Lactose-Controlled Diet

Lactose-Controlled Diet

(Lactose-Free Diet)

What Is Lactose?

Lactose is a type of carbohydrate. It is in milk and milk products. It is broken down in the small intestines by an enzyme called lactase.

Why Should I Follow This Diet?

If you are lactose intolerant, your body cannot break down large amounts of lactose. This may cause gas, bloating, cramping, and diarrhea. Eating less lactose will ease these problems.

Lactose intolerance happens when there is not enough lactase enzyme. It can also happen if you have problems with your small intestines.

The Basics

The goal is to ease problems until they do not bother you. The amount of lactose you can eat differs from person to person. Keep a log of the foods that you eat. Write down any problems that you have.

Common Sources

Lactose is in all dairy items. Some items have more than others. It can also be in other foods. To find out if a food has it, look for these words on the label:

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

Lactose-Free Foods

These foods do not have lactose:

  • Lactose-free milk like Lactaid
  • Broth-based soups
  • Soy, almond, and rice milk
  • Fish, beef, pork, lamb, and poultry prepared without dairy products
  • Tofu and tofu products made without dairy products
  • Bread, cereal, and crackers prepared without dairy products
  • Sorbet
  • Gelatin

Low Lactose Foods

These foods have two grams or less per serving. Most people can eat them in small amounts.

  • Aged cheese, like Swiss, Cheddar, or Parmesan—1 to 2 ounces
  • Cream cheese—2 tablespoons
  • Cottage cheese—½ cup
  • Orange sherbet—½ cup

Finding the Right Amount

Try cutting back on dairy products first. You may be able to have it in small amounts or with other foods. Cultured dairy products like yogurt and kefir do not often cause problems. They have bacteria that help break down the lactose. Aged cheeses have low amounts of lactose and often do not cause problems.

Other Choices

Lactose-reduced and lactose-free milk are alternatives to regular milk. Nondairy choices are soy milk and rice milk.

Lactase enzyme tablets can also be taken when milk and milk products are eaten. They have the enzyme you need to break down the lactose.

Some Concerns

Dairy products are a good source of calcium. Milk is also fortified with vitamin D, which your body needs to use calcium. If you cut back on or stop eating these foods, be sure you are getting these nutrients somewhere else. Good sources of calcium are fortified orange juice, fortified breakfast cereals, canned fish with bones, and tofu. Good sources of vitamin D are salmon, mackerel, egg yolks, and sunlight.

Tips

Here are some diet tips:

  • Use a food log to find out which foods cause problems for you.
  • Slowly make changes to your diet and note the changes.
  • Try cutting down on the serving sizes of foods that have lactose.
  • Eat lactose-containing foods with other foods.
  • Read food labels for items that may have lactose.
  • Look for Kosher food products labeled “Pareve.” This means they do not have dairy.
  • Try taking a lactase pill before you eat foods with lactose.
  • Work with a dietitian to make changes.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org
Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org

CANADIAN RESOURCES:

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

References:

Calcium. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed July 23, 2021.
Dietary guidelines for Americans 2020-2025 and online materials. US Department of Agriculture and US Department of Health and Human Services. Available at: https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials. Accessed July 23, 2021.
Lactose intolerance. American Gastroenterological Association website. Available at: https://www.gastro.org/practice-guidance/gi-patient-center/topic/lactose-intolerance. Accessed July 23, 2021.
Lactose intolerance. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance. Accessed July 23, 2021.
Lactose intolerance in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lactose-intolerance-in-adults. Accessed July 23, 2021.
Last reviewed July 2021 by EBSCO Medical Review BoardDianne Scheinberg Rishikof MS, RD, LDN

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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