Lactose-Free Milk and Nondairy Beverages
Milk used to be simple. Your mom went to the store, bought a carton, and then plunked down a tall glass right next to your chocolate chip cookies. Nowadays, Mom might find the choices downright bewildering: lactose-free milk, nondairy beverages such as soy, rice, and almond milks -- even oat, multigrain, or hemp milk.
These alternatives have hit the store shelves, but why choose them? The reasons are many. Some people buy lactose-free milk because uncomfortable symptoms of lactose intolerance have soured them on regular cow’s milk. Others, such as people with true milk allergies, can’t drink cow’s milk at all, so they turn to plant-based milks to get their nutrition.
Diarrhea and Lactose Intolerance: When Dairy Is the Problem
Milk may do a body good, but not if you’re one of 30 to 50 million people who suffers from lactose intolerance. Lactose intolerance results from an inability to digest the natural sugar (lactose) found in milk and milk products. Lactose intolerance symptoms can include bloating, diarrhea, gas, and cramping. But there are ways to manage lactose intolerance while reaping the nutritional benefits of dairy products.
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Cow’s milk, including lactose-free cow's milk, does offer strong benefits, says registered dietitian Karen Ansel, MS, RD, CDN, a spokeswoman for the American Dietetic Association and co-author of the Baby and Toddler Cookbook. “In addition to having a lot of calcium and vitamin D -- which are really important and we don’t get enough of -- cow’s milk is a really great source of protein.”
Lactose Intolerance
Lactose intolerance occurs when you don’t make enough of an enzyme called lactase, which breaks down the milk sugar lactose, Ansel says. When the sugar stays undigested, telltale signs can creep up: diarrhea, gas, and bloating.
“You can have varying degrees of lactose intolerance,” Ansel says. “Somebody might be able to actually drink a glass of milk in a day. Somebody might not be able to have any. Somebody might be able to have some if they space it out, so it really depends. Different people might produce different amounts of lactase.”
“As we get older, we produce less and less of it,” she says. “What a lot of people find is that in adulthood, it becomes more of a problem, but it wasn’t a problem for them when they were children.”
Experiment to see how much dairy you can tolerate, or eat food when you drink regular milk to try to ease symptoms, Ansel says. You can also buy lactose-free cow's milk, which has been treated with lactase so that the milk sugar is completely broken down, she says. Nutritionally, lactose-free cow's milk is comparable to regular cow’s milk, she says. Or you can try other lactose-free milk options.
But one word of caution, Ansel says. Some people believe that they’re lactose intolerant when they actually have a true milk allergy. “There’s actually a pretty big difference,” she says. “Lactose intolerance has to do with an inability to metabolize or break down lactose. That’s a metabolic issue.” And a true milk allergy is uncommon.
In contrast, “A food allergy to milk has to do with your immune system. When you drink milk, your body perceives one of the proteins in milk as a foreign invader. Your body responds by producing antibodies to fight that protein. When those antibodies are released, it causes the symptoms of an allergic reaction.”
Milk allergy symptoms can include itching, swelling, hives, a runny nose, or difficulty breathing, Ansel says. Also, “You could have digestive symptoms. That’s why a lot of times, people confuse milk allergy with lactose intolerance. They do sometimes have overlapping symptoms.”
“Allergy can be a dangerous thing,” she adds. If you suspect that you might be allergic to milk, ask your doctor about allergy testing, she says. “You really shouldn’t try to diagnose it yourself.”
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