Nutrition Articles

Lactose Intolerance and a Healthy Diet

Ditch the Pain, Not the Calcium

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Milk. It does a body good.

Unless it doesn't, that is.

While milk is an excellent source of calcium and protein, up to 75% of the world's population cannot properly digest lactose, the sugar found in milk. When they try, the result is tummy trouble that can range from a mild discomfort to severe pain.

Not drinking milk to appease a sensitive stomach is one option, but the calcium found in milk is essential to good health and a major building block for bones and teeth. It also helps your heart to beat, your muscles to contract (and relax) and your blood to clot.

So what should a person with milk sensitivity do?

Understanding Lactose Intolerance
Lactose intolerance happens when your digestive system lacks the enzyme lactase, which it needs to break down milk sugar (lactose) into simpler forms that can be absorbed into the bloodstream. When the milk sugar is not broken down and absorbed properly, additional water is drawn into the intestinal tract. There, the healthy bacteria found in the intestine ferment the sugar, resulting in symptoms that range in intensity from very mild to severe and usually begin 30 minutes to 2 hours after eating dairy. Gas, nausea, bloating, cramping and diarrhea are the most common symptoms. Lactose intolerance is a matter of degree; some people fall ill after drinking an entire glass of milk, while others would be sick after drinking a small sip.

Production of that important enzyme lactase slows down after age two, but most people don't notice symptoms until they are significantly older. Conditions such as celiac disease, inflammatory bowel disease, and Crohn’s disease can also lead to lactose intolerance. Certain medications or illnesses, such as the flu, can cause temporary lactose intolerance, too.

Caucasians of northern European descent have the lowest incidence of lactose intolerance (about 15%). In contrast, up to 90% of Eastern Asians, 80% of American Indians, 65% of Africans and African-Americans, and 50% of Hispanics have some degree of lactose intolerance, according to Harvard Medical School. Because lactase levels increase during the third trimester of pregnancy, premature infants of all ethnicities at a greater risk of developing the condition.
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About The Author

Becky Hand Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. A certified health coach through the Cooper Institute with a master's degree in health education, she makes nutrition principles practical, easy-to-apply and fun. See all of Becky's articles.

Member Comments

  • SUKI103
    I forwarded this to my brother, who in his 60's developed lactose intolerance. He was surprised that you did not mention in the article that in an extremely high number of cases, medications (pills) contain lactose - so that a person who is taking a large numebr of pills will probably be consuming a lot of lactose before they even start trying to consume it in foods.
    He also was surprised that you make no mention that butter and cottage cheese are fine (note: we are not in the USA so it might be different there).
    Just for the record...........
    .
    Wishing you all the best of health!
    Sue - 5/27/2015 10:11:29 AM
  • i find that i can drink goats milk i have several places to goats milk alot easier on tummy and taste great with cereal but still small portion only - 9/9/2014 3:08:22 PM
  • I can not have milk or soy milk. This did not start until last year........ - 6/4/2014 3:43:30 PM
  • RKTHETEXGAL
    I have found that even with a lactose intolerance/eczem
    a caused by milk, my son and I can drink cows milk with no reactions whatsoever...if its Raw milk; no pasteurization or homogenation...ju
    st right from the cow. Its still got all the good bacteria that those processes take away...the stuff thats good for your gut, that aids digestion. When you take away the good bacteria during pasteurization it makes it hard to digest the milk itself, which is why so many people have an intolerance. Now I don't know what the concensus on raw milk is here and while I'm a big supporter of it, this in no way means I am trying to tell anyone to drink raw milk...its just what works for us. If you don't like milk, OK, don't drink it. I happen to love it and am overjoyed that we can enjoy it now without any I'll effects! - 3/24/2014 12:46:54 PM
  • MJOHNSON2076
    I'm lactose intolerant. I drink almond milk or lactose free milk, which I personally think tastes much better than regular milk. I don't generally have problems with cheese or yogurt as long as I don't eat too much. Ice cream is usually a hit or miss for me regardless of the amount. Some times I can eat it without any problems and then others I have issues with even one spoonful. - 2/21/2014 6:35:45 PM
  • ANDREAYAYA
    I've found I can have one dairy containing food (never straight milk or soft cheese or ice cream) if I don't eat any other lactose foods for a week. I also take acidophilus 4x a week to keep my innards healthy. For years I avoided it totally until I learned the importance of a healthy gut. I also eat lots of high fiber foods like beans to keep things "moving!" - 4/11/2013 8:34:52 PM
  • I'm lactose intolerant. I find I get symptoms if Idrink more than 4 fl ozs of milk, a yogurt or soft cheeses so I have soya substitutes. I also like rice milk and goat's milk is ok too. I only eat hard mature cheeses or 85% dark chocolate and I avoid anything else with large amounts of milk or milk products in them.

