For many lactose intolerance can be a distressing and unwanted condition. This article discusses the difference between lactose intolerance and milk allergy as well as offering diet advice including what hidden products to look out for.
Lactose intolerance means there is a deficiency in lactase - a product that helps break down lactose. As such the body cannot digest lactose which is a natural sugar found in many food products that comes from animal milks. Lactose intolerance is also referred to as milk protein intolerance and lactase deficiency. Lactose intolerance is common condition that is more prevalent in adults as the consumption of lactose generally lowers after childhood.
Research has shown that people with lactose intolerance are able to consume a certain amount of lactose before the body is unable to process the lactose properly. A serving of around 250 ml of milk has been found to be tolerable and even a total amount of 500 ml of milk spaced evenly throughout the day is also generally tolerable. A little bit of trial and error may be needed to find your own personal lactose limit. For 250 ml of whole milk the amount of lactose is around 15 grams and 30 grams for 500 ml of whole milk. With this information it is helpful to have an idea how much lactose is found within dairy foods.
Lactose content for common dairy foods
Product Serving size Lactose content Whole milk / full fat milk 250ml 15g Skimmed milk / low fat milk 250ml 15g Yoghurt 170g 8.5g on average Sour cream 125ml 3g Cream cheese 40g 1g Cottage cheese 40g 1g Cheddar cheese 2 slices / 40g 0.04g Brie cheese 40g 0.04g
This information highlights that foods you would consider “high in dairy” can have small amounts of lactose. In contrast whey, milk powder and coffee creamer have about 50% of their weight as lactose - definitely ones to avoid. Note that skimmed milk does not have any less lactose than whole milk, only the fat content is reduced in these milks.
For lactose tolerance it can come down to individual tolerance, some may be able to tolerate a few glasses of milk and some may only be able to consume one glass. For some it may help to supplement with lactase enzymes to help aid the digestion of dairy products. Keep an eye on calcium levels as people on low dairy diets tends to become deficient in calcium, if they are low a calcium supplement can help.
Lactose intolerance symptoms
The symptoms of lactose intolerance are generally digestive problems such as bloating, gas and diarrhea after consumption of milk or milk derived products. Although these can be very uncomfortable, embarrassing and can reduce quality of life, it is not life threatening unlike a milk allergy. Milk allergy and lactose intolerance often are confused with each other but should they are not treated the same, see below for information on the serious condition of milk allergy.
A milk allergy is a more serious problem that is not as common as lactose intolerance. Cows’ milk allergy affects around 5% of young children with symptoms showing in a few months from birth. Most children outgrow the allergy and are able to have dairy by around five years of age. If you are one of the small percentage of the population with a milk allergy it helps to follow a dairy free diet. The dairy free food list page will offer some help for avoiding products with dairy in them.
Milk allergy symptoms
Symptoms of a milk allergy that may immediately show after consumption of milk include: hives, wheezing and vomiting. After time further symptoms may include: diarrhea, abdominal cramping, loose stools which may have blood, colic (for babies). Milk allergy can cause anaphylaxis which is a life threatening reaction that constricts airways preventing the ability to breathe. If a reaction to milk is shown for you or your child seek medical advice even if the reaction is mild. See Mayo Clinic website for more information.
Dairy Free Diet
An entirely dairy free diet is not required for lactose intolerance but the information will still be of use to help avoid particularly high lactose foods. For milk allergy then a strict dairy free diet is advisable. Be sure to read food labels to help identify foods that contain dairy. In the UK and EU you will find on all ingredient lists that allergens are highlighted with milk being one of these allergens - see food.gov.uk. Although food labels highlight milk products it still can be a little overwhelming finding foods that are suitable for a dairy free or low dairy diet. Supermarkets these days often sell a variety of diary free products from milk (such as soya milk and coconut milk) to cheese to dairy free bread. The choice and variety has increased a lot over the past 5 years.
What to look out for
There are many ingredients that you have to look out for that may not obviously contain cows milk or derived products. Examples of ingredients that contain cows’ milk derived products are:
- Sodium caseinates
- Lactic acid
- Milk powder
- Milk Solids
For a more indepth list go to the lactose free food list which offers information on what foods contain lactose and which products can be used as a substitute.