If your doctor just broke the news that you're lactose intolerant, it doesn't mean you'll never get to savor another bite of ice cream.
At first, many people fear they'll have to give up all dairy products, says Dee Sandquist, RD, a dietitian in Fairfield, Iowa. But with some trial and error, most people find they can still eat small amounts of dairy without having symptoms such as bloating, gas, stomach pain, diarrhea, or nausea.
Dairy foods are important to the health of your bones, because they're loaded with calcium and vitamin D. So the trick is to make sure you're getting enough of these nutrients, whether from dairy or other foods.
"Listen to your body and your symptoms," says Sandquist, who is also a spokeswoman for the Academy of Nutrition and Dietetics.
How Severe Are Your Symptoms?
How much dairy you can eat depends on how much lactase -- the enzyme that digests lactose -- your body makes, says Yuri A. Saito-Loftus, MD, MPH. She's an assistant professor in the Mayo Clinic's division of gastroenterology and hepatology. "That does vary a little bit from individual to individual. We don't know 100% what controls that. Presumably, it's genetically determined."
Some people with lactose intolerance can adapt. You may be able to add small amounts of foods with lactose to your diet over time and have fewer symptoms. "If you keep eating dairy, you can stimulate some lactase production," Saito-Loftus says. "That may help you better tolerate dairy products."
If your symptoms are so severe that you can't handle lactose in any foods, talk to your doctor about how to get enough calcium and vitamin D.
What Foods You Can Eat -- and How Much
"Many people know their symptoms pretty well, so they know if they can handle just a little bit or not," Sandquist says. In that case, you may be able to keep a mental tally of foods or amounts of foods to avoid. Other people get a better sense of what their body can take by jotting down notes. “A diary is extremely helpful because then you can log what symptoms you have, what you've eaten,” Sandquist says. “You can look back and see if there’s a pattern.”
Figure out what foods you can eat. If you're not sure which foods with lactose you can handle, try one dairy food at a time, Sandquist says. You should be able to tell whether it bothers you within 30 minutes to 2 hours after eating it. Any discomfort from lactose intolerance is likely to set in by then. For example, drink a half-cup of dairy milk and see how well you tolerate it.
See how much you can eat. If you don't have symptoms from the food and the amount you try, slowly add more to see at what point you do have symptoms. For instance, maybe you don't have symptoms with a cup of milk, but you do with one and a fourth cups of milk. So your tolerance level is one cup.
If you do have symptoms, cut back on the amount to see if you can handle a smaller portion.
Once you've found how much of one food you can handle, start testing another food.