• Lactose-Controlled Diet

    (Lactose-Free Diet)

    What Is Lactose?

    Lactose is a type of carbohydrate found in milk and milk products. It is 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. 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. The amount of lactose that 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. Some products contain more lactose than others. This carbohydrate 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:
    • Cream
    • Dried milk
    • Lactose
    • Milk
    • Milk solids
    • Powdered milk
    • Whey

    Lactose-Free Foods

    The following foods generally contain no 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 prepared without dairy products
    • Bread, cereal, and crackers made without dairy products
    • Sorbet
    • Gelatin

    Low Lactose Foods

    The following foods contain only small amounts of lactose (2 grams or less per serving) and can often be tolerated in small amounts:
    • Aged cheese, like Swiss, Cheddar, or Parmesan—1-2 ounces
    • Cream cheese—2 tablespoons
    • Cottage cheese—½ cup
    • Orange sherbet—½ cup

    Finding Your Level of Dairy Tolerance

    Before cutting dairy products out completely, try cutting back. Milk is usually better tolerated in small amounts (4 ounces or less at a time) 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 . Lactase enzyme tablets can also be added to milk to reduce the lactose content. Non-dairy 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. 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

    Academy of Nutrition and Dietetics http://www.eatright.org

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

    CANADIAN RESOURCES

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

    Health Canada Food and Nutrition http://www.hc-sc.gc.ca

    References

    Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed February 15, 2013.

    Lactose intolerance. American Gastroenterological Association website. Available at: http://www.gastro.org/wmspage.cfm?parm1=854 . Accessed January 3, 2010.

    Lactose intolerance. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/. Updated April 23, 2012. Accessed February 15, 2013.

    Lactose intolerance in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated March 4, 2012. Accessed Februar 15, 2013.

    Understanding Food Allergies and Intolerences. American Gastroenterological Association website. Available at: http://www.gastro.org/patient-center/diet-medications/food-allergies-fructose-intolerance-and-lactose-intolerance#Top. Updated April 24, 2010. Accessed February 15, 2013.

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