Living with Lactose Intolerance: A Practical Approach

Written by: Leora Aframian, MS, RDN

Lactose intolerance stems from an inability to digest the sugar molecules found in dairy products. The sugar molecule is called lactose and the enzyme that our body uses to break it down is called lactase. Those with lactose intolerance know first-hand the uncomfortable symptoms that can follow a dairy meal. Some of the symptoms of lactose intolerance which include gas, bloating, nausea, diarrhea, and gastrointestinal discomfort, can be present 30 minutes to 2 hours after a meal.

Lactose intolerance vs Milk allergy

Lactose intolerance should be differentiated against a milk allergy, the distinction between the two can sometimes cause confusion. Lactose intolerance is caused by an inability to digest the sugar in milk products while a milk allergy fosters a response from the immune system to the proteins found in milk. When a milk allergy is present, all foods and beverages in the diet containing milk or milk products should be eliminated from the diet (Webb). However, in lactose intolerance that may not necessarily be true, due to the fact that there is a vast array of tolerance levels. The lactose threshold can differ from person to person. Some may be able to tolerate small amounts of milk while others may tolerate yogurt and hard cheeses without suffering from symptoms (Gordon).

Lactose intolerance and strategy

One strategy in overcoming lactose intolerance is to tap into the many lactose-free options available in the modern market. Those who are extra sensitive and avoid most milk products, in general, should strive to get their calcium and vitamin D from non- dairy sources.

When following a mostly non-dairy diet it’s important to be cognizant of your calcium needs and include a variety of sources including:

  • Canned salmon, sardines, or other fish with edible soft bones
  • Dried beans
  • Broccoli
  • Leafy green vegetables
  • Soy Foods
  • Beans, Peas, and Lentils
  • Almonds

Vitamin D is also a nutrient to take into consideration when avoiding dairy.

Non-dairy sources of vitamin D include:

  • Eggs
  • Fatty fish such as salmon

Some avoid dairy milk due to their lactose intolerance or personal preferences and opt for non-dairy alternatives such as nut, soy, rice, or oat milk. There are variations in the different nutritional profiles of lactose friendly milk on the market. Let’s compare a few options to find the one that best matches your nutritional preferences.

3 Types of Milk and Their Nutritional Profile

Lactose-Free Reduced Fat Milk:

1 cup of reduced-fat (2%) milk contains approximately*:

  • 122 calories
  • 8 grams of protein
  • 11 grams of carbohydrates
  • 5 grams of fat
  • 290 mg of calcium
  • 2.9 micrograms of vitamin D

The lactose-free milk that you see in the grocery store is cow’s milk with the added enzyme lactase to help break down the sugars in milk that are difficult to digest. Lactose-free milk contains the same amount of calcium and vitamin D as regular milk. This group of milk contains higher amounts of protein and vitamin D than the dairy alternatives below. Reduced-fat (2%) milk contains 5 grams of fat, if you are looking for a lower fat content you can opt for low fat (1%) which contains approximately 2.3 grams, on par with those mentioned below.

Soy Milk

1 cup of soy milk contains approximately*:

  • 105 calories
  • 6 grams of protein
  • 12 grams of carbohydrates
  • 1.5 grams of fat
  • 300 mg of calcium
  • 2.7 micrograms of vitamin D

Soy milk contains some of the highest values of protein among the dairy alternatives. It comes close to dairy milk in protein, calcium vitamin D, and calorie content. Generally, soy is a good source of plant protein for those following a plant-based diet. Soy contains less fat than reduced-fat lactose-free milk.

Almond Milk

1 cup of unsweetened almond milk contains approximately*:

  • 36 calories
  • 1.44 grams of protein
  • 1.42 grams of carbohydrates
  • 2.6 grams of fat
  • 481 mg of calcium
  • 2.44 micrograms of vitamin D

Almonds are naturally a good source of calcium, the antioxidant vitamin E, and are a low-calorie option. Almond milk is not a strong source of protein in comparison to both lactose-free and soy milk. Almond milk is also lower in carbohydrates than the other two milk sources mentioned.

Lactose intolerance may manifest differently from person to person. Some may tolerate larger quantities of lactose without experiencing symptoms. Those with lower thresholds should review food labels and look for and avoid ingredients such as whey, curd, dry milk powder, or solids (Webb). It is important to be in touch with your body and pay attention to your level of intolerance as it may not look the same as your friend’s.

*Nutrient values have been retrieved from the USDA.

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1. Gordon, B., RDN, LD. (2020, May 14). Lactose Intolerance. Retrieved from https://www.eatright.org/health/allergies-and-intolerances/food-intolerances-and-sensitivities/lactose-intolerance

2. US Department of Agriculture. (n.d.). FoodData Central Search Results. Retrieved from https://fdc.nal.usda.gov/fdc-app.html

3. Webb, D., PhD, RD. (2015, May). The Latest on Lactose Intolerance: What It Is, How It’s Diagnosed, and Tips for Counseling Clients. Today’s Dietitian, 17(5), 38. Retrieved from https://www.todaysdietitian.com/newarchives/050515p38.shtml

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