less of the lactase enzyme. Symptoms may occur during the
    teen or adult years.
  • In some cases, the small intestine stops making lactase after an injury or after a
    disease or infection.  
  • Some babies born too early (premature babies) may not be able to make enough lactase.
    This is often a short-term problem that goes away.
  • In very
    rare cases, some newborns can’t make any lactase from birth.

What are the symptoms of lactose intolerance?

Each person’s symptoms may vary. Symptoms often start about 30 minutes to 2 hours
after you have food or drinks that have lactose.

Symptoms may include:

  • Belly (abdominal) cramps and pain
  • Nausea
  • Bloating
  • Gas
  • Diarrhea

How severe your symptoms are will depend on how much lactose you have had. It will
also depend on how much lactase your body makes.

The symptoms of lactose intolerance may look like other health problems. Always see
your healthcare provider to be sure.

How is lactose intolerance diagnosed?

Your healthcare provider will talk to you about your past health and family history.
He or she will give you a physical exam.

You may be asked not to have any milk or milk products for a short time to see if
your symptoms get better.

You may also have some tests to check for lactose intolerance. These may include:

  • Lactose tolerance test. This test checks how your digestive system absorbs lactose. You will be asked not
    to eat or drink anything for about 8 hours before the test. This often means not eating
    after midnight. For the test, you will drink a liquid that has lactose. Some blood
    samples will be taken over a 2-hour period. These will check your blood sugar (blood
    glucose) level. If your blood sugar levels don’t rise, you may be lactose intolerant.
  • Hydrogen breath test. You will drink a liquid that has a lot of lactose. Your breath will be checked several
    times. High levels of hydrogen in your breath may mean you are lactose intolerant.
  • Stool acidity test. This test is used for infants and young children. It checks how much acid is in the
    stool. If someone is not digesting lactose, their stool will have lactic acid, glucose,
    and other fatty acids.  

How is lactose intolerance treated?

There is no treatment that can help your body make more lactase. But you can manage
your symptoms by changing your diet.

In
the past, people who were lactose intolerant were told to stop taking dairy products.
Today, health experts suggest you try different dairy foods and see which ones cause
fewer symptoms. That way you can still get enough calcium and other important nutrients
such as vitamin D.

Lactose intolerance symptoms can be unpleasant, but they won’t hurt you. So try to
find dairy foods that don’t cause severe symptoms.

Here are some tips for managing lactose in your diet:

  • Start
    slowly.
    Try adding small amounts of milk or milk products and see how your
    body reacts.
  • Have milk
    and milk products with other foods.
    You may find you have fewer symptoms if
    you take milk or milk products with your meals. Try eating cheese with crackers or
    having milk with cereal.   
  • Eat dairy
    products with naturally lower levels of lactose.
    These include hard cheeses
    and yogurt.
  • Look for
    lactose-free and lactose-reduced milk and milk products
    . These can be found
    at many food stores. They are the same as regular milk and milk products. But they
    have the lactase enzyme added to them.
  • Ask about
    lactase products.
    Ask your healthcare provider if you should take a lactase
    pill or lactase drops when you eat or drink milk products.

If you have trouble finding dairy products that don’t cause symptoms, talk to your
healthcare provider. He or she can suggest other foods to be sure you get enough calcium.
You may need to take calcium supplements.

Children with lactose intolerance should be seen by a healthcare provider. Children
and teenagers need dairy foods. They are a major source of calcium for bone growth
and health. They also have other nutrients that children need for growth.

Living with lactose intolerance

Lactose intolerance can affect you every time you eat a snack or meal. So you need
to
be careful about the foods you eat every day. But many people can tolerate a certain
amount of lactose and don’t need to completely give it up.

It’s important to read food labels. Lactose is often added to some boxed, canned,
frozen, and prepared foods such as:

  • Bread
  • Cereal
  • Lunch meats
  • Salad dressings
  • Cake and cookie mixes
  • Coffee creamers

Check food labels for words that may mean a food has lactose in it, such as:

  • Butter
  • Cheese
  • Cream
  • Dried milk
  • Milk solids
  • Powdered milk
  • Whey

When should I call my healthcare provider?

Call your healthcare provider if you have trouble managing your symptoms. Some symptoms
can be embarrassing. Your healthcare provider can work with you to help keep them
under control.

Key points about lactose
intolerance

  • Lactose intolerance is when your body can’t break down or digest lactose. Lactose
    is a sugar found in milk and milk products.
  • It happens when you don’t have enough of an enzyme called lactase. Lactase breaks
    down lactose in food.
  • The most common symptoms of lactose intolerance are belly cramps and pain, nausea,
    bloating, gas, and diarrhea.
  • There is no treatment that can help your body make more lactase.
  • You can
    manage your symptoms by changing your diet. Or you can take enzyme supplements when
    you eat or drink foods that have lactose.
  • It’s
    important to talk with your provider about getting enough calcium and vitamin D.

Next steps

Tips
to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider
    tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines,
    treatments, or tests. Also write down any new instructions your provider gives
    you.
  • Know why a new medicine or treatment is prescribed, and how it will help you.
    Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or
    procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for
    that visit.
  • Know how you can contact your provider if you have questions.

Medical Reviewer: Raymond Kent Turley BSN MSN RN

Medical Reviewer: John Hanrahan MD

Medical Reviewer: L Renee Watson MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Lactose Intolerance: Symptoms, Diagnosis & Treatments

Overview

Read the ingredients on food labels

What is lactose intolerance?

Lactose intolerance is the inability to digest lactose, the sugar primarily found in milk and dairy products. It is caused by a shortage of lactase in the body, an enzyme produced by the small intestine that is needed to digest lactose. While lactose intolerance is not dangerous, its symptoms can be distressing.

Who is affected by lactose intolerance?

For most people, lactose intolerance develops over time as the body produces less lactase.

It is estimated that 36% of Americans and 68% of the world population have some degree of lactose intolerance. Lactose intolerance affects people from certain ethnic populations and races—such as Latin Americans, African-Americans, Native Americans, Asians, East Europeans and Middle Easterners—more than others.

