Understanding Lactose Intolerance and Ways to Manage It

What is lactose intolerance?
Lactose intolerance occurs when your body does not have sufficient amounts of the enzyme called lactase to break down lactose, which is a sugar naturally found in milk and dairy products. When your body has trouble digesting and breaking down lactose, it travels to the colon undigested where bacteria can ferment the lactose. This fermentation process may cause uncomfortable symptoms including gas, bloating, cramps and diarrhea.

What foods contain lactose?
Milk and dairy products such as cow’s milk, yogurt, cheese and ice cream are the main sources of lactose.
Lactose can also be used in the development and manufacturing of various foods such as breads, baked goods, cereals and snack foods. Check food labels for ingredients such as:
- Milk
- Lactose
- Milk soilds
- Milk powder
- Cream
- Buttermilk
- Curds
- Whey
Ways to manage lactose intolerance
Lactose intolerance should not cause you to avoid milk and other dairy foods completely. Dairy products contribute important nutrients such as calcium and vitamin D needed for bone health. As well, dairy products have been associated with other important health benefits, such as a reduction in the risk of high blood pressure, diabetes, and colorectal cancer.
The good news is that many dairy foods are well tolerated and therefore lactose intolerance should not restrict you from including dairy foods in your diet. There are several ways to help manage lactose intolerance and its associated symptoms:
- Consuming small amounts of lactose spaced throughout the day with other foods
- Most people with lactose intolerance can tolerate some lactose. Research shows, in general consuming a single dose containing up to 12 grams of lactose (the equivalent of 1 cup of milk) can be tolerated without significant symptoms, particularly if consumed with other foods. Consuming lactose-containing foods with a meal has shown better tolerance. Further, most people with lactose intolerance can tolerate up to 2 cups of milk per day, divided into smaller quantities.
- Consuming dairy foods with lower amounts of lactose
- Dairy products such as yogurt and hard cheeses like cheddar, mozzarella and Swiss have lower amounts of lactose compared to milk and therefore may be better tolerated.
- Consuming lactose-free milk and dairy foods
- Lactose-free dairy products such as milk, yogurt and cheese are available in most grocery stores and are an ideal substitute. Check nutrition labels for lactose-free products.
- Taking lactase tablets or adding lactase drops
- Lactase enzyme tablets are available that can be taken before eating foods with lactose; or lactase enzyme drops can be added to liquid foods that contain lactose. Both strategies offer other ways to help manage lactose intolerance. Speak with your pharmacist to determine what is best for you.
Other ways to get calcium
There are many non-dairy foods that are also sources of calcium such as:
- Calcium-fortified plant-based beverages such as soy, almond, coconut, oat, cashew and rice
- Calcium-fortified orange juice
- Dark green vegetables such as bok choy, kale and collard greens
- Nuts like almonds and Brazil nuts
- Canned fish with soft bones such as salmon and sardines
- Beans like chickpeas, white beans and navy beans
- Soybean foods such as edamame or tofu
Do you need a calcium supplement?
The good news is that there are various strategies to help manage lactose intolerance enabling you to get calcium through diet. Speak to your Healthcare Professional to help assess your diet and determine if a calcium supplement may be right for you.
Take Away
- Lactose intolerance should not cause you to avoid milk and other dairy foods completely
- Dairy foods contribute important nutrients such as calcium and vitamin D needed for bone health. As well, dairy products have been associated with other important health benefits, such as a reduction in the risk of high blood pressure, type 2 diabetes, and colorectal cancer.
- There are several ways to help manage lactose intolerance so you can continue including dairy foods as part of your diet
- There are also many other non-dairy foods to help meet your calcium needs
- If you have symptoms of lactose intolerance, see your Healthcare Professional