Know Your Lactose Limit
If you're lactose intolerant, it's still possible to eat foods with lactose -- in moderation. The key is to know your limit. Keep a food diary, write down when, what, and how much you ate, and how it affected you. You should see a pattern emerge and will learn how much or how little lactose you can tolerate. Then, stick to your limit.
Consider Lactose-Free Milk and Other Dairy
For regular milk drinkers, most supermarkets have lactose-free or low-lactose milk in their dairy case or specialty foods sections. You can also find lactose-free cheese, lactose-free yogurt, and other dairy products. It can be difficult to get enough calcium when you are lactose intolerant. Lactose-free milk, however, has the same amount of calcium as traditional milk.
Take Control of Your Diet
Rather than struggling to find something on a menu that you can eat, take control by brown bagging it. When cooking at home, you can replace milk in recipes with lactose-free milk. Or buy a cookbook that features lactose-free recipes and start experimenting. Many classic recipes can be adapted to fit a lactose-intolerant diet. Control what ingredients go in the meal and you may be surprised at how much you can eat.
Consider Lactase Supplements
It's not a cure, but taking lactase enzyme supplements can help you tolerate foods containing lactose. Supplements are found in a variety of forms, including liquid, caplets, and chewable tablets. They may be particularly helpful if you don't know the exact ingredients in your meal. If supplements do not resolve your symptoms, be sure to check with your doctor.
Hunting for Hidden Lactose
Lactose is found in most dairy products, except those marked "lactose-free," such as lactose-free milk or cheese. It also can be in prepared foods such as dried mixes, frozen meals, and baked goods. Read food labels carefully, and watch out for ingredients such as "milk solids," "dried milk," and "curd." If you choose to eat these foods, you may need to take a lactase supplement to help prevent symptoms.
Ask the Experts
Learning a new way of eating isn't easy, but you don’t have to do it alone. Ask your doctor to recommend a nutritionist or dietitian to help you manage your diet. She can teach you how to read food labels, share healthy eating tips, determine how much dairy you can tolerate without symptoms, and come up with reduced-lactose or lactose-free alternatives to provide a well-balanced diet.
Smaller Portions, Fewer Symptoms
Maybe you can't enjoy a big glass of milk with cookies, but you can try a smaller serving. Start with a 4-ounce glass instead of a full 8 ounces. Gradually increase the amount of dairy you eat until you begin to notice unpleasant symptoms. Listen to your body. It will tell you when you've reached your limit. If you want to avoid lactose completely, try lactose-free dairy milk or non-dairy beverages, such as soy milk.
Enjoy Dairy on the Side
Instead of eating or drinking dairy products by themselves, try having them with food that doesn't contain lactose. For some people, combining dairy with other food may reduce or even eliminate their usual symptoms. So don't just drink a glass of milk in the morning. Pour it over cereal or have a piece of toast on the side.
Make Better Cheese Choices
With lactose intolerance, you can still eat cheese, but choose carefully. Hard, aged cheeses like Swiss, parmesan, and cheddars are lower in lactose. Other low-lactose cheese options include cottage cheese or Feta cheese made from goat or sheep's milk. Certain types of cheeses -- especially soft or creamy ones like Brie -- are higher in lactose. If you want to avoid dairy completely, try lactose-free and dairy-free cheeses.
Learn to Love Yogurt
Look for yogurt with live and active bacterial cultures. When you eat this type of yogurt, the bacterial cultures can help break down the lactose. Plus just one cup of plain, low-fat yogurt provides 415 mg of calcium. But forget frozen yogurt. It doesn't contain enough live cultures, which means it may cause problems for people who are lactose intolerant. To be safe, you can always choose lactose-free yogurt.
Probiotics for Lactose Intolerance
For some people, probiotics can ease symptoms of lactose intolerance. Probiotics are live microorganisms, usually bacteria, that restore the balance of "good" bacteria in your digestive system. They can be found in foods like yogurt or kefir -- probiotic-rich milk -- as well as dietary supplements. Check with your doctor to see if probiotics might help you.
Eating Out When Lactose Intolerant
It's possible to eat out following a lactose-free diet. Ask your server if there's a guide for the menu that shows you which foods contain milk. Or let your host know which foods you're avoiding. Take a lactase supplement in case dairy ingredients slip in. Eat simply. For example, skip cream sauces and dairy condiments like sour cream.
Low-Lactose Home Cooking
Cooking low-lactose requires a change of thinking. The simpler you cook, the better. Use herbs and seasonings to flavor meat, fish, and vegetables. Stick to fresh ingredients and use fewer prepared foods. Experiment with chicken stock or lactose-free milks to make sauces. Use low-lactose cheeses for baking. Explore cuisines -- such as Mediterranean or Asian -- that don't rely very much on dairy products.
Listen to Your Body
As you experiment with eating dairy products, you'll figure out how much your digestive system can tolerate. Listen to your body and choose accordingly. Want a slice of cheese pizza? Remember how you felt the last time you ate one. Were you bloated, uncomfortable, or crampy? If so, take a lactase supplement or have a sandwich or salad instead.
Reviewed by Brunilda Nazario, MD on July 12, 2012
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