Lactose intolerance means that your body has a hard time breaking down lactose, which is the sugar in milk and other dairy products. Lactase, the enzyme that breaks down lactose, naturally decreases in adulthood and is especially low in certain populations, but that doesn’t mean that your body can’t break down some lactose.

If you are following a dairy free diet because of a lactose intolerance diagnosis, keep reading! Two things I want you to know:

The lactose load that is provided during the hydrogen breath test is closer to 25-50 grams of lactose. The likelihood that you are ingesting that amount in ONE sitting through food is very low. By personalizing your lactose intake, you might find you can tolerate more than you thought.
Your lactose tolerance changes over time. Certain diagnosis also put you at a higher risk for intolerance such as food poisoning, SIBO, or celiac. Note: some conditions are short term or require another intervention to heal.

Lactose content also differs hugely in dairy products. A good rule of thumb is: if the dairy is hard, aged, and/or contains live cultures (ie yogurt or kefir), there is a good chance it is low/lower in lactose. Check out below for more details and tips.

HIGH LACTOSE FOODS include sweetened condensed milk, milk or chocolate milk, sheep milk, eggnog, ice cream. Ranging from 6-20 grams of lactose per serving.

MEDIUM LACTOSE FOODS are yogurt, Greek yogurt, cottage cheese, American cheese, half & half, kefir, mozzarella, or ricotta cheese. Ranging from 1-6 grams of lactose per serving.

VERY LOW TO NO LACTOSE CONTAINING FOODS are hard, aged cheeses such as cheddar, gouda, Colby, Havarti, pecorino, parmesan, Swiss, soft/aged: blue, camembert, brie, feta, goat cheese, cream cheese, sour cream, whipped cream, butter, whey protein isolate, and nutritional supplements such as Orgain or Ensure. Usually having less to 1 gram of lactose per serving.

Other suggestions:

Spread out your lactose throughout the day and gauge tolerance as the day progresses, since this might be a load issue rather than a specific food issue.
For high-to-medium lactose dairy products, choose “lactose free” and/or choose plant-based products made with soy, oat, almond, to mention a few.
When eating out, take a lactase enzyme with your meal. This will provide added digestive support in case there is more lactose in the meal than you anticipated.

If you decide that dairy free is the best choice for you, make sure you find optimal replacements of calcium, vitamin D, and protein, since dairy can be a good source of these. This is achievable with proper guidance.

My goal is to widen your eating options and only avoid foods that you need to. Educating yourself in the intricacies of lactose vs. dairy will empower you to make better choices, increase variety in your diet, and maintain a happy belly.

Let me know if you have any other questions and thank you for reading!
Alanna