How do I know if processed foods contain lactose?

When buying food, read the ingredients on food labels carefully. Ingredients derived from milk that contain lactose include:

  • Whey.
  • Cheese.
  • Milk by-products.
  • Dry milk solids.
  • Lactose.
  • Butter.
  • Curds.
  • Nonfat dry milk.
  • Dry milk powder.

Also avoid items that state “may contain milk” on the food label. Depending on the severity of your symptoms, you may need to avoid or limit foods containing these ingredients.

The following ingredients come from milk and do not contain lactose:

  • Casein
  • Lactalbumin
  • Lactate
  • Lactic acid

Lactose is also present in about 20% of prescription medications, such as birth control pills (oral contraceptives), and about six percent of over-the-counter medications, such as some tablets for stomach acid and gas. Viactiv® calcium chews contain lactose and should be avoided while following a lactose-free diet.

These medications usually affect only people with severe lactose intolerance. Ask your healthcare provider which medications contain lactose, and read the labels on over-the-counter medications to check their lactose content.

Foods that contain lactose in small quantities include:

  • Bread and baked goods.
  • Milk chocolate and some candies.
  • Salad dressings and sauces.
  • Breakfast cereals and cereal bars.
  • Instant potatoes, soups, rice and noodle mixes.
  • Lunch meats (other than kosher).
  • Cheese flavored crackers and other snacks.
  • Mixes for pancakes, biscuits, and cookies.
  • Margarine and butter.
  • Organ meats (such as liver).
  • Sugar beets, peas, lima beans.
  • Certain coffee creamers.

Symptoms and Causes

What causes lactose intolerance?

Lactose intolerance is caused by a shortage of lactase in the body, an enzyme produced by the small intestine that is needed to digest lactose. Certain digestive diseases (such as Crohn’s disease, ulcerative colitis, and celiac disease), stomach or intestinal infections, and injuries to the small intestine (such as surgery, trauma, chemotherapy, or radiation therapy) may reduce the amount of lactase available to process lactose properly. If the small intestine is injured, lactose intolerance may be temporary, with symptoms improving after the intestine has healed.

What are the symptoms of lactose intolerance?

Symptoms of lactose intolerance include nausea, cramps, gas, bloating, or diarrhea within 30 minutes to 2 hours after consuming milk or dairy products. Symptoms occur because there is not enough lactase being produced by the body to digest the lactose consumed. The severity of symptoms varies, depending on the amount of lactose an individual person can tolerate. Some people may be sensitive to extremely small amounts of lactose-containing foods while others can eat larger amounts before they notice symptoms.

Diagnosis and Tests

How is lactose intolerance diagnosed?

The most common test for the diagnosis of lactase deficiency is the hydrogen breath test. This test is done at an outpatient clinic or doctor’s office. In practice, many doctors will ask patients who suspect they have lactose intolerance to avoid milk and dairy products for 1 or 2 weeks to see if their symptoms subside, and will then confirm the diagnosis with the hydrogen breath test. The hydrogen breath test measures the amount of hydrogen in the breath after drinking a lactose-loaded beverage.

Management and Treatment

How is lactose intolerance treated?

Lactose intolerance is easily treated. The goal of treatment is to control symptoms through dietary changes.

People with lactose intolerance can usually find a level of lactose-containing foods that will not produce symptoms. You can learn through trial and error what amount and type of lactose-containing products you can tolerate or you can temporarily eliminate all lactose-containing foods from your usual diet using a Lactose-Free Diet, then gradually add them back to find your level of tolerance and comfort.

For trial and error, try having smaller portions of your usual dairy foods, substituting them with lactose-free dairy products, or consuming milk and dairy products with meals because lactose may be better tolerated when eaten with other foods. Further, you may be may notice better tolerance of certain dairy foods that contain lower amounts of lactose, such as cheese, yogurt and cottage cheese.

Living With

Lactose-free diet

If desired, a lactose-free diet should be followed for two weeks. If symptoms have subsided after the 2-week strict diet, gradually add foods with lactose back into the diet slowly and monitor tolerance. You may be able to tolerate up to 12 grams of lactose at one time.

Lactose content of milk and milk products

High-lactose foods

The following foods contain approximately 5-8 grams of lactose:

Food Serving
Milk (whole, reduced fat, fat-free, buttermilk, goat’s milk) 1/2 cup
Evaporated milk 1/4 cup
Cheese spread and soft cheeses 2 oz.
Cottage cheese 3/4 cup
Ricotta cheese 3/4 cup
Yogurt, plain 1/2 cup
Ice cream 3/4 cup
Heavy cream 1/2 cup
Non-fat dry milk powder 2 Tbsp

Low-lactose foods

The following foods contain approximately 0-2 grams of lactose:

Food Serving
Condensed milk 1/2 cup
Half and half 1/2 cup
Sour cream 2 Tbsp
Milk, treated with lactase enzyme 1/2 cup
Sherbet 1/2 cup
Aged cheese (such as blue, brick, cheddar, Colby, Swiss, Parmesan 1-2 oz.
Processed cheese 1 oz.

Tips for adding lactose foods back after a lactose diet:

  • Gradually add small amounts of food and drinks that contain lactose to determine your tolerance level. You may be able to tolerate up to 1/2 cup of milk or the equivalent with each meal.
  • Drink milk in servings of one cup or less.
  • Try hard cheeses that are low in lactose, like cheddar.
  • Drink milk with a meal or with other foods.
  • Try yogurt or Greek yogurt with active cultures. You may be able to digest yogurt better than milk. Your own tolerance may vary depending on the brand. Frozen yogurt may not be tolerated as well as yogurt.
  • Substitute lactose-reduced dairy products and 100 percent lactose-free milk for regular dairy products. These products are located in the dairy section of most supermarkets.
  • The lactase enzyme is also available in liquid, tablet or chewable form. No prescription is needed and it can help you tolerate foods containing lactose. Take the enzyme with the lactose-containing food. Lactase will help you digest the lactose so your body can absorb it. Some over-the-counter enzyme products that are available include Lactaid®, Lactrace®, Dairy Ease®, and Sure-Lac®.
  • Many canned nutritional supplements (such as Ensure®, Boost®) are lactose-free. Product labels should be checked.

