No need to ditch dairy with lactose intolerance

By Claire Florsheim, J.D., R.D., L.D.
Health and Wellness Program Coordinator
Dairy MAX, Inc.

Studies show that a diet rich in dairy foods like milk, cheese, and yogurt may help reduce the risk of chronic diseases such as osteoporosis, diabetes, hypertension, cardiovascular disease, and certain cancers. Unfortunately, a common misconception is that dairy avoidance is the best prescription for lactose intolerance, but without dairy it can be difficult to meet recommended levels of many essential nutrients, including calcium, vitamin D, and potassium. This can lead to nutrient deficiencies and missed opportunities to capture the health benefits boasted by a dairy-rich diet.

Many people with lactose intolerance can still comfortably enjoy dairy—typically up to 12 grams of lactose, or the amount in one 8-ounce glass of milk—at one time. Additionally, lactose-free milk, yogurt, and hard, natural cheeses contain little to no lactose and tend to be better-tolerated. Your patients can confidently add dairy foods into their diets with simple solutions:

• Lactose-free milk is real cow’s milk without the lactose and is nutritionally equivalent to regular cow’s milk. Lactase enzymes added to milk pre-digest lactose so the body does not have to.
• Yogurt contains live and active cultures which help break down the lactose in milk so that little remains. Many people find they can tolerate this small amount comfortably.
• Hard, natural cheeses such as cheddar, colby, and swiss are also low in lactose, as most of the lactose in milk is lost and/or broken down during the cheese-making process.

So what can you do to help patients manage their lactose intolerance? Follow these simple steps:

Diagnose: Many people who say they are lactose intolerant have never been diagnosed by a health professional. It is difficult to confirm lactose intolerance based on digestive discomfort alone, because gastrointestinal disturbances may relate to any number of different conditions. A two-step process is recommended for diagnosing lactose intolerance: (1) the patient provides verbal or written confirmation of gastrointestinal symptoms; and (2) the patient tests positive for lactose maldigestion via lactose tolerance test, hydrogen breath test, or stool acidity test.

Guide: Advise patients that they can still comfortably consume dairy and encourage them to meet the Dietary Guidelines for Americans recommendation of three servings per day. Guide patients through the process of gradually adding dairy back into the diet, recommending that they spread dairy intake throughout the day and describing how tolerance can actually be increased gradually over time.  Inform patients that lactase supplements may also help improve digestion.

Explain: Explain to patients why they may be able to tolerate lactose-free milk, cheese, and yogurt. Patients who have been avoiding dairy may be reluctant to add it back into their diets so it is important that they understand why these options may work better for them.

Lactose intolerance is an individual condition. Help patients find their personal level of tolerance and enjoy dairy as well as the health benefits that come with it.