Low-Lactose Diet

The low lactose diet is designed to decrease symptoms of bloating, gas, abdominal cramping, nausea and diarrhea resulting from incomplete digestion of milk sugar, or "lactose." The goal is eat dairy products for healthy bones and teeth without uncomfortable symptoms.

When to Follow a Low-Lactose Diet

The diet is used for children with lactose intolerance or lactase deficiency. Symptoms of lactose intolerance may develop 30 minutes to 2 hours after eating lactose-containing foods and drinks. Lactose intolerance varies; if an individual has no symptoms, then no restrictions are needed. Following the lactose controlled diet will help control symptoms.

Modifications

The diet restricts foods containing lactose, or milk sugar, found mostly in dairy products. Most persons with lactase deficiency can tolerate small amounts of lactose without a problem. Children with severe lactase deficiency may need to avoid even smaller sources of lactose.

Food label terms that may indicate lactose in the product include milk, milk solids, whey, lactose, curds, margarine, skim milk, powder, sweet or sour cream, buttermilk, and malted milk.

Dairy products can be consumed based on individual tolerance- whether or not you develop symptoms depends on the individual and the amount of dairy product that you consume.

Some dairy products are better tolerated than others.

  • Whole milk may be better tolerated than lower fat milks.
  • Cocoa and chocolate milk may be better tolerated than plain milk
  • Yogurt and aged cheeses are better tolerated, due to lower lactose content.
  • Frozen yogurt and ice cream are often tolerated because of their solid consistency and their fat content

Lactose reduced dairy products such as "Lact-Aid" treated milk can be found in most supermarkets, and come with varying degrees of lactose reduction (e.g., 70 to 100% treated). Patients may choose to treat milk with enzyme products drops or tablets; brands include "Dairy Ease" and "Lact-Aid."

Lactose Content of Common Foods and Beverages

 Product Lactose (g)
 Milk (1 cup) 9-13
 Yogurt, low-fat (1 cup) 11-15
 Cottage cheese (1 cup) 5-8
 Aged cheese (1 oz.) 0.4-0.8
 Ice cream (1 cup) 9
 Sherbet, orange (1 cup) 4
 Half and half, light cream, whipped cream topping (1 tbsp) 0.5
 Sour cream (1 tbsp) <1


Guidelines for Food Selection for Low Lactose Diet

Food Category   Recommended May Need to be Volume Limited
Beverages
Lact-Aid treated milk or soy milk.
Regular milk in moderate quantities as tolerated by the individual. 
Supplements such as Ensure, Pediasure, Boost, and Nutren Jr. are lactose-free.
Regular milks as tolerated.
Breads and cereals Whole grain or enriched breads and cereals
Cereals prepared a lot of with milk or milk products
Desserts Cakes, cookies, pies; flavored gelatin desserts; water ices made with allowed foods
Those prepared with a lot of milk or milk products such as ice cream or ice milk, custard, puddings, Tiramisu
Fats Margarine, salad dressing, non-dairy creamer, all oils
Cream cheese in large amounts
Fruits All fruits and fruit juices
None
Meats and meat alternatives All meats, poultry, fish, and shellfish; eggs; dried peas and beans; nuts; peanut butter; aged cheese (if tolerated); yogurt (if tolerated)
Cottage cheese
Potatoes and Other Starches
Potatoes-enriched rice, barley, noodles,  spaghetti, macaroni, and other pastas
Potatoes prepared with large quantities of milk or cheese
Soups Broth, bouillon; soups made with allowed ingredients
Creamed soups in large volumes
Sweets Sugar, corn syrups, honey, jellies, jams
Large amounts of milk chocolate
Vegetables All Vegetables prepared with large amounts of milk or milk products

The amount of lactose tolerated is very individual. The goal is to eat a tolerable amount of dairy products to assure excellent calcium and vitamin D intake for healthy bones and teeth.

Consider a calcium and vitamin D supplement such as Viactiv or calcium citrate if you must limit the intake significantly.