How can I maintain a balanced diet?

Milk and dairy products are a major source of calcium, an essential nutrient for the growth and repair of bones and teeth throughout life. Calcium is also essential for blood to clot normally, muscles and nerves to function properly, and the heart to beat normally.

People who are lactose-intolerant don’t necessarily have to consume milk and dairy products to get the calcium they need to maintain proper nutrition.

If you have trouble consuming enough calcium-rich foods in your daily diet, talk to your healthcare provider or a Registered Dietitian about taking a calcium supplement. The amount of calcium you will need from a supplement will depend on how much calcium you are consuming through food sources.

The following foods contain calcium:

Food Serving Calcium
Sardines 3 oz. 325 mg
Spinach (cooked) 1 cup 240 mg
Broccoli (cooked) 1 cup 180 mg
Calcium-fortified orange juice 8 oz. 350 mg
Calcium-fortified soy or almond milk 8 oz. 300 mg
Dried beans (cooked) 1 and 1/2 cup 150 mg
Tofu 1/2 cup 250 mg

How to Tell If You’re Lactose Intolerant or If It’s Something Else

If milk messes with your stomach, you might just assume you’re lactose intolerant and call it a day. But that’s not the only cause of dairy trouble, and knowing exactly why milk does a number on your gut will help you get a better handle on your symptoms.

First things first: Lactose intolerance isn’t the same thing as a milk allergy.

“Lactose intolerance is the inability to digest lactose, which is the sugar in milk. An allergy to milk is basically your immune system reacting to the proteins in milk, not the sugar,” James R. Baker, Jr., M.D., professor emeritus from the University of Michigan and CEO and CMO of Food Allergy Research & Education, tells SELF.

With lactose intolerance, your body essentially has an enzyme deficiency. It doesn’t make enough lactase—an enzyme in your small intestine that helps your body break down the sugar in milk. As a result, undigested lactose reaches your colon, where it reacts with gut bacteria. This digestive misstep can then lead to stomach discomfort.

A milk allergy, on the other hand, means your immune system has gone awry. It attacks milk proteins—namely, casein and whey—when they enter your body. It sees these proteins as potential threats. Your body may respond by producing chemicals called histamines, prompting an allergic reaction.

Your symptoms will provide a major clue about what’s troubling you.

People with a milk allergy often have an immediate reaction, within minutes. “Symptoms include mild ones such as skin rashes, hives, itchiness, and stomach pain. But they can also be serious, such as trouble breathing and poor blood circulation,” Scott H. Sicherer, M.D., professor of pediatrics, allergy, and immunology at Icahn School of Medicine at Mount Sinai, tells SELF. In fact, a food allergy can be life-threatening. It can result in anaphylaxis, a severe allergic reaction. And depending on your immune system, it might take only a dab of dairy for it to happen.

Symptoms of lactose intolerance often take longer to manifest—from many minutes to hours. That’s because it takes time for lactose to go through your gastrointestinal tract and reach your colon. Once it does, you may experience gas, bloating, an upset stomach, and diarrhea. These symptoms may be uncomfortable, but they aren’t life-threatening. And the severity usually depends on how much lactose you consume.

Your age is another indicator.

Another possible clue to your dairy problem is when you first started having symptoms. Most people with a milk allergy develop it as a child and outgrow it. Developing a food allergy as an adult is pretty uncommon. “Usually by the time you are an adult, your immune system has sorted itself out so it doesn’t react to things like food,” Dr. Baker adds.

So it’s more likely that a recently noted dairy reaction was lactose intolerance. Some people—about 10 to 15 percent in the U.S.—develop this problem. The exact reason is unclear, but “we know with aging the gut’s physiology declines,” Gerard E. Mullin, M.D., a board-certified gastroenterologist and associate professor of medicine at The Johns Hopkins Hospital, tells SELF.

And your family tree may provide some insight.

Allergies and lactose intolerance can be passed down through families. You may be more prone to developing a food allergy if family members have allergies, too. That includes any type of allergy, such as hay fever or eczema.

A drop in lactase is often genetic, although it may sometimes be caused by problems in the small intestine, such as an infection. Certain groups of people are more likely to suffer from lactose intolerance, including African-Americans, Hispanics, American Indians, and Asian Americans.

So what should you do if dairy is wreaking havoc on your gut?

The only way to be certain about what’s causing your reaction to dairy is to see your doctor. He or she will be able to make a diagnosis after asking about your symptoms and doing certain tests. To check for a milk allergy, your doctor may take a blood sample or prick your skin and put some milk on it to see if there is a reaction. You may also be asked to eat a bit of dairy in your doctor’s office. A breath test or stool sample may be used to diagnose lactose intolerance.

90,000 “I am lactose intolerant and I train with weights: what should I do?

Reflecting on a related topic and taking into account my own individual needs, I decided to talk a little about this, helping many people who do strength training, as well as from an early age or have become lactose intolerant over the years.

In fact, this should alert even many people who have this intolerance, and if you want to know it.

It is known that at birth a mammal, that is, not obtained from eggs, like most birds, reptiles and fish, has as its main food breast milk produced by your mother’s mammary glands.

In fact, milk is an opaque white secretion secreted by the mammary glands of a more advanced creature, consisting of certain nutrients.

Each type of milk from different mammals has a different composition for each creature that it will feed.

Therefore, breast milk is not the same as the milk of a lioness, not the same as the milk of a tigress, and so on.

In addition, breast milk is a substance of paramount importance in this phase, considering not only nutritional value and factors, but also everything that makes up it, for example, the number of antibodies that will help the immune system of the newborn, preventing this and stages ahead of illness, infection and the like.

