Depending on the cause and the severity of the lactose intolerance, the intake of lactose must be restricted to a greater or lesser degree. Most people with adult-type hypolactasia can still tolerate a certain amount of cow's milk or other dairy products, especially if they are spread throughout the day. But this needs to be assessed on an individual basis.
Secondary lactose intolerance often results in excluding all sources of lactose from the diet during the acute phase of the underlying disorder after which they can be consumed again gradually.
People intolerant to lactose are unable to tolerate the recommended amount of 3 or 4 portions of dairy products a day. Milk and other dairy products are the main source of calcium and riboflavin (vitamin B2) and they are also rich in protein. Therefore lactose-free alternatives needs to be used daily to provide the necessary nutrients. Soya dairy free alternatives to milk, yogurts and desserts are a suitable option to choose, as they don’t contain any lactose. The products fortified with calcium and vitamin B2 should be chosen where possible (1).
The lactose content of different dairy products can also vary. Generally speaking, yoghurt and fermented milk are usually better tolerated, because yoghurt contains lactose-digesting lactic (acid) bacteria. Lactose levels in cheese largely depend on curding and ripening time, so hard cheese contains very little lactose compared to soft cheeses, which usually contain a higher amount.
Some products use lactose as a necessary ingredient or additive, eg. in processed cheese, some meats, pastries, pancake and pastry mixes, instant soups, instant mashed potatoes, confectionary, salad dressing, tooth paste, and some medications but these are often tolerated (2).
Soya dairy free alternatives to milk, yogurts and desserts are completely lactose-free and can be included in a lactose-free diet without any problem.
References
- Vesa TH et al. Lactose intolerance. J Am Coll Nutrition 2000; 19(2): 165S-75S
- Van den Driessche M. Lactose-intolerantie, verwarring en misverstanden. Nutrinews 1999; 2