Lactose Free
Lactose is a sugar found in dairy products. Many people have a low level of lactase, the protein needed to digest lactose. If the amount of lactase in the body falls below a certain level, clinical symptoms of lactose intolerance may result.(1) Typical symptoms of lactose intolerance include:
• Diarrhea
• Bloating and flatulence
• Abdominal pain
The tendency to have decreased levels of lactase varies by country, race and ethnic group. In the United States, it is estimated that 60% to 90% of adult blacks and Orientals have lactose malabsorption compared with 5% to 15% of adult whites of northern European extraction.(2)
Even if you have reduced amounts of lactase in your digestive system, you may still be able to tolerate some dairy products. For example, many people can tolerate yogurt if it contains active bacterial cultures. Many frozen yogurts do not contain these cultures at all or contain insufficient quantities of them.
Lactose-free soymilk
If you eat or drink dairy products, it may be more helpful to do so in small quantities at different times throughout the day. Also, some dairy products may be easier to tolerate than others. For example, some people may tolerate whole milk but not skim milk. This is because the fats in whole milk may slow the passage of milk through the digestive tract and improve your digestion of lactose. It may also help to consume milk products with solid foods to slow the rate of passage through your digestive system.(1)
Low-lactose milk may also relieve milk intolerance. On the other hand - and contrary to earlier expectations - certain milk forms do not appear to alleviate symptom response (such as sweet acidophilus milk).(1)
Lactose-free milk and milk products
Low-lactose diet: generally eliminates only milk and milk products. However, some can tolerate milk in small amounts (2 oz) throughout the day or as part of a meal. Some can tolerate small amounts of yogurt. These patients can experiment to find a level of lactose they can tolerate. Some people can build up their level of tolerance by gradually introducing the lactose-containing foods.
Lactose-free diet: all lactose producst must be eliminated, including foods that are prepared with milk, both at home and in commercially packaged foods. These people may be able to use 100% lactose free milk or soy milk. Labels should always be read carefully
Lactose-free infant formula
Foods that contain lactose*
Dairy Products(3)
• Milk, low-fat milk, skim milk, chocolate milk, buttermilk fluid (all contain similar amounts; some people may digest fatted or sweetened milk better than skim milk)
• Sweetened condensed milk (contains more lactose than regular milk)
• Dried whole milk, instant nonfat dry milk (contains less lactose than regular milk)
• Low-fat yogurts (contain about as much lactose as milk, but unpasteurized yogurts with active bacterial cultures are often easier to digest)
• Frozen yogurts (often lack active bacterial cultures or contain insufficient amounts)
• Ice cream
• Ice milk
• Sherbet
• Cheese (most common types contain similar amounts of lactose)
• Cottage cheese (contains about half as much lactose as milk)
• Low-fat cottage cheese (2% fat) (contains slightly more lactose than regular cottage cheese)
• Cream (whipped topping, light, half and half)
• Butter
*This list is provided as an aid in the management of lactose intolerance. Other products that may contain lactose may not be included. This is not a substitute for specific dietary instructions provided by your doctor.
Other foods that may contain "hidden" lactose (4)
• "Non-dairy" creamers Powdered artificial sweeteners Foods containing milk powder or nonfat milk solids Bread/Cake Margarine (including some labeled as 100% corn oil)
• Creamed soups
• Pancakes, waffles
• Puddings, custards
• Confections (including chocolate)
• Certain meat products
Sample Lactose-Free Menu (5)
Breakfast
Orange juice, calcium fortified 1/2 cup
Oatmeal 1 cup
Italian bread 2 slices w.jelly and margarine
Tea or Coffee w.non-dairy creamer
Lunch
Turkey 2 oz
Italian bread 2 slices
Mayonnaise 1/2 tbsp
Tossed green salad 1 cup
Oil & vinegar 2 tsp
Tomato 2 slices
Chopped carrot 1
Celery 1 stalk
Banana
Lactose-free milk 1 cup
Dinner
Roast beef 4 oz
Noodles 1/2 cup
Broccoli 1 cup
Italian bread 1 slice w.margarine
Fresh or frozen fruit
Tea or Coffee w.non-dairy creamer
References:
1 National Dairy Council Dairy Council Digest. 1985;56:25-30.
2. Anderson L, et al, eds. Nutrition in Health and Disease. 17th ed. Philadelphia, Pa: JB Lippincott Co; 1982:441
3. Shils ME, Young VR. Modem Nutrition in Health alii Disease. 7th ed. 1988:1596
4. Miller JB. Hidden food ingredients, chemical food additives and incomplete food labels. Ann Allergy. 1978;41:93-98
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