A lactose-free diet restricts dietary sources of lactose, a sugar found in milk and dairy products. A lactose-free diet differs from a dairy-free diet in that someone who is avoiding lactose may still consume lactose-free dairy products.
Those with lactose intolerance benefit from following a lactose-free (or low-lactose) diet. Those with lactose intolerance do not produce enough of the enzyme lactase in their small intestine. Lactase breaks down lactose sugar.
Without lactase, lactose sugar makes its way to the large intestine intact. Here, gut bacteria break down the lactose sugar, producing gas and drawing fluid into the bowel. This can lead to uncomfortable gastrointestinal symptoms such as:
“Lactase non-persistence” is the most common cause of lactose intolerance. In this condition, individuals produce less of the lactase enzyme as they get older. “Congenital lactase deficiency” is a less common reason for lactose intolerance. In this condition, individuals do not produce sufficient lactase from birth.
Additionally, some may develop temporary lactose intolerance often referred to as “secondary lactase deficiency.” This may occur after a bout of food poisoning, small intestinal bacterial overgrowth (SIBO), or an insult to the small intestine such as surgery, radiation therapy, chemotherapy-induced intestinal inflammation, certain medications, or inflammatory illnesses such as Crohn’s disease or Celiac disease. In these cases, lactose intolerance may resolve once the small intestine heals and is able to produce sufficient lactase again.
If you have lactose intolerance, you are certainly not alone. Current estimates suggest that 68% of the world’s population has lactose intolerance. The condition is even more common among those of African, Asian, or Hispanic descent.
Lactose intolerance can be diagnosed with a few methods including:
A lactose-free diet may include the following:
Depending on your level of lactose tolerance, you may be able to tolerate small quantities of dairy products that are low in lactose. These include hard aged cheeses like parmesan, cheddar, and Swiss, as well as Greek yogurt, kefir, butter, and foods containing whey protein isolate. Alternatively, you may be able to tolerate lactose-containing dairy products if you take lactase pills with these foods.
You can find thousands of foods without lactose on the Fig app!
If you are strictly adhering to a lactose-free diet, the following foods are avoided:
You can find a full list of foods to avoid with lactose intolerance in the Fig app.
When dining out, inform your server that you are lactose-intolerant and ask how foods are prepared. Bringing lactase pills with you can also help to mitigate potential GI symptoms if you choose to consume some lactose-containing foods.
Be sure to check ingredient labels when grocery shopping to help you avoid sneaky sources of lactose. The Fig app does this for you, helping you to identify lactose-free foods with ease!
When grocery shopping, foods that commonly contain hidden sources of lactose include but are not limited to:
While following a lactose-free diet generally involves little nutritional risk, if you do not consume any dairy products (including those that are lactose-free), there are a few nutritional considerations to keep in mind:
The body needs calcium for bone health, muscle contraction, nerve transmission, and blood clotting. Since dairy products are notoriously rich sources of calcium, it’s important to include plenty of other calcium-rich foods in your diet. If you regularly consume lactose-free dairy products, this is less of a concern.
If you opt to limit or eliminate all forms of dairy, there are many other calcium-rich foods you can include in your diet such as:
For more ways to incorporate non-dairy sources of calcium into your diet, check out our blog post on the topic, found here.
Vitamin D plays a number of important roles in the body. These roles include supporting proper immune function, facilitating calcium absorption, promoting stable mood, and much more. Most cow’s milk is fortified with vitamin D in the US, but many dairy alternatives are not fortified.
That said, while vitamin D-rich foods can help you maintain adequate vitamin D levels, our body’s main way of obtaining vitamin D is by synthesizing it. We synthesize vitamin D when the sun’s UV rays strike our skin. Depending on where you live, certain genetic factors, and how much time you typically spend outdoors in sunlight, it may be challenging to get enough vitamin D.
To find out where you stand, check your vitamin D levels regularly. If they’re low, speak with your physician or registered dietitian about potential supplementation. Additionally, a few lactose-free foods also contain some vitamin D including:
For most, following a lactose-free diet poses little nutritional risk, especially if you consume a varied, well-balanced diet rich in lactose-free calcium sources.
However, those with a dairy allergy should not follow a lactose-free diet but rather an entirely dairy-free diet. People with a dairy allergy should exclude lactose-free dairy products and foods or ingredients derived from dairy. This is because food allergies are immune reactions to proteins in food. Eliminating lactose from a dairy product will not remove its allergenic milk proteins. Similarly, those with a milk protein intolerance should follow a dairy-free or dairy-restricted diet rather than a lactose-free diet.
Additionally, an entirely lactose-free diet may not be necessary for those with milder forms of lactose intolerance. Every individual’s lactose tolerance level varies depending on the amount of lactase enzyme they produce. Some individuals produce none, whereas others produce enough to tolerate low-lactose foods. These include parmesan cheese or even small portions of higher-lactose foods like milk. Working with a registered dietitian can help you determine your threshold for lactose tolerance and find out the extent to which you may be able to liberalize your diet without experiencing symptoms.
Lactose free milk is not dairy free. Even though lactose free milk contains lactase to break down the lactose, it still comes from dairy sources such as cows. Therefore, lactose free milk is still considered a dairy product.
Dairy products contain a sugar called lactose. Therefore, lactose free refers to foods without lactose. These foods include non-dairy products like grains, legumes, fruits and vegetables. They also include dairy products with lactase, the enzyme that breaks down lactose.