Does milk upset your stomach? You could be lactose intolerant.
But even if you are, you can probably still enjoy light coffee and creamy desserts without discomfort. Here's how.
Lactose-Free and Nondairy Options
Dairy products are high in calcium, protein, and other nutrients. You may still be able to get these nutrients from dairy if you're lactose intolerant.
- “On average, most lactose-intolerant people can tolerate about 250 ml of lactose,” says David Goldstein, MD, a gastroenterologist in Emerson, N.J. That's about 1 cup (8 ounces) of dairy milk. Start by trying 1/2 cup of regular milk or less with a meal.
- Take lactase tablets or capsules before eating or drinking foods that have dairy products or milk.
- Drink and cook with lactose-free milk. It has added lactase to break down the lactose. It also has about the same nutrients as regular milk.
For nondairy milk, consider these options. They vary in nutrition, so before you buy, compare the labels next to cow's milk. Choose one that is fortified with calcium, vitamin D, and other nutrients. Use unsweetened nondairy milk in savory dishes like mashed potatoes. You might like vanilla, chocolate, or other flavors for baking.
- Soy milk is the best source of protein of the nondairy options. It's thicker than cow's milk and slightly beige in color.
- Coconut milk is creamy like whole milk. It has little protein, though, and about the same saturated fat as whole milk -- about 4 grams in a cup.
- Almond milk is also like cow’s milk in texture, though slightly beige in color. It tastes faintly like almonds. It may have more calcium than dairy milk, along with vitamins D and E. But an 8-ounce glass of almond milk has only about 1 gram of protein.
- Rice milk is white, like cow's milk, and thinner and sweeter than almond milk. It doesn't work as well as thicker milks in sauces and puddings. It is low in protein, like almond milk. But you can find it fortified with calcium.
- Hemp milk is thick and sometimes a little grainy. It is made of hemp seeds, which are high in heart-healthy omega-3 fatty acids. It also has protein but falls short in calcium.
If you have stomach symptoms while using any non-dairy options, the problem may be guar gum. It's often added for thickness, says Sonya Angelone, RDN, a dietician in San Francisco and a spokeswoman for the Academy of Nutrition and Dietetics. “This can affect some people adversely, and they experience gas just like they might with lactose."
Lactose Intolerance vs. Milk Allergy
Lactose intolerance is not the same as a milk allergy, which involves your immune system.
Lactose is the sugar in milk. If you're lactose intolerant, a glass of milk or a bowl of creamy soup can give you intestinal trouble like cramps, gas, diarrhea, or bloating. That's because your small intestine isn’t making enough of the enzyme lactase. Lactase breaks down milk sugar so your bloodstream can absorb it well.
A milk allergy can cause stomach pain, bloating, and diarrhea, too. But it can also cause hives, swelling, and more severe symptoms, like a drop in blood pressure and trouble breathing.
“If you think you have lactose intolerance, get tested so you have a clear diagnosis,” suggests Beth Kitchin, PhD, RDN. She's an assistant professor of nutrition sciences at the University of Alabama at Birmingham. "The dietary advice for each is really different, so getting an accurate diagnosis is important.”
First, your doctor may suggest you avoid all milk products briefly to see if your symptoms improve. If they do, the doctor may do a test to confirm that you are lactose intolerant.