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Lactose Intolerance

Did you know that over one third of Americans are lactose intolerant? On the other hand, under 2% of American adults have a milk allergy. Although they are often confused, milk allergies and lactose intolerance are different from one another. Let’s talk about what lactose intolerance is, what milk allergies are, and how you can manage both of them!

What is lactose intolerance? How is it different from a milk allergy?

People with lactose intolerance can have mild or severe symptoms depending on their bodies, how much lactose they consumed, and what they consumed it with.

When a person is allergic to milk, their immune system reacts to a protein in milk. Allergic reactions can be mild or severe, and symptoms vary widely. Symptoms can include hives, nausea, vomiting, tingling in the mouth or throat, or dizziness. Milk allergies are most common in young children. Most, but not all, children with milk allergies will outgrow them and be able to include dairy in their diets as adults. If you are having severe symptoms that could be related to an allergic reaction, always seek emergency medical attention.

Dairy products have key nutrients, including calcium, potassium, vitamin A, and vitamin D. If you have lactose intolerance or a milk allergy, it is still important to get those nutrients. Luckily, there are plenty of ways you can still meet your nutrient needs!

What can I eat if I’m lactose intolerant?

People who have lactose intolerance can still enjoy dairy products! Everyone is different, so if you are lactose intolerant, you can see how your body reacts to different dairy products. Hard cheeses, like cheddar and Swiss cheese, have very low amounts of lactose. Other good options include Greek yogurt and cottage cheese.

Milk and regular yogurt have higher amounts of lactose, but you can still include them in your diet. Many people who have lactose intolerance are able to consume the amount of lactose in 1 cup of milk or 6 ounces of yogurt without stomach discomfort. It may help to consume these foods as part of a meal. If you have been completely avoiding milk and yogurt, try starting with a small portion and slowly increasing the amount over time.

If regular dairy products cause digestive symptoms, there are other ways you can include dairy products in your diet. There are many lactose-free dairy products available at the grocery store, including lactose-free milk, yogurt, cottage cheese, and even ice cream. Also, over-the-counter products (such as Lactaid pills or chewable tablets) can be taken when consuming lactose-containing products to prevent symptoms.

What can I eat if I have a milk allergy?

People with milk allergies should avoid all milk and dairy products. They cannot eat or drink lactose-free dairy products. They should also check food labels to make sure packaged foods do not contain milk.

Cross-contamination can cause allergic reactions for people with milk allergies. Cross-contamination is when a small amount of an allergen is transferred to an allergen-free food because of shared preparation or storage equipment or improper food handling. To avoid cross-contamination when preparing food for somebody with a milk allergy, be sure to keep dairy foods and non-dairy foods away from each other, to wash all equipment between uses, and to wash hands and change gloves after handling dairy foods.

You can still meet your nutrient needs if you have a milk allergy. While there are many plant-based milk and yogurt products on the market that do not contain dairy, most of them do not have the nutrients that dairy milk has. The best substitute for dairy milk is soy milk. Soy milks have plenty of protein, and are usually fortified with calcium, vitamin A, and vitamin D. You can also buy soy-based yogurts that have similar nutrient profiles to dairy products.

There are also other ways to get the nutrients you need without consuming milk products. For calcium, you can eat beans, tofu, fortified cereals, and dark green vegetables like broccoli and spinach. To get enough potassium, increase your intake of fruit, vegetables, beans, nuts, and seeds. Vitamin A is plentiful in red and orange vegetables, cantaloupe, some types of fish, and fortified breakfast cereals. Vitamin D is found in mushrooms, eggs, certain types of fish, and fortified foods like breakfast cereal. Your body can also make its own vitamin D if you get a lot of sunlight. However, many people have difficulty meeting their vitamin D needs, especially in winter. Talk to your doctor or Registered Dietitian about taking a vitamin D supplement to ensure you are meeting your nutrient needs.

What if I’m not sure if I have a milk allergy or am lactose intolerant?

If you or your children have symptoms that occur after consuming dairy products, talk to your doctor. Your doctor may do a few tests to find out what is causing your symptoms. Food allergies can be dangerous and even life-threatening, so it is important to talk to a health professional if you suspect you may have one. Only medical professionals such as doctors can diagnose lactose intolerance or a milk al

lergy. For more information on how to safely meet your nutrient needs if you already have been diagnosed with lactose intolerance or a milk allergy, check out the resources below or contact a Registered Dietitian.



  1. Storhaug CL, Fosse SK, Fadnes LT. Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017;2(10):738-746. doi:10.1016/S2468-1253(17)30154-1

  2. Gupta RS, Warren CM, Smith BM, et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630

Author: Stella Grill-DuBois


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