If desired, a lactose-free diet should be followed for two weeks. If symptoms have subsided after the 2-week strict diet, gradually add foods with lactose back into the diet slowly and monitor tolerance. You may be able to tolerate up to 12 grams of lactose at one time.
Lactose content of milk and milk products
The following foods contain approximately 5-8 grams of lactose:
|Milk (whole, reduced fat, fat-free, buttermilk, goat's milk)||1/2 cup|
|Evaporated milk||1/4 cup|
|Cheese spread and soft cheeses||2 oz.|
|Cottage cheese||3/4 cup|
|Ricotta cheese||3/4 cup|
|Yogurt, plain||1/2 cup|
|Ice cream||3/4 cup|
|Heavy cream||1/2 cup|
|Non-fat dry milk powder||2 Tbsp|
The following foods contain approximately 0-2 grams of lactose:
|Condensed milk||1/2 cup|
|Half and half||1/2 cup|
|Sour cream||2 Tbsp|
|Milk, treated with lactase enzyme||1/2 cup|
|Aged cheese (such as blue, brick, cheddar, Colby, Swiss, Parmesan||1-2 oz.|
|Processed cheese||1 oz.|
Tips for adding lactose foods back after a lactose diet:
- Gradually add small amounts of food and drinks that contain lactose to determine your tolerance level. You may be able to tolerate up to 1/2 cup of milk or the equivalent with each meal.
- Drink milk in servings of one cup or less.
- Try hard cheeses that are low in lactose, like cheddar.
- Drink milk with a meal or with other foods.
- Try yogurt or Greek yogurt with active cultures. You may be able to digest yogurt better than milk. Your own tolerance may vary depending on the brand. Frozen yogurt may not be tolerated as well as yogurt.
- Substitute lactose-reduced dairy products and 100 percent lactose-free milk for regular dairy products. These products are located in the dairy section of most supermarkets.
- The lactase enzyme is also available in liquid, tablet or chewable form. No prescription is needed and it can help you tolerate foods containing lactose. Take the enzyme with the lactose-containing food. Lactase will help you digest the lactose so your body can absorb it. Some over-the-counter enzyme products that are available include Lactaid®, Lactrace®, Dairy Ease®, and Sure-Lac®.
- Many canned nutritional supplements (such as Ensure®, Boost®) are lactose-free. Product labels should be checked.
How can I maintain a balanced diet?
Milk and dairy products are a major source of calcium, an essential nutrient for the growth and repair of bones and teeth throughout life. Calcium is also essential for blood to clot normally, muscles and nerves to function properly, and the heart to beat normally.
People who are lactose-intolerant don't necessarily have to consume milk and dairy products to get the calcium they need to maintain proper nutrition.
If you have trouble consuming enough calcium-rich foods in your daily diet, talk to your healthcare provider or a Registered Dietitian about taking a calcium supplement. The amount of calcium you will need from a supplement will depend on how much calcium you are consuming through food sources.
The following foods contain calcium:
|Sardines||3 oz.||325 mg|
|Spinach (cooked)||1 cup||240 mg|
|Broccoli (cooked)||1 cup||180 mg|
|Calcium-fortified orange juice||8 oz.||350 mg|
|Calcium-fortified soy or almond milk||8 oz.||300 mg|
|Dried beans (cooked)||1 and 1/2 cup||150 mg|
|Tofu||1/2 cup||250 mg|