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Due to popular demand, the food industry has made millions on dairy products that have less lactose (milk sugar) OR have lactase — the enzyme that breaks down lactose — added to the dairy product. Interestingly, there is not conclusive proof that either of these products actually help folks digest lactose better. (1,2)
Probiotics have also been touted as a cure for lactose intolerance, but once again, the science is lacking to support these claims. (1,2) That said, I have no doubts that many people do feel better when using lactase and probiotic support. In this article, I want to offer some additional strategies for lactose intolerance.
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How Much Lactose is OK, and How Much is Not?
Most people with lactose intolerance have little or no symptoms when they ingest small amounts of lactose. Studies show that most can safely consume the following amounts of lactose without any symptoms: (1)
- Up to 12 grams of lactose in a single meal (about 250 mL of milk)
- Up to 24 grams of lactose spread out through the day (about 500 mL of milk)
Lactose-related symptoms may be milder or even absent when dairy is eaten in smaller amounts spread throughout the day or with other foods. Combining dairy products with more solid, dense or fatty foods can slow the delivery of lactose into the small intestine, therefore avoiding lactose surges into the small intestine. (1)
Lactose-Free Dairy Products
Fermented dairy products such as cheese, quark, or yogurt contain less lactose than fresh milk. Many hard cheeses contain no lactose or almost no lactose at all. It is common that people with lactose intolerance do not have symptoms when they eat good quality yogurt.
During the process of culturing or fermenting milk, the lactic acid bacteria will ingest much of the milk sugar or lactose and, in addition, help break down the casein – a hard-to-digest dairy protein. (1) Raw cheese, which is now legal in the US, sits or ferments for at least 3 months. This is wonderful, because those during those 3 months of fermentation, the casein and lactose in the cheese is reduced significantly.
The slow introduction of lactose into the diet has shown to help people develop the ability to effectively digest lactose, but the key is slow and steady. When working with patients, I often recommend troubleshooting other aspects of the digestive process to be sure there are no other weak links that may be responsible for this intolerance.