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HealthInfo Canterbury

How to manage lactose intolerance

You should not avoid all milk and milk products. Milk and milk products help to keep your body and bones healthy and strong. This is because they contain nutrients such as protein and calcium.

Even if you are lactose intolerant, regularly eating small amounts of lactose is good for you. It helps the bacteria in your large bowel break down lactose without causing symptoms.

The following tips will help you lower your lactose intake, and make sure you get enough protein and calcium.

Use lactose-free milk instead of regular milk

You should be able to cope with a small amount of regular milk in tea and coffee, or a small glass of regular milk. This is especially true if you have it at the same time as other food. If you want to have more than a small glass, use a lactose-free milk.

There are many different kinds of lactose-free milks. These include lactose-free cow's milk, soy milk, rice milk and almond milk. You can buy these in supermarkets. Lactose-free cows milk and soy milk are the best options. They contain a lot more protein than rice or almond milk. If you choose soy or rice milk, make sure they have added calcium.

Use lactose-free yoghurt instead of regular yoghurt

Some people with lactose intolerance can eat regular yoghurt. This is especially true if the yoghurt contains live bacteria. The bacteria break down some of the lactose in the yoghurt. They also supply lactase, which helps your body break down the remaining lactose. If you can't tolerate regular yoghurt, use a soy yoghurt, coconut yoghurt or yoghurt made from lactose-free cow's milk. You can buy these in the supermarket.

Use sorbet or lactose-free ice cream instead of regular ice cream

Many different sorbets and soy-based ice creams are available in the supermarket. These are high in sugar, so keep them for an occasional treat.

Use hard and semi-hard cheeses instead of soft, unripened cheeses

Hard and semi-hard cheeses contain either no or very little lactose. Hard and semi-hard cheeses include cheddar, edam, brie, camembert, feta, mozzarella, gouda, and parmesan. Haloumi cheese and soft, unripened cheeses that come in a tub contain small amounts of lactose. These include ricotta, cottage cheese, cream cheese, mascarpone, and crème fraîche. You should avoid these, or eat them in small quantities, such as two tablespoons or less.

Have food and drinks that contain lactose at the same time as other foods

This makes the lactose pass through your gut more slowly, giving the lactase you do have more time to work. Whole milk (dark blue top) is usually easier to tolerate than trim milk (green top), because it contains less lactose and more fat.

How much lactose can I have?

Most people with lactose intolerance can drink small amounts of milk. Different people can have different amounts of lactose. To work out how much you can have, start drinking small amounts of milk. Start with ¼ cup a day. If you cope with this, try having ½ cup of milk a day and so on.

Most adults with lactose intolerance can cope with 4 g of lactose or less at one time (4 g is the amount of lactose in ¼ cup (65 ml) of trim milk).

The following table shows how much lactose is in some common foods and drinks.

Food or drink

Serve

Lactose (g)

Whole milk (dark blue top)

1 cup

12

Trim milk (green top)

1 cup

16

Yoghurt

1 pottle (150 g)

9

Ice cream

2 scoops

6

Cream, whipped

¼ cup

2

Cream cheese

1 tablespoon

1

Hard and semi-hard cheeses, such as cheddar, edam, brie, mozzarella and feta

40 g

0

Lactose-free cow's milk, soy milk, rice milk or almond milk

1 cup

0

Butter, margarine

1 teaspoon

0

1 cup = 250 ml

Written by HealthInfo clinical advisers. Endorsed by Nutrition and Dietetics, Christchurch Hospital. March 2016.

Sources

Page reference: 250024

Review key: HILAC-250023