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Lactose intolerance is the inability to digest lactose — the primary sugar in dairy.

The condition can cause stomach pain, bloating, excessive gas, and diarrhea with the consumption of too much lactose.

Fortunately, you can treat lactose intolerance by limiting foods with lactose in your diet.

This article explains what to eat and avoid with lactose intolerance and provides a sample lactose intolerance diet meal plan.

lactose intolerant diet

What is lactose intolerance?

Lactose intolerance is a digestive disorder caused by the inability to digest lactose.

It’s different from a cow’s milk allergy, which is caused by an allergic reaction to the protein in milk.

Lactose intolerance a common condition, affecting about 70% of the world’s population (1).

It’s most common in Blacks, Hispanics, and Asians.

People who are lactose intolerant don’t make produce enough lactase — the enzyme needed to digest lactose.

Lactose is a disaccharide, meaning it’s made up of two sugars — glucose and galactose (2).

Lactase helps break down lactose into glucose and galactose so your small intestine can absorb them.

Without enough lactase, lactose moves through your small intestine undigested and causes various digestive symptoms, including stomach cramps, bloating, and diarrhea.

These symptoms can occur within 30 minutes to 1 to 2 hours after consuming dairy products (2).

The most common cause of lactose intolerance is a decrease in lactase production with age.

In other instances, lactose intolerance may be caused by infections or inflammation that affect the small intestine like celiac disease and decrease lactase production.

Lactose intolerant diet

Lactose is the primary sugar in dairy, which you must limit from your diet.

Dairy products include:

  • cow’s milk
  • cream cheese
  • cheese
  • cottage cheese
  • ice cream
  • whipped cream

You will also want to limit foods that use some form of dairy as an ingredient, such as (3):

  • cookies, cakes, and other baked goods
  • chocolate
  • sauces and gravies
  • breakfast cereals
  • instant soups
  • salad dressings
  • margarine
  • processed meats
  • powdered meal replacements
  • pudding and custard

You can determine whether a product contains dairy by reading the nutrition label. Most products will note whether they contain milk.

Added milk or dairy products can also be called:

  • whey
  • curds
  • milk sugar
  • malted milk
  • sour cream
  • buttercream

While similar sounding, lactic acid, lactalbumin, and lactate are different from lactose.

Some dairy is recommended with lactose intolerance

The severity of lactose intolerance symptoms varies based on the dose of lactose consumed and the level of lactase deficiency.

However, most people with lactose intolerance can tolerate a dose of at least 12 grams of lactose — equal to about one cup (240 mL) of milk — without problems (4).

Up to 18 grams of lactose may be tolerated when consumed with a meal or spread throughout the day (5).

Cow’s milk and other dairy products are the largest contributors of calcium in the diets of Americans and are also are a major source of vitamin D, vitamin B2, vitamin B12, vitamin A, and high-quality protein (6).

Therefore, the general recommendation is that you don’t need to completely restrict dairy with lactose intolerance but limit your intake based on your tolerance (7).

Dairy products with the highest lactose include milk and ice cream, while yogurt, butter, and hard cheeses like cheddar contain much lower amounts.

One-day sample lactose intolerant diet

Here is a one-day sample lactose intolerant diet plant that contains less than 12 grams of lactose:

Breakfast: Scrambled eggs and oatmeal mixed with a half-cup (120 mL) of milk and topped with sliced banana and cinnamon.

Snack: One cup of Greek yogurt and mixed nuts.

Lunch: Avocado and spinach chicken salad wrap.

Snack: Apple slices with peanut butter.

Dinner: Grilled salmon, herb roasted potatoes, and sugar snap peas.

Other treatments for lactose intolerance

In addition to limiting your intake of dairy, several other treatments can help manage lactose intolerance.

Lactase supplements

Lactase enzyme supplements are available over-the-counter.

You take them with your first bite or sip of dairy to help your gut break down lactose, allowing for better absorption.

While the effectiveness of these products can vary from person to person, they may be very effective for some people (8).

Some lactose-free brands of cow’s milk and ice cream already contain the lactase enzyme.

Purchase lactase supplements online.

Probiotics

Probiotics are the good bacteria living in your digestive tract.

Several probiotic strains have shown varying degrees of efficacy for improving lactose intolerance symptoms (9, 10).

One of the most studied probiotics is Bifidobacteria, which is often found in probiotic yogurt and supplements (11, 12).

Find probiotic supplements online.

Lactose exposure

Regularly including lactose in your diet could help your body adapt to it (13).

This process — referred to as colonic adaptation — supports the growth of lactose-digesting bacteria in your large intestine, which could help reduce intolerance symptoms.

Interestingly, this colonic adaption disappears when lactose is eliminated from the diet, which could lead to worse intolerance symptoms when lactose is added back to the diet.

The bottom line

Lactose intolerance occurs when the small intestine does not produce enough lactase to digest lactose, the sugar found in dairy products.

Most people with lactose intolerance can consume some dairy products without experiencing any symptoms.

Lactase supplements, probiotics, and lactase exposure are also treatments that can help you manage lactose intolerance.


Gavin Van De Walle, MS, RD, LN
Gavin Van De Walle, MS, RD, LN

Gavin Van De Walle holds a master's degree in human nutrition and bioenergetics. He is a registered dietitian who aims to arm the public with evidence-based nutrition recommendations so they can make their own educated and informed health decisions.