Ask Well
I recently learned that I'm
lactose intolerant. Do I really need to avoid all dairy?
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Some 30 million to 50 million
people in the United States have lactose intolerance. This means their bodies
can't adequately break down lactose, the sugar present in milk.
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The result can be gas, bloating,
nausea, diarrhea and abdominal pain, symptoms that typically occur within about
30 to 60 minutes of eating a lactose-rich food, said Beth Ferrell Jenks, a
dietitian and assistant professor of nutrition at the University of North
Carolina at Chapel Hill.
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The good news: While individual
tolerances to dairy foods can vary, certain lower-lactose dairy products can
help keep lactose intolerance symptoms at bay.
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Eating With Lactose
Intolerance
?Trouble with lactose intolerance tends to
begin in adulthood, when our bodies gradually makes less lactase, an enzyme
that breaks down lactose.
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Some people might not notice this
change, said Dr. Suneeta Krishnareddy, a gastroenterologist at Columbia
University Irving Medical Center in New York City. But others may have symptoms
that include nausea and vomiting, said Dr. Nitin K. Ahuja, a gastroenterologist
at Penn Medicine in Philadelphia.
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Understanding your triggers
involves some trial and error.
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Here are the dairy products most,
and least, likely to exacerbate your symptoms.
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The Worst Offenders
DAIRY MILK Skim, 1 percent, 2
percent and whole milk all contain between 12 and 12.5 grams of lactose per
cup. That's around the maximum amount of lactose people with an intolerance can
consume per day without having symptoms, said Ella Haddad, a dietitian and
professor emeritus of nutrition at Loma Linda University in California.
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UNAGED (OR FRESH) CHEESE
Cheese generally contains less
lactose than milk, but some varieties have more than others. Cheeses that
haven't been aged typically contain more lactose than aged cheeses, Ms. Jenks
said. This is because during the aging process, bacteria break lactose down,
converting it into lactic acid. Unaged cheeses tend to be soft and moist. A
half-cup serving of cottage cheese with 2 percent milk fat contains about four
grams of lactose. Divo table-spoons of fat-free cream cheese has nearly two
grams.
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ICE CREAM
Many ice creams, which are mainly
made from milk and cream, are rich in lactose. But some contain more lactose
than others. If an ice cream contains more milk than cream (you can tell by
checking if milk is listed before cream on the ingredients list), it is
probably rich in lactose, Dr. Haddad said. This is because milk contains more
lactose than cream.
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OK in Moderation m
HARD CHEESE Varieties like
Parmesan, Cheddar and Swiss have been aged and therefore contain little lactose
and are often easier to digest than un-aged varieties, Dr. Krishnareddy said. A
one-and-a-half-ounce serving of Parmesan or Cheddar, for instance, contains
less than one-tenth of a gram of lactose.
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OTHER FERMENTED PRODUCTS
Fermented dairy foods like yogurt, kefir and sour cream contain bacteria that
help break down lactose, Dr. Krishnareddy said. This lessens the load on your
small intestine.
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BUTTER This kitchen staple is
made from milk, cream or both by separating the fat from the rest of the
liquid, leaving most of the lactose behind, Dr. Haddad said. One pat of butter
or a table-spoon of cream contains about half a gram of lactose or less.
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What Else Can Help?
?Many supermarkets carry lactose-free dairy
products made from milk but with the lactase enzyme mixed in.
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Dairy-free products like milk
made from almonds, soy or oats; cheese made from nuts; and ice cream made from
soy or coconuts are also lactose-free.
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Over-the-counter lactase enzyme
supplements can help reduce your symptoms when taken with a meal.
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Caroline Hopkins Legaspi
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