O milk is an excellent food, a source of carbohydrates, proteins with a very high biological value and a very high content of PDCAA, a source of calcium with the best absorption and bioavailability by the body, a source of many vitamins and minerals, has excellent absorption, etc.d. .

However, milk can be a wonderful disorder for people with lactose intolerance, especially for a bodybuilder, as, in addition to milk and most of its derivatives, they are excellent foods for gaining muscle mass.Most of the supplements we take are also derived from milk …

List of Contents

What is lactose?

In short, lactose is a sugar found in milk and milk derivatives. In human milk, it is present in approximately 6-8% of milk, in cow’s milk, its availability is approximately 4-6%.

What is lactose intolerance and its causes

Lactose intolerance is a disease, genetic or not, in which the enzyme lactase is responsible for the hydrolysis of lactose in its two monosaccharides, glucose and galactose.

This disease, as already mentioned, can be genetic or can be transmitted over the years due to insufficient milk intake, including due to low natural production of the enzyme.

As mentioned, this will happen naturally, as in most cases when milk is not consumed.

This is because the body understands that there is no need to waste energy with the production of an enzyme to digest something that, in theory and only in theory, will NOT be missed and will NOT be a food source.

Lactose intolerance is more common in adults and, if properly treated, is not dangerous. This disease occurs mainly in the regions of Asia, Africa, Native Americans, and the Mediterranean.

Between other causes of diseases, one can cite: intestinal surgery; a small intestine infection caused by a virus or bacteria; and intestinal diseases that damage the intestinal mucosa .However, these reasons are always more rare and difficult to find.

Another common milk problem is milk protein (casein) allergy which should not be confused with lactose intolerance or galactose intolerance (which, among other things, is the worst and most delicate).

Symptoms of lactose intolerance

Symptoms in a person with lactose intolerance usually occur between 30 minutes and 2 hours after eating some dairy food and disappear only when the product is interrupted in the body, i.e. complete digestion and elimination.Among the most common symptoms are:

  • Convulsions;
  • gas;
  • Diarrhea; and also
  • Bloating.

If you experience any of these symptoms after eating foods that contain lactose, be aware that high doses usually cause serious complications and can significantly worsen symptoms.

If you have any suspicions, see a doctor immediately.

How to Avoid Lactose Intolerance

But, being milk and raw materials are so important Out of so many things associated with nutrition associated with increasing muscle mass, is it impossible for lactose intolerance to achieve good results in bodybuilding?

The answer is no! But you need to take some precautions and make some changes, and we will look at some of them later.

Diet:

Basically, the Lactose Intolerance Diet may or may not contain any very low lactose milk derivative depending on its sensitivity.

Despite this, only with time will we be able to determine what these quantities are.

When I found out that I was lactose intolerant, it was quite interesting: for a long time I stopped using milk or dairy products in my diet.

When I recovered, I had no problems as I had milk (and a lot of milk) all my life. However, over time gastric discomfort, gastric and intestinal problems began to manifest themselves more and more intensely.

Was suspicious of everything: gluten, avenin, dyes, combinations, expired foods, thickeners and other huge list. I was suspicious of counterfeit whey protein brands, supplement brands, altered expiration dates.

And nothing worked. That was when, in the light, I imagined that it could be lactose, even if I doubted strongly, because, as I said, I have been drinking milk throughout my life and in large quantities.

Both cow’s milk and milk from other animals, such as buffalo milk. I eliminated all dairy products from the diet, and the problem remained …

It was then that I became even more suspicious of GROSS intolerance that even a very small amount of lactose present in whey protein could be the cause of this whole disorder.

There was nothing else, I started using whey protein, always isolated and without carbohydrates, so as not to be exposed to any risk. As if by magic, the problem was solved after almost 6 months of agony.

First of all, the problem was this: What to do with the diet? With some caution and ALWAYS following the nutrition labels, there was nothing to run around, milk and dairy products, by no means .

Some people consume “lactose-free” foods that are not actually filtered, but rather contain lactase.

So for extreme intolerance like me, it is always beneficial to have eyes for more than just being aware of these details.

From the moment you identify foods you CANNOT eat then start thinking about alternatives to for two main reasons: you have lost important sources of protein, and the second is that your diet is otherwise is likely to become unbearable and unusable.

So first of all forget about textured soy protein .It has been proven to be one of the worst proteins in terms of bone decalcification, anti-nutritional factors, isoflavones, etc. Secondly, choose more varied food sources and always remember to be lactose-free.

Today in the Brazilian market this may not be a strong point, but there are good options that, although expensive, are worth it: Bread (including sweet potatoes), pasta, cakes, yoghurts and products with lactase itself (if you you can eat it) and much more..

Nothing that good research can solve your problem. Just pay close attention to the “traces of milk” on the labels and of course the added (and added amounts) of sugar, especially sucrose.

Creativity will be the key . Try to learn the mixes and recipes that work, and most of all, create your own recipes. Here are some replacement tips :

Milk: Virgin coconut extract, almond extract, rice / oat drinks, macadamia extract, etc.D.
Cheese: Cottage 0% lactose, cottage without varnish, tofutti, etc.
Yogurt: Luckfree.

Supplement

Another factor that is very worrisome, but unfortunately not very likely to change, is that is additive . There will be nothing special and creative here, and there will be no advice.

So isolated whey (and of course paying attention to the amount of lactose, because some of them still, even isolated and / or hydrolyzed, contain lactose), meat proteins, lactose-free capsules, caseins, some proteins with lactase, amino acids, nitrogen oxides these are supplements that you can choose .

Yes, they are expensive, often overpriced, but we can still think of options that are a little more viable for our pocket since albumin.

In such cases, even more than the importance of a well-structured diet , aiming for as little additives as possible.

One way out is to import this product from abroad at a much more affordable price. One site where I always buy nutritional supplements overseas is bodybuilding.com, which is the largest website for nutritional supplements in the world and delivers them all over the world without red tape.

