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Problems Digesting Dairy Products

Managing Lactose Intolerance

There is no treatment to make the body produce more lactase enzyme, but the symptoms of lactose intolerance can be controlled through diet.

Most older children and adults do not have to avoid lactose completely. People have different levels of tolerance to lactose. Some people might be able to have a tablespoon of milk in a cup of coffee with little or no discomfort. Others have reactions that are so bad they stop drinking milk entirely. Some people who cannot drink milk may be able to eat cheese and yogurt-which have less lactose than milk-without symptoms. They may also be able to consume a lactose-containing product in smaller amounts at any one time.

  • Common foods with lactose are
  • milks, including evaporated and condensed
  • creams, including light, whipping, and sour
  • ice creams
  • sherbets
  • yogurts
  • some cheeses (including cottage cheese)
  • butters

Lactose may also be added to some canned, frozen, boxed, and other prepared foods such as

  • breads and other baked goods
  • cereals
  • mixes for cakes, cookies, pancakes, and biscuits
  • instant potatoes, soups, and breakfast drinks
  • lunch meats (other than Kosher)
  • frozen dinners
  • salad dressings
  • margarines
  • candies and other snacks

Dietary supplements with lactase enzyme are available to help people digest foods that contain lactose. However, FDA has not formally evaluated the effectiveness of these products, and you may want to ask your doctor if these supplements are right for you.

Look at Labels

"Lactose-free" or "lactose-reduced" milk and other products are widely available in grocery stores. These products may be fortified to provide the same nutrients as their lactose-containing counterparts.

There is no FDA definition for the terms "lactose free" or "lactose-reduced," but manufacturers must provide on their food labels information that is truthful and not misleading. This means a lactose-free product should not contain any lactose, and a lactose-reduced product should be one with a meaningful reduction. Therefore, the terms lactose-free and lactose-reduced have different meanings, and a lactose-reduced product may still contain lactose that could cause symptoms.

Lactose-free or lactose-reduced products do not protect a person who is allergic to dairy products from experiencing an allergic reaction. People with milk allergies are allergic to the milk protein, which is still present when the lactose is removed.

Look at the ingredient label. If any of these words are listed, the product probably contains lactose:

  • milk
  • cream
  • butter
  • evaporated milk
  • condensed milk
  • dried milk
  • powdered milk
  • milk solids
  • margarine
  • cheese
  • whey
  • curds

Highly sensitive individuals should also beware of foods labeled "non-dairy," such as powdered coffee creamers and whipped toppings. These foods usually contain an ingredient called sodium caseinate, expressed as "caseinate" or "milk derivative" on the label, that may contain low levels of lactose.

Testing for Lactose Intolerance

A doctor can usually determine if you are lactose intolerant by taking a medical history. In some cases, the doctor may perform tests to help confirm the diagnosis. A simple way to test at home is to exclude all lactose-containing products from your diet for two weeks to see if the symptoms go away, and then reintroduce them slowly. If the symptoms return, then you most likely are lactose intolerant. But you may still want to see your doctor to make sure that you are lactose intolerant and do not have a milk allergy or another digestive problem.

WebMD Public Information from the FDA