Lactose-Controlled Diet
all information

Lactose-Controlled Diet

(Lactose-Free Diet)

What Is Lactose?

Lactose is a type of carbohydrate found in milk and milk products. It’s sometimes referred to as milk-sugar. Lactose is broken down in the small intestines by the enzyme lactase.

Why Should I Follow a Lactose-Controlled Diet?

If you are lactose intolerant, your body is unable to digest large amounts of lactose. Consuming lactose may result in symptoms such as gas, bloating, cramping, and diarrhea . Reducing the amount of lactose in your diet will prevent or reduce these symptoms.

Lactose intolerance usually occurs when there is a shortage of the lactase enzyme. But it can also occur with diseases or injuries that affect the small intestines.

Lactose-Controlled Diet Basics

The goal of this diet is to reduce any lactose-induced symptoms to a point where they are not bothersome. How much lactose is tolerated will vary from person to person. You may find it helpful to keep a log of the foods that you eat and any symptoms that you have.

Common Sources of Lactose

Lactose is found in all dairy products, but some contain more than others. The table below groups some common lactose-containing foods by how much lactose they contain.

High-Lactose Foods

  • Milk
  • Ice cream

Medium-Lactose Foods

  • Yogurt
  • Cottage cheese
  • Sherbet

Low-Lactose Foods

  • Aged cheese (eg, cheddar and Swiss)
  • Sour cream
  • Butter

Other Sources of Lactose

Lactose can also be an ingredient in other types of food. To determine whether a food contains lactose, look for the following key words on the ingredient list:

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

Foods that commonly contain these ingredients include:

  • Margarine
  • Bread and other baked goods
  • Salad dressings
  • Deli meats
  • Snack foods
  • Candies
  • Instant breakfast drinks

Finding Your Level of Dairy Tolerance

Before cutting dairy products out completely, try cutting back. Milk is usually better tolerated in small amounts and when consumed with food. Cultured dairy products, such as yogurt and kefir, are often well-tolerated because they contain bacteria that help break down the lactose. Aged cheeses, such as cheddar and Swiss, which contain very low amounts of lactose, are also usually well-tolerated.

Alternatives to Milk

Alternatives to regular milk include lactose-reduced and lactose-free milk (eg, Lactaid). Lactase enzyme tablets can also be added to milk to reduce the lactose content. Nondairy alternatives include soy milk and rice milk.

Nutritional Concerns

Dairy products are an excellent source of calcium. Milk is also fortified with vitamin D, which is necessary for your body to use calcium. So if you cut back on or eliminate these products, be sure you are getting these nutrients elsewhere. Good sources of calcium include fortified orange juice, fortified breakfast cereals, fish canned with bones, and tofu. Good sources of vitamin D include salmon, mackerel, egg yolks, and sunlight.

Suggestions on Eating a Lactose-controlled Diet

  • Use a food log to pinpoint which foods are troublesome.
  • Make gradual changes to your diet and note the effects.
  • Try cutting down on portion sizes of lactose-containing foods.
  • Consume lactose-containing foods with other foods.
  • Read food labels for ingredients that may indicate the presence of lactose.
  • Look for Kosher food products labeled “Pareve” This means they contain no dairy.
  • Try taking a lactase supplement before eating lactose-containing foods.
  • Work with a registered dietitian to create a diet that works for you.

RESOURCES:

American Dietetic Association
http://www.eatright.org

American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES:

Canada's Food Guide
http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_e.html

Dietitians of Canada
http://www.dietitians.ca

References:

General guidelines for managing lactose intolerance. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/lactosediet.cfm . Accessed April 9, 2007.

Lactose intolerance. American Gastroenterological Association website. Available at: http://www.gastro.org/wmspage.cfm?parm1=854 . Accessed April 9, 2007.

Lactose intolerance. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/ . Accessed April 9, 2007.



Last reviewed May 2008 by Dianne Scheinberg, MS, RD, LDN

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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