Lactose intolerance is a real and important clinical syndrome, but its true prevalence is not known, according to a report released in February by the NIH Consensus Development Conference: Lactose Intolerance and Health. Not enough data is available to estimate the prevalence of true lactose intolerance in the United States, the report stated, but it's likely the numbers are lower than those often reported.

Many individuals with real or perceived lactose intolerance avoid dairy and ingest inadequate amounts of calcium, potassium and vitamin D, which may predispose them to decreased bone accrual, osteoporosis, and other adverse health outcomes.  In data presented by Dr. Connie Weaver from Purdue University, among teenagers that exclude dairy from the diet, 100% lacked key nutrients such as calcium, vitamin D, phosphorous and potassium. Although theoretically adequate nutrients can be consumed from non-dairy sources, teenagers in our culture do not eat enough of the foods needed to get adequate amounts of these nutrients if they do not include dairy. This is especially important because peak bone mass is attained during the teenage years and if this window of opportunity is missed, bone is compromised for the remainder of life. 

In most cases, individuals experiencing lactose intolerance symptoms do not need to eliminate dairy completely. Research is clear that many people with lactose malabsorption or intolerance can, in fact, tolerate significant amounts of dairy food. There is evidence that increasing consumption of dairy foods gradually over time can improve the body’s tolerance of lactose. The following simple, evidence-based dietary strategies are a healthy approach to coping with lactose intolerance:

• Drink small amounts of milk with meals.  Consuming milk with other foods or a meal can make it easier to digest. By introducing small amounts of milk at meals, over time tolerance improves for most individuals.
• Eat yogurt. Yogurts that contain live and active cultures can make it easier for the body to digest lactose.
• Eat aged cheeses. Aged cheeses like Swiss, Parmesan, Gouda, Colby, Provolone, Cheddar, Edam, Fontina, Gruyere, Muenster and Monterey Jack have very little lactose.
• Drink lactose-free milk. Lactose-free milk is available in most local supermarkets in the dairy aisle. However, this option is more expensive and research shows in many cases is not necessary. 

I asked a colleague who has lactose intolerance if these techniques really work and she said absolutely. Her primary suggestion was to keep experimenting to find the milk and dairy foods—and the amounts—that work for you. The gradual introduction of dairy foods into the diet on a regular basis can improve the body’s ability to digest lactose. The body will slowly build up the enzyme it needs to digest the lactose.

Maureen Bligh, MA, RD
Project Manager