Bonus tip: how to train with lactose intolerance

Guys, on our DDM channel he recorded a really cool video about people who exercise, but who are lactose intolerant. Look now and see what he has to say …

Conclusion:

A Lactose intolerance is something that can harm a bodybuilder’s achievement.However, this will only be a problem if you don’t take proper care of it and pay attention to the details necessary to live with it.

Therefore, always try to learn more about methods and alternatives to get around the problem.

As stated in the article, the cheapest way to overcome this problem is to know food well and know how to manage it in our favor.

There are two methods for this: visiting a nutritionist or gaining knowledge.I’ll leave here two tips from digital books that can help you in your quest for food knowledge.

First, this is the Lean Nutrition and Supplement Guide and you can find out more by clicking here.

Another is a cookbook called 100 recipes for increasing muscle mass and you can get acquainted with it by clicking here. These two books can do a lot to help you learn more about food, prepare it, and improve your diet.

Good workout!

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I am lactose intolerant and I train with weights: what should I do?

Test with lactose for the diagnosis of lactase deficiency in the Republic of Belarus

Lactose intolerance (hypolactasia) – a pathological condition caused by a decrease in the level of lactase – an enzyme necessary for the proper digestion of milk sugar (lactose).

Lactase deficiency can manifest itself at any age, and its symptoms are determined by the excessive growth of intestinal microflora that assimilates lactose, as well as the osmotic effect of undigested lactose in the intestine (water retention in feces).The main symptoms of lactose intolerance are bloating, abdominal pain, and diarrhea.

Lactose intolerance occurs in two forms

Primary lactase deficiency is hereditary, age dependent and usually manifests itself between 5 and 20 years. Typically, 50–70% of the lactase activity is retained. It is not treated.

Secondary lactase deficiency is caused by temporary damage to the small intestine or inflammatory processes of the gastrointestinal tract, which can be caused by malnutrition, celiac disease, gastroenteritis and other diseases.Secondary lactase deficiency also occurs in infants and young children after bowel disease. The manifestations of the disease usually disappear within 2-4 weeks.

Diagnosis of lactose intolerance and disease control

Lactose intolerance can already be guessed on the basis of its manifestations. Since with lactose intolerance, it is necessary to reduce the use of dairy products containing it, which occupy a very important place in the human diet, you should first carefully make sure that it is this disease that is involved.

Today there are the following tests for the diagnosis of lactase deficiency

1. Test for lactose tolerance. During the test, the patient is given 50 g of lactose (an amount approximately corresponding to that contained in a liter of milk) and the blood glucose level is determined before taking the solution, 20 and 40 minutes after. If your blood glucose does not rise, you are lactose intolerant.

2. Analysis of exhaled air .If the hydrogen content in it increases, this indicates that under the influence of the microflora of the large intestine, the process of fermentation of lactose is taking place, and the patient has its intolerance.

3. Rapid test to assess the activity of lactase in a biopsy sample (a piece of duodenal mucosa taken during esophagogastroduodenoscopy). The procedure is absolutely painless. A biopsy specimen is taken from the lining of the upper small intestine and analyzed immediately after completion of the esophagogastroduodenoscopy.The duration of the test is 20-25 minutes, after which the doctor informs about the presence or absence of enzymes that break down lactose, which will make it possible to establish the correct diagnosis and prescribe treatment.

Depending on the severity of the disease, the amount of lactose in the diet should be reduced to a greater or lesser extent. Typically, a person with hypolactasia tolerates 2-3 g of lactose per day.

Preference should be given to fermented milk products, in which part of the lactose is fermented into lactic acid.In particular, you should pay attention to foods containing probiotic bacteria, as some of them secrete lactase.

With lactose intolerance, when few dairy products are consumed, calcium deficiency may occur. Long-aged hard cheeses that are lactose-free are a good source of calcium. There are also lactase capsules that can be taken with food containing lactose. In the case of severe lactose intolerance, care should be taken with bioactive supplements and medications, as lactose is often used as a filler in them.

Indigenous microbes and features of digestion / Habr

The term “holobiont” unites the host organism and its indigenous microbes (indibiome), the aggregate of genetic material in the host-microbe system gives a more accurate description of a complex system and, due to the possibilities of directed changes in the microbiota, allows to correct the conditions characterized by like distress.

Lactose intolerance is a set of symptoms that manifest itself as discomfort, bloating, loose stools and diarrhea when drinking milk or lactose-containing foods.Symptoms are associated with the active growth of bacteria in the lower parts of the intestine, if lactose is not digested by the enzyme (lactase) of our body in the upper parts.

The study of the effect of lactose intolerance (LI) prompted thoughts about the evolution of digestion, revealed the existence of contradictions in the description by specialists and suggested some solutions to improve the health of the geek. In many respects, NL is not a good model for other types of reactions to foods, which does not prevent, on the basis of the material below, to build very plausible hypotheses about the interaction of the genes of our body and the genes of the microbes inhabiting our intestines.

Digestion 101

The process of digestion of food in the human body begins in the mouth with the enzyme amylase, which breaks down complex carbohydrates (starch) to simpler sugars, then in the stomach pepsin and other enzymes break down proteins, then, in the duodenum, pancreatic enzymes break down fats. proteins, carbohydrates and nucleic acids, in the next section, the small intestine, enzymes are secreted by the intestinal cells themselves and are responsible for the breakdown of the remaining sugars and fats, and, finally, in the large intestine, bacteria are involved in the breakdown of complex polysaccharides (dietary fiber).Evolutionarily, many different bacteria in the gut are used to break down a huge number of bond options in polysaccharides. In the database of enzymes for working with polysaccharides (

CaZymes

), bacteria are in the lead, they have 12,743 different enzymes, and eukaryotes are represented by only 243 enzymes. The simple interpretation is as follows: plants build their cell walls in thousands of different ways, and it is not at all profitable for a macro-organism to evolve and have a new gene for each plant, it is much more economical to carry with you an arsenal of bacteria, the genome capacity of which exceeds ours by orders of magnitude, and more , bacteria can quickly divide, and therefore mutate and exchange genetic material

horizontally

.

