Lactose Sensitivity

Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer

Lactose is a naturally occurring sugar found in milk and milk products, such as ice cream and cheese. Lactose intolerance is a condition that causes digestive symptoms when lactose-containing products are eaten. Since it does not involve an immune response, lactose intolerance is not considered an allergy. Diagnosis by a doctor is important as symptoms of lactose intolerance can mimic other gastrointestinal disorders.

Lactose intolerance happens when the body lacks the enzyme lactase to break down lactose in the small intestine, resulting in symptoms such as abdominal pain, bloating, diarrhea, gas, nausea, and vomiting. The severity of symptoms can depend on the amount of lactose consumed and the severity of the intolerance.

The treatment for lactose intolerance is based on managing your symptoms. Most health experts don’t adhere to the elimination of all dairy products due to the inadequate amounts of calcium and vitamin D that may result. This deficiency can predispose you to decreased bone accrual, osteoporosis, and other adverse health outcomes. Try some dairy-containing foods and alternatives to see which cause fewer symptoms. This allows you to still get calcium and other important nutrients in your diet.

Lactose-free foods are easy to find on Sifter. Start here →

Risk Factors

• Cancer treatments: Abdominal radiation treatment or intestinal complications from cancer treatment can increase the risk of lactose intolerance.
• Small intestine disease: Bacterial overgrowth, celiac disease, or Crohn’s can cause lactose intolerance.
• Ethnicity: People of African, Asian, Hispanic, and American Indian descent have higher rates of lactose intolerance.
• Increasing age: Lactose intolerance usually appears in adulthood and is uncommon in babies and young children.
• Premature birth:. Infants born prematurely may have reduced levels of lactase.

Reading Labels

Make sure you read labels to see if milk/lactose has been added to foods. Outside of milk and milk products, you may find it in the following products:

• Baked goods
• Candy, including milk chocolate
• Cereal
• Coffee creamers
• Salad dressings

Healthy Eating Tips

• Avoid large intakes of milk and milk-containing products at one time.
• Choose smaller servings of dairy because the smaller the serving, the less likely it is to cause gastrointestinal problems.
• Save milk for mealtime, and drink milk with other foods to slow the digestive process and lessen symptoms.
• Experiment with an assortment of dairy products because they all have varying amounts of lactose. For example, hard cheeses have small amounts of lactose and generally cause no symptoms.
• Try cultured milk products, such as yogurt, because the bacteria used in processing naturally produces the enzyme that breaks down lactose.
• Buy lactose-free or milk-alternative products. You can find these products at most supermarkets in the refrigerated dairy section.
• Use over-the-counter lactase enzyme supplements, such as Dairy Ease® or Lactaid®, before you eat dairy. These products help some people to digest lactose without symptoms. There are also lactase drops available to add to entire cartons of milk.
• Talk to your doctor or dietitian about whether you should consider a calcium and vitamin D supplement since those nutrients are most easily found in dairy products.

Most people with lactose intolerance don’t have to avoid lactose completely. Many people can tolerate a certain amount of lactose in their diet. Determine what is best for you. If you need to supplement with calcium, take lactase enzyme tablets, choose lactose-free products, or decrease the intake of lactose-containing products in order to manage symptoms. Talk to your doctor or dietitian for more information on a diet for lactose intolerance.

Additional Resources

IFFGD: Lactose Intolerance
Mayo Clinic: Lactose Intolerance
NIDDK: Symptoms & Causes of Lactose Intolerance