Lactose Intolerance Test
How to Manage Lactose Intolerance
Although the body's ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes. Most people with lactose intolerance can tolerate some amount of lactose in their diet. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by taking them with meals.
The amount of change needed in the diet depends on how much lactose a person can consume without symptoms. For example, one person may have severe symptoms after drinking a small glass of milk, while another can drink a large glass without symptoms. Others can easily consume yogurt and hard cheeses such as cheddar and Swiss but not milk or other milk products.
The Dietary Guidelines for Americans 2005 recommend that people with lactose intolerance choose milk products with lower levels of lactose than regular milk, such as yogurt and hard cheese.
Lactose-free and lactose-reduced milk and milk products, available at most supermarkets, are identical to regular milk except that the lactase enzyme has been added. Lactose-free milk remains fresh for about the same length of time or longer than regular milk if it is ultra-pasteurized. Lactose-free milk may have a slightly sweeter taste than regular milk. Soy milk and other products may be recommended by a health professional.
People who still experience symptoms after dietary changes can take over-the-counter lactase enzyme drops or tablets. Taking the tablets or a few drops of the liquid enzyme when consuming milk or milk products may make these foods more tolerable for people with lactose intolerance.
Parents and caregivers of a child with lactose intolerance should follow the nutrition plan recommended by the child’s doctor or dietitian.
Lactose Intolerance and Calcium Intake
Milk and milk products are a major source of calcium and other nutrients. Calcium is essential for the growth and repair of bones at all ages. A shortage of calcium intake in children and adults may lead to fragile bones that can easily fracture later in life, a condition called osteoporosis.
The amount of calcium a person needs to maintain good health varies by age. Recommendations are shown in Table 1.
Table 1. Recommended calcium intake by age group
| Age group | Amount of calcium to consume daily, Age group in milligrams (mg) |
|---|---|
| 0–6 months | 210 mg |
| 7–12 months | 270 mg |
| 1–3 years | 500 mg |
| 4–8 years | 800 mg |
| 9–18 years | 1,300 mg |
| 19–50 years | 1,000 mg |
| 51–70+ years | 1,200 mg |
Women who are pregnant or breast-feeding need between 1,000 and 1,300 mg of calcium daily.
Getting enough calcium is important for people with lactose intolerance when the intake of milk and milk products is limited. Many foods can provide calcium and other nutrients the body needs. Non-milk products that are high in calcium include fish with soft bones such as salmon and sardines and dark green vegetables such as spinach.
Table 2 lists foods that are good sources of dietary calcium.
Table 2. Calcium content in common foods
| Non-milk Products | Calcium Content |
|---|---|
| Rhubarb, frozen, cooked, 1 cup | 348 mg |
| Sardines, with bone, 3 oz | 325 mg |
| Spinach, frozen, cooked, 1 cup | 291 mg |
| Salmon, canned, with bone, 3 oz | 181 mg |
| Soy milk, unfortified, 1 cup | 61 mg |
| Orange, 1 medium | 52 mg |
| Broccoli, raw, 1 cup | 41 mg |
| Pinto beans, cooked, 1/2 cup | 40 mg |
| Lettuce greens, 1 cup | 20 mg |
| Tuna, white, canned, 3 oz.. | 12 mg |
| Milk and Milk Products | |
| Yogurt, with active and live cultures, plain, low-fat, vitamin D-fortified, 1 cup | 415 mg |
| Milk, reduced fat, vitamin D-fortified, 1 cup | 285 mg |
| Swiss cheese, 1 oz.. | 224 mg |
| Cottage cheese, 1/2 cup | 87 mg |
| Ice cream, 1/2 cup | 84 mg |
Yogurt made with active and live bacterial cultures is a good source of calcium for many people with lactose intolerance. When this type of yogurt enters the intestine, the bacterial cultures convert lactose to lactic acid, so the yogurt may be well-tolerated due to a lower lactose content than yogurt without live cultures. Frozen yogurt does not contain bacterial cultures, so it may not be well-tolerated.
Calcium is absorbed and used in the body only when enough vitamin D is present. Some people with lactose intolerance may not be getting enough vitamin D. Vitamin D comes from food sources such as eggs, liver, and vitamin D-fortified milk and yogurt. Regular exposure to sunlight also helps the body naturally absorb vitamin D. Talking with a doctor or registered dietitian may be helpful in planning a balanced diet that provides an adequate amount of nutrients—including calcium and vitamin D—and minimizes discomfort. A health professional can determine whether calcium and other dietary supplements are needed.