Lactose intolerance

Mammals lose their ability to digest lactose when they reach a certain age, due to the end of breastfeeding. One of the most important events in the development of pastoralist society was the acquisition and spread of a genetic mutation that facilitates the digestion of lactose in adulthood. The genetics of Europeans have been well studied, it has been shown that there is a characteristic genetic mutation in the European population, in the presence of which the gene for lactase, an enzyme responsible for the digestion of lactose in the small intestine, is expressed in adulthood.Available evidence suggests that lactose intolerance may be associated with

comorbidity with

a wide range of diseases, from calcium-related osteoporosis to inflammatory bowel disease (IBD), as systemic bowel irritation is thought to increase the risk of IBD.

Intestinal bacteria are the main factor creating symptoms, it is assumed that the composition of the microbiota is associated with the severity of the manifestation of NL, or, on the contrary, a certain composition can neutralize the effects of lactose.Preliminary data from epidemiological studies have revealed associations of bacterial species with symptoms. In this regard, the concept of indigenous microbes (see Indigenous microbes) takes on new facets of meaning.

Data analysis field

One of the publications (see

Indigenous microbes of the vagina

) caused a heated discussion on the relevance of such articles on Habr, I invite colleagues interested in data analysis to join the study of the topic. Interestingly, the issue of lactose intolerance has not been systematically studied, since LN is not a disease and for the most part belongs to ordinary doctors in the same category as allergies to certain foods.

It is possible to systematically approach the issue from the data point of view: conduct the text of mining literature (more than 3000 articles), select all known human genetic polymorphisms associated with lactose tolerance (estimated at least several dozen), compile a database of mutation frequencies in various ethnic groups , using text-mining approaches, make a map of the area of ​​knowledge, where diseases, genotypes, methods of testing IP, microbial taxa and symptoms will be related.An analysis of the genomes of intestinal bacteria and metagenomic data can be performed to create an orthology of beta-galactosidases and their occurrence in intestinal bacteria.

Food allergies and intolerances

The estimated economic burden from food allergies and intolerances in the United States is $ 25 billion a year (

ref.

), and that’s just for children under 16. It is worth distinguishing between allergies and intolerances, allergy implies that the food component becomes an antigen and with an increase in the dose or frequency of exposure to the allergen, the developing reaction of the immune system can be fatal, the most common allergens are nuts and seafood.Food intolerance manifests itself in the absence of a significant reaction from the immune system, however, as a result of incomplete or improper digestion, food components cause symptoms such as nausea, diarrhea, and gas formation. It is believed that intolerance to individual components is much more common and dose-dependent: up to a certain amount, the body is able to assimilate the food component, and above a certain threshold, symptoms appear. The most common example of food intolerance is lactose intolerance (LI).

In an adult who assimilates milk well, the enzyme responsible for the digestion of lactose (lactase) is found in the villi of the enterocytes of the small intestine; in the case of NL, the enzyme is detected only in rare enterocytes within the same villi. The ability to digest lactose is determined mainly by the level of gene expression, and therefore is determined genetically.

Genetics of lactose intolerance

The incidence of IP and the age of its manifestation depends on the ethnic group (Heyman, 2006; Swallow, 2003).Among the Spaniards, the frequency is up to 8 percent, Ashkenazi 60-80%, Asians and American Indians up to 100%. The opposite situation has developed among the North European ethnic groups (Johnson, 1981), where IP occurs in 2%. In most studies, the same polymorphism is found that is responsible for maintaining a high level of lactase (C / T-13910). This polymorphism, located 13.9 kb upstream of the lactase gene in the genome, explains most cases of lactose tolerance in the European population (Enattah et al., 2007). To date, at least 8 unique nucleotide polymorphisms characteristic of a particular race associated with lactose intolerance are known (Torniainen et al., 2009).

Despite the fact that the symptoms themselves disappear with the refusal to drink milk, the American Society of Gastroenterology believes that the obtained indicators of comorbidity indicate the importance of research on IP.

There is some evidence for the association of IP and disease, in particular osteoporosis, depression, abdominal pain, irritable bowel syndrome and fructose intolerance (Schiffner et al., 2016).

Determination of lactose intolerance

Clinical methods for determining lactose intolerance include the following methods:

  1. Test for lactose intolerance. Blood glucose is measured two hours after drinking a lactose drink. If the glucose level does not rise, then the lactose has not been digested.
  2. Hydrogen breath test. After drinking a lactose drink, the concentration of hydrogen in the exhaled air is measured.In case of intolerance, its levels will be increased, because lactose will be metabolized in the large intestine to hydrogen, which is then excreted through respiration.
  3. 13C-test – a test for the concentration of modified carbon, carried out after drinking a drink with 13C-labeled lactose. If it is digested in the small intestine, 13C-labeled glucose can be detected in the blood.
  4. Stool acidity test. For children who cannot pass the above tests due to their very young age, a stool acidity test is used.Fermentation of lactose in the large intestine leads to acidification of feces (due to lactic acid).

The role of microbiota

The role of the microbiota in the development and severity of symptoms is not fully understood. It is assumed that undigested lactose comes from the small intestine to the large intestine and is fermented by the gut microbiota. During fermentation, short-chain fatty acids, hydrogen, methane and carbon dioxide are formed, thereby increasing intestinal pressure and intestinal transit time.Acidification of the contents of the colon and an increase in osmotic load leads to an increase in the secretion of electrolytes and fluids, which leads to loose stools and diarrhea.

There are studies that show an increase in the cytotoxicity of fecal waters in persons with IP (Windey et al., 2015). Campbell’s group in the UK is developing a theory about specific bacterial toxins (Campbell et al., 2010), suggesting that a certain composition of microflora, when ingested with such a high-energy resource as lactose, leads to the production of low- or high-molecular bacterial toxins that cause symptoms …

The first epidemiological studies have identified (Kurilshikov et. Al 2016) a link between genetic polymorphism, microbiota composition, and symptom manifestation. However, in general, the question of the influence of the composition of the microbiota as a factor in the manifestation of symptoms of IP has not been studied.

