Eating dairy with lactose intolerance

I was recently invited to a dinner cooked by Caitlin MacEachen Steininger put on by Dairy MAX, the dairy council around here. The event included a 9-course tasting menu prepared with dairy-filled foods that were safe for lactose intolerant people. I brought along my lactose intolerant boyfriend just to be sure, and it’s true folks: you can eat dairy if you’re lactose intolerant! We’ll talk about what those foods are in a bit, but let’s first discuss why it’s important.

Reasons why everyone should consume dairy products:

BONE HEALTH Dairy milk is the primary source of calcium and vitamin D for most people. Vitamin D can be produced by your body with the help of sunlight, but most of us don’t get enough of that either!

Dairy contains high-quality protein. It’s true that meat also contains high quality protein, but lowfat dairy is one of the best ways to get protein without the saturated fat that is inevitable with meat. There certainly are other sources still, but dairy is a great option!

The protein in dairy is especially good for weight loss and building muscle. It’s the gosh darn truth! Whey protein is particularly rich in leucine, an amino acid that can spur anabolism (building muscle). Also, dairy is particularly effective at aiding weight loss and weight loss maintenance.

Dairy is an excellent NATURAL source of calcium. You may say “but my alternative milk also has calcium!” It’s not natural, people! The calcium that is added to nutmilks, rice milk, hemp milk, etc. is tossed in there in processing and precipitates out of solution. If you don’t vigorously shake your alternative milk before drinking, you will consume very little calcium at all. You don’t have to worry about that with milk, because the (naturally-occurring) calcium is suspended in solution. Save it for your shake weight.

Dairy milk has just 3 ingredients. Milk, vitamin A, and vitamin D. Simple. Natural. Compare this to your standard almond milk on the shelf: water, almonds, salt, locust bean gum, sunflower lecithin, gellan gum, natural flavor, calcium carbonate, vitamin E acetate, vitamin A palmitate, vitamin D2. Now, we all know I’m not an opponent of food science and I do appreciate the mouth feel that can be given by some of these different additives but there are plenty of people out there who would prefer not to consume them.

Cheese. Who doesn’t love it??????

bacchanal cheese tray

Cheese (dairy!) and other delicious things at Bacchanal in New Orleans, one of the most magical places around.

Dairy is one of those food groups that has been demonized of late, with may people trying to eliminate it from their diet. This may be for many reasons:

  • Veganism is on the upswing, so people may choose to abstain from all animal-based products
  • Many “clean eating” proponents (which is, by the way, a completely undefined and un-scientific term) claim that elimination of dairy is essential for a healthy diet or “detoxification” (see previous parenthetical statement)
  • Some people are allergic to casein and whey, the proteins in milk
  • By some measures, lactose intolerance affects 33% of people 

Although I come bearing good news for the people who fall under the last bullet point, I am unfortunately unable to wave my magic dietitian carrot stick and make it so that the others can safely enjoy milk products.

The difference between a milk allergy and lactose intolerance (LI), is that when a person has an allergy, their immune system (in very basic terms) misfires in response to a specific foreign protein that results in their allergic reaction. Symptoms of a milk allergy may include stomach upset, vomiting, or anaphylaxis, but often results in a more subtle skin rash or hives. With LI the issue is the milk sugar, lactose. Normally, we produce lactase enzyme in our digestive tract which breaks this sugar down (remember learning bout the lac operon in high school genetics??) . If this enzyme is not being produced sufficiently, there can be significant gastrointestinal distress, i.e. people make a lot of smelly air and may have other even more troublesome symptoms. Because of overlapping symptoms of LI and dairy allergy, it’s possible to self-diagnose incorrectly. In order to truly determine whether you’re lactose intolerant, you should get a hydrogen breath test at the doctor.

While that stat I reported for LI is quite high, a lot of that number is based on self-report. How legitimate is that? Well, let’s put it this way: how many people do you know who identify as LI? How many of those people have actually gotten a hydrogen breath test? Yeah, probably not many. One of the speakers at the dinner, orthopedist Dr. Sonya Sloan, brought up the point that certain ethnic groups with particularly high rates of LI like African Americans (75%) often assume that they are unable to tolerate dairy, and therefore don’t try. This can have significant consequences for bone health, since dairy is a primary source of dietary calcium and vitamin D in the American diet.

HOWEVER (!) EVEN IF you assume that you have LI, you can still eat dairy. How? Check it out:

  • Aged Cheese is lactose free because the milk sugar naturally breaks down in the aging process. This does not include fresh cheese like chevre, cream cheese, and farmer’s cheese; but pretty much all the hard cheeses you’ll ever come across have extremely low levels of lactose, if any.
  • Yogurt contains bacterial cultures that break down lactose for us! Helloooooo delicious breakfasts!
  • Lactose-free products like lactaid milk, ice cream, and cottage cheese. There are many generic lactose-free brands, like Mootopia at HEB for all the Texans reading this.
  • Lactase enzyme pills are on the market, which you simply take before you eat lactose-containing foods and it supplies the enzyme that your body isn’t producing.

That covers most of the dairy products that anyone would ever want to eat, I think. With endless ways to put them together, there are more than enough ways to incorporate all that protein, calcium, and vitamin D goodness into your day! Some of my favorite ways to eat dairy include:

  • Milk with whole grain cereal
  • Greek yogurt of all sorts
  • Greek yogurt tzatziki
  • Cheese sprinkled in scrambled eggs
  • STRING CHEESE plus fruit as the world’s most perfect snack
  • Sliced cheddar with apples (mourning that I’m missing apple picking season!!)
  • Yogurt in place of sour cream or mayonnaise for almost any recipe (check out this guide)
  • Ice cream 😉

One response to “Eating dairy with lactose intolerance

  1. Good read! I have seen several that are not LI or Vegan shy away from dairy citing “clean eating” as the reason. I never understood why it was unclean. Thanks for allaying my fears that it’s not dirty. (I type this as I am inhaling a spoonful of Chobani (plaint, NF of course) with a couple of fresh strawberries!


    Liked by 1 person

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