Is lactose-free the same as dairy-free?
Navigating the grocery aisles can be especially confusing if you’ve recently been diagnosed with lactose intolerance, or another condition that’s managed by avoiding certain ingredients and/or foods. For people who have recently discovered that they have this digestive issue, a common question is whether lactose-free and dairy-free mean the same thing.
The short answer is no, but of course it’s more complicated than that. Here’s what you need to know.
Dairy-Free vs Lactose-Free
People who have to avoid dairy foods for medical reasons typically have an allergy to one of two proteins found in milk—whey or casein. And because eating a food you’re allergic to can have serious, and sometimes life-threatening consequences, people with a milk allergy have to be vigilant about avoiding dairy and other foods that contain these milk proteins.
Lactose intolerance, on the other hand, is much less serious, although the symptoms can certainly cause misery. Unlike an allergy, where the immune system attacks the person’s own body, an intolerance is due to a difficulty breaking down or absorbing a certain component of food. “Lactose is the carbohydrate in milk and dairy products,” explains Rosie Schwartz, a Toronto registered dietitian and nutrition writer.
Lactose—a carbohydrate in milk—is the offender for someone with lactose intolerance. Due to a lack of lactase—an enzyme that ‘chops’ lactose down into smaller ‘building blocks’ called simple sugars—lactose remains ‘whole’, so the small intestine can’t absorb it. Instead, it passes into the large intestine. Here, it’s fermented by bacteria, producing gas and fluids, which is what leads to those not-so-pleasant symptoms of lactose intolerance such as gas, bloating and diarrhea.
What Can I Eat if I’m Lactose Intolerant?
Now that we’ve cleared that up, let’s talk about which foods you can eat, and which you might want to avoid if you have lactose intolerance.
Foods that are dairy free contain no milk or milk ingredients‚ which include casein, whey, and lactose. That means if you’re cutting out lactose because you’re intolerant to it, consuming dairy-free foods shouldn’t result in uncomfortable symptoms.
In Canada, the claim ‘dairy-free’ or ‘non-dairy’ can’t be used on the labels of products containing any milk derivatives. And these substances don’t always have names that the average person would recognize as being made from milk. For example, butter, milk fat, yogurt, sour cream, hydrolyzed milk protein, milk solids, cheese and cheese curds are all milk products—as of course, are casein, whey, and lactose. But so are a long list of other compounds, including lactalbumin, lactoferrin, lactoglobulin, caseinate, and casein/rennet casein.
Lactose-Free Dairy Products
In contrast to dairy-free foods, which are made without milk or other dairy, lactose free foods aren’t necessarily made without lactose. Some brands of lactose-free milk, for instance, are filtered to remove the lactose. However, another, much easier method is used to produce other brands of lactose-free milk—adding the enzyme lactase. (Either type of lactose-free milk can then be used to produce a lactose-free cheese, such as as Black Diamond Lactose Free cheese products including the recently launched Lactose Free Marble cheddar sticks). Lactase splits lactose into two, smaller sugar molecules—glucose and galactose. In addition to rendering the product lactose free, this process does something else, as well.
“Because the lactose is broken down into simple sugars, that can make lactose free milk taste sweeter than regular milk,” notes Schwartz, “but it doesn’t actually contain more sugar.”
And since lactose-free dairy products are still, after all, dairy products, they contain the milk proteins whey and casein. However, needless to say, lactose-free products are an excellent choice for people with lactose intolerance. You may also want to experiment with consuming regular dairy along with a lactase supplement. (Many people find one type works better than others, so you may need to try a few different brands).
Naturally Lactose-Free Foods
Many foods are naturally lactose free—particularly minimally- or unprocessed:
- Beans and pulses
- Fruits and vegetables
- Fish and seafood
- Whole grains
- Soy foods (such as tofu and tempeh)
And while they vary in nutritional value, plant-based milks (such as coconut, almond, soy and oat) and cheeses (some of which are nut-based) also contain no lactose.
It’s also worth noting that despite names that sound as if they’re related to lactose, according to Dietitians of Canada, the following ingredients do not in fact contain it:
- Lactic acid
Foods High in Lactose (Avoid or Limit)
So what are the foods you should avoid if you’re cutting out lactose? Here are some of the most common ones.
- Milk. (This includes flavoured, condensed and evaporated milk, and non-fat milk powder.) Of all dairy products, milk contains the most lactose—roughly 13 grams per one cup serving. And cow’s milk isn’t the only kind that contains a large dose of lactose—so does milk from other mammals, such as goats and sheep.
- Butter and Cream. Cream, and foods that are made with it, such as buttermilk, butter, ice cream, custard and cream cheese, are typically high in lactose.
- Cheese and Curds (some types). So-called soft cheeses, which are high in moisture, such as ricotta, creamed cottage cheese, and feta tend to be higher in lactose than harder cheeses, such as Parmesan Swiss, cheddar and Mozzarella. That’s because the bacteria used in cheese-making can break down some of the lactose, so the longer the cheese is ‘aged’, the lower the amount that remains. For example, “an old cheddar cheese would be very low in lactose,” Schwartz says. Cheeses that are naturally lower in lactose may be good choices if you’re one of the people with lactose intolerance who can eat small amounts without suffering symptoms.
- Chocolate (some types). If you love chocolate, read the label before you buy it. While dark chocolate with 70 percent or more cocoa is typically both lactose and dairy free, many other types contain milk, milk solids, and other sources of lactose.
- Kefir and Yogurt (some types). Fermented milk products such as kefir and yoghurt are among the foods you may want to avoid if you have lactose intolerance. That said, because some lactose in kefir is ‘digested’ during the fermentation process, it may be better tolerated than foods higher in lactose. Similarly, as with cheeses, some yoghurt—specifically the Greek type— is lower in lactose and consequently, may be better tolerated if you can eat smaller amounts of lactose without problems. Or you can experiment by making your own Greek yoghurt. “If you strain your own regular yogurt, the liquid that comes out is whey, which would reduce the lactose content,” Schwartz explains.
- Whey and whey protein. Foods you may react to if you’re lactose intolerant include margarine containing whey powder, and whey protein powder. However, the whey protein isolate found in protein bars and some protein powders is very low in lactose.
- Hidden sources. “Frequently, people run into trouble because they don’t know that lactose may be found in other foods,” Schwartz notes. Some of these are a bit more obvious, such cream- or cheese-based sauces, cheese flavouring and smoothies, for instance. Others are less so, including some baked goods, breads, breaded or battered meats, salad dressings and margarines. And then there are the real eyebrow-raisers. “The food industry is very resourceful, and so whey is often used as a filler in other foods,” Schwartz explains. “It can be added to hot-dogs,” and cold cuts, she adds, “so it’s important to read labels.” And it’s not just food manufacturers—the pharmaceutical industry does this too. Lactose is used as a filler in some prescription and non-prescription medications. “For some people, that’s enough to trigger a reaction,” Schwartz says.
Hopefully now that you have a better understanding of where lactose can hide and which foods are high in lactose, you’ll be able to enjoy eating a variety of delicious, healthy foods while keeping uncomfortable symptoms at bay.