who think they may be lactose intolerant should see
their physician because the symptoms of lactose intol-
erance can be quite similar to those of more serious
and sometimes progressive diseases such asceliac dis-
ease(a gluten intolerance),Crohn’s disease, giardia
(a parasitic infection of the bowel), andinflammatory
bowel disease. Lactose intolerance can be diagnosed
by giving the individual lactose and then measuring
changes in the sugar (glucose) level in their blood. In
lactose intolerant individuals lactose is not broken
down into sugars that can be absorbed from the intes-
tine. Therefore, the level of glucose in the blood will be
lower than expected. Lactose can also be diagnosed by
a hydrogen breath test.
Lactose and diet
Lactose intolerance is treated by eliminating lac-
tose from the diet beyond the level where it produces
symptoms. Alternately, enzymes such as LACTAID
or Dairy Ease can be added to milk 24 hours before
drinking. These enzymes pre-digest lactose and can
eliminate 70–99% of it. Lactose-reduced milk is avail-
able at many supermarkets. All LACTAID and Dairy
Ease milk is 70% lactose-free except for non-fat LAC-
TAID, which contains no lactose. When eating other
foods that contain lactose, LACTAID and Dairy Ease
capsules are taken at the same time that an individual
begins eating. These capsules contain enzymes to help
digest lactose.
Since dairy products are the main source ofcal-
ciumin the standard American diet, people who elim-
inate milk, cheese, yogurt, and other dairy products
must adjust their diet to get enough calcium. Calcium
is critical to building and maintaining strong bones
and teeth and is needed for metabolic processes such
as muscle contraction and nerve impulse transmission.
The United States Institute of Medicine (IOM) of
the National Academy of Sciences has developed val-
ues for the adequate intake (AI) of calcium. These
values are based on age and gender. Some nutritionists
and researchers believe that they are too low. The AI
values for calcium are listed below.
children birth–6 months: AI 210 mg
children 7–12 months: AI 270 mg
children 1–3 years: AI 500 mg
children 4–8 years: AI 800 mg
children 9–13 years: IA 1,300 mg
adolescents 14–18 years: IA 1,300 mg
adults age 19–50: IA 1,000 mg
adults over age 50: IA 1,200 mg
pregnant women 18 years and younger: IA 1,300 mgpregnant women over age 18: IA 1,000 mg
breastfeeding women 18 years and younger: IA
1,300 mg
breastfeeding women over age 18: IA 1,000 mg
Some good sources of calcium that do not contain
lactose are:
sardines with bones, canned in oil, 3 ounces: 270–
325 mg
salmon with bones, canned, 3 ounces: 180–205 mg
tofu, firm, made with calcium sulfate added, 1/2
cup: 204 mg
pinto or red beans, cooked, 1/2 cup: 43 mg
white beans, cooked, 1/2 cup: 113 mg
bok choy, 1/2 cup cooked: 61 mg
bread, whole wheat, 1 slice: 20 mg
orange juice, fortified with calcium, 6 ounces:
200–260 mg
soymilk, 1 cup: 200–300 mg
A dietitian can help the severely lactose intolerant
person develop a meal plan that will meet their dietary
need for calcium and/or recommend a calcium supple-
ment. Calcium supplements are available over-the-
counter at pharmacies and supermarkets.FunctionLactose intolerance cannot be cured. The purpose
of the lactose intolerance diet is to bring the symptoms
of bloating, gas, abdominal discomfort, and diarrhea
under control so that the individual is comfortable,
and the symptoms do not disrupt his or her daily
activities.Benefits
The benefit of a lactose intolerant diet is that the
uncomfortable symptoms of bloating, nausea, stom-
ach cramps, and diarrhea are controlled.Precautions
Lactose intolerance is variable. Individuals must
work out through trial and error how much and which
lactose-containing foods then can eat without stimu-
lating symptoms. During trial and error experimenta-
tion, there will be moments of misjudgment when
symptoms develop.Risks
The greatest risk to this diet is that the individual
will not get enough calcium.Lactose intolerance diet