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Lactose intolerant? Not all dairy is off limits 

By Rachel Meltzer Warren, MS, RD

Myth: If you’re lactose intolerant, dairy is a no-no.

Truth: Chances are, you can tolerate some milk products.

Wait, what? If you have trouble processing lactose, a type of sugar found in dairy products, you’ve probably avoided milk, ice cream, and yogurt for good reason — namely, the uncomfortable symptoms that appear when you consume them. But it turns out, to the surprise of many people with lactose intolerance, that all dairy need not be off limits.

In most cases, lactose intolerance is caused by low levels of the enzyme lactase. Lactase helps your body break lactose down into the simple sugars glucose and galactose, which can then be absorbed into the bloodstream. If lactose is not broken down, it travels to your colon where intestinal bacteria ferment it, resulting in gas, bloating, and diarrhea. You are more likely to have lactose intolerance if you are of Black, Asian, Hispanic, or Native American descent; have an intestinal disorder like Crohn’s Disease or Colitis; were born prematurely; or have undergone chemotherapy. Your chances of developing lactose intolerance also increase as you get older. 

Since in most cases a person with lactose intolerance has a limited ability to break down lactose rather than no ability at all, that person can tolerate some dairy — with a few considerations. Everyone has a different threshold, so the exact cutoff point for you is something you’ll have to learn by trial and error. But here are a few ways you — yes you, the one with lactose intolerance — can get some dairy back into your diet:

Yogurt: The healthy bacteria in yogurt and kefir (a yogurt-like drink) help your body to digest the lactose, meaning that many people who normally have trouble with dairy can actually handle a serving of yogurt. Strained Greek yogurt has even less lactose than regular yogurt, which makes it an extra good choice for a person with lactose intolerance. Just make sure the yogurt you’re eating has live active cultures.

Hard cheese: Thanks to the fermentation process used in cheesemaking, many aged cheeses like cheddar, parmesan, and asiago are virtually lactose free, meaning many people with lactose intolerance can eat it without experiencing any symptoms. Fresh cheeses, however, like mozzarella and cottage cheese, are higher in the milk sugar.

Lactose-free products: Several brands now offer lactose-free versions of dairy foods like milk, sour cream, and yogurt. How do they do it? Easy cheesy: They add lactase, the enzyme your body needs to break down lactose to the foods themselves.

Lactase pills: If you can’t find or don’t like products with the lactase added in, you can supplement with your own lactase any time you eat regular dairy products. This is any easy fix to safely enjoy a dairy-rich meal out or at a friend’s house; just be sure to carry lactase caplets with you so you can be ready at any time.

What about goat’s and sheep’s milk? While some people with lactose intolerance say they find it easier to process goat’s and sheep’s milk cheese, the milk from both animals contains roughly the same amount of lactose as cow’s milk. Still, it may be worth experimenting with in small amounts to see if it has the same impact on you. 

Since everyone is different, and tolerance levels can change over time, only you can decide how much lactose is too much for you. Luckily, there are loads of non-dairy alternative products on the market now to make your low-lactose or lactose-free diet an easy one to adhere to. Almond-, coconut-, and soy-based nondairy milks can be a smart (and tasty) way to keep dairy to a minimum throughout your day so you can comfortably enjoy a generous sprinkle of parmesan cheese on your pasta, or a yogurt for snack.

Lactose in Dairy Foods

*The lactose in yogurt is easily digested by many with lactose intolerance thanks to the yogurt’s healthy bacteria. 

Published April 28, 2014. 

Rachel Meltzer Warren is a registered dietitian nutritionist and author of The Smart Girl’s Guide to Going Vegetarian.

See also: 

• What's triggering your IBS?
• Causes and treatments for diarrhea
• Get advice in our Lactose Intolerance Community