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Lactose Intolerance

Contributors: Barbara Gordon, RDN, LD

Reviewed: April 09, 2020

Woman upset stomach | Lactose Intolerance
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Lactose intolerance means the body can’t digest foods that contain lactose. Lactose is a naturally occurring sugar found in dairy products such as milk, yogurt and cheese. Many people are able to have these foods and beverages without problem, but some individuals are unable to break this sugar down.

Lactose intolerance runs in families—so if your parents or siblings are affected, your risk may be higher. Not everyone with lactose intolerance reacts the same. Different people may be able to tolerate some foods and beverages that contain lactose, whereas other people may not be able to tolerate these foods at all.

Certain health conditions and treatments also may lead to lactose intolerance, like celiac disease, some types of cancer treatment and gastrointestinal surgery. As someone recovers, they may be able to go back to consuming foods and drinks that contain lactose.

Diagnosis

People with lactose intolerance may experience a range of digestive complaints after eating foods or consuming drinks that contain lactose. Symptoms may include:

  • Bloating
  • Diarrhea
  • Gas
  • Nausea
  • Stomach pain

Your health care provider may ask you if certain foods upset your stomach, as well as about your family medical history.

Your provider may also order a hydrogen breath test to help diagnose lactose intolerance. Or, they may refer you to a registered dietitian nutritionist, or RDN. An RDN can help you determine how much lactose you may be able to tolerate and ensure you’re getting an adequate amount of nutrients for good health.

Lactose-Controlled Diet

If you are lactose intolerant, you will need to limit foods containing this milk sugar.

Most people with lactose intolerance can consume small amounts of lactose without experiencing symptoms. Yogurt and hard cheeses, such as cheddar or Swiss, tend to be easier to digest. However, everyone is different in how much they can consume.

Sources of Lactose

Milk-based products. This includes milk, cheese, yogurt, cottage cheese and butter, as well as whipped cream, half-and-half, dry milk powder, evaporated and condensed milks. 

Packaged and prepared foods also may contain lactose. Reading the ingredient list can help you identify if a food contains lactose. Dairy products may be used as an ingredient in a variety of foods, including breads, waffles, cakes, instant potatoes, cream soups, protein bars and meal replacement shakes. Lactose may also be present in unexpected items such as non-dairy creamers, margarine and deli meats.

Medicine may contain lactose. If you take prescription or over-the-counter drugs, talk with your health care provider.  Ask if any of these products contain lactose and if the amount might be bothersome to you.

Getting the Nutrients That You Need

Milk and dairy products are common sources of calcium for many people in the United States and are often fortified with vitamin D. If you’re reducing your dairy intake, it’s important to choose other sources of calcium and vitamin D.

Get calcium and vitamin D from foods that do not contain lactose.

Lactose-free versions of dairy products are available in most supermarkets. These products offer a similar amount of calcium as their milk and dairy counterparts and are often fortified with vitamin D. A combination of other foods also may help you to meet your calcium needs throughout the day, checking the Nutrition Facts label is a great way to find out if a food or beverage provides calcium or vitamin D.

Find a Nutrition Expert

Want help figuring out what foods you may safely enjoy because of a lactose intolerance?  The Academy of Nutrition and Dietetics has a searchable database of RDNs. Enter your zip code to find a list of RDNs in your area.

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