Lactose and dairy products on a low FODMAP diet

The good news is that if you have IBS and are following a low FODMAP diet, you only need to limit lactose if you suffer from lactose intolerance (speak to your dietitian about how this is diagnosed). Not sure what this means? You can learn more about lactose intolerance https://www.monashfodmap.com/blog/what-is-lactose-intolerance/.

What if I do have IBS and lactose intolerance?

No worries, you still have quite a few options…

Option 1: Keep having regular, lactose containing dairy

Say what? You might be surprised to know that studies have shown that even people with diagnosed lactose intolerance can still tolerate up to two cups (yes, 500ml!) of regular milk each day.¹

But how can this be? Spreading out your regular dairy intake into small portions throughout the day will help you tolerate the lactose better.¹ Research has also shown that consuming regular dairy products as part of meal rather than alone will improve tolerance.² Some studies have even suggested that daily consumption of lactose containing dairy products, in small amounts at first but building up over time, can actually improve your body’s ability to digest lactose.^{3, 4}

Fortunately, lactose-free dairy products are now readily available in many countries throughout the world. These are still a great choice if you are super sensitive to lactose, as they contain all of the same important nutrients as regular milk, such as calcium and protein.

What makes these products different is that the lactose they contain has been broken down, making it easier for your body to digest. The downside? If lactose tolerance can be improved with regular lactose consumption, lactose free dairy products won’t help with this. Lactose free products are also generally more expensive than regular dairy products.

Also, some products that are promoted as ‘lactose free’ are naturally low in lactose anyway, so you might unnecessarily be paying more for a specialised product when the regular version is just as good. How do you avoid this? Learn which foods actually contain lactose https://www.monashfodmap.com/blog/what-is-lactose-intolerance/.

Option 3: Take a lactose digestion aid

There are several products available to help people with lactose intolerance digest lactose better. These contain the enzyme ‘lactase’ and are usually available in drop or tablet form from most pharmacies. They are best taken in the recommended dose when eating or drinking foods containing large amounts of lactose.

Option 4: Choose lactose free, dairy alternatives

If you are vegetarian or vegan, chances are you are already very familiar with non-dairy milk alternatives. Even if you aren’t, you have probably noticed the huge number of dairy free milks that have hit the supermarket shelves in the past few years. Whilst there are many types of non-dairy milk alternatives available, it is important to remember that if you are replacing regular milk, you also need to replace the nutrients that go along with it.

Unfortunately non-dairy milks do not naturally contain calcium, instead it must be added by the manufacturer. You should also be aware that some manufacturers add no calcium at all, or add it in much smaller amounts than would be found naturally in regular dairy milk. If you do choose a non-dairy milk, make sure to check the nutrition information panel on the packet and try to find a brand that contains at least 200-300mg of calcium per serve.

You should also check the app for suitable non-dairy milk alternatives, as not all types are low FODMAP, even though they don’t contain lactose.

Have more questions? Post them below or comment on the Facebook post and one of our dietitian’s will get back to you.

References:

1. Suarez FL, Savaiano D, Arbisi P, Levitt MD. Tolerance to the daily ingestion of two cups of milk by individuals claiming lactose intolerance. The American journal of clinical nutrition. 1997;65(5):1502-6.
2. Shaukat A, Levitt MD, Taylor BC, MacDonald R, Shamliyan TA, Kane RL, et al. Systematic Review: Effective Management Strategies for Lactose Intolerance. Annals of Internal Medicine. 2010;152(12):797-803.
3. Hertzler SR, Savaiano DA. Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. The American journal of clinical nutrition. 1996;64(2):232-6.
4. Hertzler SR, Savaiano DA, Levitt MD. Fecal hydrogen production and consumption measurements. Response to daily lactose ingestion by lactose maldigesters. Digestive diseases and sciences. 1997;42(2):348-53.