Lactose-free diet for whom, how and why?

The goal: To stop gastrointestinal disorders, diarrhea, dizziness, difficulty concentrating, fatigue, muscle or joint pain … that may cause intolerance to lactose (milk sugar).

Does it work? Yes, if we are really intolerant to lactose. This is where it gets complicated, because the intolerance is highly variable between individuals and their genetic characteristics: while some can bear a little amount of dairy products, others cannot even tolerate the milk contained in a bite of chocolate (but it is very rare)! The reason: an intestinal enzyme, lactase, which digests lactose but is known to decrease in amount with age.

For whom? People who would present problems when they consume more than 12g of lactose per day (the equivalent of a glass of milk). Those who complain of chronic diarrhea or suffer from hives, vomiting, asthma after drinking milk (even powdered milk in a dessert or cake) should try eliminating dairy products for a month and see what happens. Intolerance can diminish or disappear in two or three weeks. If doubt persists, the doctor will prescribe a ‘hydrogen breath test’ (or ‘breath test’) to get to the heart of the matter. This is carried out in specialized gastroenterology services.

In practice: The lactose intolerant can safely consume hard cheeses in cooked, soft or melted form which contain virtually no lactose (56 mg Parmesan, 101 mg for Brie) but they must remove all dairy products, yogurt, cottage cheese or petits suisses that are high in lactose (3000 mg in yogurt and 2700 mg or cottage cheese). Moreover, we find in supermarkets low-lactose milk with up to  90% less lactose.

If you have removed all the cow cheese and dairy products from your diet because your homeopath or osteopath has recommended it, you must compensate with sufficient calcium intake for the sake of your bone mass. These could vary from calcium mineral waters (Talians, Hépar, Contrex, Courmayer …), to goat cheese and sheep dairy, soy or rice fortified with calcium, and also broccoli, sesame seeds, watercress, cabbage and asparagus. If necessary, your doctor may find it useful to prescribe calcium tablets as well.

Expert opinion: Dr. Jean-Michel Lecerf, specialist nutrition and endocrinology:

‘Some people are lactose intolerant without knowing it, some others think that they when in fact they are not. Others, finally, become temporarily intolerant, following a gastroenteritis. One thing is clear: do not remove all dairy products for a long period without adequately compensating for their calcium intake. In the absence of severe intolerance, one can try to gradually reintroduce lactose products and withdraw them back if symptoms recur; try to find the smallest possible dose with which you are not affected’.

More from our special DIETS series:

The gluten-free diet

The ‘low-sugar’ diet

The ‘low salt’ diet

Stephen Rica