From a tall glass of milk to macaroni and cheese to decadent chocolate mousse, dairy is a major component in many dishes. For the lactose-intolerant, this presents a challenge. Luckily, with a little planning and a little creativity, you can forgo dairy without giving up rich, flavorful food.
What is Lactose Intolerance?
During digestion, the primary carbohydrate in milk, called “lactose,” is denatured by an enzyme called lactase. Lactose is a complex molecule that can’t be absorbed or accepted by the body until lactase breaks it down into subcomponents like glucose and galactose, a process that usually happens in the small intestine. Lactose tolerant people produce plenty of lactase enzymes, and have no difficulty drinking milk and eating other dairy products. But those who are lactose intolerant don’t produce enough of the enzyme to handle the complex molecules in large, concentrated amounts of dairy products. If lactose isn’t properly broken down in the small intestine, it can enter the large intestine intact. Once there, it can lead to painful intestinal cramping, bloating, diarrhea, nausea and other problems. The National Institute of Diabetes, Digestive and Kidney Diseases suggests that 30 to 60 million people in America, about 1 in 6, have some form of lactose intolerance (2011).
A person’s degree of intolerance to lactose depends on the amount of lactase his or her body produces. Lactose intolerance isn’t generally an either/or proposition. A small amount of lactase production means a moderate tolerance for a low, controlled intake of dairy products. A person with a very small amount or lactase in their body may be totally lactose intolerant. For a completely lactose intolerant person, even small amounts of dairy can lead to complications that may be severe enough to require a trip to the emergency room.
Those who are mildly lactose intolerant can usually enjoy a varied diet with few restrictions, as long as they steer clear of large doses of undiluted dairy products like glasses of milk and bowls of ice cream. If you suffer from acute lactose intolerance, on the other hand, you may require a truly lactose-free diet, which can present a bit of a challenge.
Tips for a Lactose-Free or Limited-Lactose Lifestyle
If you love dairy products and don’t relish the idea of living without them, a few tips can ease the adjustment to a lactose-free diet. Some of these suggestions also apply if you’re indifferent to dairy, but don’t want to place yourself at risk by accidently consuming dairy products and having to suffer through the consequences.
First, understand your limitations. Again, lactose tolerance occurs along a broad spectrum. You may or may not be able to tolerate an occasional cube of cheese or dark chocolate. And if you can tolerate these things and you enjoy them, there’s no need to go without. Keep a journal to track your food intake and monitor your reactions. Make a note of everything you eat, and be sure to document anything that can be considered a symptom of lactose intolerance. You may be more sensitive to some forms of dairy than others, and this is a good way to make an assessment.
Soy Milk and Other Dairy Substitutes
Second, making use of creative substitutes can help you keep variety in your diet. Substitutes include:
- Butter: Vegetable oil, coconut butter or lactose-free margarine; fruit purees, such as apple sauce, may be substituted for butter in some baked goods
- Cheese: Hummus, mayonnaise, guacamole or a soy-based spread
- Cow’s milk: Soy, rice or or almond milk, or lactose-free milk
- Ice Cream: Dairy-free options, such as coconut-based and soy-based ice cream, or dairy-free sorbets
- Yogurt: Non-dairy yogurt options.
Dining Out with Lactose Intolerance
Pay attention to your venue and ordering choices when you dine out at restaurants. To ensure you’re not unknowingly eating any dairy while dining out:
- Ask your server careful questions. If she doesn’t know about the lactose content of a certain dish, either ask the chef yourself or play it safe and order something else.
- Avoid fried foods, since coatings are often made with milk and milk products.
- Choose salad. As long as you select the dressing and have it served on the side, there are few ingredients that can make their way into a salad without your knowledge. Skip the shredded cheese on the top and you’ll be able to verify the dairy-free status of every bite with your own eyes.
- Embrace all things vegan. Vegetarian options are meat-free but can still contain dairy items. Vegan items don’t contain any ingredients derived from animals, including dairy. For the lactose intolerant person, a vegan menu or entirely vegan restaurant can offer a wide variety of culinary experiences that are interesting, innovative, delicious and safe.
- Think about how products are made. Baked items, batter-based items (like pancakes and waffles) and anything with fluffy or scrambled eggs may contain milk. If in doubt, ask or steer clear.
- Lean toward kosher and Mediterranean options. Kosher foods, especially meats, are made with all dairy carefully excluded. Going Mediterranean means choosing pasta with olive oil and tomato-based, rather than cream-based, sauces.