Caring for you as we would for ourselves

Do you think you might be lactose intolerant and need to avoid dairy products?

Lactose intolerance is caused by a lactase deficiency. Lactase is an enzyme and without it your body is unable to split or digest lactose, a type of sugar mainly found in milk and dairy products. This means that large amounts of lactose enter the intestine, resulting in an increased flow of water into the bowels, which can lead to diarrhoea. Eventually, bacteria present in the intestine begin to ferment the unsplit lactose, causing intestinal gas to develop, which in turn causes stomach cramps, bloating and diarrhoea.

This intolerance is caused by a genetic mutation and is very common in people from Mediterranean, Asian and African countries.

Lactose intolerance should not be confused with a cow's milk protein allergy, which is rare in adults and usually seen in children.

Establishing an accurate diagnosis is essential because many patients mistakenly think they are lactose intolerant when they actually have a bowel condition with similar symptoms, such as diarrhoea or abdominal pain. The first step is to eliminate dairy products, such as milk, yoghurt and cream cheese, from your diet and then reintroduce these products a few weeks later. If the symptoms come back, a hydrogen breath test is a simple way of determining if you may be lactose intolerant.

If a diagnosis of lactose intolerance is confirmed, treatment involves reducing lactose from your daily diet. Lactose is mainly found in milk from cows, sheep and goats as well as some non-fermented dairy products, including cream, sour cream, coffee creamer, kefir, cream cheese, quark, cottage cheese and whipped soft cheese. Be aware that the food industry frequently uses lactose in all kinds of products, including cured meat, bread and condiments.

It is thought that most people with lactose intolerance can tolerate up to 10 g of lactose throughout the day, which is the equivalent of 200ml of milk.

Work out your own tolerance level and avoid completely eliminating dairy products as they are your body’s main source of calcium. Lactose-intolerant people can achieve a healthy diet with good levels of calcium by choosing lactose-free dairy products and aged cheeses, such as Brie and Camembert, which only contain traces of lactose. Calcium-rich mineral water is also a great way to supplement dairy products.

Here are some tips to help you rebuild your tolerance to lactose:

  • Only drink small amounts of milk on a full stomach.
  • Split your intake of different dairy products and eat other foods at the same time.
  • Incorporate milk into your cooking, for example with mashed potatoes, rice pudding and semolina.
  • Try to eat yoghurt and mature cheeses, which naturally contain less lactose thanks to the lactic acid bacteria present in yoghurt and the draining and ripening of aged cheeses.
  • Drink lactose-free milk rather than plant-based milks, which are often low in calcium.
  • If you find it difficult to control your intake of lactose, for example when eating out at restaurants, dinner parties or on holiday, you can take liquid drops, tablets or capsules that contain lactase substitutes.

It is important to make sure you get enough calcium throughout your life in order to build and maintain strong bones. If there is a risk you have a calcium deficiency, speak to your doctor who can prescribe calcium and vitamin D supplements, if necessary.

Raffi Maghdessian, Manager, Nutrition Unit