    As for calcium, since I had a gastric bypass I'm prescribed 2 calcium carbonate 1.25g/colecalcife
    rol 400iu calcichews at night, so I don't have to worry about that. - 2/1/2013 4:03:07 PM
  • I agree. Cow's milk is for baby cows.

    There are plenty of vegetable sources of calcium without having to take supplements. It seems a shame to me that most people don't know that they can get calcium from kale and almonds just as easily as they can from cow's milk without all of the dangers of casein, which is a powerful carcinogen.

    Don't get me wrong, I used to love milk and cheese, but after learning about all of the harm that it does, I just could not stomach it anymore. It also makes me sad that none of spark's meal plans are dairy free. - 7/17/2012 10:55:01 AM
  • Cow's milk is for baby cows, not humans! I agree with BARBBF!

    People who cannot tolerate lactose are the norm! Our bodies slowly turns off the gene to make the lactose enzyme into adulthood after we are weaned off of our mother's milk. Those who can still tolerate milk into adulthood have a mutation that keeps the gene turned on, so they can still break down lactose. - 7/17/2012 8:43:29 AM
  • Another hidden source is medication - always check the inactive ingredients. - 5/14/2011 2:41:47 PM
  • I sometimes take care of my 5 year old nephew who has always been lactose intolerant. Even the lactose free milk gives him gas. He loves almond milk and ice cream, so I have to buy him sorbet. As I get older I find that I cannot drink it anymore as well. It helps me when I have to take care of him because I am more careful when he is around. This article is very helpful I will share it with his mother, and not to worry I will still encourage her to work with the doctor to find alternatives for him. - 5/14/2011 7:58:23 AM
  • Thanks for the list of foods one might not consider when seeking to avoid dairy...they can sure wrench you stomach, that's for sure. Although i have a major problem and use Lactaid or Dairy-Ease, I can enjoy yogurt and some cheeses, including cottage cheese. - 5/14/2011 12:21:28 AM
  • BASKETLADYBLUE
    I am new to this board and and wanted to comment about those of you who have
    have problems with cheese. I also had the same issue, but there is a lactose free cheese available. The brand name is Cabot and they are from Vermont but the cheese is available in most grocery stores. I am in PA and I can get in any of our stores around here. I use the seriously sharp and I have no problems after eating it.

    I hope this helps

    Eileen - 1/23/2011 7:55:00 AM
  • MOIRADOON
    Thank you for helping me understand better! I was most likely lactose intolerant my entire life, with severe belly aches that my adoptive parents thought were nerves (and caused nerves!). In my early adult days a doctor told me to "try" eliminating dairy from my diet but, like my parents, I sloughed it off. After childbirth symptoms increased. By early menopause I was fully lactose intolerant but with many respiratory issues. An allergist told me to try lactose free products but I still developed the Asthmatic Bronchitis. That's when he told me I have a Dairy Allergy (and lactose intolerance). I've been about 7 years without dairy now and it is difficult, but tried-and-true, when I have any dairy products, I blossom out with a severe Asthmatic Bronchitis. I didn't understand but your article shed a lot of light on the subject for me. Thanks! - 6/25/2010 11:07:41 AM
  • I had a severe reaction for more than 20 years when I attempted to eat several foods, most especially pork. I eliminated all of them completely from my diet. But now, I have been able to slowly reintroduce them. I do not know - but it has been suggested by doctors - that now that pigs are being fed controlled diets and not refuse/scraps that this has changed the chemical composition of their meat. I have had many others who were just as reactive to pork as I was say that now they can consume some. Granted, there are precatutions I must take - as little grease/oli as possible, etc. But to be able to have sausage or bacon with everyone else for breakfast is a blessing. - 5/25/2010 5:23:37 AM

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