By Cynthia Sass, M.P.H., R.D.
Thirty to 50 million Americans produce insufficient amounts of the enzyme (lactase) needed to digest lactose, the naturally occurring sugar in milk. Rather than being broken down and absorbed, lactose gets trapped in the digestive tract. This can trigger nausea, gas and diarrhea—usually within 30 minutes to two hours of eating.
Avoiding milk will spare you the unpleasant effects of undigested lactose; however, by doing so you’re also eliminating foods rich in calcium and vitamin D. These nutrients are essential to good health (and maintaining strong bones), so it’s important to get enough of them from other foods.
Good news: you have a lot of options. You can drink Lactaid, which is “regular” cow’s milk with lactase added. Or try “milks” made from soy, rice or almonds. Choose those fortified with 25 to 30 percent of the daily value for both calcium and vitamin D per cup.
Many with lactose intolerance can enjoy cheeses (particularly aged ones) and yogurts—made from both cow’s and goat’s milk—symptom-free; much of the lactose is removed during processing. If even these foods cause trouble, you can try nondairy (e.g., soy) versions. They usually don’t mimic dairy-based products in taste or nutritional value; some come close on texture.
Eating more of nondairy foods that supply good amounts of vitamin D (e.g., mackerel) and calcium (e.g., kale, almonds) also will help you meet your needs for these nutrients. Still suspect you may be falling short? Consult a dietitian (eatright.org), who can help you decide if you need supplements.