blue background with a spilled glass of milk
blue background with a spilled glass of milk

How to Manage Lactose Intolerance with Dairy

Posted by Deana Hildebrand, Ph.D., RD, SNS, LD

Friday, January 4, 2013

Tags: Lactose Intolerance, Nutrition

I’m lactose intolerant but love milk and yogurt. These foods are a regular part of my daily food choices.

I’m not alone, yet many people are excluding milk and dairy food from their diet in response to symptoms perceived as lactose intolerance. A frequent, yet unfortunate, result of people incorrectly self-diagnosing lactose intolerance is the exclusion of milk and dairy foods from the diet.

Milk is important for good health

  • The exclusion of calcium-rich dairy foods can lead to poor bone health. 
  • Milk and dairy foods provide nine essential nutrients needed for good health. It provides three of the four nutrients most lacking in children’s diets; including calcium, vitamin D and potassium.                             

Lactose is a natural sugar

  • Lactose is the naturally occurring, healthy sugar, or carbohydrate, found in the milk produced by animals. (These animals include cows, goats and humans.)
  • Lactose is digested by lactase, an enzyme that is produced in the intestine.
  • Lactase breaks down the lactose into two smaller units of sugar (monosaccharides) called glucose and galactose, which are then absorbed into the blood stream.
  • The sugars provide the body with the fuel it needs for energy.

Prevalence of lactose intolerance

  • The prevalence of lactose intolerance in the United States is difficult to determine because many people self-diagnose the health condition.
  • They may be experiencing gastrointestinal symptoms including diarrhea, abdominal pain, flatulence and/or bloating.

The symptoms may be related to other health conditions such as irritable bowel syndrome or medications they are taking. When people think they may have lactose intolerance, it is important to work with a health care professional such as a registered dietitian.

There are some groups of people who are genetically inclined to produce less lactase. They include African-Americans, Hispanic Americans, Asian Americans and Native Americans. However, medical tests indicate the rate among these populations is not as high as self-reported data.

Managing lactose intolerance

It’s possible for lactose intolerant people to consume calcium-rich dairy foods. These foods include milk, yogurt, hard cheeses and lactose-reduced foods. Below are some tips to reduce symptoms without compromising calcium and vitamin D consumption.

  • Consume dairy foods at mealtime. The fiber in fruits, vegetables and whole grains slows digestion and gives the body more time to digest the lactose.
  • Try reduced-fat instead of fat-free milk products. Like fiber, the fat slows digestion.
  • Eat dairy foods in small amounts
    • One serving of milk is one cup (eight ounces), the amount in a school milk carton.
    • One serving of hard cheese is one ounce, or about the size of a domino.
    • One serving of yogurt is one cup (eight ounces). Look for yogurt with live enzymes that aid in digestion.
  • Experiment with different amounts of dairy foods to find the amount that is tolerated.
  • Use lactose-free or reduced-lactose dairy products. Lactase has been added to these foods so the lactose is already broken down into the smaller sugars. This is the tip that works best for me. My whole family enjoys these foods, so I do not have to buy different milk for different people. 
  • Buy lactase tablets and add to milk. They can be found in most pharmacies.

These tips should be helpful in getting enough calcium-rich dairy foods needed for good health and strong bone development. For variety, mix and match the dairy foods to get the needed amount of calcium.

Source: Dietary Reference Intakes. National Academies Press. Available at www.nap.edu.

Deana Hildebrand, Ph.D., RD, SNS, LD

Dr. Deana Hildebrand is an associate professor and extension specialist focusing on maternal, child and family nutrition in the department of nutritional sciences at Oklahoma State University College of Human Sciences.

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