Fermented milk products

An interesting explanation in terms of the influence of indigenous microbes is the explanation of the ability of people with IP to digest fermented milk products. Most fermented milk products (kefir, yogurt) do not differ much from milk in terms of the amount of lactose, but their use, even in the presence of IP, does not lead to symptoms.

Important note.
Since the topic is not discussed in textbooks, colleagues often cite unfounded statements, without evidence, believing that only the absence of lactose allows you to drink kefir.
For example, the Chemistry and Life magazine www.hij.ru/read/articles/all/5394 states that kefir contains no lactose. Moreover, the respected magazine also trolls Malysheva (we already have a common past on Habr (link)).
In principle, asking a question to “Dr. Google” one can find various interpretations, most of the colleagues apparently think that since kefir does not cause a reaction, then there is no lactose in it either.
Actually there is.
Original article with measurement (milk 5 g of lactose, kefir 3.7 g) (link)
Most of the work refers to Renner and Renz-Schaven, 1986 or Hallé et al., 1994, where 100 g of kefir is 4 g of lactose.
Conclusion : there is enough lactose in kefir.

To be honest, I myself was surprised that there is so much lactose in fermented milk products. It was all the more interesting to understand the details. The work (de Verse et al., 2001) reveals a mechanism according to which the microbial beta-galactosidase contained in fermented dairy products avoids digestion in the stomach, since it is located in the cell membrane of bacteria and, when it enters the upper intestine, hydrolyzes lactose.

Once again. Microbes from fermented foods give us their enzymes, carrying them to the upper intestines in their bodies. In the small intestine, bacterial enzymes help us to digest lactose, and it does not enter the large intestine, and therefore there are no symptoms of NL.

Reasoning

The same reasoning applies to many fermented foods for which fermentation conditions have been selected in the course of human development. Most often, plant foods can be fermented with indibiom that live directly on the leaves, such as sauerkraut.Fermentation is external (in relation to human) digestion, and more fermented foods contain a mixture of enzymes for the best absorption of foods within our intestines.

Another observation: bacteria are a factor that can both positively and negatively affect food intolerance. And there seems to be an optimal combination of gut microbiome and product microbiome that will avoid negative reactions.

Conclusion

The problem described above has largely not received proper attention, since IP is not officially considered a disease and data on economic burden, comorbidity and disease statistics are rather fragmentary.While many issues are being resolved today by national or international societies or consortia, the issue of lactose intolerance remains unaddressed. A related fact is the disunity of researchers and studies: different assessment technologies or protocols for assessing IP are used, individual polymorphisms are considered, there is no standardized validated questionnaire and coordination towards epidemiological research.

Why it matters

The ability to use milk for food is considered a powerful evolutionary impetus in the development of mankind, the appearance of a mutation that allows the digestion of lactose according to calculations (Bersaglieri, T.et al. 2004) increased the number of healthy offspring by 19% among its owners. There is no data yet, but it is clear that the microbial part of the holobiont also co-evolved with human digestion, possibly also compensating for the lack of lactase in an individual with IP. Deciphering the mechanisms of microbial adaptation in the case of IP would make it possible to proceed to the study of the processes of coevolution.

Comorbidity data also speaks about the importance of LN in the pathogenesis of multifactorial diseases, here microbial compensation and correct control over the state of intolerance would lead to direct economic consequences – an increase in the working-age population.

Research on fermented foods, potentially allowing microbiota adjustment without the use of drugs or nutritional supplements. Dealing with food intolerances using fermented foods is undoubtedly in the realm of interests not only in healthcare, but also in pharmaceuticals and food companies.

Lactose intolerance is a good model for researching and solving issues of food intolerance in general. Although the mechanisms may differ in the case of other intolerances, the approach to the study of the issue itself can be extended to other problems: the detection of genetic dependences, the determination of the mechanisms of regulation of enzyme activity, the search for links with the intestinal microbiota and the correction of the microbiota in order to reduce the negative effects of intolerance.

How can I enjoy latte when traveling outside Scandinavia with lactose intolerance? [closed]

The 5 most DANGEROUS travel destinations in the world!

I have been suffering from lactose intolerance for about 10 years. This seems to be a common problem in Sweden, as grocery stores now have good substitutes for all milk-based products. All cafes have the option to order a lactose-free latte. And I love my latte.Over the past 10 years, it has grown from a rarity to a very common one here in Sweden.

But travel is different. I assumed it was impossible to get a lactose-free latte overseas and never asked. I stick to my only espresso. And when I was shopping at the grocery store, I didn’t see either. (Finland is an exception.) So to my question, are there other countries besides Sweden and Finland where lactose-free alternatives are available?

  • yeah – on purpose 🙂 might break the rules now?
  • 1 Anyone who mentions a coffee shop like Starbucks: When ordering a drink with soy milk, you have to tell the barista that you are lactose intolerant.If you do not do this, you may be at risk of cross-infection. My sister is lactose intolerant, and while visiting Starbucks, she discovered that they reuse the rag they use to wipe the milk steamer when wiping the soy milk steamer. But when she tells them that she is lactose intolerant, barists tend to be extra careful and more aware of the sources of cross-contamination.
  • On hold.So do I need to ask a specific question for each continent, country, or something else?
  • @froderik: Yes, I would say that when you think about tavels and worry about lactose, ask about “the problem you are facing.” There are too many differences. In Laos, soy milk seemed easier to obtain than cow’s milk. In Mongolia, people traditionally eat dairy products during the summer months. Other countries have Starbucks.
  • 1 @hippietrail good review! Edited accordingly

First of all, globally, lactose tolerance is an abnormality and not lactose intolerance.Roughly a quarter of the world’s population retains the ability to digest lactose after adulthood / breastfeeding, this ability is achieved through genetic selection and is most prominent in the northern European cattle population. In Sweden, only 2% of the population is lactose intolerant, but this number rises to 15-25% in Germany, 50% in Italy and even 70% in Sicily. In East Asia and southern Africa and South America, 90–100% of the population is lactose intolerant.

