Managing Lactose Intolerance
Written by: CDHF
Updated: March 15th, 2023
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Millions of Canadians deal with lactose intolerance. Not everyone diagnosed can tolerate the same amount of lactose. Many people with lactose intolerance can eat some foods with lactose by changing the amount, type, and timing of these foods. Other people may need to limit or avoid these foods altogether. Managing lactose intolerance can be tricky, so we’ve outlined some ways to manage your diagnosis.
Signs and Symptoms of Lactose Intolerance
First things first, it’s important to recognize the difference between lactose intolerance and an allergy – as the two are not the same and managing them will be different.
Individuals with lactose intolerance often experience discomfort after consuming dairy. Symptoms can begin as early as 30 minutes after dairy is consumed or can be delayed up to 2 hours after consumption.
While lactose intolerance may present itself differently among individuals, common signs and symptoms include:
- Diarrhea
- Nausea
- Vomiting
- Stomach cramps/pain
- Bloating
- Excessive gas
By adulthood, up to 70% of people no longer produce enough lactase to properly digest the lactose in milk, so if you’re wondering if you can suddenly become lactose intolerant – the answer is yes.
Lactose can be found in:
- Regular & low-fat milk
- Cheese
- Ice cream
- Regular and low-fat yogurt
- Milk Chocolate / Flavoured Milk
- Cream
- Buttermilk / Eggnog
- Whey
Can also be an ingredient in foods like bread, cereal, and salad dressings so be sure to read packaging labels!
On the other hand, individuals with a milk allergy experience an allergic reaction to a protein in milk. Symptoms usually develop within minutes to 2 hours after eating the food or drink, and can range from mild to severe. These include:
- Rashes
- Hives
- Itching
- Trouble breathing
- Wheezing
- Loss of consciousness
A milk allergy can affect people of all ages, but it is most common in children, and many will outgrow it. If you are experiencing any of the symptoms above, reach out to your health care professional.
Lifestyle and Dietary Changes for Lactose Intolerance
Now that we understand how to recognize a lactose intolerance, let’s go over some ways to manage the not so pleasant symptoms.
Try adjusting your lifestyle and dietary choices by:
- Eating lactose foods with a meal instead of on their own, as lactose may be better tolerated when eaten with other food.
- Taking a lactase enzyme before you eat foods that contain dairy. This may prevent the symptoms of lactose intolerance. Options include low-lactose milk with lactase, which is available in most grocery stores, and lactase tablets that are available in pharmacies. It’s important to consult a registered dietitian or your physician before beginning use of lactase tablets as a way to combat lactose intolerance.1
- Consuming lactose in moderation. Studies have shown that some people have a tolerance to one cup of milk per day (12g of lactose) without symptoms2, so try consuming a little at a time.
- Being aware of lactose levels in food. There are certain types of dairy products that can be enjoyed by one who is lactose intolerant. Hard cheeses such as cheddar, parmesan, and Swiss have lower amounts of lactose compared to soft cheeses like brie, soft mozzarella, and cottage cheese. Butter, dark chocolate, and probiotic yogurt are also very low in lactose, so they may be easier to digest! Always read the labels if you are unsure!
For some, decreasing the amount of lactose in your diet or avoiding altogether may be necessary.
Foods that are lactose free include:
- Fruits
- Vegetables
- Grains
- Meats
- Soya or coconut-based yogurts and cheeses
- Any dairy-free or lactose-free dairy products that include:
- Lactose-free milk, yogurt, cheese, and ice cream, which still have the same great taste as regular milk products!
Lactose-free dairy products also contain the same amount of calcium as regular dairy products, which is important to avoid calcium deficiencies when on a lactose-free diet. Non dairy sources of calcium include chia seeds, sesame seeds, broccoli, celery and almonds. However levels of lactose in these foods are typically lowered and not as well absorbed as in dairy products.
Vitamin D is an important vitamin/mineral to be mindful of when avoiding dairy as it builds and maintains healthy bones. Milk is a great source of Vitamin D, so switching to lactose-free milk will have the same nutritional qualities. You can also obtain Vitamin D through sunlight, vitamin supplements, fatty fish and certain vegetables, such as mushrooms (if grown under UV light).
Individuals with lactose intolerance can still enjoy a diverse and nutritious diet without sacrificing taste. Managing lactose intolerance can be done by paying attention to what foods trigger symptoms and adjusting your diet accordingly. Always speak with your doctor or registered dietitian before making changes to your diet to ensure you are still getting the nutrients you need when avoiding lactose.
This article was made possible due to an unrestricted educational grant from Lactantia.
References:
- Malik, T. (2021) Lactose Intolerance. https://www.ncbi.nlm.nih.gov/books/NBK532285/
- https://www.ncbi.nlm.nih.gov/books/NBK534631/
- CDHF. (2023). Lactose Intolerance. https://cdhf.ca/en/digestive-conditions/lactose-intolerance/
