Which Foods Should You Avoid if You Are Lactose Intolerant?

Lactose is a type of sugar found in dairy products. Avoid foods like milk, cheese, yogurt, and foods with these products if you are lactose intolerant.

Lactose is a type of sugar found in dairy products. If you're lactose intolerant, your body can't break down lactose because you don't have enough of the enzyme lactase. Although you may know that you need to avoid milk and dairy products, lactose may be a hidden ingredient in other products. 

All milk and milk products contain lactose. Lactose may also be in other foods and drinks that contain milk or dairy products. 

Milk 

All types of milk contain lactose, including: 

• Whole milk
• Low Fat milk
• Fat-free milk
• Evaporated milk
• Condensed milk
• Chocolate milk 

Cheese

There are eight varieties of cheese, and all contain lactose. They include: 

• Blue cheese
• Hard cheese
• Pasta filata
• Processed cheese
• Semi-hard cheese
• Semi-soft cheese
• Soft and fresh cheese
• Semi-ripened cheese

These varieties include cheeses such as: 

• Asiago cheese
• American cheese
• Blue cheese
• Brie
• Camembert
• Cheddar
• Cheese curds
• Colby
• Cottage cheese
• Cream cheese
• Swiss cheese
• Farmer's cheese
• Feta cheese
• Mozzarella 
• Gouda
• Parmesan
• Ricotta

Yogurt

Yogurt contains lactose, although the good bacteria used to culture yogurt may help you digest it. Strained yogurt, such as Icelandic and Greek yogurt, are thicker and have less lactose than other varieties. 

Packaged Products

You might be surprised that some of your favorite packaged products contain lactose. Milk products are often used in boxed, canned, prepared, or frozen foods, including: 

• Baked goods like pancakes, bread, cookies, and cakes
• Breakfast foods
• Instant potatoes
• Soups
• Margarine
• Snack foods
• Salad dressings
• Processed meats, including lunch meats, sausage, hot dogs, and bacon
• Coffee creamer, including powdered and liquid nondairy coffee creamer
• Nondairy whipped topping

When you're checking labels, look for the following terms that indicate a product contains lactose: 

• Milk
• Whey
• Lactose
• Milk by-products
• Milk solids
• Curds
• Dry milk powder 

If you're concerned about getting enough calcium with a lactose-free diet, try these nondairy, calcium-rich foods: 

• Leafy greens such as spinach, bok choy, kale, turnip greens, and collards
• Tofu, if calcium sulfate is an ingredient
• Calcium-enriched products such as juices and plant-based milk like almond milk or rice milk
• Canned fish such as sardines and salmon packed with bones 
• Tahini, which is sesame butter or paste 

Your small intestine doesn't make enough lactase if you're lactose intolerant. Lactase is the enzyme that breaks down the lactose found in food so your body can digest it. Symptoms of lactose intolerance may differ for everyone, but they usually start between 30 minutes and two hours after you eat food containing lactose and can include: 

• Stomach pain and cramps
• Bloating
• Nausea
• Diarrhea
• Gas

You may not need to avoid all dairy products if you're lactose intolerant. Some dairy foods may not cause as many symptoms as others, and you may be able to tolerate small amounts of dairy foods. Here are some tips for incorporating dairy into your diet to see if you can tolerate it: 

Start With Small Amounts

Add milk or dairy products to your diet slowly, starting with a very small amount to see how you respond:  

Avoid Eating Dairy Alone

If you're trying milk products, eat them with other foods to see if that reduces the symptoms. Your symptoms may be less severe if you eat milk or cheese products as part of a meal: 

Try Different Dairy Products

Dairy products have different amounts of lactose, so one person may not cause symptoms while another does. Hard cheeses usually have less lactose and don't cause symptoms for many people. Milk and ice cream both have high amounts of lactose. However, you may be able to eat ice cream because the fat content might reduce symptoms. 

You may be able to tolerate yogurt since the bacteria used to culture it breaks down lactose. You can also try lactose-free dairy products. 

Try Lactase Enzymes

Over-the-counter lactase enzyme drops or tablets may help you digest milk and other dairy products. You can try taking them just before you eat foods containing milk. They aren't effective for everyone, so try them with a small amount of dairy in case you still have symptoms.

Although healthy diet guidelines often include dairy, it's possible to have a very healthy diet without dairy. In fact, there are some concerns about including dairy in your diet. Dairy products present people with challenges that include: 

Saturated Fat

Dairy products are a major source of saturated fat and cholesterol in the American diet. Diets high in saturated fat and cholesterol are associated with an increased risk of heart disease. 

Cancer Risk

Dairy products such as milk and cheese are high in fat and hormones, which may be associated with an increased risk of breast cancer. One study showed that women who ate the most cheese, including American, cheddar, and cream cheese, had a 53% increased risk of developing breast cancer. 

Bone Fractures

Milk products may be associated with an increased risk of bone fractures. One study showed that men who consumed the most dairy products as teenagers were more likely to experience bone fractures as adults. An analysis of studies that examined adolescent girls' diet, exercise habits, and stress fractures found that consuming dairy products didn't help prevent stress factors.