So why is lactose-free dairy products so common in Scandinavia, where they do not seem to be medically required, at least not as often as in many other countries? Why can Italians drink a cappuccino or latte with regular milk, even if half of Italians are lactose intolerant? The EFSA (European Food Safety Agency) concluded in a 2010 study that most people with lactose intolerance can tolerate up to 12 g of lactose at a time or 20-24 g of lactose daily with no or only minor symptoms.For regular cow’s milk, this corresponds to a single dose of about 250 ml or a daily dose of 400-500 ml. Obviously, lactose intolerance is not necessarily an argument in favor of using lactose-free dairy products in coffee drinks.

However, it is often argued that the purported health benefits of lactose-free dairy products are just a marketing joke. Most Scandinavians are wealthy enough to pay extra, even just for believing that they are doing something good for their body and soul.

  • I can confirm that small doses are not a problem. I had a cortado this fall when I was in Spain and it worked. A lactose milk latte wouldn’t be all that enjoyable … You also need to lower your intake altogether to avoid problems.
  • Also – I’m laughing at your last statement. Trolling?
  • I’m not trying to troll, but I wondered why lactose-free dairy products seem so much more affordable in Scandinavian countries than in other countries.First, these countries have the lowest levels of lactose intolerance, and even for people with lactose intolerance, the use of lactose-free dairy products is really only necessary if you want to drink milk as a thirst quencher. Why do Scandinavians sometimes pay a very high premium for lactose-free dairy products when most of the time they don’t get any real benefit from them other than being trendy and chic?
  • From what I know, only Scandinavians who have problems buying food.But I have no data to support this. Lactose-free products are in a separate location and cover the basics, but nothing more. Let’s say one-tenth of the dairy products in stores are lactose-free. I think the answer can be found in the fact that our culture is used to drinking a lot of milk and we are still thirsty when we suffer from lactose intolerance.

Of course there are many cafes in the UK that sell lactose free lattes.

Soy milk is most often used instead of real milk.

So this includes Starbucks in many countries, as well as smaller coffee chains and some local coffee shops.

In addition to @RoryAlsop’s answer, Starbucks and Dunkin Donuts offer lattes and other caffeinated beverages with soy milk in the US.

Most small coffee shops in the US do too.

  • 1 Almond milk is also widely available in US coffee shops.

90,000 Can I Be Really Lactose Intolerant?

Many people think they are lactose intolerant.And as it turns out, most of them are probably right, because the vast majority of people over the age of two have legal lactose intolerance. Embarrassed? I will guide you through this.

Fast Oats vs. Old Fashioned Oatmeal

First of all, what

is lactose?

Christine Urso

Lactose is a naturally occurring disaccharide (a fancy word for two sugars linked together) composed of glucose and galactose.

Lactose must be broken down by the enzyme lactase for digestion. When lactase is in short supply, a common syndrome known as “lactose intolerance,” bacteria in the intestines try to ferment it, leading to unpleasant symptoms.

How do I know if I am lactose intolerant?

Catherine Baker

First, how do you feel after drinking milk or eating ice cream? Common symptoms include abdominal pain, gas, diarrhea, a large bloated stomach, discomfort, abdominal cramps, nausea, vomiting, and, in some cases, constipation.

Many people complain of discomfort after consuming dairy products, and for good reason. The vast majority of people over two years of age are lactose intolerant.

Natalie Beam

Yeah, you read that right. It is more unusual to be lactose tolerant than intolerant.

Biologically, humans, like all mammals, are designed to consume milk from their mothers while they are young. Thus, they are born with quite a lot of lactase, an enzyme that helps you digest it.

But as you get older, your body starts producing less and less lactase, because biologically, most mammals stop drinking milk and need more lactose after infancy.

Catherine Baker

So, once you reach the age of two, 75% of people have a lot less lactose than you were born, because Mother Nature decided a long time ago that you didn’t need it.

And your legacy can play at your risk: although fewer people of northern European descent suffer from lactose intolerance, it is extremely common among people from northern Europe.Asian descent.

Is lactose intolerance dangerous?

Aakanksha Joshi

Lactose intolerance can cause diarrhea and severe stomach pain, so if you suffer from excessive loose stools, make sure you are hydrated and eat right, as diarrhea can cause your body to not absorb many of the things that which it needs.

However, lactose intolerance is an intolerance, not an allergy, which is an important difference.People with milk allergies can have life-threatening reactions to even small amounts of dairy products, and lactose intolerance – while causing some discomfort – is not the same thing.

Tory Walsh

Most people with lactose intolerance can tolerate up to two servings of dairy products a day (even better if they are spread out) without too many problems, but everyone is different and only you know your body best.

Just make sure if you rely on dairy for calcium and Vitamin D.You get these nutrients from other sources, such as fortified non-dairy foods and grains, or from certain fruits, vegetables, legumes, and tofu.

What foods are high in lactose?

Amanda Schulman

Well, obviously, milk has quite a lot of lactose in it. Milk-based drinks, including milkshakes and favorites. frapps are also on the lactose list.

Other sources include whipped cream, coffee creamer, ice cream, sorbet, custard, puddings, and cream soups.Some cheeses, especially processed cheeses, tend to contain more lactose as well.

Paige Marie Rogers

Certain snacks, cheese crackers, chocolates and candies, caramel, sauce mixes and baked goods can also hide lactose, so be sure to read labels carefully if you want to know.

Anything processed with whey casein (milk protein), milk by-products, milk powder, or cottage cheese may also contain dairy products.

Catherine Baker

Certain dairy products, including butter, ghee, aged cheeses such as Swiss cheese, mozzarella, parmesan, cheddar and brie, cream cheese and half and half, contain less lactose.Some people can tolerate yogurt, as probiotics help some to break down sugar.